diff --git "a/data/train.conll" "b/data/train.conll" deleted file mode 100644--- "a/data/train.conll" +++ /dev/null @@ -1,80031 +0,0 @@ -En B-PRESENT_ILLNESS -Mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1997, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -intervenida, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -glándula I-PRESENT_ILLNESS -suprarrenal I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -clínicamente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -funcionante I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -manifestó I-PRESENT_ILLNESS -clínicamente I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -poco I-PRESENT_ILLNESS -específicas, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -postparto I-PRESENT_ILLNESS -inmediato; I-PRESENT_ILLNESS -la B-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -abdominales I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cmts., I-EXPLORATION -sólida I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -calcificación I-EXPLORATION -y I-EXPLORATION -necrosis I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -siendo I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -análisis, I-EXPLORATION -presentaba I-EXPLORATION -ligero I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cortisoluria I-EXPLORATION -(284.5 I-EXPLORATION -mcgr./24h.) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -17-OH-esteroides I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -(12.7 I-EXPLORATION -mcg./24h.), I-EXPLORATION -sin I-EXPLORATION -síntomas I-EXPLORATION -de I-EXPLORATION -hipercortisolismo I-EXPLORATION -sistémico. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -resección I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -histológico I-TREATMENT -de I-TREATMENT -carcinoma I-TREATMENT -suprarrenal I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -x I-TREATMENT -7 I-TREATMENT -x I-TREATMENT -5 I-TREATMENT -cmts. I-TREATMENT -(215 I-TREATMENT -grs.) I-TREATMENT -bien I-TREATMENT -encapsulado, I-TREATMENT -aunque I-TREATMENT -con I-TREATMENT -invasión I-TREATMENT -vascular, I-TREATMENT -amplias I-TREATMENT -zonas I-TREATMENT -de I-TREATMENT -necrosis I-TREATMENT -y I-TREATMENT -un I-TREATMENT -índice I-TREATMENT -mitótico I-TREATMENT -de I-TREATMENT -5.8/50; I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histoquímico I-TREATMENT -fue I-TREATMENT -(+) I-TREATMENT -para I-TREATMENT -Vimentina I-TREATMENT -y I-TREATMENT -(-) I-TREATMENT -para I-TREATMENT -Citoqueratina, I-TREATMENT -EMA, I-TREATMENT -Cromogranina I-TREATMENT -y I-TREATMENT -Sm- I-TREATMENT -100. I-TREATMENT -Se I-TREATMENT -etiquetó I-TREATMENT -como I-TREATMENT -Estadio I-TREATMENT -II I-TREATMENT -y I-TREATMENT -Grado I-TREATMENT -II. I-TREATMENT -Treinta B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -estudios I-EVOLUTION -radiológicos I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -una I-EVOLUTION -masa I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -lecho I-EVOLUTION -de I-EVOLUTION -resección I-EVOLUTION -previo I-EVOLUTION -de I-EVOLUTION -7 I-EVOLUTION -cmts., I-EVOLUTION -en I-EVOLUTION -contacto I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -hilio I-EVOLUTION -renal I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -técnicamente I-EVOLUTION -resecable; I-EVOLUTION -se B-TREATMENT -reintervino I-TREATMENT -y I-TREATMENT -se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -recidiva I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -nefrectomía I-TREATMENT -izquierda, I-TREATMENT -esplenectomía I-TREATMENT -y I-TREATMENT -pancreatectomía I-TREATMENT -distal I-TREATMENT -(radical I-TREATMENT -completa I-TREATMENT -y I-TREATMENT -con I-TREATMENT -márgenes I-TREATMENT -libres). I-TREATMENT -Posteriormente, I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -sistémico I-TREATMENT -adyuvante I-TREATMENT -con I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -completos I-TREATMENT -de I-TREATMENT -cisplatino I-TREATMENT -(CDDP) I-TREATMENT -y I-TREATMENT -etopósido I-TREATMENT -(VP-16) I-TREATMENT -en I-TREATMENT -régimen I-TREATMENT -adyuvante. I-TREATMENT - I-TREATMENT -Cuatro B-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -once I-EVOLUTION -meses I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -inicial, I-EVOLUTION -se I-EVOLUTION -detecta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -radiológico I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -varios I-EVOLUTION -nódulos I-EVOLUTION -hepáticos I-EVOLUTION -sugerentes I-EVOLUTION -de I-EVOLUTION -metástasis. I-EVOLUTION -Se B-TREATMENT -sometió I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -abdominal I-TREATMENT -realizándose, I-TREATMENT -previo I-TREATMENT -control I-TREATMENT -con I-TREATMENT -ecografía I-TREATMENT -hepática I-TREATMENT -intraoperatoria, I-TREATMENT -una I-TREATMENT -bisegmentectomía I-TREATMENT -IV-B I-TREATMENT -y I-TREATMENT -V I-TREATMENT -y I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -limitada I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -VIII; I-TREATMENT -el B-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -anatomía-patológica I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -nódulos I-EXPLORATION -(de I-EXPLORATION -tamaño I-EXPLORATION -variable I-EXPLORATION -entre I-EXPLORATION -0.5 I-EXPLORATION -y I-EXPLORATION -1.5 I-EXPLORATION -cmts.) I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -suprarrenal. I-EXPLORATION - I-EXPLORATION -Diez B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -se I-EVOLUTION -detecta I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -recidiva I-EVOLUTION -tumoral I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -subdiafragmático I-EVOLUTION -izquierdo I-EVOLUTION -(de I-EVOLUTION -6 I-EVOLUTION -x I-EVOLUTION -4 I-EVOLUTION -cmts. I-EVOLUTION -según I-EVOLUTION -la I-EVOLUTION -TAC) I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -raiz I-EVOLUTION -del I-EVOLUTION -mesenterio, I-EVOLUTION -esta I-EVOLUTION -última I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -x I-EVOLUTION -3 I-EVOLUTION -cmts. I-EVOLUTION -y I-EVOLUTION -localizada I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -salida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -arteria I-EVOLUTION -mesentérica I-EVOLUTION -superior I-EVOLUTION -(AMS). I-EVOLUTION -Dada B-TREATMENT -la I-TREATMENT -difícil I-TREATMENT -resecabilidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -nueva I-TREATMENT -recidiva I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -con I-TREATMENT -intención I-TREATMENT -neoadyuvante I-TREATMENT -( I-TREATMENT -5 I-TREATMENT -ciclos I-TREATMENT -completos I-TREATMENT -de I-TREATMENT -CDDP I-TREATMENT -y I-TREATMENT -VP-16), I-TREATMENT -decidiéndose I-TREATMENT -por I-TREATMENT -regresión I-TREATMENT -parcial I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -exploración I-TREATMENT -quirúrgica. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -masas I-TREATMENT -tumorales, I-TREATMENT -la I-TREATMENT -primera I-TREATMENT -incluyendo I-TREATMENT -el I-TREATMENT -pilar I-TREATMENT -izquierdo I-TREATMENT -del I-TREATMENT -diafragma I-TREATMENT -y I-TREATMENT -una I-TREATMENT -pastilla I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -cmts. I-TREATMENT -de I-TREATMENT -dicho I-TREATMENT -músculo, I-TREATMENT -y I-TREATMENT -la I-TREATMENT -segunda I-TREATMENT -disecando I-TREATMENT -en I-TREATMENT -su I-TREATMENT -origen I-TREATMENT -el I-TREATMENT -tronco I-TREATMENT -celíaco I-TREATMENT -y I-TREATMENT -la I-TREATMENT -AMS I-TREATMENT -y I-TREATMENT -resecando I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -tumoral I-TREATMENT -entre I-TREATMENT -ambos I-TREATMENT -vasos. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -recidiva, I-EXPLORATION -estando I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -no I-EXPLORATION -afectos. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -satisfactoria. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra, I-EVOLUTION -tras I-EVOLUTION -7 I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -del I-EVOLUTION -tumor I-EVOLUTION -primario, I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -aceptable, I-EVOLUTION -mínimamente I-EVOLUTION -limitada I-EVOLUTION -por I-EVOLUTION -las I-EVOLUTION -deposiciones I-EVOLUTION -diarreicas I-EVOLUTION -secundarias I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -denervación I-EVOLUTION -simpática I-EVOLUTION -celíaca. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -controlado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Consultas I-PRESENT_ILLNESS -Externas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hipertrofia I-PRESENT_ILLNESS -benigna I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -próstata. I-PRESENT_ILLNESS -Presenta I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -monosintomática I-PRESENT_ILLNESS -autolimitada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -urinocultivos I-PRESENT_ILLNESS -negativos. I-PRESENT_ILLNESS -En B-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -ureteropielocaliectasia I-EXPLORATION -grado I-EXPLORATION -II I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -U.I.V. I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -anulación I-EXPLORATION -funcional I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -motivo B-TREATMENT -por I-TREATMENT -el I-TREATMENT -cuál, I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -nefrostomia I-TREATMENT -percutánea I-TREATMENT -derecha, I-TREATMENT -que I-TREATMENT -confirma I-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -urográfico. I-TREATMENT -Ocho B-EXPLORATION -meses I-EXPLORATION -antes, I-EXPLORATION -est: I-EXPLORATION -udio I-EXPLORATION -ecográfico I-EXPLORATION -y I-EXPLORATION -U.I.V. I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -cabe I-PAST_MEDICAL_HISTORY -destacar: I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -conocidas. I-PAST_MEDICAL_HISTORY -HTA. I-PAST_MEDICAL_HISTORY -Diabetes I-PAST_MEDICAL_HISTORY -Mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -Miocardiopatía I-PAST_MEDICAL_HISTORY -hipertrófica. I-PAST_MEDICAL_HISTORY -Aneurisma I-PAST_MEDICAL_HISTORY -carotídeo I-PAST_MEDICAL_HISTORY -intracerebral I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -secuelas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -practicada I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -siguiente: I-EXPLORATION -Abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible, I-EXPLORATION -no I-EXPLORATION -doloroso, I-EXPLORATION -no I-EXPLORATION -megalias, I-EXPLORATION -Fosas I-EXPLORATION -renales I-EXPLORATION -libres I-EXPLORATION -indoloras. I-EXPLORATION -Genitales I-EXPLORATION -externos I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -patológicos. I-EXPLORATION -Tacto I-EXPLORATION -rectal I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -HBP I-EXPLORATION -grado I-EXPLORATION -I-II. I-EXPLORATION -Se I-EXPLORATION -llevan I-EXPLORATION -a I-EXPLORATION -cabo I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -EXPLORACIONES I-EXPLORATION -COMPLEMENTARIAS: I-EXPLORATION - I-EXPLORATION -ANALISIS: I-EXPLORATION -Glucemia I-EXPLORATION -145 I-EXPLORATION -mg/dl, I-EXPLORATION -Creatinina I-EXPLORATION -1.4 I-EXPLORATION -mg/dl. I-EXPLORATION -Resto I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -CITOLOGIA I-EXPLORATION -URINARIA: I-EXPLORATION -Compatible I-EXPLORATION -con I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -transicionales I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado. I-EXPLORATION - I-EXPLORATION -PIELOGRAFIA I-EXPLORATION -DESCENDENTE I-EXPLORATION -a I-EXPLORATION -traves I-EXPLORATION -de I-EXPLORATION -Nefrostomia: I-EXPLORATION -Defecto I-EXPLORATION -de I-EXPLORATION -replección I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -uréter I-EXPLORATION -sacro-ilíaco I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -longitud, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared. I-EXPLORATION - I-EXPLORATION -ESTUDIO I-EXPLORATION -FUNCIONAL I-EXPLORATION -DE I-EXPLORATION -RIÑON I-EXPLORATION -DERECHO: I-EXPLORATION -Aclaramiento I-EXPLORATION -de I-EXPLORATION -Creatinina I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -ml/minuto. I-EXPLORATION - I-EXPLORATION -TAC I-EXPLORATION -ABDOMINO-PELVICO: I-EXPLORATION -Aneurisma I-EXPLORATION -de I-EXPLORATION -Aorta I-EXPLORATION -infrarrenal. I-EXPLORATION -Atrofia I-EXPLORATION -hidronefrótica I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -visualizarse I-EXPLORATION -imágenes I-EXPLORATION -endoluminales I-EXPLORATION -intraureterales. I-EXPLORATION -Dudosas I-EXPLORATION -adenopatías I-EXPLORATION -paravesicales. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -y I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -de I-TREATMENT -vías I-TREATMENT -de I-TREATMENT -uréter I-TREATMENT -derecho, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenido I-TREATMENT -quirúrgicamente I-TREATMENT -practicándose I-TREATMENT -nefroureterectomía I-TREATMENT -radical I-TREATMENT -derecha I-TREATMENT -con I-TREATMENT -evolución I-TREATMENT -postoperatoria I-TREATMENT -satisfactoria. I-TREATMENT -El B-EXPLORATION -dictamen I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -nos I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -pielonefritis I-EXPLORATION -crónica I-EXPLORATION -y I-EXPLORATION -cambios I-EXPLORATION -de I-EXPLORATION -arteriosclerosis, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -lesión I-EXPLORATION -inflamatoria I-EXPLORATION -ureteral I-EXPLORATION -que I-EXPLORATION -oblitera I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -en I-EXPLORATION -capas I-EXPLORATION -musculares, I-EXPLORATION -erosión I-EXPLORATION -de I-EXPLORATION -urotelio I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -Actinomices. I-EXPLORATION -Tras B-EVOLUTION -9 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -mantiene I-EVOLUTION -una I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -aceptable I-EVOLUTION -(Creatinina I-EVOLUTION -sérica I-EVOLUTION -2.1 I-EVOLUTION -mg/dl I-EVOLUTION -) I-EVOLUTION -y I-EVOLUTION -es I-EVOLUTION -controlado I-EVOLUTION -por I-EVOLUTION -HBP I-EVOLUTION -sintomática. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -monorrena I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -incluída I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -programa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -IRC I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pielonefritis I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -nefrectomía I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -absceso I-PAST_MEDICAL_HISTORY -pararrenal I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -rotura I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -contenía I-PAST_MEDICAL_HISTORY -cálculo I-PAST_MEDICAL_HISTORY -coraliforme I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ureteroscopia I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cálculo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -uréter I-PAST_MEDICAL_HISTORY -pelviano I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -febrero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1990. I-PAST_MEDICAL_HISTORY -Hígado I-PAST_MEDICAL_HISTORY -graso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Digestivo, I-PAST_MEDICAL_HISTORY -HTA, I-PAST_MEDICAL_HISTORY -hipertrigliceridemia, I-PAST_MEDICAL_HISTORY -sobrepeso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -gota. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Trasplante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -fosa I-PAST_MEDICAL_HISTORY -ilíaca I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -incidencias I-PAST_MEDICAL_HISTORY -(también I-PAST_MEDICAL_HISTORY -arteria I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -parche I-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anastomosis I-PAST_MEDICAL_HISTORY -vasculares I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ilíacas I-PAST_MEDICAL_HISTORY -externas, I-PAST_MEDICAL_HISTORY -implante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -uréter I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -vejiga I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Paquin). I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -+5 I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -rechazo I-PAST_MEDICAL_HISTORY -agudo I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -pulses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -6-Metil-Prednisolona I-PAST_MEDICAL_HISTORY -(400mg/día, I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -días) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -dada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2'3 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -progresivamente I-PAST_MEDICAL_HISTORY -descenderán I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -mantendrán I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -actualidad I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -0'8-1'1. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -inmunosupresor I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ciclosporina I-PAST_MEDICAL_HISTORY -8mg/Kg, I-PAST_MEDICAL_HISTORY -micofenolato I-PAST_MEDICAL_HISTORY -mofetilo I-PAST_MEDICAL_HISTORY -2gr/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -prednisona I-PAST_MEDICAL_HISTORY -1mg/Kg. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -abril I-PAST_MEDICAL_HISTORY -de1999, I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -trasplante, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -temblor I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambas I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -inicialmente I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -atribuído I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -toxicidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ciclosporina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -descenso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pauta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -corticoides. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -embargo, I-PAST_MEDICAL_HISTORY -ante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -empeoramiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cuadro, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -asintomática, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Neurología. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -momento, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -medio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -(marzo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2000) I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha, I-PRESENT_ILLNESS -temblores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -parestesias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -moderados I-EXPLORATION -signos I-EXPLORATION -piramidales I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -EEII, I-EXPLORATION -más I-EXPLORATION -acusados I-EXPLORATION -en I-EXPLORATION -eI I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -claro I-EXPLORATION -déficit I-EXPLORATION -motor; I-EXPLORATION -la I-EXPLORATION -sensibilidad I-EXPLORATION -profunda I-EXPLORATION -estaba I-EXPLORATION -también I-EXPLORATION -levemente I-EXPLORATION -alterada. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -ayudaron I-EXPLORATION -a I-EXPLORATION -esclarecer I-EXPLORATION -el I-EXPLORATION -diagnóstico: I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -RMN I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -2 I-EXPLORATION -lesiones I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -mielitis I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cervical I-EXPLORATION -C2-C4 I-EXPLORATION -y I-EXPLORATION -dorsal I-EXPLORATION -alto I-EXPLORATION -D1. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -potenciales I-EXPLORATION -evocados I-EXPLORATION -demostraron I-EXPLORATION -retraso I-EXPLORATION -significativo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -latencia I-EXPLORATION -del I-EXPLORATION -nervio I-EXPLORATION -tibial. I-EXPLORATION - I-EXPLORATION -LCR: I-EXPLORATION -leve I-EXPLORATION -pleocitosis I-EXPLORATION -linfocítica, I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -proteínas I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -bandas I-EXPLORATION -IgG I-EXPLORATION -oligoclonales. I-EXPLORATION - I-EXPLORATION -Pruebas I-EXPLORATION -serológicas, I-EXPLORATION -ELISA I-EXPLORATION -y I-EXPLORATION -Western I-EXPLORATION -Blot, I-EXPLORATION -resultaron I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -HTLV-I I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -y I-EXPLORATION -sangre. I-EXPLORATION - I-EXPLORATION -PCR I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -positiva I-EXPLORATION -también I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -virus I-EXPLORATION -detectándose I-EXPLORATION -también I-EXPLORATION -en I-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -elevada. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -pulses I-TREATMENT -de I-TREATMENT -6-Metil-Prednisolona I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -de I-TREATMENT -agudización I-TREATMENT -del I-TREATMENT -proceso I-TREATMENT -y I-TREATMENT -pauta I-TREATMENT -descendente I-TREATMENT -progresivamente I-TREATMENT -de I-TREATMENT -corticoides. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -además I-EVOLUTION -de I-EVOLUTION -hábito I-EVOLUTION -cushingoide, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -audición I-EVOLUTION -progresiva, I-EVOLUTION -incontinencia I-EVOLUTION -de I-EVOLUTION -orina I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -nocturno I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -mejorado I-EVOLUTION -con I-EVOLUTION -Tolterodina I-EVOLUTION -(pendiente I-EVOLUTION -de I-EVOLUTION -estudio I-EVOLUTION -urodinámico I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual) I-EVOLUTION -y I-EVOLUTION -evoluciona I-EVOLUTION -hacia I-EVOLUTION -discreta I-EVOLUTION -invalidez. I-EVOLUTION - I-EVOLUTION - -Nuestra B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -dilatada, I-PAST_MEDICAL_HISTORY -artrosis, I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -anexectomía I-PAST_MEDICAL_HISTORY -junto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -quimio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -tumoración I-PAST_MEDICAL_HISTORY -ginecológica I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -lumbar I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -derechos I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -aumentando I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -deambulación. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -vez, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompaña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nauseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -picos I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa I-PRESENT_ILLNESS -aunque I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encuentra I-PRESENT_ILLNESS -afebril I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presenta: I-EXPLORATION -soplo I-EXPLORATION -protomesosistólico I-EXPLORATION -en I-EXPLORATION -ápex, I-EXPLORATION -abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -y I-EXPLORATION -flanco I-EXPLORATION -derechos. I-EXPLORATION -También I-EXPLORATION -destaca I-EXPLORATION -dolor I-EXPLORATION -espontáneo I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -muslo I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -aumenta I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -movilidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -extremidad. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -Urgencias I-EXPLORATION -destaca I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda I-EXPLORATION -(17.200 I-EXPLORATION -leucocitos I-EXPLORATION -con I-EXPLORATION -84% I-EXPLORATION -de I-EXPLORATION -neutrófilos), I-EXPLORATION -567.000 I-EXPLORATION -plaquetas, I-EXPLORATION -urea I-EXPLORATION -1.35, I-EXPLORATION -creatinina I-EXPLORATION -1.80. I-EXPLORATION - I-EXPLORATION -Como I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -se I-EXPLORATION -solicitan I-EXPLORATION -Rx. I-EXPLORATION -de I-EXPLORATION -vías I-EXPLORATION -urinarias I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -imagen I-EXPLORATION -cálcica I-EXPLORATION -en I-EXPLORATION -silueta I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -ectasia I-EXPLORATION -pielocalicial I-EXPLORATION -derecha I-EXPLORATION -respectivamente. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnostico I-TREATMENT -de I-TREATMENT -cólico I-TREATMENT -nefrítico I-TREATMENT -derecho I-TREATMENT -complicado I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -ingreso I-TREATMENT -para I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -intravenoso. I-TREATMENT -Se I-TREATMENT -coloca I-TREATMENT -en I-TREATMENT -quirófano I-TREATMENT -catéter I-TREATMENT -externo I-TREATMENT -en I-TREATMENT -uréter I-TREATMENT -derecho I-TREATMENT -con I-TREATMENT -salida I-TREATMENT -de I-TREATMENT -abundante I-TREATMENT -orina I-TREATMENT -limpia. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -lo I-EVOLUTION -largo I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -cólico I-EVOLUTION -va I-EVOLUTION -cediendo I-EVOLUTION -aunque I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -dolor I-EVOLUTION -sordo I-EVOLUTION -en I-EVOLUTION -fosa I-EVOLUTION -lumbar I-EVOLUTION -y I-EVOLUTION -continúa I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -muslo I-EVOLUTION -derecho. I-EVOLUTION -Es B-TREATMENT -valorada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -Traumatología I-TREATMENT -pautando I-TREATMENT -tratamiento I-TREATMENT -antiinflamatorio I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -rotura I-TREATMENT -fibrilar I-TREATMENT -del I-TREATMENT -cuadriceps. I-TREATMENT - I-TREATMENT -Debido B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -dolor I-EXPLORATION -lumbar I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -revisión I-EXPLORATION -ecográfica I-EXPLORATION -objetivándose I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -músculo I-EXPLORATION -psoas I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -5.5 I-EXPLORATION -cm. I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -un I-EXPLORATION -TAC. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -absceso I-EXPLORATION -retroperitoneal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -compartimento I-EXPLORATION -del I-EXPLORATION -músculo I-EXPLORATION -psoas I-EXPLORATION -iliaco I-EXPLORATION -derecho I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -L2-L3 I-EXPLORATION -sin I-EXPLORATION -perder I-EXPLORATION -la I-EXPLORATION -continuidad I-EXPLORATION -hasta I-EXPLORATION -anillo I-EXPLORATION -inguinal I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartar I-EXPLORATION -la I-EXPLORATION -participación I-EXPLORATION -del I-EXPLORATION -uréter I-EXPLORATION -derecho I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -tercio I-EXPLORATION -medio. I-EXPLORATION - I-EXPLORATION -Una B-DERIVED_FROM/TO -vez I-DERIVED_FROM/TO -confirmado I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -nos I-DERIVED_FROM/TO -ponemos I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -contacto I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Radiología I-DERIVED_FROM/TO -Intervensionista I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -drenaje I-DERIVED_FROM/TO -percutáneo. I-DERIVED_FROM/TO -Mediante B-EXPLORATION -ecografía I-EXPLORATION -se I-EXPLORATION -coloca I-EXPLORATION -catéter I-EXPLORATION -10 I-EXPLORATION -fr. I-EXPLORATION -evacuando I-EXPLORATION -200 I-EXPLORATION -cc. I-EXPLORATION -material I-EXPLORATION -purulento, I-EXPLORATION -del I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -envía I-EXPLORATION -muestra I-EXPLORATION -microbiológica I-EXPLORATION -(en I-EXPLORATION -los I-EXPLORATION -días I-EXPLORATION -sucesivos I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -Bacteriodes I-EXPLORATION -fragilis I-EXPLORATION -y I-EXPLORATION -Streptococcus I-EXPLORATION -sanguis). I-EXPLORATION -El I-EXPLORATION -débito I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -drenaje I-EXPLORATION -es I-EXPLORATION -progresivamente I-EXPLORATION -menor I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -nuevo I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -TAC, I-EXPLORATION -evidenciándose I-EXPLORATION -la I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION -del I-EXPLORATION -absceso. I-EXPLORATION -Se B-EVOLUTION -decide I-EVOLUTION -retirar I-EVOLUTION -el I-EVOLUTION -tubo I-EVOLUTION -de I-EVOLUTION -drenaje I-EVOLUTION -al I-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -colocación I-EVOLUTION -pero I-EVOLUTION -es I-EVOLUTION -necesario I-EVOLUTION -recolocación I-EVOLUTION -de I-EVOLUTION -catéter I-EVOLUTION -14 I-EVOLUTION -fr. I-EVOLUTION -por I-EVOLUTION -empeoramiento I-EVOLUTION -clínico. I-EVOLUTION - I-EVOLUTION -Se B-EXPLORATION -desconoce I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -foco I-EXPLORATION -primario I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -ingreso, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -colonoscopia I-EXPLORATION -para I-EXPLORATION -intentar I-EXPLORATION -buscar I-EXPLORATION -un I-EXPLORATION -origen I-EXPLORATION -digestivo I-EXPLORATION -del I-EXPLORATION -problema. I-EXPLORATION -No I-EXPLORATION -es I-EXPLORATION -posible I-EXPLORATION -sobrepasar I-EXPLORATION -el I-EXPLORATION -ángulo I-EXPLORATION -esplénico I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -halla I-EXPLORATION -un I-EXPLORATION -foco I-EXPLORATION -primario. I-EXPLORATION -Desde I-EXPLORATION -el I-EXPLORATION -punto I-EXPLORATION -de I-EXPLORATION -vista I-EXPLORATION -urológico I-EXPLORATION -tampoco I-EXPLORATION -se I-EXPLORATION -justifica I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -del I-EXPLORATION -absceso. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -hace I-EXPLORATION -cavitograma I-EXPLORATION -para I-EXPLORATION -estudiar I-EXPLORATION -la I-EXPLORATION -morfología I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tamaño I-EXPLORATION -del I-EXPLORATION -absceso I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -indica I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -lavados I-EXPLORATION -con I-EXPLORATION -fibrinolíticos I-EXPLORATION -intracavitarios I-EXPLORATION -(100.000 I-EXPLORATION -unidades I-EXPLORATION -de I-EXPLORATION -urokinasa I-EXPLORATION -en I-EXPLORATION -10 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -suero I-EXPLORATION -fisiológico). I-EXPLORATION - I-EXPLORATION -Después B-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -y I-EVOLUTION -diez I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -ingreso, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -confirmada I-EVOLUTION -mediante I-EVOLUTION -técnicas I-EVOLUTION -de I-EVOLUTION -imagen. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -en I-EVOLUTION -nuestras I-EVOLUTION -consultas, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -total I-EVOLUTION -del I-EVOLUTION -proceso. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad, I-PAST_MEDICAL_HISTORY -brucelosis, I-PAST_MEDICAL_HISTORY -lumboartrosis, I-PAST_MEDICAL_HISTORY -litiasis I-PAST_MEDICAL_HISTORY -biliar, I-PAST_MEDICAL_HISTORY -apendicectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cesárea. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -casual, I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm. I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -confirma I-EXPLORATION -este I-EXPLORATION -hallazgo I-EXPLORATION -evidenciándose I-EXPLORATION -masa I-EXPLORATION -sólida I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho; I-EXPLORATION -comprobándose I-EXPLORATION -realce I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -infusión I-EXPLORATION -de I-EXPLORATION -contraste, I-EXPLORATION -no I-EXPLORATION -objetivándose I-EXPLORATION -adenopatías I-EXPLORATION -hiliares, I-EXPLORATION -ni I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -órganos I-EXPLORATION -de I-EXPLORATION -vecindad. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -masa I-TREATMENT -sólida I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -adenocarcinoma I-TREATMENT -renal I-TREATMENT -es I-TREATMENT -intervenida, I-TREATMENT -realizándose I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -lumbar I-TREATMENT -oblícua I-TREATMENT -nefrectomía I-TREATMENT -radical, I-TREATMENT -siendo I-TREATMENT -el I-TREATMENT -curso I-TREATMENT -postoperatorio I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -tumoración I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -invade I-EXPLORATION -cápsula, I-EXPLORATION -su I-EXPLORATION -aspecto I-EXPLORATION -al I-EXPLORATION -corte I-EXPLORATION -es I-EXPLORATION -homogéneo, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -blancogrisaceo. I-EXPLORATION -La I-EXPLORATION -pelvis I-EXPLORATION -y I-EXPLORATION -cálices I-EXPLORATION -no I-EXPLORATION -están I-EXPLORATION -afectados I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -renal I-EXPLORATION -esta I-EXPLORATION -libre. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -tumoración I-EXPLORATION -redondeada I-EXPLORATION -de I-EXPLORATION -márgenes I-EXPLORATION -bien I-EXPLORATION -definidos, I-EXPLORATION -que I-EXPLORATION -crece I-EXPLORATION -por I-EXPLORATION -expansión I-EXPLORATION -sin I-EXPLORATION -invadir, I-EXPLORATION -de I-EXPLORATION -naturaleza I-EXPLORATION -mesenquimal, I-EXPLORATION -compuesta I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -dispuestas I-EXPLORATION -en I-EXPLORATION -fascículos I-EXPLORATION -entrelazados, I-EXPLORATION -los I-EXPLORATION -núcleos I-EXPLORATION -presentan I-EXPLORATION -ligera I-EXPLORATION -variación I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -forma, I-EXPLORATION -la I-EXPLORATION -actividad I-EXPLORATION -mitótica I-EXPLORATION -es I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -50 I-EXPLORATION -CGA, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -hemorragias I-EXPLORATION -ni I-EXPLORATION -necrosis. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -queratinas I-EXPLORATION -(AE-1,AE-3), I-EXPLORATION -EMA I-EXPLORATION -(anfígeno I-EXPLORATION -epitelial I-EXPLORATION -de I-EXPLORATION -membrana) I-EXPLORATION -con I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -excluye I-EXPLORATION -la I-EXPLORATION -naturaleza I-EXPLORATION -epitelial I-EXPLORATION -del I-EXPLORATION -tumor. I-EXPLORATION -Negatividad I-EXPLORATION -para I-EXPLORATION -vimentina, I-EXPLORATION -HMB45, I-EXPLORATION -S-100. I-EXPLORATION -Positividad I-EXPLORATION -para I-EXPLORATION -marcadores I-EXPLORATION -vasculares I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -trama I-EXPLORATION -vascular I-EXPLORATION -y I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -actino. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Neurolues, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -secuelas I-PAST_MEDICAL_HISTORY -establecidas I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -trastornos I-PAST_MEDICAL_HISTORY -mnésicos I-PAST_MEDICAL_HISTORY -visuales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -verbales, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -radiculoneuropatía I-PAST_MEDICAL_HISTORY -múltiple. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -radiología I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -presentaba I-EXPLORATION -elongación I-EXPLORATION -aórtica I-EXPLORATION -sin I-EXPLORATION -repercusión I-EXPLORATION -clínica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -electroencefalograma I-EXPLORATION -con I-EXPLORATION -trazado I-EXPLORATION -normal, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -TC I-EXPLORATION -craneal I-EXPLORATION -con I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -contraste I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -morfología I-EXPLORATION -cerebral I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -Lues I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -test I-EXPLORATION -RPR I-EXPLORATION -y I-EXPLORATION -TPHA I-EXPLORATION -fueron I-EXPLORATION -positivos. I-EXPLORATION -El I-EXPLORATION -ácido I-EXPLORATION -fólico I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -rango I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestras I-DERIVED_FROM/TO -consultas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Urodinámica I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -trastornos I-DERIVED_FROM/TO -miccionales I-DERIVED_FROM/TO -refiriendo I-DERIVED_FROM/TO -incontinencia I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -urgencia, I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -precisando I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -prensa I-DERIVED_FROM/TO -abdominal I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -vaciado I-DERIVED_FROM/TO -vesical. I-DERIVED_FROM/TO -Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -urodinámico I-EXPLORATION -objetivándose I-EXPLORATION -un I-EXPLORATION -detrusor I-EXPLORATION -hiperrefléxico I-EXPLORATION -con I-EXPLORATION -presiones I-EXPLORATION -altas I-EXPLORATION -y I-EXPLORATION -contracciones I-EXPLORATION -involuntarias I-EXPLORATION -no I-EXPLORATION -inhibidas I-EXPLORATION -que I-EXPLORATION -ocasionaban I-EXPLORATION -escapes; I-EXPLORATION -la I-EXPLORATION -curva I-EXPLORATION -de I-EXPLORATION -Presión/ I-EXPLORATION -Flujo I-EXPLORATION -no I-EXPLORATION -mostraba I-EXPLORATION -alteraciones. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -detrusor I-TREATMENT -hiperactivo I-TREATMENT -de I-TREATMENT -causa I-TREATMENT -neurogénica I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anticolinérgicos, I-TREATMENT -estando B-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -estable I-EVOLUTION -clínicamente I-EVOLUTION -con I-EVOLUTION -urgencia I-EVOLUTION -ocasional I-EVOLUTION -sin I-EVOLUTION -incontinencia. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenina, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -blanca, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -nefrítico I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -ultrasonido I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -doble I-EXPLORATION -sistema I-EXPLORATION -pieloureteral I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -litiasis I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -cáliz I-EXPLORATION -medio, I-EXPLORATION -doble I-EXPLORATION -sistema I-EXPLORATION -pieloureteral I-EXPLORATION -izquierdo. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -excretora I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -litiasis I-EXPLORATION -renal I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -doble I-EXPLORATION -sistema I-EXPLORATION -pieloureteral I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -hidronefrosis I-EXPLORATION -derecha, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -tres I-EXPLORATION -sistemas I-EXPLORATION -ureteropielocaliciales. I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -objetivo I-EXPLORATION -de I-EXPLORATION -poder I-EXPLORATION -visualizar I-EXPLORATION -la I-EXPLORATION -desembocadura I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -uréteres I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vejiga I-EXPLORATION -realizamos I-EXPLORATION -urografía I-EXPLORATION -excretora I-EXPLORATION -por I-EXPLORATION -venoclisis I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -en I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -sistemas I-EXPLORATION -ureteropielocaliciales I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -uréteres I-EXPLORATION -desembocando I-EXPLORATION -independientes I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vejiga. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -triple I-EXPLORATION -sistema I-EXPLORATION -ureteropielocalicial I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -entrada I-EXPLORATION -independiente I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -uréteres I-EXPLORATION -en I-EXPLORATION -vejiga. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -cistoscopia I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -tres I-EXPLORATION -meatos I-EXPLORATION -ureterales I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -izquierdo, I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -ellos I-EXPLORATION -por I-EXPLORATION -delante I-EXPLORATION -del I-EXPLORATION -trígono, I-EXPLORATION -cerca I-EXPLORATION -del I-EXPLORATION -cuello, I-EXPLORATION -otro I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -trígono I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -último I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -mismo, I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -derecho I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -dos I-EXPLORATION -meatos I-EXPLORATION -ureterales. I-EXPLORATION -Todos I-EXPLORATION -eyaculando I-EXPLORATION -orinas I-EXPLORATION -claras I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -'hoyo I-EXPLORATION -de I-EXPLORATION -golf'. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -intervenido B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hipospadias I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -correcta I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -micción I-PAST_MEDICAL_HISTORY -confortable. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -urólogo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -sordo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ingle I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -testículo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -muy I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -totalidad, I-EXPLORATION -irregular I-EXPLORATION -e I-EXPLORATION -indurado I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -testicular I-EXPLORATION -con I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -exploración I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -testicular I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -describe I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -quístico I-EXPLORATION -con I-EXPLORATION -tabiques I-EXPLORATION -finos I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -granuloma I-EXPLORATION -con I-EXPLORATION -calcificaciones I-EXPLORATION -intratesticular I-EXPLORATION -y I-EXPLORATION -fuera I-EXPLORATION -del I-EXPLORATION -testículo I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -otro I-EXPLORATION -quiste I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -ecos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -a I-EXPLORATION -descartar I-EXPLORATION -quiste I-EXPLORATION -epidermoide I-EXPLORATION -o I-EXPLORATION -hidatídico. I-EXPLORATION -Los I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -alfa I-EXPLORATION -fetoproteína I-EXPLORATION -y I-EXPLORATION -BHCG I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -TAC I-EXPLORATION -solicitado I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -evidenciaba I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -sólida I-EXPLORATION -retroperitoneal I-EXPLORATION -izquierda I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hilio I-EXPLORATION -renal I-EXPLORATION -lateroaórtica I-EXPLORATION -y I-EXPLORATION -prerrenal I-EXPLORATION -de I-EXPLORATION -54x51x90 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -una I-TREATMENT -orquiectomía I-TREATMENT -inguinal I-TREATMENT -izquierda I-TREATMENT -con I-TREATMENT -resultado I-TREATMENT -anatomo-patológico I-TREATMENT -de I-TREATMENT -teratoma I-TREATMENT -maduro I-TREATMENT -puro I-TREATMENT -poco I-TREATMENT -diferenciado I-TREATMENT -limitado I-TREATMENT -a I-TREATMENT -testículo I-TREATMENT -sin I-TREATMENT -invasión I-TREATMENT -vascular I-TREATMENT -que I-TREATMENT -afectaba I-TREATMENT -a I-TREATMENT -túnica I-TREATMENT -albugínea I-TREATMENT -pero I-TREATMENT -no I-TREATMENT -a I-TREATMENT -vaginal, I-TREATMENT -sin I-TREATMENT -afectación I-TREATMENT -de I-TREATMENT -rete I-TREATMENT -testis I-TREATMENT -de I-TREATMENT -5x3x3 I-TREATMENT -mm. I-TREATMENT -de I-TREATMENT -tamaño. I-TREATMENT -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -adyuvante. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Nos B-EXPLORATION -encontramos I-EXPLORATION -ante I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -testicular I-EXPLORATION -no I-EXPLORATION -seminomatoso I-EXPLORATION -estadio I-EXPLORATION -pT2 I-EXPLORATION -N3, I-EXPLORATION -M0 I-EXPLORATION -según I-EXPLORATION -la I-EXPLORATION -clasificación I-EXPLORATION -TNM I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -estadio I-EXPLORATION -II I-EXPLORATION -c I-EXPLORATION -sin I-EXPLORATION -factores I-EXPLORATION -de I-EXPLORATION -mal I-EXPLORATION -pronóstico. I-EXPLORATION -En B-TREATMENT -esta I-TREATMENT -situación I-TREATMENT -se I-TREATMENT -plantean I-TREATMENT -dos I-TREATMENT -opciones, I-TREATMENT -comenzar I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT -y I-TREATMENT -plantear I-TREATMENT -resección I-TREATMENT -si I-TREATMENT -persistía I-TREATMENT -masa I-TREATMENT -residual I-TREATMENT -o I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -linfadenectomia I-TREATMENT -retroperitoneal. I-TREATMENT - I-TREATMENT -Dada I-TREATMENT -la I-TREATMENT -negatividad I-TREATMENT -de I-TREATMENT -los I-TREATMENT -marcadores I-TREATMENT -tumorales I-TREATMENT -y I-TREATMENT -la I-TREATMENT -anatomía I-TREATMENT -patológica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -testicular I-TREATMENT -y I-TREATMENT -la I-TREATMENT -conocida I-TREATMENT -quimioresistencia I-TREATMENT -del I-TREATMENT -teratoma I-TREATMENT -maduro I-TREATMENT -puro I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -linfadenectomía I-TREATMENT -retroperitoneal I-TREATMENT -por I-TREATMENT -las I-TREATMENT -posibilidades I-TREATMENT -de I-TREATMENT -ser I-TREATMENT -curativa I-TREATMENT -si I-TREATMENT -la I-TREATMENT -histología I-TREATMENT -era I-TREATMENT -coincidente I-TREATMENT -con I-TREATMENT -el I-TREATMENT -primario I-TREATMENT -sin I-TREATMENT -existir I-TREATMENT -otros I-TREATMENT -componentes I-TREATMENT -tumorales I-TREATMENT -no I-TREATMENT -seminomatosos. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -linfadenectomía I-TREATMENT -retroperitoneal I-TREATMENT -hasta I-TREATMENT -vasos I-TREATMENT -iliacos I-TREATMENT -obteniendo I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -observada I-TREATMENT -en I-TREATMENT -Figura I-TREATMENT -2. I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -anatomo-patológico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -teratoma I-EXPLORATION -maduro I-EXPLORATION -puro I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -componentes I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -capas I-EXPLORATION -embrionarias I-EXPLORATION -sin I-EXPLORATION -invasión I-EXPLORATION -linfovascular. I-EXPLORATION -EL B-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -vigilancia I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -mediante I-EVOLUTION -marcadores, I-EVOLUTION -TAC I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -radiografía I-EVOLUTION -de I-EVOLUTION -tórax I-EVOLUTION -periódicas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -blanco, B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -llevando I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -prostatismo I-PAST_MEDICAL_HISTORY -caracterizado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -polaquiuria I-PAST_MEDICAL_HISTORY -nocturna I-PAST_MEDICAL_HISTORY -(3-4 I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -noche), I-PAST_MEDICAL_HISTORY -disuria, I-PAST_MEDICAL_HISTORY -chorro I-PAST_MEDICAL_HISTORY -débil, I-PAST_MEDICAL_HISTORY -micción I-PAST_MEDICAL_HISTORY -demorada, I-PAST_MEDICAL_HISTORY -micciones I-PAST_MEDICAL_HISTORY -imperiosas, I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -mejorando I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -impuesto I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cabecera I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -llegando I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -RAO. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -sonda I-PRESENT_ILLNESS -vesical I-PRESENT_ILLNESS -permanente I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -RAO, I-PRESENT_ILLNESS -fracasando I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -intentos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -retirar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -misma, I-PRESENT_ILLNESS -al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -constata I-EXPLORATION -mucosas: I-EXPLORATION -húmedas I-EXPLORATION -y I-EXPLORATION -normocoloreadas, I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -no I-EXPLORATION -infiltrado, I-EXPLORATION -auscultación I-EXPLORATION -cardiorespiratoria I-EXPLORATION -normal, I-EXPLORATION -abdomen I-EXPLORATION -negativo, I-EXPLORATION -fosas I-EXPLORATION -lumbares I-EXPLORATION -libres, I-EXPLORATION -puntos I-EXPLORATION -pielorreno-ureterales I-EXPLORATION -no I-EXPLORATION -dolorosos, I-EXPLORATION -genitales I-EXPLORATION -externos I-EXPLORATION -y I-EXPLORATION -regiones I-EXPLORATION -inguinales I-EXPLORATION -normales, I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -una I-EXPLORATION -próstata I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -volumen, I-EXPLORATION -superficie I-EXPLORATION -regular, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -consistencia I-EXPLORATION -fibroadenomatosa, I-EXPLORATION -grado I-EXPLORATION -III, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -hiperplasia I-EXPLORATION -benigna I-EXPLORATION -de I-EXPLORATION -próstata I-EXPLORATION -(HBP). I-EXPLORATION -Analítica I-EXPLORATION -sanguínea I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -hemoglobina, I-EXPLORATION -hematocrito, I-EXPLORATION -leucocitos I-EXPLORATION -totales, I-EXPLORATION -urea I-EXPLORATION -creatinina, I-EXPLORATION -PSA I-EXPLORATION -y I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Ecográfícamente I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -el I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -prostático I-EXPLORATION -con I-EXPLORATION -ecogenicidad I-EXPLORATION -heterogénea. I-EXPLORATION - I-EXPLORATION -Dado B-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -y I-TREATMENT -los I-TREATMENT -antecedentes, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -tratamiento I-TREATMENT -quirúrgico, I-TREATMENT -realizándosele I-TREATMENT -una I-TREATMENT -prostatectomía I-TREATMENT -retropúbica. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -describe I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -de I-EXPLORATION -próstata I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION -monomorfo, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -corresponde I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -linfocítico I-EXPLORATION -bien I-EXPLORATION -diferenciado. I-EXPLORATION -Posteriormente B-TREATMENT -es I-TREATMENT -remitido I-TREATMENT -al I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -Oncología I-TREATMENT -donde I-TREATMENT -la I-TREATMENT -aplican I-TREATMENT -tratamiento I-TREATMENT -radioterapia. I-TREATMENT -Actualmente B-EVOLUTION -continúa I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -de I-EVOLUTION -Urología. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -solicitar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -realización I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vasectomía. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -los I-EXPLORATION -testes I-EXPLORATION -eran I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -y I-EXPLORATION -tamaño I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -pene I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -torsión I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -60 I-EXPLORATION -grados. I-EXPLORATION -Hasta I-EXPLORATION -la I-EXPLORATION -fecha, I-EXPLORATION -dicha I-EXPLORATION -alteración I-EXPLORATION -no I-EXPLORATION -le I-EXPLORATION -había I-EXPLORATION -producido I-EXPLORATION -sintomatología I-EXPLORATION -alguna. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -escrotal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -aparecida I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -ido I-PRESENT_ILLNESS -creciendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -lentamente I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hernia I-PRESENT_ILLNESS -inguinal I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -el I-EXPLORATION -testículo I-EXPLORATION -derecho I-EXPLORATION -parecía I-EXPLORATION -situarse I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -raíz I-EXPLORATION -escrotal, I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -móvil I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -y I-EXPLORATION -suave I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -hemiescroto. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -lipoma I-EXPLORATION -escrotal. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -orina, I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -electrocardiograma I-EXPLORATION -fueron I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -escrotal I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT - I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -operación, I-TREATMENT -en I-TREATMENT -primer I-TREATMENT -lugar, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -reparación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hernia I-TREATMENT -inguinal I-TREATMENT -izquierda I-TREATMENT -con I-TREATMENT -malla I-TREATMENT -de I-TREATMENT -prolene I-TREATMENT -y I-TREATMENT -después I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exploración I-TREATMENT -del I-TREATMENT -hemiescroto I-TREATMENT -derecho. I-TREATMENT - I-TREATMENT -A I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -primera I-TREATMENT -incisión I-TREATMENT -cutánea I-TREATMENT -escrotal I-TREATMENT -derecha I-TREATMENT -intentamos I-TREATMENT -aislar I-TREATMENT -una I-TREATMENT -voluminosa I-TREATMENT -masa I-TREATMENT -blanquecina. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -por I-TREATMENT -la I-TREATMENT -dificultad I-TREATMENT -que I-TREATMENT -teníamos I-TREATMENT -en I-TREATMENT -separar I-TREATMENT -la I-TREATMENT -neoformación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -tejidos I-TREATMENT -circundantes I-TREATMENT -y I-TREATMENT -encontrar I-TREATMENT -el I-TREATMENT -testículo I-TREATMENT -derecho, I-TREATMENT -que I-TREATMENT -estaba I-TREATMENT -envuelto I-TREATMENT -por I-TREATMENT -la I-TREATMENT -masa, I-TREATMENT -decidimos I-TREATMENT -eligir I-TREATMENT -otra I-TREATMENT -vía. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -incisión I-TREATMENT -inguinoescrotál I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cual, I-TREATMENT -mediante I-TREATMENT -disección I-TREATMENT -roma I-TREATMENT -fue I-TREATMENT -más I-TREATMENT -fácil I-TREATMENT -aislar I-TREATMENT -la I-TREATMENT -neoformación, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -extendía I-TREATMENT -superiormente I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -altura I-TREATMENT -del I-TREATMENT -anillo I-TREATMENT -inguinal I-TREATMENT -externo. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -aislado I-TREATMENT -el I-TREATMENT -cordón I-TREATMENT -espermático I-TREATMENT -conseguimos I-TREATMENT -traer I-TREATMENT -fuera I-TREATMENT -el I-TREATMENT -testículo, I-TREATMENT -que I-TREATMENT -tenía I-TREATMENT -aspecto I-TREATMENT -hipotrófico I-TREATMENT -pero I-TREATMENT -no I-TREATMENT -resultaba I-TREATMENT -afectado. I-TREATMENT -También I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -resultaba I-TREATMENT -más I-TREATMENT -facil I-TREATMENT -y I-TREATMENT -segura. I-TREATMENT -Los I-TREATMENT -márgenes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -estaban I-TREATMENT -bien I-TREATMENT -delimitados I-TREATMENT -y I-TREATMENT -fáciles I-TREATMENT -de I-TREATMENT -separarse I-TREATMENT -a I-TREATMENT -excepción I-TREATMENT -de I-TREATMENT -una I-TREATMENT -zona I-TREATMENT -del I-TREATMENT -fondo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -bolsa I-TREATMENT -escrotal, I-TREATMENT -donde I-TREATMENT -la I-TREATMENT -neoformación I-TREATMENT -tenía I-TREATMENT -más I-TREATMENT -adherencia I-TREATMENT -con I-TREATMENT -el I-TREATMENT -dartos. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -aspecto I-EXPLORATION -macroscópico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neoformación I-EXPLORATION -extirpada I-EXPLORATION -era I-EXPLORATION -el I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -alongada I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -5cm I-EXPLORATION -y I-EXPLORATION -peso I-EXPLORATION -de I-EXPLORATION -140 I-EXPLORATION -gr I-EXPLORATION -aparentemente I-EXPLORATION -encapsulada I-EXPLORATION -con I-EXPLORATION -superficie I-EXPLORATION -externa I-EXPLORATION -lisa I-EXPLORATION -y I-EXPLORATION -regular. I-EXPLORATION -Al I-EXPLORATION -corte I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -se I-EXPLORATION -presentaba I-EXPLORATION -uniforme, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -denso I-EXPLORATION -y I-EXPLORATION -fibroso, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -blanquecino I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -degeneración I-EXPLORATION -mixoide I-EXPLORATION -o I-EXPLORATION -necrosis. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -grupos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -fusiformes, I-EXPLORATION -onduladas I-EXPLORATION -e I-EXPLORATION -hipercrómicas, I-EXPLORATION -estrechamente I-EXPLORATION -interpuestas I-EXPLORATION -en I-EXPLORATION -haces I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -de I-EXPLORATION -colágeno. I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -inmunohistoquímica I-EXPLORATION -se I-EXPLORATION -evidenciaba I-EXPLORATION -positividad I-EXPLORATION -citoplásmica I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -S-100. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -documentaron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -necrosis, I-EXPLORATION -mitosis I-EXPLORATION -ni I-EXPLORATION -atipias I-EXPLORATION -nucleares. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -histopatológico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -el I-EXPLORATION -de I-EXPLORATION -neurofibroma. I-EXPLORATION - I-EXPLORATION -Un B-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -revelado I-EVOLUTION -signos I-EVOLUTION -objetivos I-EVOLUTION -de I-EVOLUTION -recidiva. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -RTU I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -próstata. I-PRESENT_ILLNESS -Desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -medio I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -prostático. I-PRESENT_ILLNESS -Estudiado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urología, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -diagnostica I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hipertrofia I-PRESENT_ILLNESS -benigna I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -próstata. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -preoperatorio I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -alteraciones I-EXPLORATION -(electrocardiograma, I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -bioquímica I-EXPLORATION -normales). I-EXPLORATION -Se B-TREATMENT -programa I-TREATMENT -para I-TREATMENT -RTU. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -realizo I-TREATMENT -premedicación. I-TREATMENT -La I-TREATMENT -anestesia I-TREATMENT -intrarraquídea I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -con I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -sedestación. I-TREATMENT -Antes B-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inducción I-EXPLORATION -anestésica I-EXPLORATION -se I-EXPLORATION -monitorizo I-EXPLORATION -un I-EXPLORATION -electrocardiograma I-EXPLORATION -continuo I-EXPLORATION -(ECG), I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -(PA) I-EXPLORATION -no I-EXPLORATION -invasiva I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -SpO2. I-EXPLORATION -La B-TREATMENT -intervención I-TREATMENT -tuvo I-TREATMENT -duración I-TREATMENT -de I-TREATMENT -60 I-TREATMENT -minutos I-TREATMENT -y I-TREATMENT -transcurrio I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -3, I-TREATMENT -5 I-TREATMENT -litros I-TREATMENT -de I-TREATMENT -agua I-TREATMENT -estéril I-TREATMENT -(hipotónica) I-TREATMENT -como I-TREATMENT -liquido I-TREATMENT -de I-TREATMENT -irrigación, I-TREATMENT -contabilizandose I-TREATMENT -un I-TREATMENT -balance I-TREATMENT -negativo I-TREATMENT -de I-TREATMENT -1500ml. I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -sala I-EVOLUTION -de I-EVOLUTION -despertar I-EVOLUTION -presento I-EVOLUTION -vómitos I-EVOLUTION -e I-EVOLUTION -hipotensión I-EVOLUTION -(100/60mmHg). I-EVOLUTION -No B-TREATMENT -se I-TREATMENT -objetivaron I-TREATMENT -alteraciones I-TREATMENT -neurológicas, I-TREATMENT -ni I-TREATMENT -cardiovasculares, I-TREATMENT -ni I-TREATMENT -edema I-TREATMENT -pulmonar. I-TREATMENT -ECG I-TREATMENT -y I-TREATMENT -Rx I-TREATMENT -torax I-TREATMENT -sin I-TREATMENT -alteraciones. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -bioquímica I-TREATMENT -sanguínea I-TREATMENT -destacaba: I-TREATMENT -sodio I-TREATMENT -: I-TREATMENT -122 I-TREATMENT -mEq/L, I-TREATMENT -potasio I-TREATMENT -: I-TREATMENT -5, I-TREATMENT -9 I-TREATMENT -mmol/L, I-TREATMENT -osmolaridad I-TREATMENT -: I-TREATMENT -256 I-TREATMENT -mOsmol/kg, I-TREATMENT -urea I-TREATMENT -: I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -g/L, I-TREATMENT -creatinina I-TREATMENT -(cr.s) I-TREATMENT -: I-TREATMENT -38 I-TREATMENT -mg/L, I-TREATMENT -calcio I-TREATMENT -: I-TREATMENT -80 I-TREATMENT -mg/L, I-TREATMENT -proteínas I-TREATMENT -totales I-TREATMENT -: I-TREATMENT -51 I-TREATMENT -g/L, I-TREATMENT -albúmina I-TREATMENT -: I-TREATMENT -28 I-TREATMENT -g/L, I-TREATMENT -CPK I-TREATMENT -: I-TREATMENT -225 I-TREATMENT -U/L, I-TREATMENT -LDH I-TREATMENT -: I-TREATMENT -416 I-TREATMENT -U/L, I-TREATMENT -GOT I-TREATMENT -: I-TREATMENT -48 I-TREATMENT -U/L, I-TREATMENT -GPT I-TREATMENT -: I-TREATMENT -97 I-TREATMENT -U/L, I-TREATMENT -haptoglobina I-TREATMENT -: I-TREATMENT -43.8 I-TREATMENT -mg/dL I-TREATMENT -(rango I-TREATMENT -normal I-TREATMENT -50-220 I-TREATMENT -mg/dL), I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -de I-TREATMENT -coagulación I-TREATMENT -salieron I-TREATMENT -normales, I-TREATMENT -Hb I-TREATMENT -: I-TREATMENT -10 I-TREATMENT -g/dl, I-TREATMENT -HCT I-TREATMENT -: I-TREATMENT -28.8 I-TREATMENT -%, I-TREATMENT -leucocitos I-TREATMENT -: I-TREATMENT -6400/mm3, I-TREATMENT -plaquetas I-TREATMENT -: I-TREATMENT -220.000/mm3. I-TREATMENT -Gasometría: I-TREATMENT -pH I-TREATMENT -: I-TREATMENT -7, I-TREATMENT -30; I-TREATMENT -PCO2 I-TREATMENT -: I-TREATMENT -36 I-TREATMENT -mmHg; I-TREATMENT -PO2 I-TREATMENT -: I-TREATMENT -72 I-TREATMENT -mmHg. I-TREATMENT -Se B-EVOLUTION -procede I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -Reanimación. I-EVOLUTION - I-EVOLUTION -Tras B-TREATMENT -la I-TREATMENT -estabilización I-TREATMENT -clínica I-TREATMENT -con I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tensión I-TREATMENT -arterial, I-TREATMENT -se I-TREATMENT -pudo I-TREATMENT -prescindir I-TREATMENT -de I-TREATMENT -las I-TREATMENT -drogas I-TREATMENT -vasopresoras, I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -Furosemida I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -suero I-TREATMENT -salino I-TREATMENT -hipertónico I-TREATMENT -al I-TREATMENT -3% I-TREATMENT -para I-TREATMENT -minimizar I-TREATMENT -la I-TREATMENT -sobrecarga I-TREATMENT -de I-TREATMENT -volumen. I-TREATMENT -A I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -aplicadas I-TREATMENT -persistia I-TREATMENT -con I-TREATMENT -insuficiencia I-TREATMENT -renal I-TREATMENT -aguda I-TREATMENT -oligúrica I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días, I-TREATMENT -llegando I-TREATMENT -a I-TREATMENT -cifras I-TREATMENT -máximas I-TREATMENT -de I-TREATMENT -urea I-TREATMENT -de I-TREATMENT -2, I-TREATMENT -70 I-TREATMENT -g/L I-TREATMENT -y I-TREATMENT -de I-TREATMENT -creatinina I-TREATMENT -de I-TREATMENT -72 I-TREATMENT -mg/L, I-TREATMENT -precisando I-TREATMENT -de I-TREATMENT -04 I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -hemodiálisis. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -3 I-TREATMENT -semanas, I-TREATMENT -reinició I-TREATMENT -la I-TREATMENT -diuresis I-TREATMENT -entrando I-TREATMENT -en I-TREATMENT -fase I-TREATMENT -poliúrica, I-TREATMENT -recuperandose I-TREATMENT -así I-TREATMENT -progresivamente I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -siendo I-TREATMENT -la I-TREATMENT -Cr.s. I-TREATMENT -al I-TREATMENT -alta I-TREATMENT -de I-TREATMENT -14 I-TREATMENT -mg/L. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -normotenso, I-EVOLUTION -con I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -Cr.s. I-EVOLUTION -10 I-EVOLUTION -mg/L I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -Ccr. I-EVOLUTION -76 I-EVOLUTION -ml/minuto. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -conocida I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -enero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2003, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -acudir I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -sólida I-PRESENT_ILLNESS -dependiente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mesorriñón I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño, I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -adenomegalias I-PRESENT_ILLNESS -retrocavas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -nódulo I-PRESENT_ILLNESS -hepático I-PRESENT_ILLNESS -sospechoso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -metástasis, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -nódulos I-PRESENT_ILLNESS -pulmonares I-PRESENT_ILLNESS -bilaterales I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -campos I-PRESENT_ILLNESS -basales. I-PRESENT_ILLNESS -Para B-EXPLORATION -filiar I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -percutánea I-EXPLORATION -renal I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -nefroblastoma. I-EXPLORATION -Se B-TREATMENT -estadió I-TREATMENT -como I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -conforme I-TREATMENT -a I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -según I-TREATMENT -protocolo I-TREATMENT -SIOP, I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -poliquimioterapia I-TREATMENT -sistémica I-TREATMENT -con I-TREATMENT -actinomicina I-TREATMENT -D, I-TREATMENT -vincristina I-TREATMENT -y I-TREATMENT -doxorrubicina I-TREATMENT -separados I-TREATMENT -3 I-TREATMENT -semanas. I-TREATMENT -Al B-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -período I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -la I-EVOLUTION -reducción I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -masa I-EVOLUTION -renal I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -evidente I-EVOLUTION -cambio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -densidad I-EVOLUTION -del I-EVOLUTION -nódulo I-EVOLUTION -hepático, I-EVOLUTION -no I-EVOLUTION -habiendo I-EVOLUTION -variado I-EVOLUTION -ni I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -ni I-EVOLUTION -la I-EVOLUTION -densidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -ganglios I-EVOLUTION -regionales. I-EVOLUTION -Se B-TREATMENT -sometió I-TREATMENT -a I-TREATMENT -nefrectomía I-TREATMENT -radical I-TREATMENT -dcha, I-TREATMENT -linfadenectomía I-TREATMENT -regional I-TREATMENT -y I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -nódulo I-TREATMENT -hepático. I-TREATMENT -En I-TREATMENT -riñón I-TREATMENT -se I-TREATMENT -reconfirmó I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -nefroblastoma I-TREATMENT -con I-TREATMENT -componente I-TREATMENT -mixto, I-TREATMENT -un I-TREATMENT -tercio I-TREATMENT -de I-TREATMENT -blastema, I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -tercios I-TREATMENT -epiteliales, I-TREATMENT -acompañados I-TREATMENT -de I-TREATMENT -un I-TREATMENT -60% I-TREATMENT -de I-TREATMENT -necrosis. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -nefrectomía I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -actinomicina I-TREATMENT -D I-TREATMENT -y I-TREATMENT -vincristina, I-TREATMENT -hasta I-TREATMENT -que I-TREATMENT -en I-TREATMENT -estudio I-TREATMENT -control I-TREATMENT -aparece I-TREATMENT -un I-TREATMENT -nódulo I-TREATMENT -pulmonar I-TREATMENT -basal I-TREATMENT -izdo, I-TREATMENT -estudiado I-TREATMENT -mediante I-TREATMENT -PET, I-TREATMENT -ofreciendo I-TREATMENT -resultado I-TREATMENT -positivo, I-TREATMENT -y I-TREATMENT -procediéndose I-TREATMENT -a I-TREATMENT -resección I-TREATMENT -quirúrgica I-TREATMENT -poniendo I-TREATMENT -de I-TREATMENT -manifiesto I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -componente I-TREATMENT -nefroblastomatoso I-TREATMENT -sin I-TREATMENT -poder I-TREATMENT -reconocer I-TREATMENT -un I-TREATMENT -claro I-TREATMENT -patrón I-TREATMENT -de I-TREATMENT -crecimiento. I-TREATMENT -Posteriormente I-TREATMENT -y I-TREATMENT -siguiendo I-TREATMENT -las I-TREATMENT -indicaciones I-TREATMENT -de I-TREATMENT -la I-TREATMENT -SIOP I-TREATMENT -se I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -la I-TREATMENT -poliquimioterapia I-TREATMENT -sistémica I-TREATMENT -asociando I-TREATMENT -carboplatino I-TREATMENT -y I-TREATMENT -etopósido, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -26 I-TREATMENT -semanas. I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -46 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -inicial I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -H.T.A. I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -coágulos I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -urológicos I-PRESENT_ILLNESS -destacables I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -no I-EXPLORATION -detecta I-EXPLORATION -anomalías I-EXPLORATION -de I-EXPLORATION -interés, I-EXPLORATION -con I-EXPLORATION -riñones I-EXPLORATION -y I-EXPLORATION -vías I-EXPLORATION -excretoras I-EXPLORATION -normales, I-EXPLORATION -próstata I-EXPLORATION -discretamente I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -vejiga I-EXPLORATION -sin I-EXPLORATION -hallazgos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -cistoscopia I-EXPLORATION -practicada I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -papilar I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -izquierda I-EXPLORATION -retromeatal I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -hasta I-EXPLORATION -vertiente I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -vesical. I-EXPLORATION -Se B-TREATMENT -practica I-TREATMENT -resección I-TREATMENT -transuretral. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -de I-EXPLORATION -Brunner I-EXPLORATION -(papiloma I-EXPLORATION -invertido) I-EXPLORATION -sobre I-EXPLORATION -varios I-EXPLORATION -fragmentos I-EXPLORATION -resecados I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -conjunto I-EXPLORATION -miden I-EXPLORATION -10x15x5 I-EXPLORATION -mm.. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -asintomático I-EVOLUTION -tras I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -anexectomía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -miomas I-PAST_MEDICAL_HISTORY -uterinos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1997, I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hiato, I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -médico. I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -asimismo I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -tiroideo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diámetro, I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -coloide I-PAST_MEDICAL_HISTORY -nodular I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -PAAF I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1995. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2001, I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -nefrectomía I-PAST_MEDICAL_HISTORY -radical I-PAST_MEDICAL_HISTORY -derecha, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -heterogéneo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diámetro I-PAST_MEDICAL_HISTORY -localizado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tercio I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -derecho, I-PAST_MEDICAL_HISTORY -correspondiendo I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -anatomopatológico I-PAST_MEDICAL_HISTORY -posterior, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alto I-PAST_MEDICAL_HISTORY -grado, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -infiltración I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vena I-PAST_MEDICAL_HISTORY -renal, I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -pT3bNoMo. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -posteriormente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -coadyuvante I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -interleukina- I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -subcutánea I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -informe I-PAST_MEDICAL_HISTORY -anatomopatológico I-PAST_MEDICAL_HISTORY -macroscópico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pieza I-PAST_MEDICAL_HISTORY -describía I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -tumoral I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -infiltraba I-PAST_MEDICAL_HISTORY -pelvis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vena I-PAST_MEDICAL_HISTORY -renal, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -diámetro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -x I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -x I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -cm, I-PAST_MEDICAL_HISTORY -combinando I-PAST_MEDICAL_HISTORY -áreas I-PAST_MEDICAL_HISTORY -grisáceas I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -pardoamarillentas. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -microscópico I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tumoración I-PAST_MEDICAL_HISTORY -pseudocapsular I-PAST_MEDICAL_HISTORY -correspondiente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alto I-PAST_MEDICAL_HISTORY -grado, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -alguna I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -anaplásica. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -invadía I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -sistema I-PAST_MEDICAL_HISTORY -pielocalicial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -evidencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -invasión I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -vena I-PAST_MEDICAL_HISTORY -renal. I-PAST_MEDICAL_HISTORY -Los I-PAST_MEDICAL_HISTORY -márgenes I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -estaban I-PAST_MEDICAL_HISTORY -libres. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2004 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -control, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -detectó I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -TAC, I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -marcado I-PAST_MEDICAL_HISTORY -crecimiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lóbulo I-PAST_MEDICAL_HISTORY -tiroideo I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -heterogéneo, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -coloide I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -conocido. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2005, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nuevo I-PAST_MEDICAL_HISTORY -TAC, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -lóbulo I-PAST_MEDICAL_HISTORY -tiroideo I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -crecimiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -5, I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -desplazando I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tráquea. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -gammagrafía I-EXPLORATION -tiroidea I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -'nódulo I-EXPLORATION -frío' I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -hormonas I-EXPLORATION -tiroideas. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -crecimiento I-TREATMENT -progresivo I-TREATMENT -del I-TREATMENT -nódulo I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -hemitiroidectomía I-TREATMENT -izquierda. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -describía I-EXPLORATION -un I-EXPLORATION -hemitiroides I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -zonas I-EXPLORATION -amarillentas I-EXPLORATION -en I-EXPLORATION -superficie, I-EXPLORATION -alternando I-EXPLORATION -con I-EXPLORATION -otras I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -más I-EXPLORATION -carnoso. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -con I-EXPLORATION -citoplasma I-EXPLORATION -claro, I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -presentaban I-EXPLORATION -una I-EXPLORATION -acusada I-EXPLORATION -atipia, I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -incluso I-EXPLORATION -anaplásicas I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -figuras I-EXPLORATION -de I-EXPLORATION -mitosis. I-EXPLORATION -Presentaban I-EXPLORATION -un I-EXPLORATION -crecimiento I-EXPLORATION -difuso I-EXPLORATION -constituyendo I-EXPLORATION -nódulos I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -esclerosis I-EXPLORATION -y I-EXPLORATION -extensas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -rodeada I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -tiroideo I-EXPLORATION -respetado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -objetivaban I-EXPLORATION -folículos I-EXPLORATION -linfoides. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -técnicas I-EXPLORATION -de I-EXPLORATION -inmunohistoquímica I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -dichas I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -presentaron I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -tiroglobulina I-EXPLORATION -y I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -CK8, I-EXPLORATION -CK18, I-EXPLORATION -EMA, I-EXPLORATION -y I-EXPLORATION -Vimentina. I-EXPLORATION - I-EXPLORATION -Dadas I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -histológicas I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -perfil I-EXPLORATION -inmunohistoquímico, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -historia I-EXPLORATION -clínica I-EXPLORATION -del I-EXPLORATION -paciente, I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -renal I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -claras. I-EXPLORATION - I-EXPLORATION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Puertas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -escrotal I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemiescroto I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -traumático I-PAST_MEDICAL_HISTORY -conocido. I-PAST_MEDICAL_HISTORY -No B-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -enrojecimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -escrotal, I-EXPLORATION -más I-EXPLORATION -acusado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemiescroto I-EXPLORATION -izquierdo I-EXPLORATION -ligeramente I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -palpación. I-EXPLORATION -Cordón I-EXPLORATION -y I-EXPLORATION -testículos I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -normales I-EXPLORATION -no I-EXPLORATION -dolorosos. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -aparece I-EXPLORATION -hidrocele I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -transluminación I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -maniobra I-EXPLORATION -de I-EXPLORATION -Prehn I-EXPLORATION -es I-EXPLORATION -negativa. I-EXPLORATION -Reflejos I-EXPLORATION -cremastéricos I-EXPLORATION -conservados. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -estudio I-EXPLORATION -ultrasonográfico I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION -de: I-EXPLORATION -testículo I-EXPLORATION -y I-EXPLORATION -epidídimos I-EXPLORATION -bilaterales I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -normales I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION -al I-EXPLORATION -Eco-Doppler. I-EXPLORATION -Cubiertas I-EXPLORATION -testiculares I-EXPLORATION -y I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -de I-EXPLORATION -hemiescroto I-EXPLORATION -izquierdo I-EXPLORATION -engrosados I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -flujo I-EXPLORATION -Doppler. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -diagnosticó I-TREATMENT -de I-TREATMENT -edema I-TREATMENT -de I-TREATMENT -escroto I-TREATMENT -agudo I-TREATMENT -idiopático, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -recetaron I-TREATMENT -AINES I-TREATMENT -y B-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -cito I-EVOLUTION -para I-EVOLUTION -revisión I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días, I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -observar I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -edema, I-EVOLUTION -el I-EVOLUTION -eritema I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -habían I-EVOLUTION -desaparecido I-EVOLUTION -casi I-EVOLUTION -por I-EVOLUTION -completo. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -Colombiana B-PAST_MEDICAL_HISTORY -de B-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -episódico I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -punzada I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hematuria, I-PRESENT_ILLNESS -nauseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -patológico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -quirúrgico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -histerectomía. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -sus I-EXPLORATION -signos I-EXPLORATION -vitales, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -20kg/Mts2, I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -único I-EXPLORATION -signo I-EXPLORATION -que I-EXPLORATION -presentaba I-EXPLORATION -era I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -flanco I-EXPLORATION -izquierdo. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -manejo I-TREATMENT -médico I-TREATMENT -considerando I-TREATMENT -pielonefritis, I-TREATMENT -sin B-EVOLUTION -resolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología, I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -toma I-EXPLORATION -Tomografía I-EXPLORATION -Axial I-EXPLORATION -Computarizada, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -informa I-EXPLORATION -masa I-EXPLORATION -dependiente I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -10 I-EXPLORATION -cms, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -nefrectomía. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -quirúrgica I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -renal I-EXPLORATION -fue I-EXPLORATION -fijada I-EXPLORATION -luego I-EXPLORATION -de I-EXPLORATION -extraerse I-EXPLORATION -con I-EXPLORATION -formaldehído I-EXPLORATION -al I-EXPLORATION -10% I-EXPLORATION -y I-EXPLORATION -embebido I-EXPLORATION -en I-EXPLORATION -parafina I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -preparación I-EXPLORATION -y I-EXPLORATION -análisis I-EXPLORATION -microscópico, I-EXPLORATION -la I-EXPLORATION -coloración I-EXPLORATION -empleada I-EXPLORATION -fue I-EXPLORATION -Hematoxilina I-EXPLORATION -y I-EXPLORATION -Eosina. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -referir I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -testicular I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -termometrada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40ºC, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -escalofríos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS -acompañante I-PRESENT_ILLNESS -(disuria, I-PRESENT_ILLNESS -polaquiuria, I-PRESENT_ILLNESS -tenesmo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -miccional), I-PRESENT_ILLNESS -ausencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Durante B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -anamnesis I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -revela I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -profesión, I-PAST_MEDICAL_HISTORY -veterinario, I-PAST_MEDICAL_HISTORY -profesión I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -ciertas I-PAST_MEDICAL_HISTORY -patologías I-PAST_MEDICAL_HISTORY -infecciosas I-PAST_MEDICAL_HISTORY -(brucelosis, I-PAST_MEDICAL_HISTORY -triquinosis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -algunas I-PAST_MEDICAL_HISTORY -parasitosis). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION -teste I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -normales, I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -teste I-EXPLORATION -izquierdo, I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -eritema I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -sin I-EXPLORATION -fluctuación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -afecta I-EXPLORATION -aunque I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -movilización I-EXPLORATION -testicular. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -resulta I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -abdominal I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -percusión I-EXPLORATION -renal I-EXPLORATION -también I-EXPLORATION -descartó I-EXPLORATION -afecciones I-EXPLORATION -acompañantes I-EXPLORATION -al I-EXPLORATION -ser I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Analíticamente I-EXPLORATION -destaca I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -22.240 I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(neutrófilos I-EXPLORATION -90%). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -Ecografía I-EXPLORATION -testicular I-EXPLORATION -realizada I-EXPLORATION -previa I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -muestra I-EXPLORATION -aumentos I-EXPLORATION -homogéneos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ecogenicidad I-EXPLORATION -del I-EXPLORATION -testículo I-EXPLORATION -afecto, I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -epidídimo. I-EXPLORATION -Engrosamiento I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -absceso I-EXPLORATION -testicular. I-EXPLORATION -Imágenes I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -orquitis I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -epidídimo. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -orquitis I-TREATMENT -infecciosa, I-TREATMENT -procediéndose I-TREATMENT -a I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -con I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -que I-TREATMENT -comprendió I-TREATMENT -Doxiciclina, I-TREATMENT -Imipenem I-TREATMENT -y I-TREATMENT -Teicoplanina, I-TREATMENT -asociando I-TREATMENT -Corticoides I-TREATMENT -y I-TREATMENT -terapia I-TREATMENT -analgésica. I-TREATMENT - I-TREATMENT -Dos B-EXPLORATION -días I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -ingresse I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -ecografía, I-EXPLORATION -objetivándose I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ecogenicidad I-EXPLORATION -homogénea I-EXPLORATION -similar I-EXPLORATION -al I-EXPLORATION -contralateral, I-EXPLORATION -afectación I-EXPLORATION -epididimaria. I-EXPLORATION -Engrosamiento I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -absceso I-EXPLORATION -testicular. I-EXPLORATION -Se I-EXPLORATION -termina I-EXPLORATION -de I-EXPLORATION -filiar I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -sindrómico: I-EXPLORATION -Orquiepididimitis I-EXPLORATION -infecciosa. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -averiguar I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -patología I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -hace I-EXPLORATION -necesaria I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -que I-EXPLORATION -permitan I-EXPLORATION -conocer I-EXPLORATION -el I-EXPLORATION -germen I-EXPLORATION -causante. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -urocultivo I-EXPLORATION -resulta I-EXPLORATION -ser I-EXPLORATION -negativo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -aglutinación I-EXPLORATION -específica I-EXPLORATION -de I-EXPLORATION -Brucella. I-EXPLORATION -Sin I-EXPLORATION -embargo I-EXPLORATION -la I-EXPLORATION -seroaglutinación I-EXPLORATION -de I-EXPLORATION -Rosa I-EXPLORATION -de I-EXPLORATION -Bengala I-EXPLORATION -resulta I-EXPLORATION -positiva, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -hemocultivos, I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -Brucella I-EXPLORATION -spp. I-EXPLORATION -(los I-EXPLORATION -tres). I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -confirmación I-TREATMENT -del I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -orquiepididimitis I-TREATMENT -brucelar I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -mantener I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Doxiciclina I-TREATMENT -y I-TREATMENT -ciprofloxacino. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -favorablemente I-EVOLUTION -con I-EVOLUTION -remisión I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -litiasis I-PRESENT_ILLNESS -piélica I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -nicturia I-PRESENT_ILLNESS -3-4, I-PRESENT_ILLNESS -polaquiuria, I-PRESENT_ILLNESS -escozor I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -aislados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematuria. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -el I-EXPLORATION -sistemático I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -están I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -aparato I-EXPLORATION -urinario, I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -radiopaca I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -izquierdo. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -anecóica I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -hidronefrosis I-EXPLORATION -e I-EXPLORATION -importante I-EXPLORATION -atrofia I-EXPLORATION -cortical. I-EXPLORATION -En I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -hidronefrosis I-EXPLORATION -izquierda, I-EXPLORATION -con I-EXPLORATION -imágenes I-EXPLORATION -ecogénicas I-EXPLORATION -en I-EXPLORATION -pelvis, I-EXPLORATION -cálices I-EXPLORATION -medios I-EXPLORATION -e I-EXPLORATION -inferiores I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -cálculos. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -urografía I-EXPLORATION -intravenosa, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -distinguen I-EXPLORATION -un I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -no I-EXPLORATION -funcionante I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -bifidez I-EXPLORATION -pieloureteral, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -litiasis I-EXPLORATION -coraliforme I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pielón I-EXPLORATION -inferior I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -TAC I-EXPLORATION -abdomino-pélvico, I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -aparece I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -cavidad I-EXPLORATION -quística, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -cortical I-EXPLORATION -funcionante. I-EXPLORATION -El I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -presenta I-EXPLORATION -hipertrofia I-EXPLORATION -compensadora, I-EXPLORATION -con I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -quísticas I-EXPLORATION -corticales I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -cálculos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -inferior. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -practicar I-EXPLORATION -punción I-EXPLORATION -percutánea I-EXPLORATION -bilateral, I-EXPLORATION -observando I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -paso I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -al I-EXPLORATION -uréter I-EXPLORATION -y I-EXPLORATION -bifidez I-EXPLORATION -pieloureteral I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -litiasis I-EXPLORATION -coraliforme I-EXPLORATION -en I-EXPLORATION -pielón I-EXPLORATION -inferior. I-EXPLORATION -Se B-TREATMENT -deja I-TREATMENT -colocada I-TREATMENT -una I-TREATMENT -sonda I-TREATMENT -de I-TREATMENT -nefrostomía I-TREATMENT -en I-TREATMENT -el I-TREATMENT -lado I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -se I-TREATMENT -instaura I-TREATMENT -tratamiento I-TREATMENT -antibiótico, I-TREATMENT -al I-TREATMENT -extraer I-TREATMENT -orina I-TREATMENT -purulenta I-TREATMENT -en I-TREATMENT -la I-TREATMENT -descarga I-TREATMENT -del I-TREATMENT -pielón I-TREATMENT -inferior. I-TREATMENT -La B-EXPLORATION -gammagrafía I-EXPLORATION -renal I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -escasa I-EXPLORATION -función I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -(11%). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -cistoscopia I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -objetivan I-EXPLORATION -neorformaciones I-EXPLORATION -vesicales. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -estudios I-TREATMENT -preoperatorios I-TREATMENT -dentro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -normalidad I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenido I-TREATMENT -quirúrgicamente I-TREATMENT -realizándose I-TREATMENT -nefrolitotomía I-TREATMENT -percutánea I-TREATMENT -izquierda, I-TREATMENT -con I-TREATMENT -fragmentación I-TREATMENT -de I-TREATMENT -litiasis I-TREATMENT -con I-TREATMENT -lithoclast I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -fragmentos. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -quince I-TREATMENT -días I-TREATMENT -se I-TREATMENT -lleva I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -nefrolitotomía I-TREATMENT -con I-TREATMENT -el I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -eliminar I-TREATMENT -todos I-TREATMENT -los I-TREATMENT -restos I-TREATMENT -litiásicos. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -eliminando I-EVOLUTION -orina I-EVOLUTION -purulenta I-EVOLUTION -por I-EVOLUTION -sonda I-EVOLUTION -de I-EVOLUTION -nefrostomía I-EVOLUTION -percutánea. I-EVOLUTION -La B-EXPLORATION -angiografía I-EXPLORATION -por I-EXPLORATION -sustracción I-EXPLORATION -digital' I-EXPLORATION -(DIVAS) I-EXPLORATION -demuestra I-EXPLORATION -una I-EXPLORATION -escasa I-EXPLORATION -vascularización I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -izquierdo. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -heminefrectomía I-TREATMENT -polar I-TREATMENT -inferior I-TREATMENT -izquierda. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -postoperatorio I-TREATMENT -inmediato I-TREATMENT -se I-TREATMENT -produce I-TREATMENT -un I-TREATMENT -empeoramiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -con I-TREATMENT -fiebre I-TREATMENT -y I-TREATMENT -leucocitosis, I-TREATMENT -proceso I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -sepsis I-TREATMENT -de I-TREATMENT -origen I-TREATMENT -urinario I-TREATMENT -que I-TREATMENT -mejora I-TREATMENT -con I-TREATMENT -sueroterapia I-TREATMENT -y I-TREATMENT -antibioterapia I-TREATMENT -parenteral. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -extirpada I-EXPLORATION -corresponde I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -452 I-EXPLORATION -gramos I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -acompaña I-EXPLORATION -de I-EXPLORATION -abundante I-EXPLORATION -grasa I-EXPLORATION -intimamente I-EXPLORATION -pegada I-EXPLORATION -al I-EXPLORATION -parenquima I-EXPLORATION -renal. I-EXPLORATION -Al I-EXPLORATION -corte I-EXPLORATION -el I-EXPLORATION -parenquima I-EXPLORATION -está I-EXPLORATION -sustituido I-EXPLORATION -por I-EXPLORATION -grandes I-EXPLORATION -cavidades I-EXPLORATION -quísticas I-EXPLORATION -ocupadas I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -material I-EXPLORATION -blanquecino I-EXPLORATION -y I-EXPLORATION -blando. I-EXPLORATION -Histológicamente I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -grandes I-EXPLORATION -masas I-EXPLORATION -sólidas, I-EXPLORATION -nidos I-EXPLORATION -y I-EXPLORATION -regueros I-EXPLORATION -infiltrantes I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -hábito I-EXPLORATION -escamoso I-EXPLORATION -que I-EXPLORATION -presentan I-EXPLORATION -grandes I-EXPLORATION -núcleos I-EXPLORATION -vesiculosos I-EXPLORATION -e I-EXPLORATION -irregulares I-EXPLORATION -con I-EXPLORATION -nucleolo I-EXPLORATION -prominente, I-EXPLORATION -citoplasma I-EXPLORATION -amplio, I-EXPLORATION -bien I-EXPLORATION -definido, I-EXPLORATION -eosinófilo I-EXPLORATION -claro, I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -imágenes I-EXPLORATION -de I-EXPLORATION -queratinización I-EXPLORATION -individual I-EXPLORATION -y I-EXPLORATION -formación I-EXPLORATION -de I-EXPLORATION -perlas I-EXPLORATION -corneas. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -urografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -cirugía I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -función I-EXPLORATION -normal I-EXPLORATION -del I-EXPLORATION -hemirriñón I-EXPLORATION -superior I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -uropatía I-EXPLORATION -obstructiva. I-EXPLORATION - I-EXPLORATION -Un B-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -ingresa I-EVOLUTION -desde I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -hematuria I-EVOLUTION -macroscópica. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION -de I-EXPLORATION -replección I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -derecha, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -corroborado I-EXPLORATION -mediante I-EXPLORATION -cistoscopia. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -resección I-TREATMENT -transuretral I-TREATMENT -de I-TREATMENT -tumoración I-TREATMENT -sólida I-TREATMENT -en I-TREATMENT -cara I-TREATMENT -lateral I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -vejiga, I-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -anatomo-patológico I-TREATMENT -de I-TREATMENT -carcinoma I-TREATMENT -vesical I-TREATMENT -con I-TREATMENT -áreas I-TREATMENT -de I-TREATMENT -diferenciación I-TREATMENT -escamosa I-TREATMENT -que I-TREATMENT -infiltra I-TREATMENT -la I-TREATMENT -muscular, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -cistoprostatectomía I-TREATMENT -radical I-TREATMENT -con I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT -de I-TREATMENT -uréter I-TREATMENT -izquierdo I-TREATMENT -a I-TREATMENT -sigma I-TREATMENT -(Mainz I-TREATMENT -II). I-TREATMENT -En I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -una I-TREATMENT -nefroureterectomía I-TREATMENT -derecha, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -observa I-TREATMENT -un I-TREATMENT -riñón I-TREATMENT -hidronefrótico, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -la I-TREATMENT -unión I-TREATMENT -pieloureteral I-TREATMENT -por I-TREATMENT -un I-TREATMENT -vaso I-TREATMENT -polar. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -escamosas, I-EXPLORATION -estadio I-EXPLORATION -pT3a, I-EXPLORATION -pNx, I-EXPLORATION -pMx. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fallece I-EVOLUTION -cuatro I-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -con I-EVOLUTION -metástasis I-EVOLUTION -pulmonares I-EVOLUTION -y I-EVOLUTION -hepáticas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -litiasis I-PRESENT_ILLNESS -piélica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -riñón I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -Se B-TREATMENT -le I-TREATMENT -propone I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -NLPC. I-TREATMENT -Bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -y I-TREATMENT -en I-TREATMENT -posición I-TREATMENT -de I-TREATMENT -decúbito I-TREATMENT -prono I-TREATMENT -se I-TREATMENT -accede I-TREATMENT -al I-TREATMENT -riñón I-TREATMENT -por I-TREATMENT -grupo I-TREATMENT -calicial I-TREATMENT -inferior, I-TREATMENT -bajo I-TREATMENT -control I-TREATMENT -de I-TREATMENT -escopia. I-TREATMENT -Se I-TREATMENT -dilata I-TREATMENT -el I-TREATMENT -trayecto I-TREATMENT -de I-TREATMENT -acceso I-TREATMENT -percutáneo I-TREATMENT -con I-TREATMENT -dilatadores I-TREATMENT -metálicos I-TREATMENT -coaxiales I-TREATMENT -de I-TREATMENT -Alken. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -fragmentación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -litiasis I-TREATMENT -con I-TREATMENT -el I-TREATMENT -litotriptor I-TREATMENT -intracorpóreo I-TREATMENT -StoneBreakerTM I-TREATMENT -(LMA I-TREATMENT -Urology, I-TREATMENT -Gland, I-TREATMENT -Switzerland). I-TREATMENT -El I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -fragmentación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -litiasis I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -30 I-TREATMENT -minutos I-TREATMENT -utilizando I-TREATMENT -tres I-TREATMENT -cartuchos I-TREATMENT -de I-TREATMENT -dióxido I-TREATMENT -de I-TREATMENT -carbono I-TREATMENT -comprimido. I-TREATMENT -No B-EVOLUTION -existieron I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -procedimiento I-EVOLUTION -con B-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -doble I-TREATMENT -J I-TREATMENT -por I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -restos I-TREATMENT -litiásicos I-TREATMENT -menores I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -mm. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -al B-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -solicitada I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -prostático, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -diagnosticó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -RH I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -sólida I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -asienta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -istmo I-PRESENT_ILLNESS -renal. I-PRESENT_ILLNESS -El B-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -cm. I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -istmo I-EXPLORATION -renal I-EXPLORATION -sin I-EXPLORATION -evidenciar I-EXPLORATION -adenopatías, I-EXPLORATION -metástasis I-EXPLORATION -locoregionales I-EXPLORATION -ni I-EXPLORATION -lesiones I-EXPLORATION -a I-EXPLORATION -distancia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -vascular I-EXPLORATION -preoperatorio I-EXPLORATION -mediante I-EXPLORATION -arteriografía, I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -arterias I-EXPLORATION -renales I-EXPLORATION -con I-EXPLORATION -nacimiento I-EXPLORATION -ortotópico. I-EXPLORATION -Las I-EXPLORATION -imágenes I-EXPLORATION -selectivas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -derecha, I-EXPLORATION -evidenciaron I-EXPLORATION -vasos I-EXPLORATION -neoformados I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -rama I-EXPLORATION -medial I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -bifurcación I-EXPLORATION -con I-EXPLORATION -normalidad I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -venoso I-EXPLORATION -intra I-EXPLORATION -y I-EXPLORATION -extrarrenal. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -presunción I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -carcinoma I-TREATMENT -renal, I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -istmectomía I-TREATMENT -y I-TREATMENT -nefrectomía I-TREATMENT -izquierda I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -media. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -operatorio I-TREATMENT -se I-TREATMENT -apreció I-TREATMENT -que I-TREATMENT -la I-TREATMENT -pelvis I-TREATMENT -renal I-TREATMENT -y I-TREATMENT -el I-TREATMENT -uréter I-TREATMENT -izquierdos I-TREATMENT -se I-TREATMENT -hallaban I-TREATMENT -infiltrados I-TREATMENT -por I-TREATMENT -el I-TREATMENT -tumor. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -renal I-EXPLORATION -neoformada I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm. I-EXPLORATION -afectando I-EXPLORATION -cápsula, I-EXPLORATION -grasa I-EXPLORATION -perirrenal, I-EXPLORATION -así I-EXPLORATION -como, I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -urinaria I-EXPLORATION -izquierda. I-EXPLORATION -La I-EXPLORATION -histología I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -neuroendocrino I-EXPLORATION -de I-EXPLORATION -célula I-EXPLORATION -no I-EXPLORATION -pequeña. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmuno-histoquímico I-EXPLORATION -resultó I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -CD-56 I-EXPLORATION -y I-EXPLORATION -sinaptofisina. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -4 I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intervención, I-EXPLORATION -el I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -sólido I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm. I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -así I-EXPLORATION -como, I-EXPLORATION -adenopatías I-EXPLORATION -para-aórticas I-EXPLORATION -izquierdas I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION -retrocrurales I-EXPLORATION -subcentimétricos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -PET-TC I-EXPLORATION -mostró I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -descritas I-EXPLORATION -eran I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -metástasis. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -radioterapia I-TREATMENT -externa I-TREATMENT -(RT) I-TREATMENT -y I-TREATMENT -quimioterapia I-TREATMENT -(QT) I-TREATMENT -(carboplatino I-TREATMENT -y I-TREATMENT -VP-16) I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -tolerancia I-TREATMENT -y I-TREATMENT -respuesta I-TREATMENT -parcial. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -efectos I-EVOLUTION -secundarios I-EVOLUTION -tardíos I-EVOLUTION -de I-EVOLUTION -RT I-EVOLUTION -ni I-EVOLUTION -QT. I-EVOLUTION -Dos I-EVOLUTION -años I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -el I-EVOLUTION -TAC I-EVOLUTION -abdominal I-EVOLUTION -muestra I-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -pequeños I-EVOLUTION -ganglios I-EVOLUTION -retroperitoneales, I-EVOLUTION -sin I-EVOLUTION -otros I-EVOLUTION -hallazgos I-EVOLUTION -destacables. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -realizado I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -bilateral. I-PRESENT_ILLNESS -Resto B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -bulto I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pene, I-PRESENT_ILLNESS -doloroso I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -erección. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -cordón I-EXPLORATION -longitudinal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -del I-EXPLORATION -pene I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -tres I-EXPLORATION -centímetros, I-EXPLORATION -móvil I-EXPLORATION -y I-EXPLORATION -doloroso. I-EXPLORATION -Afebril. I-EXPLORATION -No I-EXPLORATION -adenopatías I-EXPLORATION -inguinales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -eco-doppler I-EXPLORATION -peneano I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -clara I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -dorsal I-EXPLORATION -superficial I-EXPLORATION -del I-EXPLORATION -pene I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -colapsaba I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -del I-EXPLORATION -transductor. I-EXPLORATION -Estudio I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Juicio I-EXPLORATION -Diagnóstico: I-EXPLORATION -Enfermedad I-EXPLORATION -de I-EXPLORATION -Mondor. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -y I-TREATMENT -antiinflamatorios. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -18/9/07 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -sufre I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calle, I-PRESENT_ILLNESS -golpeándose I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -lumbar. I-PRESENT_ILLNESS -Acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -MAP I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -aumenta I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -flexo-extensión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -piernas; I-PRESENT_ILLNESS -se B-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT -analgésico I-TREATMENT -y I-TREATMENT -observación I-TREATMENT -domiciliaria. I-TREATMENT -Dos B-EVOLUTION -horas I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -avisan I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -domicilio I-EVOLUTION -por I-EVOLUTION -hematuria I-EVOLUTION -franca I-EVOLUTION -e I-EVOLUTION -intenso I-EVOLUTION -dolor I-EVOLUTION -abdominal; I-EVOLUTION -presenta B-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal, I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -110/70 I-EXPLORATION -y I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas; I-EXPLORATION -se B-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -traslado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Universitario I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Salamanca I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -llegada I-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -urgencias I-EXPLORATION -(en I-EXPLORATION -torno I-EXPLORATION -las I-EXPLORATION -23 I-EXPLORATION -horas) I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -marcada I-EXPLORATION -defensa I-EXPLORATION -abdominal, I-EXPLORATION -con I-EXPLORATION -tensiones I-EXPLORATION -de I-EXPLORATION -135/85, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -94 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -minuto I-EXPLORATION -y I-EXPLORATION -pulsos I-EXPLORATION -conservados; I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -interés. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -ECG I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -fibrilación I-EXPLORATION -auricular I-EXPLORATION -no I-EXPLORATION -conocida I-EXPLORATION -previamente. I-EXPLORATION -Presenta I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -12.8 I-EXPLORATION -g/dl I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -y I-EXPLORATION -69 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -como I-EXPLORATION -datos I-EXPLORATION -más I-EXPLORATION -destacables. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -urgente I-EXPLORATION -con I-EXPLORATION -contraste, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -informa I-EXPLORATION -como I-EXPLORATION -riñón I-EXPLORATION -en I-EXPLORATION -herradura I-EXPLORATION -con I-EXPLORATION -rotura I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -medial I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -gran I-EXPLORATION -hematoma I-EXPLORATION -retroperitoneal, I-EXPLORATION -con I-EXPLORATION -extravasación I-EXPLORATION -activa I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -próxima I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -fractura I-EXPLORATION -renal; I-EXPLORATION -no I-EXPLORATION -existe I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -otras I-EXPLORATION -estructuras. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -situación I-EXPLORATION -clínica I-EXPLORATION -del I-EXPLORATION -enfermo I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -laparotomía I-EXPLORATION -media I-EXPLORATION -exploradora, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -gran I-EXPLORATION -hemorretroperitoneo I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -raíz I-EXPLORATION -de I-EXPLORATION -mesenterio, I-EXPLORATION -consecuencia I-EXPLORATION -de I-EXPLORATION -rotura I-EXPLORATION -múltiple I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hemi-riñón I-EXPLORATION -izquierdo, I-EXPLORATION -llegando I-EXPLORATION -a I-EXPLORATION -comprometer I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -intrarrenal I-EXPLORATION -(grado I-EXPLORATION -IV I-EXPLORATION -según I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -lesión I-EXPLORATION -orgánica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -American I-EXPLORATION -Association I-EXPLORATION -for I-EXPLORATION -the I-EXPLORATION -Surgery I-EXPLORATION -of I-EXPLORATION -Trauma) I-EXPLORATION -(5); I-EXPLORATION -se B-TREATMENT -realiza I-TREATMENT -evacuación I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT -retroperitoneal I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -nefrectomía I-TREATMENT -del I-TREATMENT -hemi-riñón I-TREATMENT -izquierdo. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -permanece I-TREATMENT -estable, I-TREATMENT -precisando I-TREATMENT -la I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -estable I-EVOLUTION -hemodinámicamente, I-EVOLUTION -con I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -hemoglobina I-EVOLUTION -en I-EVOLUTION -torno I-EVOLUTION -a I-EVOLUTION -10 I-EVOLUTION -g/dl, I-EVOLUTION -ligera I-EVOLUTION -febrícula, I-EVOLUTION -continúa I-EVOLUTION -con I-EVOLUTION -cierta I-EVOLUTION -distensión I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -escaso I-EVOLUTION -peristaltismo. I-EVOLUTION -En B-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -realizado I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -23/9/07 I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -optando I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -vigilancia I-EXPLORATION -activa. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -trasplantado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -1986 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -glomerulonefritis I-PRESENT_ILLNESS -mesangiocapilar I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -II, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disfunción I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -injerto I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mismo, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -obliga I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -reanudar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -1996. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -realizado I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -descenso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -inmunosupresión I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -CsA I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -adición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Azathioprina, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -resultados. I-PRESENT_ILLNESS -Presenta I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -injerto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS -hemodinámica I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -refractaria I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -médico. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -urgente I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -hematoma I-EXPLORATION -subcapsular I-EXPLORATION -e I-EXPLORATION -intraparenquimatoso I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -injerto, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -mediante I-EXPLORATION -TC, I-EXPLORATION -realizándose B-TREATMENT -trasplantectomía I-TREATMENT -pocas I-TREATMENT -horas I-TREATMENT -después. I-TREATMENT -Durante B-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -lesión I-EXPLORATION -sólida I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -injerto, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -con I-EXPLORATION -evidentes I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -ruptura I-EXPLORATION -espontánea I-EXPLORATION -y I-EXPLORATION -sangrado. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -advierten I-EXPLORATION -otras I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -sólidas I-EXPLORATION -y I-EXPLORATION -quísticas I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -del I-EXPLORATION -injerto. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -anatomopatológico I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -CCR I-EXPLORATION -multicéntrico, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -seno I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -quística I-EXPLORATION -renal I-EXPLORATION -adquirida I-EXPLORATION -del I-EXPLORATION -injerto. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -reanudó I-EVOLUTION -la I-EVOLUTION -hemodiálisis I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -y I-EVOLUTION -asintomático I-EVOLUTION -tras I-EVOLUTION -12 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -litiásica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -centro I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -riñones. I-PAST_MEDICAL_HISTORY -Según I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -informaba I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado, I-PAST_MEDICAL_HISTORY -pielolitotomía I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practica I-PAST_MEDICAL_HISTORY -pielolitotomía I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -atendida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -(año I-PAST_MEDICAL_HISTORY -2005) I-PAST_MEDICAL_HISTORY -nueva I-PAST_MEDICAL_HISTORY -nefrolitotomía I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -litiasis I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -compleja. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -urinaria I-PRESENT_ILLNESS -complicada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pionefrosis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -septicemia, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -coloca I-PRESENT_ILLNESS -cateter I-PRESENT_ILLNESS -doble I-PRESENT_ILLNESS -J I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -queda I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -posicionado, I-PRESENT_ILLNESS -subpiélico, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -resuelve I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -séptico, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -preciso I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -nefrostomia I-PRESENT_ILLNESS -percutánea I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -drenaje I-PRESENT_ILLNESS -renal, I-PRESENT_ILLNESS -situación, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -remitida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -intravenosa I-EXPLORATION -que I-EXPLORATION -aporta I-EXPLORATION -la I-EXPLORATION -enferma, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -litiasis I-EXPLORATION -radiodensa I-EXPLORATION -infecciosa, I-EXPLORATION -pielolocalicial I-EXPLORATION -múltiple I-EXPLORATION -compleja, I-EXPLORATION -sobre I-EXPLORATION -riñón I-EXPLORATION -con I-EXPLORATION -hidronefrosis I-EXPLORATION -grado I-EXPLORATION -III-IV I-EXPLORATION -por I-EXPLORATION -importante I-EXPLORATION -esclerosis I-EXPLORATION -piélica I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -cirugías I-EXPLORATION -previas I-EXPLORATION -sobre I-EXPLORATION -dicha I-EXPLORATION -unidad I-EXPLORATION -renal. I-EXPLORATION -Presenta I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -relativamente I-EXPLORATION -conservada. I-EXPLORATION -Observamos I-EXPLORATION -asimismo, I-EXPLORATION -cambios I-EXPLORATION -postquirúrgicos I-EXPLORATION -con I-EXPLORATION -moderada I-EXPLORATION -atrofia I-EXPLORATION -parenquimatosa I-EXPLORATION -de I-EXPLORATION -unidad I-EXPLORATION -renal I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -reflejaba I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -urea I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -los I-TREATMENT -hallazgos I-TREATMENT -urográficos, I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -situación I-TREATMENT -del I-TREATMENT -riñón I-TREATMENT -contralateral I-TREATMENT -y I-TREATMENT -la I-TREATMENT -edad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -lumbotomía I-TREATMENT -exploradora I-TREATMENT -para I-TREATMENT -intentar I-TREATMENT -cirugía I-TREATMENT -conservadora, I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -nefrectomía I-TREATMENT -polar I-TREATMENT -inferior I-TREATMENT -con I-TREATMENT -nefrolitotomía I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -urinaria I-TREATMENT -superior I-TREATMENT -mediante I-TREATMENT -uréterocalicostomía. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -requiere I-EVOLUTION -la I-EVOLUTION -trasfusión I-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -concentrados I-EVOLUTION -de I-EVOLUTION -hematíes I-EVOLUTION -por I-EVOLUTION -anemia I-EVOLUTION -persistente. I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -mayores I-EVOLUTION -complicaciones I-EVOLUTION -dándose I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -séptimo I-EVOLUTION -día. I-EVOLUTION -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -cambios I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -pielonefritis I-EXPLORATION -crónica I-EXPLORATION -postlitiásica I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -cálculo I-EXPLORATION -reveló I-EXPLORATION -su I-EXPLORATION -composición I-EXPLORATION -de I-EXPLORATION -fosfato I-EXPLORATION -amónico I-EXPLORATION -magnésico. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -únicamente I-EVOLUTION -molestias I-EVOLUTION -leves I-EVOLUTION -en I-EVOLUTION -flanco I-EVOLUTION -izquierdo. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -urografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -refleja I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -litiasis I-EXPLORATION -con I-EXPLORATION -cierto I-EXPLORATION -retraso I-EXPLORATION -nefrográfico I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -vía I-EXPLORATION -excretora I-EXPLORATION -derecha I-EXPLORATION -sin I-EXPLORATION -cambios I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -previos. I-EXPLORATION -El I-EXPLORATION -renograma I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -30%, I-EXPLORATION -con I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -compensador, I-EXPLORATION -70%. I-EXPLORATION -Continúa B-EVOLUTION -con I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad, I-EVOLUTION -y I-EVOLUTION -solo I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -ITU I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -cedido I-EVOLUTION -con I-EVOLUTION -ciprofloxacino. I-EVOLUTION -Presencia B-EXPLORATION -de I-EXPLORATION -pequeños I-EXPLORATION -restos I-EXPLORATION -litiásicos I-EXPLORATION -bilaterales I-EXPLORATION -subclínicos I-EXPLORATION -según I-EXPLORATION -técnicas I-EXPLORATION -de I-EXPLORATION -imagen. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Hospital, I-PRESENT_ILLNESS -porque I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -introducción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -objeto I-PRESENT_ILLNESS -metálico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -genital I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prácticas I-PRESENT_ILLNESS -erótico-sexuales. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Clínicamente B-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -asintomática, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -genital I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -material I-EXPLORATION -alguno I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vagina. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -un I-EXPLORATION -objeto I-EXPLORATION -metálico I-EXPLORATION -que I-EXPLORATION -sobresalía I-EXPLORATION -del I-EXPLORATION -contorno I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vejiga I-EXPLORATION -urinaria. I-EXPLORATION -Se I-EXPLORATION -practica I-EXPLORATION -finalmente I-EXPLORATION -ecografia, I-EXPLORATION -seguida I-EXPLORATION -de I-EXPLORATION -TAC I-EXPLORATION -abdominal, I-EXPLORATION -en I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION -objeto I-EXPLORATION -metálico I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -alojado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -del I-EXPLORATION -uréter I-EXPLORATION -pelviano I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -procede I-TREATMENT -a I-TREATMENT -intervenir I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -cistoscopia I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT -objetivándose I-TREATMENT -cilindro I-TREATMENT -metálico I-TREATMENT -que I-TREATMENT -sobresale I-TREATMENT -del I-TREATMENT -interior I-TREATMENT -del I-TREATMENT -orificio I-TREATMENT -ureteral I-TREATMENT -derecho. I-TREATMENT - I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -imposibilidad I-TREATMENT -de I-TREATMENT -extraer I-TREATMENT -dicho I-TREATMENT -objeto I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endoscópica, I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -infraumbilical, I-TREATMENT -con I-TREATMENT -apertura I-TREATMENT -de I-TREATMENT -vejiga I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -cilindro I-TREATMENT -metálico I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -cm. I-TREATMENT -de I-TREATMENT -longitud, I-TREATMENT -que I-TREATMENT -correspondía I-TREATMENT -a I-TREATMENT -perfilador I-TREATMENT -de I-TREATMENT -ojos. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anexo I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -miomatosis I-PAST_MEDICAL_HISTORY -uterina, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -gastritis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -severo I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Debuta B-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -macrohematuria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -efectúa I-PRESENT_ILLNESS -diagnostico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -exofítica I-PRESENT_ILLNESS -vesical. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -sometida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -endoscópica I-PRESENT_ILLNESS -(RTUV). I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -corto I-PRESENT_ILLNESS -plazo I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -tumoral I-PRESENT_ILLNESS -requiriendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -RTUV. I-PRESENT_ILLNESS -Tras I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -material I-PRESENT_ILLNESS -remitido I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -informa I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -trabecular I-PRESENT_ILLNESS -anaplásico. I-PRESENT_ILLNESS -Concurre B-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -segunda I-DERIVED_FROM/TO -opinión I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -ser I-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -oncólogo I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -urólogo I-DERIVED_FROM/TO -tratante. I-DERIVED_FROM/TO -En B-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -sólida I-EXPLORATION -con I-EXPLORATION -vascularización I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -periférica I-EXPLORATION -de I-EXPLORATION -35 I-EXPLORATION -x I-EXPLORATION -28 I-EXPLORATION -x I-EXPLORATION -33 I-EXPLORATION -mm I-EXPLORATION -con I-EXPLORATION -otra I-EXPLORATION -imagen I-EXPLORATION -polipoidea I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -postero I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -9 I-EXPLORATION -mm. I-EXPLORATION -En I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -severa I-EXPLORATION -atrofia I-EXPLORATION -renal I-EXPLORATION -derecha. I-EXPLORATION -Ausencia I-EXPLORATION -de I-EXPLORATION -adenomegalias. I-EXPLORATION -Vejiga I-EXPLORATION -con I-EXPLORATION -pólipo I-EXPLORATION -de I-EXPLORATION -38 I-EXPLORATION -x I-EXPLORATION -35 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION -sólido I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -superficie I-EXPLORATION -irregular. I-EXPLORATION -Otra I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -posterolateral I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -mm. I-EXPLORATION -El I-EXPLORATION -centellograma I-EXPLORATION -óseo I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -indica I-TREATMENT -cistectomía I-TREATMENT -radical I-TREATMENT -con I-TREATMENT -linfadenectomía I-TREATMENT -pelviana I-TREATMENT -bilateral I-TREATMENT -laparoscópica I-TREATMENT -y I-TREATMENT -ureterostomía I-TREATMENT -cutánea I-TREATMENT -izquierda. I-TREATMENT -La I-TREATMENT -técnica I-TREATMENT -empleada I-TREATMENT -fue I-TREATMENT -la I-TREATMENT -desarrollada I-TREATMENT -por I-TREATMENT -Castillo I-TREATMENT -et I-TREATMENT -al. I-TREATMENT -(4). I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -prepucial I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -peneano I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -niega I-PRESENT_ILLNESS -relaciones I-PRESENT_ILLNESS -sexuales I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -riesgo, I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional, I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pene I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cordón I-PRESENT_ILLNESS -indurado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -palpable I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dicha I-PRESENT_ILLNESS -región, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acentúa I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -erección. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cigarrillos/ I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -base I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -habitual; I-PAST_MEDICAL_HISTORY -en B-FAMILY_HISTORY -su I-FAMILY_HISTORY -historia I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -tampoco I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encontraron I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Durante B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -inflamación I-EXPLORATION -prepucial I-EXPLORATION -intensa I-EXPLORATION -con I-EXPLORATION -erosiones I-EXPLORATION -blanquecinas I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -candidiasis. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -peneano I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -un I-EXPLORATION -cordón I-EXPLORATION -duro I-EXPLORATION -y I-EXPLORATION -doloroso I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -surco I-EXPLORATION -balanoprepucial, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -inflamación I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -adyacente. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Mondor I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -doppler I-EXPLORATION -peneana I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -instaurado I-TREATMENT -fue I-TREATMENT -Fluconazol I-TREATMENT -tópico I-TREATMENT -1 I-TREATMENT -aplicación I-TREATMENT -/12h, I-TREATMENT -Amoxicilina- I-TREATMENT -Clavulanico I-TREATMENT -875 I-TREATMENT -mg/8h I-TREATMENT -e I-TREATMENT -Ibuprofeno I-TREATMENT -600 I-TREATMENT -mg/8h I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días, I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -reposo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -actividad I-TREATMENT -sexual I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -del I-TREATMENT -cuadro. I-TREATMENT - I-TREATMENT -Durante B-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -semana, I-EVOLUTION -se I-EVOLUTION -objetiva I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -progresiva I-EVOLUTION -del I-EVOLUTION -cordón I-EVOLUTION -dorsal I-EVOLUTION -en I-EVOLUTION -sentido I-EVOLUTION -distal I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -dolor. I-EVOLUTION -Las I-EVOLUTION -lesiones I-EVOLUTION -relacionadas I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -candidiasis I-EVOLUTION -han I-EVOLUTION -desaparecido. I-EVOLUTION -En B-EXPLORATION -este I-EXPLORATION -momento I-EXPLORATION -se I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -una I-EXPLORATION -fimosis I-EXPLORATION -puntiforme I-EXPLORATION -que I-EXPLORATION -impide I-EXPLORATION -la I-EXPLORATION -retracción I-EXPLORATION -prepucial, I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -precisará I-EXPLORATION -ser I-EXPLORATION -circuncidado. I-EXPLORATION -A I-EXPLORATION -las I-EXPLORATION -6 I-EXPLORATION -semanas I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -doppler I-EXPLORATION -peneana I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -la I-EXPLORATION -repermeabilización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -dorsal I-EXPLORATION -superficial I-EXPLORATION -del I-EXPLORATION -pene I-EXPLORATION -en I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -trombo I-EXPLORATION -venoso, I-EXPLORATION -dando I-EXPLORATION -por I-EXPLORATION -resuelto I-EXPLORATION -el I-EXPLORATION -cuadro. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -revisaron I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -historias I-PRESENT_ILLNESS -clínicas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -todos I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -pacientes I-PRESENT_ILLNESS -intervenidos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -les I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -RTU I-PRESENT_ILLNESS -vesical I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -1990-2009 I-PRESENT_ILLNESS -descartando I-PRESENT_ILLNESS -aquellos I-PRESENT_ILLNESS -tumores I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cumplían I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -criterios I-PRESENT_ILLNESS -histológicos, I-PRESENT_ILLNESS -excluyendo I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -adenocarcinomas I-PRESENT_ILLNESS -metastáticos I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -infiltración I-PRESENT_ILLNESS -local I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vejiga. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Encontramos B-EXPLORATION -nueve I-EXPLORATION -casos I-EXPLORATION -con I-EXPLORATION -carcinoma I-EXPLORATION -vesical I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION -de I-EXPLORATION -sello I-EXPLORATION -diagnosticados I-EXPLORATION -y I-EXPLORATION -tratados I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -servicio I-EXPLORATION -entre I-EXPLORATION -Enero I-EXPLORATION -de I-EXPLORATION -1992 I-EXPLORATION -y I-EXPLORATION -Enero I-EXPLORATION -de I-EXPLORATION -2009; I-EXPLORATION -ocho I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -eran I-EXPLORATION -varones I-EXPLORATION -y I-EXPLORATION -sólo I-EXPLORATION -había I-EXPLORATION -una I-EXPLORATION -mujer, I-EXPLORATION -con I-EXPLORATION -de I-EXPLORATION -edades I-EXPLORATION -comprendidas I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -39 I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -82 I-EXPLORATION -años, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -69 I-EXPLORATION -años. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -debut I-EXPLORATION -clínico I-EXPLORATION -fue I-EXPLORATION -la I-EXPLORATION -hematuria I-EXPLORATION -en I-EXPLORATION -seis I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -y I-EXPLORATION -clínica I-EXPLORATION -irritativa I-EXPLORATION -con I-EXPLORATION -polaquiuria I-EXPLORATION -y I-EXPLORATION -disuria I-EXPLORATION -importante I-EXPLORATION -en I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -ellos. I-EXPLORATION -Uno I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -pacientes I-EXPLORATION -presentaba I-EXPLORATION -importante I-EXPLORATION -síndrome I-EXPLORATION -general I-EXPLORATION -con I-EXPLORATION -caquexia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -diagnóstico. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -citológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -orina I-EXPLORATION -mostró I-EXPLORATION -células I-EXPLORATION -malignas I-EXPLORATION -en I-EXPLORATION -tres I-EXPLORATION -pacientes, I-EXPLORATION -atipias I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION -y I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -restantes. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -mostró I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -vesical I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -casos, I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -del I-EXPLORATION -pericistio I-EXPLORATION -y I-EXPLORATION -adenopatías I-EXPLORATION -múltiples I-EXPLORATION -retroperitoneales I-EXPLORATION -en I-EXPLORATION -cuatro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -y I-EXPLORATION -uropatía I-EXPLORATION -obstructiva I-EXPLORATION -uni I-EXPLORATION -o I-EXPLORATION -bilateral I-EXPLORATION -en I-EXPLORATION -cuatro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -casos. I-EXPLORATION - I-EXPLORATION -Dos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -presentaron I-EXPLORATION -alteración I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -gastroduodenal I-EXPLORATION -siendo I-EXPLORATION -completado I-EXPLORATION -con I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -y I-EXPLORATION -baja I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -antral I-EXPLORATION -con I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -metaplasia I-EXPLORATION -intestinal I-EXPLORATION -en I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -sujetos I-EXPLORATION -y I-EXPLORATION -pólipo I-EXPLORATION -adenomatoso I-EXPLORATION -de I-EXPLORATION -sigma I-EXPLORATION -en I-EXPLORATION -otro. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -histológicos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -masas I-EXPLORATION -resecadas I-EXPLORATION -con I-EXPLORATION -inclusión I-EXPLORATION -en I-EXPLORATION -parafina, I-EXPLORATION -colorante I-EXPLORATION -Hematoxilina/Eosina I-EXPLORATION -y I-EXPLORATION -tinción I-EXPLORATION -PAS. I-EXPLORATION -En I-EXPLORATION -algunos I-EXPLORATION -casos I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -inmunohistoquimicos I-EXPLORATION -(PSA, I-EXPLORATION -E-caderina, I-EXPLORATION -citoqueratina I-EXPLORATION -20, I-EXPLORATION -S100) I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -origen I-EXPLORATION -extravesical I-EXPLORATION -(1). I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -encontramos I-EXPLORATION -cuatro I-EXPLORATION -casos I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -vesical I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION -de I-EXPLORATION -sello I-EXPLORATION -primario I-EXPLORATION -puros I-EXPLORATION -y I-EXPLORATION -cinco I-EXPLORATION -mixtos I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION -de I-EXPLORATION -sello I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -seno I-EXPLORATION -de I-EXPLORATION -carcinomas I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -transicionales. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -tumores I-EXPLORATION -mostró I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -citoplasma I-EXPLORATION -amplio I-EXPLORATION -eosinófilo I-EXPLORATION -con I-EXPLORATION -vacuola I-EXPLORATION -central I-EXPLORATION -PAS I-EXPLORATION -positiva I-EXPLORATION -y I-EXPLORATION -desplazamiento I-EXPLORATION -del I-EXPLORATION -núcleo I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -periferia I-EXPLORATION -(morfología I-EXPLORATION -típica I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION -de I-EXPLORATION -sello). I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -definitivo I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -cistectomía I-TREATMENT -radical I-TREATMENT -con I-TREATMENT -derivación I-TREATMENT -tipo I-TREATMENT -Bricker I-TREATMENT -en I-TREATMENT -tres I-TREATMENT -de I-TREATMENT -los I-TREATMENT -pacientes, I-TREATMENT -cistectomía I-TREATMENT -con I-TREATMENT -derivación I-TREATMENT -Mainz I-TREATMENT -II I-TREATMENT -en I-TREATMENT -otro I-TREATMENT -de I-TREATMENT -ellos I-TREATMENT -y I-TREATMENT -paliativo I-TREATMENT -en I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -restantes I-TREATMENT -con I-TREATMENT -RTU I-TREATMENT -en I-TREATMENT -tres I-TREATMENT -casos I-TREATMENT -y I-TREATMENT -NPC I-TREATMENT -paliativas I-TREATMENT -en I-TREATMENT -otro. I-TREATMENT - I-TREATMENT -Recibieron I-TREATMENT -quimioterapia I-TREATMENT -adyuvante I-TREATMENT -tres I-TREATMENT -pacientes I-TREATMENT -consistentes I-TREATMENT -en I-TREATMENT -MVAC. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -supervivencia I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -570, I-EVOLUTION -480, I-EVOLUTION -250 I-EVOLUTION -y I-EVOLUTION -8 I-EVOLUTION -días I-EVOLUTION -para I-EVOLUTION -los I-EVOLUTION -tumores I-EVOLUTION -puros I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -512, I-EVOLUTION -410, I-EVOLUTION -280, I-EVOLUTION -270 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -mayor I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -años I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -caso, I-EVOLUTION -para I-EVOLUTION -los I-EVOLUTION -tumores I-EVOLUTION -mixtos. I-EVOLUTION -Todos I-EVOLUTION -los I-EVOLUTION -pacientes, I-EVOLUTION -excepto I-EVOLUTION -dos I-EVOLUTION -habían I-EVOLUTION -fallecido I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -realizarse I-EVOLUTION -este I-EVOLUTION -estudio. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -literatura I-EVOLUTION -revisada I-EVOLUTION -la I-EVOLUTION -supervivencia I-EVOLUTION -global I-EVOLUTION -no I-EVOLUTION -supera I-EVOLUTION -el I-EVOLUTION -11% I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -(2,3). I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -cervical. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -bocio I-EXPLORATION -difuso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -y I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -revelaron I-EXPLORATION -hormonas I-EXPLORATION -tiroideas I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -anti-tiroglobulina I-EXPLORATION -(AAT) I-EXPLORATION -positivos. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -tiroidea I-EXPLORATION -reveló I-EXPLORATION -tres I-EXPLORATION -nódulos I-EXPLORATION -tiroideos, I-EXPLORATION -el I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -mm I-EXPLORATION -con I-EXPLORATION -microcalcificaciones I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -punción-biopsia I-EXPLORATION -bajo I-EXPLORATION -ecografía, I-EXPLORATION -demostrándose I-EXPLORATION -cáncer I-EXPLORATION -papilar I-EXPLORATION -del I-EXPLORATION -tiroides. I-EXPLORATION -Se B-TREATMENT -sometió I-TREATMENT -a I-TREATMENT -tiroidectomía I-TREATMENT -total, I-TREATMENT -resultando I-TREATMENT -un I-TREATMENT -foco I-TREATMENT -de I-TREATMENT -cáncer I-TREATMENT -papilar I-TREATMENT -de I-TREATMENT -6x5x5 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -metástasis I-TREATMENT -paratraqueales I-TREATMENT -bilaterales. I-TREATMENT -Recibió I-TREATMENT -200 I-TREATMENT -mCi I-TREATMENT -de I-TREATMENT -radioyodo I-TREATMENT -con I-TREATMENT -rastreo I-TREATMENT -sistémico I-TREATMENT -post-dosis I-TREATMENT -terapéutica I-TREATMENT -negativo. I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -con I-TREATMENT -dosis I-TREATMENT -supresiva I-TREATMENT -de I-TREATMENT -levotiroxina I-TREATMENT -(Eutirox®). I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -rastreo I-EVOLUTION -sistémico I-EVOLUTION -con I-EVOLUTION -dosis I-EVOLUTION -trazadora I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -mCi, I-EVOLUTION -resultando I-EVOLUTION -negativo, I-EVOLUTION -la I-EVOLUTION -tiroglobulina I-EVOLUTION -no I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -utilidad I-EVOLUTION -dado I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -anticuerpos I-EVOLUTION -AAT: I-EVOLUTION -164 I-EVOLUTION -ng/mL. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -por I-EVOLUTION -ecografía I-EVOLUTION -cervical, I-EVOLUTION -se I-EVOLUTION -detectó I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -nódulo I-EVOLUTION -de I-EVOLUTION -9, I-EVOLUTION -6 I-EVOLUTION -mm, I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -no I-EVOLUTION -fue I-EVOLUTION -técnicamente I-EVOLUTION -posible I-EVOLUTION -de I-EVOLUTION -puncionar, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -asoció I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -títulos I-EVOLUTION -de I-EVOLUTION -AAT I-EVOLUTION -174 I-EVOLUTION -ng/mL. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -dar I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -dosis I-TREATMENT -terapéutica I-TREATMENT -de I-TREATMENT -200 I-TREATMENT -mCi I-TREATMENT -con I-TREATMENT -rastreo I-TREATMENT -que I-TREATMENT -mostró I-TREATMENT -captación I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -cervical. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -al I-EXPLORATION -año I-EXPLORATION -post I-EXPLORATION -segunda I-EXPLORATION -dosis I-EXPLORATION -de I-EXPLORATION -radioyodo, I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -supraesternal I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -ganglios I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -cada I-EXPLORATION -uno, I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -cervical I-EXPLORATION -izquierda, I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -neoplasia, I-EXPLORATION -contralaterales I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -primaria, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -ascenso I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -AAT I-EXPLORATION -a I-EXPLORATION -217 I-EXPLORATION -ng/mL. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -exploración I-TREATMENT -quirúrgica, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -disección I-TREATMENT -selectiva I-TREATMENT -de I-TREATMENT -cuello I-TREATMENT -bilateral I-TREATMENT -de I-TREATMENT -los I-TREATMENT -niveles I-TREATMENT -II, I-TREATMENT -III, I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -Vb I-TREATMENT -y I-TREATMENT -una I-TREATMENT -disección I-TREATMENT -del I-TREATMENT -nivel I-TREATMENT -VI I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -pretraqueal. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -compromiso I-EXPLORATION -neoplásico I-EXPLORATION -ganglionar I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -IV I-EXPLORATION -y I-EXPLORATION -Vb I-EXPLORATION -derechos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -IIb, I-EXPLORATION -III, I-EXPLORATION -IV, I-EXPLORATION -Vb I-EXPLORATION -y I-EXPLORATION -VI I-EXPLORATION -izquierdo. I-EXPLORATION -Recibió B-TREATMENT -300 I-TREATMENT -mCi I-TREATMENT -de I-TREATMENT -radioyodo I-TREATMENT -con I-TREATMENT -rastreo I-TREATMENT -post-dosis I-TREATMENT -negativo I-TREATMENT -y I-TREATMENT -los I-TREATMENT -AAT I-TREATMENT -se I-TREATMENT -hicieron I-TREATMENT -negativos I-TREATMENT -con I-TREATMENT -una I-TREATMENT -tiroglobulina I-TREATMENT -(TG) I-TREATMENT -menor I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -ng/mL, I-TREATMENT -con I-TREATMENT -85% I-TREATMENT -de I-TREATMENT -recuperación. I-TREATMENT - I-TREATMENT -A B-FAMILY_HISTORY -solicitud I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -realizó I-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -tiroideo I-FAMILY_HISTORY -a I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -y I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -quienes I-FAMILY_HISTORY -no I-FAMILY_HISTORY -presentaban I-FAMILY_HISTORY -evidencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -enfermedad. I-FAMILY_HISTORY -La I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -ecografía I-FAMILY_HISTORY -tiroidea I-FAMILY_HISTORY -un I-FAMILY_HISTORY -nódulo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -7 I-FAMILY_HISTORY -mm, I-FAMILY_HISTORY -el I-FAMILY_HISTORY -cual I-FAMILY_HISTORY -resultó I-FAMILY_HISTORY -ser I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -papilar, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -compromiso I-FAMILY_HISTORY -capsular I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -ganglionar. I-FAMILY_HISTORY -El I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -2 I-FAMILY_HISTORY -nódulos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -8 I-FAMILY_HISTORY -y I-FAMILY_HISTORY -5 I-FAMILY_HISTORY -mm I-FAMILY_HISTORY -cuyo I-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -con I-FAMILY_HISTORY -biopsia I-FAMILY_HISTORY -fue I-FAMILY_HISTORY -negativo I-FAMILY_HISTORY -para I-FAMILY_HISTORY -células I-FAMILY_HISTORY -neoplásicas I-FAMILY_HISTORY -y I-FAMILY_HISTORY -la I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -signos I-FAMILY_HISTORY -ecográficos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tiroiditis I-FAMILY_HISTORY -crónica I-FAMILY_HISTORY -con I-FAMILY_HISTORY -AAT I-FAMILY_HISTORY -positivos. I-FAMILY_HISTORY - I-FAMILY_HISTORY - -Paciente B-PRESENT_ILLNESS -diestro, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -disartria I-PRESENT_ILLNESS -severa, I-PRESENT_ILLNESS -desviación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -hemiplejia I-PRESENT_ILLNESS -facio-braquio-crural, I-PRESENT_ILLNESS -hemianestesia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hemianopsia I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -El B-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -examen I-EXPLORATION -no I-EXPLORATION -evidenciaba I-EXPLORATION -otras I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -precoces I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -IMACM I-EXPLORATION -derecho. I-EXPLORATION -Se B-TREATMENT -discutió I-TREATMENT -con I-TREATMENT -la I-TREATMENT -familia I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -una I-TREATMENT -progresión I-TREATMENT -a I-TREATMENT -un I-TREATMENT -IMACM I-TREATMENT -y I-TREATMENT -la I-TREATMENT -eventual I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -una I-TREATMENT -HD. I-TREATMENT -La I-TREATMENT -familia I-TREATMENT -comprendió I-TREATMENT -y I-TREATMENT -aceptó I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT - I-TREATMENT -Su B-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -A I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -h, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -en I-EXPLORATION -sopor I-EXPLORATION -superficial I-EXPLORATION -sin I-EXPLORATION -midriasis I-EXPLORATION -ni I-EXPLORATION -aparición I-EXPLORATION -de I-EXPLORATION -Babinski I-EXPLORATION -a I-EXPLORATION -derecha. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TC. I-EXPLORATION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -progresión I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -TC, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -la I-TREATMENT -HD, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -recuperó I-EVOLUTION -conciencia I-EVOLUTION -antes I-EVOLUTION -de I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -extubado I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h. I-EVOLUTION -No I-EVOLUTION -presentó I-EVOLUTION -complicaciones. I-EVOLUTION -Recuperó I-EVOLUTION -la I-EVOLUTION -movilidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -pierna I-EVOLUTION -izquierda, I-EVOLUTION -logró I-EVOLUTION -deglución I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -22 I-EVOLUTION -días. I-EVOLUTION -Desde B-TREATMENT -el I-TREATMENT -séptimo I-TREATMENT -día I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -aspirina I-TREATMENT -(325 I-TREATMENT -mg/día). I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -en I-TREATMENT -neurorrehabilitación I-TREATMENT -en I-TREATMENT -su I-TREATMENT -domicilio, I-TREATMENT -logrando B-EVOLUTION -marcha I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION -Al B-TREATMENT -cuarto I-TREATMENT -mes I-TREATMENT -se I-TREATMENT -instaló I-TREATMENT -la I-TREATMENT -plaqueta I-TREATMENT -ósea, I-TREATMENT -siendo B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -quinto I-EVOLUTION -día. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -crisis I-EVOLUTION -convulsiva, I-EVOLUTION -se B-TREATMENT -inició I-TREATMENT -fenitoína I-TREATMENT -(300 I-TREATMENT -mg/día). I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -realiza I-EVOLUTION -una I-EVOLUTION -vida I-EVOLUTION -independiente I-EVOLUTION -pero I-EVOLUTION -limitada I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -casa: I-EVOLUTION -camina I-EVOLUTION -ayudado I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -bastón, I-EVOLUTION -come I-EVOLUTION -solo, I-EVOLUTION -se I-EVOLUTION -viste I-EVOLUTION -y I-EVOLUTION -va I-EVOLUTION -al I-EVOLUTION -baño I-EVOLUTION -ayudado I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -señora I-EVOLUTION -(escala I-EVOLUTION -modificada I-EVOLUTION -de I-EVOLUTION -Rankin= I-EVOLUTION -3). I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -preguntarle I-EVOLUTION -a I-EVOLUTION -ambos I-EVOLUTION -pacientes I-EVOLUTION -y I-EVOLUTION -sus I-EVOLUTION -familias, I-EVOLUTION -individualmente, I-EVOLUTION -si I-EVOLUTION -volverían I-EVOLUTION -a I-EVOLUTION -realizar I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -sufrido I-EVOLUTION -la I-EVOLUTION -experiencia, I-EVOLUTION -respondieron I-EVOLUTION -afirmativamente. I-EVOLUTION - I-EVOLUTION - -Hombre, B-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -cardiovasculares. I-PAST_MEDICAL_HISTORY -Mientras B-PRESENT_ILLNESS -jugaba I-PRESENT_ILLNESS -fútbol, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -palpitaciones I-PRESENT_ILLNESS -rápidas, I-PRESENT_ILLNESS -regulares, I-PRESENT_ILLNESS -asociadas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -opresivo, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedieron I-PRESENT_ILLNESS -espontáneamente I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -min. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -ciudad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -hospitalizado I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -monitorización. I-PRESENT_ILLNESS -Su B-EXPLORATION -ECG I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -mostró I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -preexcitación I-EXPLORATION -ventricular, I-EXPLORATION -con I-EXPLORATION -intervalo I-EXPLORATION -PR I-EXPLORATION -corto, I-EXPLORATION -onda I-EXPLORATION -delta I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION -precordiales I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -inferior, I-EXPLORATION -con I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -repolarización I-EXPLORATION -ventricular, I-EXPLORATION -caracterizadas I-EXPLORATION -por I-EXPLORATION -supradesnivel I-EXPLORATION -ST I-EXPLORATION -en I-EXPLORATION -V2 I-EXPLORATION -y I-EXPLORATION -V3. I-EXPLORATION -Se I-EXPLORATION -controlaron I-EXPLORATION -enzimas I-EXPLORATION -cardíacas I-EXPLORATION -seriadas. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -éstas, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -coronariografía I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Fue B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -EEF I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -mostró I-DERIVED_FROM/TO -HPE I-DERIVED_FROM/TO -lateral I-DERIVED_FROM/TO -izquierdo, I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -cual I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -exitosamente I-DERIVED_FROM/TO -fulgurado. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Mujer, B-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tetralogía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Fallot, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -correctora I-PAST_MEDICAL_HISTORY -definitiva I-PAST_MEDICAL_HISTORY -consistente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cierre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -comunicación I-PAST_MEDICAL_HISTORY -interventricular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ampliación I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -TSVD I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -anillo I-PAST_MEDICAL_HISTORY -valvular I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -parche I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pericardio, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -TVS I-PAST_MEDICAL_HISTORY -recurrentes, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amiodarona, I-PAST_MEDICAL_HISTORY -requiriendo I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -hospitalizaciones I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antiarrítmicos I-PAST_MEDICAL_HISTORY -intravenosos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -cardioversión I-PAST_MEDICAL_HISTORY -eléctrica. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -ecocardiográfico I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -moderado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -función I-PAST_MEDICAL_HISTORY -sistólica I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ventrículo I-PAST_MEDICAL_HISTORY -derecho, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -libre I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -progresiva I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -TSVD, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -llegó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -constituir I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -verdadero I-PAST_MEDICAL_HISTORY -aneurisma, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nueva I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -implantó I-PAST_MEDICAL_HISTORY -homoinjerto I-PAST_MEDICAL_HISTORY -valvulado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -arteria I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -resecó I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -aneurisma I-PAST_MEDICAL_HISTORY -ventricular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -esta I-PAST_MEDICAL_HISTORY -última I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -mantuvo I-PAST_MEDICAL_HISTORY -asintomática, I-PAST_MEDICAL_HISTORY -libre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -arritmias, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -capacidad I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -I. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -mantuvo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amiodarona I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -suspendió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -23 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -embarazo. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -palpitaciones I-PRESENT_ILLNESS -rápidas, I-PRESENT_ILLNESS -sostenidas. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -documentó I-PRESENT_ILLNESS -taquicardia I-PRESENT_ILLNESS -ventricular I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -150 I-PRESENT_ILLNESS -latidos I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -minuto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -imagen I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bloqueo I-PRESENT_ILLNESS -completo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -rama I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -eje I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -hemodinámico. I-PRESENT_ILLNESS -Se B-TREATMENT -hospitalizó I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona I-TREATMENT -intravenosa, I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -permaneció I-TREATMENT -con I-TREATMENT -taquicardia, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -después I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -cardioversión I-TREATMENT -eléctrica. I-TREATMENT -Su B-EXPLORATION -electrocardiograma I-EXPLORATION -en I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -mostró I-EXPLORATION -conducción I-EXPLORATION -aurículo-ventricular I-EXPLORATION -con I-EXPLORATION -PR I-EXPLORATION -de I-EXPLORATION -200 I-EXPLORATION -ms I-EXPLORATION -y I-EXPLORATION -complejos I-EXPLORATION -QRS I-EXPLORATION -ancho I-EXPLORATION -con I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -bloqueo I-EXPLORATION -completo I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -240 I-EXPLORATION -ms I-EXPLORATION -de I-EXPLORATION -duración. I-EXPLORATION -Estando B-TREATMENT -hospitalizada I-TREATMENT -presentó I-TREATMENT -recurrencia I-TREATMENT -de I-TREATMENT -TVS, I-TREATMENT -apareciendo I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -morfología, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -intentar I-TREATMENT -tratamiento I-TREATMENT -mediante I-TREATMENT -fulguración I-TREATMENT -con I-TREATMENT -radiofrecuencia. I-TREATMENT -Bajo B-EXPLORATION -sedación I-EXPLORATION -con I-EXPLORATION -midazolam I-EXPLORATION -y I-EXPLORATION -fentanyl, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -electrofisiológico. I-EXPLORATION -Por I-EXPLORATION -vía I-EXPLORATION -venosa I-EXPLORATION -femoral I-EXPLORATION -derecha I-EXPLORATION -se I-EXPLORATION -avanzaron I-EXPLORATION -tres I-EXPLORATION -catéteres I-EXPLORATION -cuadripolares I-EXPLORATION -(Daig®, I-EXPLORATION -St. I-EXPLORATION -Jude I-EXPLORATION -Medical I-EXPLORATION -Inc) I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -ubicaron I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -alta I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -derecha, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -His I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ápex I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -derecho, I-EXPLORATION -para I-EXPLORATION -registrar I-EXPLORATION -potenciales I-EXPLORATION -endocavitarios I-EXPLORATION -y I-EXPLORATION -realizar I-EXPLORATION -estimulación. I-EXPLORATION -Con I-EXPLORATION -estimulación I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -ápex I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -ciclo I-EXPLORATION -basal I-EXPLORATION -de I-EXPLORATION -550 I-EXPLORATION -ms I-EXPLORATION -e I-EXPLORATION -introduciendo I-EXPLORATION -dos I-EXPLORATION -extraestímulos I-EXPLORATION -se I-EXPLORATION -indujo I-EXPLORATION -fácilmente I-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -morfologías I-EXPLORATION -de I-EXPLORATION -taquicardia. I-EXPLORATION -Mediante I-EXPLORATION -mapeo I-EXPLORATION -durante I-EXPLORATION -estimulación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -TSVD, I-EXPLORATION -con I-EXPLORATION -catéter I-EXPLORATION -de I-EXPLORATION -fulguración I-EXPLORATION -EPT I-EXPLORATION -curva I-EXPLORATION -estándar I-EXPLORATION -y I-EXPLORATION -punta I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -mm I-EXPLORATION -(Boston I-EXPLORATION -Scientific® I-EXPLORATION -Corporation) I-EXPLORATION -se I-EXPLORATION -reprodujo I-EXPLORATION -la I-EXPLORATION -morfología I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -taquicardias, I-EXPLORATION -con I-EXPLORATION -concordancia I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -12 I-EXPLORATION -derivaciones I-EXPLORATION -del I-EXPLORATION -electrocardiograma. I-EXPLORATION -Además B-TREATMENT -se I-TREATMENT -aplicó I-TREATMENT -radiofrecuencia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -región I-TREATMENT -del I-TREATMENT -infundíbulo, I-TREATMENT -identificando I-TREATMENT -zonas I-TREATMENT -de I-TREATMENT -electrogramas I-TREATMENT -fragmentados I-TREATMENT -y I-TREATMENT -potenciales I-TREATMENT -mediodiastólicos I-TREATMENT -durante I-TREATMENT -taquicardia. I-TREATMENT -Se I-TREATMENT -completó I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -46 I-TREATMENT -pulsos I-TREATMENT -de I-TREATMENT -radiofrecuencia. I-TREATMENT -Post-radiofrecuencia I-TREATMENT -se I-TREATMENT -repitió I-TREATMENT -la I-TREATMENT -estimulación I-TREATMENT -ventricular, I-TREATMENT -introduciendo I-TREATMENT -hasta I-TREATMENT -tres I-TREATMENT -extraestímulos, I-TREATMENT -sin I-TREATMENT -lograr I-TREATMENT -reinducir I-TREATMENT -TVS I-TREATMENT -aun I-TREATMENT -bajo I-TREATMENT -efecto I-TREATMENT -de I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -isoproterenol I-TREATMENT -endovenoso. I-TREATMENT - I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -dada I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -con I-TREATMENT -amiodarona I-TREATMENT -100 I-TREATMENT -mg/día. I-TREATMENT -Después B-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -suspendió I-EVOLUTION -el I-EVOLUTION -antiarrítmico I-EVOLUTION -por I-EVOLUTION -nuevo I-EVOLUTION -embarazo. I-EVOLUTION -A I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -monitorización I-EVOLUTION -con I-EVOLUTION -electrocardiograma I-EVOLUTION -de I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -muestra I-EVOLUTION -sólo I-EVOLUTION -extrasistolia I-EVOLUTION -ventricular I-EVOLUTION -aislada I-EVOLUTION -ocasional I-EVOLUTION -de I-EVOLUTION -morfología I-EVOLUTION -diferente I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -taquicardias I-EVOLUTION -ventriculares I-EVOLUTION -tratadas. I-EVOLUTION - I-EVOLUTION - -Historia B-PRESENT_ILLNESS -actual: I-PRESENT_ILLNESS -mujer, I-PRESENT_ILLNESS -84 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mantenía I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -buenas I-PRESENT_ILLNESS -condiciones I-PRESENT_ILLNESS -generales, I-PRESENT_ILLNESS -autovalente I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -actividades I-PRESENT_ILLNESS -habituales. I-PRESENT_ILLNESS -Ingresó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -31/12/04 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -través I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -decaimiento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -inespecífico. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -semilíquidas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -leve. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -observada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hijo I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -comprometida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -falta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -reactividad I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -órdenes I-PRESENT_ILLNESS -verbales, I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -fija, I-PRESENT_ILLNESS -midriasis I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipoventilación I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -evoluciona I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apnea, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -sometida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -reanimación I-PRESENT_ILLNESS -básica, I-PRESENT_ILLNESS -recuperando I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ventilación I-PRESENT_ILLNESS -espontánea. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -mórbidos: I-PAST_MEDICAL_HISTORY -angina I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pecho I-PAST_MEDICAL_HISTORY -estable I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -cerebrovascular I-PAST_MEDICAL_HISTORY -cerebeloso I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -secuelas, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -Linfoma I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -recidiva I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA) I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -difícil I-PAST_MEDICAL_HISTORY -manejo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -mitral I-PAST_MEDICAL_HISTORY -severa, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -disnea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -medianos I-PAST_MEDICAL_HISTORY -esfuerzos. I-PAST_MEDICAL_HISTORY -Terapia I-PAST_MEDICAL_HISTORY -habitual: I-PAST_MEDICAL_HISTORY -carvedilol I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -losartan I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -espironolactona I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -hidroclorotiazida I-PAST_MEDICAL_HISTORY -12, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -amlodipino I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY -Mantenía I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -laboratorio I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -periódica. I-PAST_MEDICAL_HISTORY -De I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -exámenes I-PAST_MEDICAL_HISTORY -previos, I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -basal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -mg/dl, I-PAST_MEDICAL_HISTORY -clearence I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -35-40 I-PAST_MEDICAL_HISTORY -ml/min I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -electrocardiograma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ritmo I-PAST_MEDICAL_HISTORY -sinusal. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Examen B-EXPLORATION -físico: I-EXPLORATION -soporosa, I-EXPLORATION -sin I-EXPLORATION -déficit I-EXPLORATION -neurológico I-EXPLORATION -focal, I-EXPLORATION -presión I-EXPLORATION -arterial: I-EXPLORATION -146/76 I-EXPLORATION -mmHg, I-EXPLORATION -pulso I-EXPLORATION -30 I-EXPLORATION -a I-EXPLORATION -40 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -Sa02 I-EXPLORATION ->95%. I-EXPLORATION -Pulso I-EXPLORATION -venoso I-EXPLORATION -yugular I-EXPLORATION -normal. I-EXPLORATION -Examen I-EXPLORATION -cardíaco: I-EXPLORATION -ruidos I-EXPLORATION -regulares, I-EXPLORATION -soplo I-EXPLORATION -holosistólico I-EXPLORATION -intensidad I-EXPLORATION -III/VI I-EXPLORATION -en I-EXPLORATION -foco I-EXPLORATION -mitral. I-EXPLORATION -Sin I-EXPLORATION -signos I-EXPLORATION -congestivos I-EXPLORATION -pulmonares, I-EXPLORATION -sin I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -extremidades. I-EXPLORATION -Abdomen I-EXPLORATION -depresible I-EXPLORATION -e I-EXPLORATION -indoloro. I-EXPLORATION - I-EXPLORATION -Laboratorio I-EXPLORATION -al I-EXPLORATION -ingreso: I-EXPLORATION -electrocardiograma: I-EXPLORATION -ritmo I-EXPLORATION -idioventricular I-EXPLORATION -50/min, I-EXPLORATION -trastorno I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -conducción I-EXPLORATION -intraventricular I-EXPLORATION -mal I-EXPLORATION -definido I-EXPLORATION -con I-EXPLORATION -QRS I-EXPLORATION -0, I-EXPLORATION -12 I-EXPLORATION -s I-EXPLORATION -y I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -aumentadas I-EXPLORATION -de I-EXPLORATION -voltaje. I-EXPLORATION -Electrólitos I-EXPLORATION -plasmáticos: I-EXPLORATION -K: I-EXPLORATION -8, I-EXPLORATION -4 I-EXPLORATION -mEq/l, I-EXPLORATION -Cl: I-EXPLORATION -109 I-EXPLORATION -mEq/l, I-EXPLORATION -Na: I-EXPLORATION -132 I-EXPLORATION -mEq/, I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -24, I-EXPLORATION -PCO2: I-EXPLORATION -27, I-EXPLORATION -HCO3 I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -mEq/, I-EXPLORATION -anion I-EXPLORATION -gap I-EXPLORATION -10. I-EXPLORATION -BE: I-EXPLORATION --14, I-EXPLORATION -4. I-EXPLORATION -Nitrógeno I-EXPLORATION -ureico I-EXPLORATION -61 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -2, I-EXPLORATION -63 I-EXPLORATION -mg/dl, I-EXPLORATION -hematocrito I-EXPLORATION -33%, I-EXPLORATION -hemoglobina I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dl, I-EXPLORATION -glóbulos I-EXPLORATION -blancos I-EXPLORATION -8.660, I-EXPLORATION -glicemia I-EXPLORATION -137 I-EXPLORATION -mg/dl, I-EXPLORATION -troponinas I-EXPLORATION -T I-EXPLORATION -<0, I-EXPLORATION -01, I-EXPLORATION -orina I-EXPLORATION -completa I-EXPLORATION -normal. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -sin I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -mixomatosis I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídea, I-EXPLORATION -con I-EXPLORATION -prolapso I-EXPLORATION -mitral I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídea I-EXPLORATION -severas, I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda I-EXPLORATION -concéntrica I-EXPLORATION -leve I-EXPLORATION -con I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -normal, I-EXPLORATION -dilatación I-EXPLORATION -biauricular I-EXPLORATION -moderada. I-EXPLORATION - I-EXPLORATION -Evolución: B-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -diarrea I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -hospitalización. I-EVOLUTION -No B-TREATMENT -hubo I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -médicas I-TREATMENT -habituales I-TREATMENT -para I-TREATMENT -controlar I-TREATMENT -la I-TREATMENT -hiperkalemia, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -hemodiálisis I-TREATMENT -de I-TREATMENT -emergencia I-TREATMENT -después I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -recuperó I-TREATMENT -ritmo I-TREATMENT -sinusal I-TREATMENT -102 I-TREATMENT -por I-TREATMENT -min, I-TREATMENT -inicialmente I-TREATMENT -hipertensa I-TREATMENT -sistólica I-TREATMENT -hasta I-TREATMENT -208/63 I-TREATMENT -mmHg I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -con I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -propanolol I-TREATMENT -mantuvo I-TREATMENT -presiones I-TREATMENT -normales, I-TREATMENT -en B-EXPLORATION -estas I-EXPLORATION -circunstancias I-EXPLORATION -presentó I-EXPLORATION -angina I-EXPLORATION -de I-EXPLORATION -pecho I-EXPLORATION -con I-EXPLORATION -infradesnivel I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ECG I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -de I-EXPLORATION -daño I-EXPLORATION -miocárdico: I-EXPLORATION -CPK I-EXPLORATION -fracción I-EXPLORATION -MB I-EXPLORATION -hasta I-EXPLORATION -8, I-EXPLORATION -3 I-EXPLORATION -mg/dl, I-EXPLORATION -TT I-EXPLORATION -hasta I-EXPLORATION -0, I-EXPLORATION -072 I-EXPLORATION -y I-EXPLORATION -mioglobina I-EXPLORATION -hasta I-EXPLORATION -384 I-EXPLORATION -mg/dl, I-EXPLORATION -el I-EXPLORATION -K I-EXPLORATION -había I-EXPLORATION -descendido I-EXPLORATION -a I-EXPLORATION -4, I-EXPLORATION -7 I-EXPLORATION -mEq/L. I-EXPLORATION -Fracción I-EXPLORATION -excretada I-EXPLORATION -de I-EXPLORATION -Na I-EXPLORATION -13%, I-EXPLORATION -fracción I-EXPLORATION -excretada I-EXPLORATION -de I-EXPLORATION -nitrógeno I-EXPLORATION -ureico: I-EXPLORATION -16%. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -normalizó I-EVOLUTION -antes I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -su I-EVOLUTION -potasio I-EVOLUTION -y B-EXPLORATION -diuresis, I-EXPLORATION -mantuvo I-EXPLORATION -cifras I-EXPLORATION -tensionales I-EXPLORATION -normales, I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -creatinina I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -3 I-EXPLORATION -m/dl, I-EXPLORATION -nitrógeno I-EXPLORATION -ureico I-EXPLORATION -24 I-EXPLORATION -mg/dl I-EXPLORATION -y B-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -ni B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -local, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mejilla I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malar I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta, I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -absceso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -dental. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -firme, I-EXPLORATION -fijo I-EXPLORATION -y I-EXPLORATION -levemente I-EXPLORATION -doloroso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -ocupación I-EXPLORATION -del I-EXPLORATION -vestíbulo I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -extensión I-EXPLORATION -al I-EXPLORATION -paladar I-EXPLORATION -duro I-EXPLORATION -y I-EXPLORATION -blando I-EXPLORATION -derechos. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -sólido-quística I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -netos, I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -musculares I-EXPLORATION -faciales I-EXPLORATION -profundos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -malar I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -rellenaba I-EXPLORATION -seno I-EXPLORATION -maxilar. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -proceso I-EXPLORATION -expansivo, I-EXPLORATION -sólido I-EXPLORATION -quístico, I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -quinta I-EXPLORATION -pieza I-EXPLORATION -dental I-EXPLORATION -superior I-EXPLORATION -derecha, I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho, I-EXPLORATION -expandía I-EXPLORATION -y I-EXPLORATION -adelgazaba I-EXPLORATION -sus I-EXPLORATION -paredes, I-EXPLORATION -especialmente I-EXPLORATION -hacia I-EXPLORATION -fosa I-EXPLORATION -maxilar I-EXPLORATION -y I-EXPLORATION -pterigomaxilar, I-EXPLORATION -destruyendo I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION -ventral I-EXPLORATION -de I-EXPLORATION -cornetes I-EXPLORATION -nasales I-EXPLORATION -y I-EXPLORATION -ascendiendo I-EXPLORATION -el I-EXPLORATION -piso I-EXPLORATION -orbitario I-EXPLORATION -con I-EXPLORATION -abombamiento I-EXPLORATION -del I-EXPLORATION -paladar I-EXPLORATION -óseo I-EXPLORATION -hacia I-EXPLORATION -cavidad I-EXPLORATION -oral. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -incisional, I-EXPLORATION -cuyo I-EXPLORATION -diagnóstico I-EXPLORATION -fue: I-EXPLORATION -quiste I-EXPLORATION -óseo I-EXPLORATION -aneurismático. I-EXPLORATION -A B-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses I-TREATMENT -fue I-TREATMENT -reintervenida I-TREATMENT -extirpándose I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -tumoral I-TREATMENT -que I-TREATMENT -ocupaba I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -derecho, I-TREATMENT -con I-TREATMENT -destrucción I-TREATMENT -de I-TREATMENT -su I-TREATMENT -pared I-TREATMENT -anterior I-TREATMENT -y I-TREATMENT -medial, I-TREATMENT -paladar I-TREATMENT -óseo I-TREATMENT -y I-TREATMENT -reborde I-TREATMENT -alveolar I-TREATMENT -superior. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -extracción I-TREATMENT -amplia I-TREATMENT -mediante I-TREATMENT -maxilectomía I-TREATMENT -de I-TREATMENT -infraestructura, I-TREATMENT -que I-TREATMENT -consiste I-TREATMENT -en I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -de I-TREATMENT -las I-TREATMENT -estructuras I-TREATMENT -antes I-TREATMENT -mencionadas, I-TREATMENT -conservando I-TREATMENT -el I-TREATMENT -piso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -órbita. I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -quirúrgica, I-EXPLORATION -macroscópicamente, I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -expansiva, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -compuesta I-EXPLORATION -por I-EXPLORATION -múltiples I-EXPLORATION -cavidades, I-EXPLORATION -separadas I-EXPLORATION -por I-EXPLORATION -tabiques I-EXPLORATION -pardo I-EXPLORATION -rojizos, I-EXPLORATION -rellenos I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION -hemático. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -numerosos I-EXPLORATION -tabiques I-EXPLORATION -que I-EXPLORATION -separaban I-EXPLORATION -cavidades, I-EXPLORATION -sin I-EXPLORATION -revestimiento I-EXPLORATION -endotelial, I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -irregular I-EXPLORATION -y I-EXPLORATION -contenido I-EXPLORATION -hemático. I-EXPLORATION -Los I-EXPLORATION -tabiques I-EXPLORATION -tenían I-EXPLORATION -estroma I-EXPLORATION -fibroso, I-EXPLORATION -células I-EXPLORATION -gigantes I-EXPLORATION -multinucleadas, I-EXPLORATION -fibroblastos, I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -antigua I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -con I-EXPLORATION -tejido I-EXPLORATION -osteoide, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -anaplasia. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -actividad I-EXPLORATION -mitótica. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -coexistencia I-EXPLORATION -con I-EXPLORATION -otras I-EXPLORATION -lesiones. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -en I-EVOLUTION -controles I-EVOLUTION -permanentes, I-EVOLUTION -evolucionando I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -soldado. B-PAST_MEDICAL_HISTORY -Al B-PRESENT_ILLNESS -reiniciar I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -entrenamiento I-PRESENT_ILLNESS -físico I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -intención I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -participar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -triatlón, I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -actividad I-PRESENT_ILLNESS -física I-PRESENT_ILLNESS -intensa, I-PRESENT_ILLNESS -recorrió I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -kilómetros I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -bicicleta I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -ascendió I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cima I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cerro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1.828 I-PRESENT_ILLNESS -metros, I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -calor I-PRESENT_ILLNESS -ambiental I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ingiriendo I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -escaso I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -líquidos. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -bajar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -montaña I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -mareos, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -diarrea, I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -muscular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -calambres I-PRESENT_ILLNESS -musculares I-PRESENT_ILLNESS -intensos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades. I-PRESENT_ILLNESS -En B-TREATMENT -el I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -se I-TREATMENT -lo I-TREATMENT -hidrató, I-TREATMENT -enviándolo I-TREATMENT -posteriormente I-TREATMENT -a I-TREATMENT -su I-TREATMENT -domicilio. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -subsiguiente I-EVOLUTION -acudió I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION -por I-EVOLUTION -debilidad I-EVOLUTION -muscular, I-EVOLUTION -mialgias I-EVOLUTION -difusas, I-EVOLUTION -calambres I-EVOLUTION -y I-EVOLUTION -malestar I-EVOLUTION -general. I-EVOLUTION -Había I-EVOLUTION -orinado I-EVOLUTION -escasamente I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -anterior. I-EVOLUTION -Existía B-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -fuerzas I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -muscular. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -mostraron I-EXPLORATION -azotemia I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -enzimas I-EXPLORATION -musculares. I-EXPLORATION -La I-EXPLORATION -orina I-EXPLORATION -era I-EXPLORATION -rosada I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -sedimento I-EXPLORATION -mostró I-EXPLORATION -1 I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -eritrocitos I-EXPLORATION -por I-EXPLORATION -campo. I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -una I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -aguda I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -RML I-EXPLORATION -de I-EXPLORATION -esfuerzo I-EXPLORATION -y B-EVOLUTION -se I-EVOLUTION -trasladó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos. I-EVOLUTION -Allí B-TREATMENT -recibió I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -isotónica, I-TREATMENT -bicarbonato I-TREATMENT -y I-TREATMENT -furosemide, I-TREATMENT -recuperando B-EVOLUTION -rápidamente I-EVOLUTION -la I-EVOLUTION -diuresis. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -9 I-EVOLUTION -días I-EVOLUTION -siguientes I-EVOLUTION -se I-EVOLUTION -obtuvo I-EVOLUTION -una I-EVOLUTION -recuperación I-EVOLUTION -paulatina I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal, I-EVOLUTION -sin I-EVOLUTION -emplearse I-EVOLUTION -diálisis, I-EVOLUTION -persistiendo I-EVOLUTION -las I-EVOLUTION -mialgias, I-EVOLUTION -los I-EVOLUTION -calambres I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -elevación I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -enzimas I-EVOLUTION -musculares. I-EVOLUTION -Fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -décimoprimer I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -con I-EVOLUTION -azotemia I-EVOLUTION -leve I-EVOLUTION -(creatinina I-EVOLUTION -1, I-EVOLUTION -43 I-EVOLUTION -mg/dl, I-EVOLUTION -uremia I-EVOLUTION -51 I-EVOLUTION -mg/dl) I-EVOLUTION -y I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -creatinquinasa I-EVOLUTION -(CK) I-EVOLUTION --total I-EVOLUTION -elevada. I-EVOLUTION -Un I-EVOLUTION -mes I-EVOLUTION -después, I-EVOLUTION -estando I-EVOLUTION -con I-EVOLUTION -actividad I-EVOLUTION -física I-EVOLUTION -liviana, I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -concentración I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -enzimas I-EVOLUTION -musculares I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -obeso, I-PRESENT_ILLNESS -marino I-PRESENT_ILLNESS -mercante, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -estilo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -sedentario. I-PRESENT_ILLNESS -Estando I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vacaciones, I-PRESENT_ILLNESS -observó I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -ahogaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mar. I-PRESENT_ILLNESS -Intentó I-PRESENT_ILLNESS -rescatarla I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mucho I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desesperación, I-PRESENT_ILLNESS -aspirando I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tragando I-PRESENT_ILLNESS -mucha I-PRESENT_ILLNESS -agua, I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -casi I-PRESENT_ILLNESS -ahogarse. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -siguientes I-PRESENT_ILLNESS -tuvo I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -incapacidad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -alimentarse, I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -intensas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -débito I-PRESENT_ILLNESS -urinario. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia. I-PRESENT_ILLNESS -Estaba B-EXPLORATION -hipertenso I-EXPLORATION -(170/110 I-EXPLORATION -mmHg) I-EXPLORATION -y I-EXPLORATION -tenía I-EXPLORATION -aliento I-EXPLORATION -urémico. I-EXPLORATION -Era I-EXPLORATION -llamativa I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -petequias I-EXPLORATION -conjuntivales I-EXPLORATION -(signo I-EXPLORATION -de I-EXPLORATION -asfixia) I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal. I-EXPLORATION -La I-EXPLORATION -ecotomografía I-EXPLORATION -mostró I-EXPLORATION -riñones I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacó I-EXPLORATION -azotemia I-EXPLORATION -marcada I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -enzimas I-EXPLORATION -musculares. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -sedimento I-EXPLORATION -mostró I-EXPLORATION -sólo I-EXPLORATION -2 I-EXPLORATION -a I-EXPLORATION -3 I-EXPLORATION -eritrocitos I-EXPLORATION -por I-EXPLORATION -campo. I-EXPLORATION -Se B-TREATMENT -manejó I-TREATMENT -con I-TREATMENT -aporte I-TREATMENT -de I-TREATMENT -volumen I-TREATMENT -y I-TREATMENT -bicarbonato I-TREATMENT -parenteral. I-TREATMENT -Al I-TREATMENT -día I-TREATMENT -siguiente I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -urémicos I-TREATMENT -se I-TREATMENT -intensificaron I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -hemodializó I-TREATMENT -por I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -consecutivos. I-TREATMENT -Al B-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -inició I-EVOLUTION -una I-EVOLUTION -poliuria I-EVOLUTION -con I-EVOLUTION -recuperación I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -función I-EVOLUTION -renal, I-EVOLUTION -hasta I-EVOLUTION -alcanzar I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -1, I-EVOLUTION -1 I-EVOLUTION -mg/dl I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -episodio I-EVOLUTION -inicial I-EVOLUTION -referido. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipertenso, B-PAST_MEDICAL_HISTORY -tabáquico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dislipidémico. I-PAST_MEDICAL_HISTORY -Comenzó B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -bajo, I-PRESENT_ILLNESS -opresivo, I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -hipocondrios I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -espalda, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -decidió I-PRESENT_ILLNESS -consultar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -síntomas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -estaba I-EXPLORATION -vígil, I-EXPLORATION -orientado, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -140/90, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -80 I-EXPLORATION -lat/min, I-EXPLORATION -con I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -simétricos I-EXPLORATION -y I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -relevantes. I-EXPLORATION - I-EXPLORATION -Un I-EXPLORATION -electrocardiograma I-EXPLORATION -practicado I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -sólo I-EXPLORATION -demostró I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -hallazgos I-EXPLORATION -relevantes. I-EXPLORATION - I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -fuerte I-EXPLORATION -dolor I-EXPLORATION -torácico I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -disección I-EXPLORATION -aórtica, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -angiografía I-EXPLORATION -por I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -(Angio-Tac), I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -flap I-EXPLORATION -de I-EXPLORATION -disección I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -agudo, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -descendente I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hilios I-EXPLORATION -renales, I-EXPLORATION -con I-EXPLORATION -permeabilidad I-EXPLORATION -del I-EXPLORATION -falso I-EXPLORATION -lumen I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hemotórax I-EXPLORATION -menor I-EXPLORATION -y I-EXPLORATION -hemopericardio. I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -entonces I-EXPLORATION -disección I-EXPLORATION -aórtica I-EXPLORATION -aguda I-EXPLORATION -tipo I-EXPLORATION -B, I-EXPLORATION -complicada I-EXPLORATION -por I-EXPLORATION -rotura. I-EXPLORATION - I-EXPLORATION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -complicación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -disección, I-TREATMENT -anatomía I-TREATMENT -favorable I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -y I-TREATMENT -de I-TREATMENT -los I-TREATMENT -accesos I-TREATMENT -vasculares, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -endovascular. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT -con I-TREATMENT -acceso I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -arterias I-TREATMENT -femorales I-TREATMENT -e I-TREATMENT -hipotensión I-TREATMENT -controlada, I-TREATMENT -instalándose I-TREATMENT -prótesis I-TREATMENT -endovascular I-TREATMENT -(Talent®) I-TREATMENT -de I-TREATMENT -34 I-TREATMENT -mm I-TREATMENT -de I-TREATMENT -diámetro I-TREATMENT -y I-TREATMENT -130 I-TREATMENT -mm I-TREATMENT -de I-TREATMENT -longitud I-TREATMENT -en I-TREATMENT -la I-TREATMENT -aorta I-TREATMENT -torácica I-TREATMENT -con I-TREATMENT -resultado I-TREATMENT -técnico I-TREATMENT -adecuado, I-TREATMENT -cobertura I-TREATMENT -de I-TREATMENT -sitio I-TREATMENT -de I-TREATMENT -fractura I-TREATMENT -proximal I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -inmediatas. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -adecuada I-EXPLORATION -posición I-EXPLORATION -de I-EXPLORATION -endoprótesis I-EXPLORATION -con I-EXPLORATION -exclusión I-EXPLORATION -del I-EXPLORATION -falso I-EXPLORATION -lumen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -torácica, I-EXPLORATION -sólo I-EXPLORATION -con I-EXPLORATION -permeabilidad I-EXPLORATION -de I-EXPLORATION -éste I-EXPLORATION -distal I-EXPLORATION -a I-EXPLORATION -origen I-EXPLORATION -de I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -inferior, I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -aumentado I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -ingreso. I-EXPLORATION -Los I-EXPLORATION -accesos I-EXPLORATION -vasculares I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -complicaciones. I-EXPLORATION -Se B-EVOLUTION -decidió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -cinco I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -procedimiento, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -control I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -procedimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -con I-EVOLUTION -Angio-Tac I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -demostró I-EVOLUTION -complicaciones I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -endoprótesis, I-EVOLUTION -con I-EVOLUTION -exclusión I-EVOLUTION -total I-EVOLUTION -del I-EVOLUTION -falso I-EVOLUTION -lumen I-EVOLUTION -torácico I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -variaciones I-EVOLUTION -con I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -examen I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enseñanza I-PAST_MEDICAL_HISTORY -media I-PAST_MEDICAL_HISTORY -completa, I-PAST_MEDICAL_HISTORY -casada, I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Asistió B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -consultorio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -primaria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -angustiosos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -depresivos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -iniciados I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hija I-PRESENT_ILLNESS -mayor. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -exacerbado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año, I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -hijo. I-PRESENT_ILLNESS -Junto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -anterior, I-PRESENT_ILLNESS -golpeaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hija, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -marido I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -sugirió I-PRESENT_ILLNESS -consultar. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Psiquiatría I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -pesquisa I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -hizo I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -general I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -antecedente I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -abuso I-DERIVED_FROM/TO -sexual I-DERIVED_FROM/TO -infantil, I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -hasta I-DERIVED_FROM/TO -esa I-DERIVED_FROM/TO -fecha I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -había I-DERIVED_FROM/TO -silenciado. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Antecedentes. B-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -golpeada I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -alcohólico, I-PAST_MEDICAL_HISTORY -quién I-PAST_MEDICAL_HISTORY -abusó I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ella I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -caricias I-PAST_MEDICAL_HISTORY -sexuales I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -penetración, I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -15, I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -abandonó I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -colegio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -trasladó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -ciudad I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trabajar I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -asesora I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -hogar. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -casa I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -trabajó I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -violada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -patrona. I-PAST_MEDICAL_HISTORY -Esta I-PAST_MEDICAL_HISTORY -experiencia I-PAST_MEDICAL_HISTORY -traumática I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -silenció I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -susto, I-PAST_MEDICAL_HISTORY -vergüenza I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -culpa. I-PAST_MEDICAL_HISTORY -Posteriormente I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -angustia, I-PAST_MEDICAL_HISTORY -pesadillas I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -intrusivas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -violación I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -cedieron I-PAST_MEDICAL_HISTORY -espontáneamente I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -mes, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -abandono I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lugar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo. I-PAST_MEDICAL_HISTORY -Estos I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -reactivaron I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -después, I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -divisó I-PAST_MEDICAL_HISTORY -casualmente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -calle I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -victimario I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nuevamente I-PAST_MEDICAL_HISTORY -cedieron I-PAST_MEDICAL_HISTORY -espontáneamente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -regreso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -lugar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -casó I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -sexual. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -angustia I-PAST_MEDICAL_HISTORY -relacionada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -idea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tener I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hija, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -podría I-PAST_MEDICAL_HISTORY -suceder I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ella, I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -decir I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -violada. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -angustia I-PAST_MEDICAL_HISTORY -aumentó I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -nació I-PAST_MEDICAL_HISTORY -ésta, I-PAST_MEDICAL_HISTORY -agregándose I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -puerperio I-PAST_MEDICAL_HISTORY -anhedonia, I-PAST_MEDICAL_HISTORY -intolerancia, I-PAST_MEDICAL_HISTORY -irritabilidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -labilidad I-PAST_MEDICAL_HISTORY -emocional, I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consultó. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -reiniciar I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -sexual, I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -parto, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -oportunidad I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -marido I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -efecto I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -alcohol, I-PAST_MEDICAL_HISTORY -reaparecieron I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -percepciones I-PAST_MEDICAL_HISTORY -olfativas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -abusaba I-PAST_MEDICAL_HISTORY -sexualmente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ella. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -volvió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -«sentir I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -olor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -padre» I-PAST_MEDICAL_HISTORY -cerca I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ella. I-PAST_MEDICAL_HISTORY -Antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -recuerdos I-PAST_MEDICAL_HISTORY -borrosos I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -abuso I-PAST_MEDICAL_HISTORY -sufrido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -niñez. I-PAST_MEDICAL_HISTORY -Después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -incidente, I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -abuso I-PAST_MEDICAL_HISTORY -infantil I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -presentaron I-PAST_MEDICAL_HISTORY -egodistónicamente I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -vez I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sexuales. I-PAST_MEDICAL_HISTORY -Además, I-PAST_MEDICAL_HISTORY -aparecieron I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipervigilancia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -conductas I-PAST_MEDICAL_HISTORY -evitativas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -sexual, I-PAST_MEDICAL_HISTORY -originándose I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -frigidez I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -serios I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pareja. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -violación I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -disfunción I-PAST_MEDICAL_HISTORY -sexual I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -habían I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -develadas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente. I-PAST_MEDICAL_HISTORY -Un I-PAST_MEDICAL_HISTORY -ejemplo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -constata I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -ficha I-PAST_MEDICAL_HISTORY -clínica, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ginecología I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -matrimonio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -fibroadenoma I-PAST_MEDICAL_HISTORY -mamario, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -atendió I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -esa I-PAST_MEDICAL_HISTORY -oportunidad I-PAST_MEDICAL_HISTORY -consignó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes: I-PAST_MEDICAL_HISTORY -nulípara I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sexuales, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -referencia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -traumáticos I-PAST_MEDICAL_HISTORY -sexuales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Evolución B-EVOLUTION -y I-EVOLUTION -tratamiento. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -experimentó I-EVOLUTION -un I-EVOLUTION -gran I-EVOLUTION -alivio I-EVOLUTION -cuando I-EVOLUTION -el I-EVOLUTION -médico I-EVOLUTION -general I-EVOLUTION -le I-EVOLUTION -preguntó I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -antecedente I-EVOLUTION -de I-EVOLUTION -abuso I-EVOLUTION -sexual. I-EVOLUTION -Uno I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -aspectos I-EVOLUTION -que I-EVOLUTION -más I-EVOLUTION -la I-EVOLUTION -habían I-EVOLUTION -angustiado I-EVOLUTION -durante I-EVOLUTION -su I-EVOLUTION -vida I-EVOLUTION -era I-EVOLUTION -el I-EVOLUTION -miedo I-EVOLUTION -de I-EVOLUTION -que I-EVOLUTION -otras I-EVOLUTION -personas, I-EVOLUTION -incluyendo I-EVOLUTION -su I-EVOLUTION -marido, I-EVOLUTION -supiesen I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -historia I-EVOLUTION -traumática I-EVOLUTION -sexual, I-EVOLUTION -pues I-EVOLUTION -se I-EVOLUTION -imaginaba I-EVOLUTION -que I-EVOLUTION -sería I-EVOLUTION -rechazada I-EVOLUTION -y I-EVOLUTION -enjuiciada, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -para I-EVOLUTION -su I-EVOLUTION -alivio I-EVOLUTION -no I-EVOLUTION -ocurrió. I-EVOLUTION - I-EVOLUTION -Con I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -especialidad I-EVOLUTION -habló I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -otros I-EVOLUTION -antecedentes I-EVOLUTION -traumáticos. I-EVOLUTION -Posteriormente I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -tercera I-EVOLUTION -intervención, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refirió I-EVOLUTION -sus I-EVOLUTION -traumas I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -marido, I-EVOLUTION -quien I-EVOLUTION -no I-EVOLUTION -sólo I-EVOLUTION -la I-EVOLUTION -comprendió I-EVOLUTION -sino I-EVOLUTION -que I-EVOLUTION -también I-EVOLUTION -le I-EVOLUTION -brindó I-EVOLUTION -apoyo. I-EVOLUTION -Después I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -acontecimiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -mejoró I-EVOLUTION -sustancialmente, I-EVOLUTION -remitieron I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -depresivos, I-EVOLUTION -la I-EVOLUTION -disfunción I-EVOLUTION -sexual I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -maltrato I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -hija. I-EVOLUTION - I-EVOLUTION -Asistió I-EVOLUTION -en I-EVOLUTION -total I-EVOLUTION -a I-EVOLUTION -cinco I-EVOLUTION -controles I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Psiquiatría I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -su I-EVOLUTION -mejoría. I-EVOLUTION -Durante B-TREATMENT -ese I-TREATMENT -tiempo I-TREATMENT -se I-TREATMENT -la I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -fluoxetina I-TREATMENT -20 I-TREATMENT -mg/día I-TREATMENT -y I-TREATMENT -meleril I-TREATMENT -25 I-TREATMENT -mg/día. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION -de I-EVOLUTION -salud I-EVOLUTION -mental I-EVOLUTION -se I-EVOLUTION -enteró I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -asintomática, I-EVOLUTION -trabajando I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -conflictos I-EVOLUTION -de I-EVOLUTION -pareja. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -intenso, I-PAST_MEDICAL_HISTORY -bronquítico I-PAST_MEDICAL_HISTORY -crónico, I-PAST_MEDICAL_HISTORY -portador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -prostático I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución. I-PAST_MEDICAL_HISTORY -Enfermedad B-PRESENT_ILLNESS -actual: I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -4/6/04 I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial I-PRESENT_ILLNESS -opresivo. I-PRESENT_ILLNESS -Se B-TREATMENT -diagnosticó I-TREATMENT -infarto I-TREATMENT -agudo I-TREATMENT -de I-TREATMENT -miocardio I-TREATMENT -y I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -fibrinolítico I-TREATMENT -sistémico I-TREATMENT -con I-TREATMENT -estreptoquinasa. I-TREATMENT -Reapareció B-EXPLORATION -angor, I-EXPLORATION -realizándose I-EXPLORATION -cineangiocoronariografía I-EXPLORATION -(CACG) I-EXPLORATION -de I-EXPLORATION -urgencia I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -arterias I-EXPLORATION -coronarias I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -significativas. I-EXPLORATION -En B-EVOLUTION -forma I-EVOLUTION -inmediata I-EVOLUTION -al I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -procedimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -frialdad I-EVOLUTION -intensa I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -ambos I-EVOLUTION -miembros I-EVOLUTION -inferiores I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -distal, I-EVOLUTION -con I-EVOLUTION -cianosis I-EVOLUTION -de I-EVOLUTION -dedos I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -pies. I-EVOLUTION -Concomitantemente I-EVOLUTION -apareció I-EVOLUTION -epigastralgia, I-EVOLUTION -náuseas I-EVOLUTION -y I-EVOLUTION -vómitos. I-EVOLUTION - I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -destacaba I-EXPLORATION -cianosis I-EXPLORATION -de I-EXPLORATION -dedos I-EXPLORATION -de I-EXPLORATION -pies, I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -seca I-EXPLORATION -en I-EXPLORATION -3º, I-EXPLORATION -4º I-EXPLORATION -y I-EXPLORATION -5º I-EXPLORATION -dedos I-EXPLORATION -derechos I-EXPLORATION -y I-EXPLORATION -3º I-EXPLORATION -y I-EXPLORATION -5º I-EXPLORATION -dedos I-EXPLORATION -izquierdos. I-EXPLORATION - I-EXPLORATION -Examen I-EXPLORATION -cardiovascular: I-EXPLORATION -ritmo I-EXPLORATION -irregular I-EXPLORATION -110 I-EXPLORATION -lpm, I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -conservados, I-EXPLORATION -simétricos I-EXPLORATION -en I-EXPLORATION -4 I-EXPLORATION -miembros. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio. I-EXPLORATION -Azoemia: I-EXPLORATION -140 I-EXPLORATION -mg/dL. I-EXPLORATION -Creatininemia: I-EXPLORATION -5, I-EXPLORATION -8 I-EXPLORATION -mg/dL I-EXPLORATION -(función I-EXPLORATION -renal I-EXPLORATION -3 I-EXPLORATION -meses I-EXPLORATION -previos I-EXPLORATION -normal). I-EXPLORATION -Depuración I-EXPLORATION -de I-EXPLORATION -creatinina: I-EXPLORATION -11 I-EXPLORATION -ml/min. I-EXPLORATION -Hemograma, I-EXPLORATION -ionograma I-EXPLORATION -sanguíneo I-EXPLORATION -y I-EXPLORATION -glicemia: I-EXPLORATION -normales. I-EXPLORATION -Examen I-EXPLORATION -de I-EXPLORATION -orina: I-EXPLORATION -densidad I-EXPLORATION -1015; I-EXPLORATION -proteínas I-EXPLORATION -2, I-EXPLORATION -09 I-EXPLORATION -g/L; I-EXPLORATION -hematíes+++; I-EXPLORATION -leucocitos++. I-EXPLORATION -Antígeno I-EXPLORATION -prostático I-EXPLORATION -específico: I-EXPLORATION -2, I-EXPLORATION -4 I-EXPLORATION -ng/mL. I-EXPLORATION -Ecografía I-EXPLORATION -aparato I-EXPLORATION -urinario: I-EXPLORATION -tamaño I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -espesor I-EXPLORATION -parenquimatoso I-EXPLORATION -conservados, I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION -pielocalicial I-EXPLORATION -izquierda, I-EXPLORATION -hipertrofia I-EXPLORATION -prostática I-EXPLORATION -grado I-EXPLORATION -III. I-EXPLORATION -ECG: I-EXPLORATION -fibrilación I-EXPLORATION -auricular I-EXPLORATION -con I-EXPLORATION -frecuencia I-EXPLORATION -promedio I-EXPLORATION -de I-EXPLORATION -90 I-EXPLORATION -lpm. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -normal. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda, I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -aurícula I-EXPLORATION -izquierda, I-EXPLORATION -fracción I-EXPLORATION -de I-EXPLORATION -eyección I-EXPLORATION -ventricular I-EXPLORATION -izquierda: I-EXPLORATION -57%. I-EXPLORATION -Doppler I-EXPLORATION -arterial I-EXPLORATION -miembros I-EXPLORATION -inferiores: I-EXPLORATION -lesiones I-EXPLORATION -hemodinámicamente I-EXPLORATION -significativas I-EXPLORATION -en I-EXPLORATION -sector I-EXPLORATION -ilíaco I-EXPLORATION -y I-EXPLORATION -femoral I-EXPLORATION -común, I-EXPLORATION -bilaterales; I-EXPLORATION -arterias I-EXPLORATION -distales I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -significativas. I-EXPLORATION -Colonoscopia: I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -ulceradas I-EXPLORATION -superficiales I-EXPLORATION -cubiertas I-EXPLORATION -por I-EXPLORATION -fibrina, I-EXPLORATION -desde I-EXPLORATION -recto I-EXPLORATION -bajo I-EXPLORATION -hasta I-EXPLORATION -sigmoides I-EXPLORATION -proximal, I-EXPLORATION -donde I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION -más I-EXPLORATION -extensas I-EXPLORATION -e I-EXPLORATION -impidieron I-EXPLORATION -proseguir I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -(aspecto I-EXPLORATION -de I-EXPLORATION -colitis I-EXPLORATION -isquémica). I-EXPLORATION -Biopsia I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -sigmoides: I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -de I-EXPLORATION -especificidad. I-EXPLORATION -Gastroscopia: I-EXPLORATION -lesiones I-EXPLORATION -ulceradas I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -duodeno. I-EXPLORATION -Fondo I-EXPLORATION -de I-EXPLORATION -ojo: I-EXPLORATION -embolias I-EXPLORATION -colesterínicas I-EXPLORATION -en I-EXPLORATION -retina I-EXPLORATION -izquierda. I-EXPLORATION -Biopsia I-EXPLORATION -de I-EXPLORATION -piel: I-EXPLORATION -cristales I-EXPLORATION -de I-EXPLORATION -colesterol I-EXPLORATION -ocluyendo I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -mediano I-EXPLORATION -calibre; I-EXPLORATION -trombosis I-EXPLORATION -vascular I-EXPLORATION -en I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -calibre. I-EXPLORATION - I-EXPLORATION -Evolución B-EVOLUTION -y I-EVOLUTION -tratamiento. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -evolución, I-EVOLUTION -destacó I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -masiva I-EVOLUTION -(reiterado I-EVOLUTION -en I-EVOLUTION -dos I-EVOLUTION -oportunidades) I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -tranfusiones; I-TREATMENT -posteriormente, B-EVOLUTION -diarrea I-EVOLUTION -mantenida. I-EVOLUTION -Esto I-EVOLUTION -impidió I-EVOLUTION -su I-EVOLUTION -traslado I-EVOLUTION -para I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -angiorresonancia I-EVOLUTION -magnética I-EVOLUTION -para I-EVOLUTION -evaluación I-EVOLUTION -de I-EVOLUTION -aorta I-EVOLUTION -torácica I-EVOLUTION -y I-EVOLUTION -abdominal. I-EVOLUTION -A I-EVOLUTION -nivel I-EVOLUTION -ocular, I-EVOLUTION -presentó I-EVOLUTION -gran I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -agudeza I-EVOLUTION -visual. I-EVOLUTION -Hubo I-EVOLUTION -franco I-EVOLUTION -empeoramiento I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -miembros I-EVOLUTION -inferiores, I-EVOLUTION -llegando B-TREATMENT -a I-TREATMENT -requerir I-TREATMENT -opiáceos, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -simpaticectomía I-TREATMENT -lumbar I-TREATMENT -unilateral, I-TREATMENT -con I-TREATMENT -criterio I-TREATMENT -analgésico, I-TREATMENT -con I-TREATMENT -resultado I-TREATMENT -favorable. I-TREATMENT - I-TREATMENT -Bajo B-EVOLUTION -tratamiento I-EVOLUTION -médico, I-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -estabilización I-EVOLUTION -de I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -creatinina, I-EVOLUTION -destacando I-EVOLUTION -el I-EVOLUTION -difícil I-EVOLUTION -manejo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -HTA, I-EVOLUTION -que I-EVOLUTION -requirió I-EVOLUTION -de I-EVOLUTION -múltiples I-EVOLUTION -fármacos. I-EVOLUTION - I-EVOLUTION -Como B-TREATMENT -tratamiento I-TREATMENT -tentativo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -base, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -anticoagulante I-TREATMENT -(enoxaparina I-TREATMENT -1 I-TREATMENT -mg/kg I-TREATMENT -peso I-TREATMENT -corporal I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h) I-TREATMENT -y I-TREATMENT -corticoides I-TREATMENT -(prednisona I-TREATMENT -0, I-TREATMENT -5 I-TREATMENT -mg/kg I-TREATMENT -peso I-TREATMENT -corporal), I-TREATMENT -debiendo I-TREATMENT -ser I-TREATMENT -suspendida I-TREATMENT -por I-TREATMENT -la I-TREATMENT -hemorragia I-TREATMENT -digestiva I-TREATMENT -relatada. I-TREATMENT - I-TREATMENT -Evolución B-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -control: I-EVOLUTION -hubo I-EVOLUTION -caída I-EVOLUTION -espontánea I-EVOLUTION -de I-EVOLUTION -falanges I-EVOLUTION -distales I-EVOLUTION -del I-EVOLUTION -tercer I-EVOLUTION -dedo I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -pies I-EVOLUTION -y I-EVOLUTION -quinto I-EVOLUTION -dedo I-EVOLUTION -de I-EVOLUTION -pie I-EVOLUTION -izquierdo, I-EVOLUTION -estabilización I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -renal. I-EVOLUTION -Azoemia: I-EVOLUTION -80 I-EVOLUTION -mg/dL. I-EVOLUTION -Creatininemia: I-EVOLUTION -2, I-EVOLUTION -5 I-EVOLUTION -mg/dL. I-EVOLUTION -Continúa I-EVOLUTION -actualmente I-EVOLUTION -bajo I-EVOLUTION -tratamiento I-EVOLUTION -médico I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -repetido I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -deterioro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -ni I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -digestivo. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipotiroidea. B-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -2000 I-PRESENT_ILLNESS -debutó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -falla I-PRESENT_ILLNESS -renal, I-PRESENT_ILLNESS -ingresando I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS -crónica. I-PRESENT_ILLNESS -En B-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -siguientes I-EVOLUTION -tuvo I-EVOLUTION -múltiples I-EVOLUTION -oclusiones I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -accesos I-EVOLUTION -vasculares, I-EVOLUTION -practicándose B-TREATMENT -fístulas I-TREATMENT -arteriovenosas I-TREATMENT -radiocefálicas I-TREATMENT -y I-TREATMENT -braquiales I-TREATMENT -bilaterales, I-TREATMENT -instalación I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -axilohumerales I-TREATMENT -bilaterales I-TREATMENT -de I-TREATMENT -politetrafluoretileno I-TREATMENT -(PTFE) I-TREATMENT -y I-TREATMENT -numerosos I-TREATMENT -catéteres I-TREATMENT -transitorios I-TREATMENT -y I-TREATMENT -tunelizados I-TREATMENT -en I-TREATMENT -posiciones I-TREATMENT -yugular, I-TREATMENT -subclavia I-TREATMENT -y I-TREATMENT -femoral. I-TREATMENT -En B-EXPLORATION -2003 I-EXPLORATION -se I-EXPLORATION -determinó I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina, I-EXPLORATION -TTPK, I-EXPLORATION -anticoagulante I-EXPLORATION -lúpico, I-EXPLORATION -VDRL, I-EXPLORATION -antitrombina I-EXPLORATION -III I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -anticardiolipina I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM, I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -o I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -2004 I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -una I-EXPLORATION -diabetes I-EXPLORATION -mellitus I-EXPLORATION -2. I-EXPLORATION - I-EXPLORATION -En B-TREATMENT -marzo I-TREATMENT -de I-TREATMENT -2005 I-TREATMENT -recibió I-TREATMENT -un I-TREATMENT -riñón I-TREATMENT -de I-TREATMENT -donante I-TREATMENT -cadáver, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -que I-TREATMENT -compartía I-TREATMENT -2 I-TREATMENT -antígenos I-TREATMENT -DR I-TREATMENT -y I-TREATMENT -presentaba I-TREATMENT -incompatibilidades I-TREATMENT -en I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -antígenos I-TREATMENT -A I-TREATMENT -y I-TREATMENT -B. I-TREATMENT -Su B-EXPLORATION -reactividad I-EXPLORATION -histórica I-EXPLORATION -y I-EXPLORATION -previa I-EXPLORATION -al I-EXPLORATION -trasplante I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -linfocitos I-EXPLORATION -de I-EXPLORATION -panel I-EXPLORATION -era I-EXPLORATION -0%. I-EXPLORATION -Hubo B-TREATMENT -un I-TREATMENT -sangrado I-TREATMENT -intraoperatorio I-TREATMENT -abundante, I-TREATMENT -usaba I-TREATMENT -clopidogrel I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -la I-TREATMENT -oclusión I-TREATMENT -de I-TREATMENT -los I-TREATMENT -catéteres. I-TREATMENT -Recibió I-TREATMENT -glóbulos I-TREATMENT -rojos, I-TREATMENT -plaquetas, I-TREATMENT -plasma I-TREATMENT -fresco I-TREATMENT -congelado I-TREATMENT -e I-TREATMENT -inmunosupresión I-TREATMENT -con I-TREATMENT -ciclosporina I-TREATMENT -(CsA), I-TREATMENT -micofenolato I-TREATMENT -(MMF) I-TREATMENT -y I-TREATMENT -esteroides. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -necrosis I-EVOLUTION -tubular I-EVOLUTION -aguda, I-EVOLUTION -hemodializándose I-EVOLUTION -en I-EVOLUTION -6 I-EVOLUTION -ocasiones I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -14 I-EVOLUTION -días. I-EVOLUTION -Recibió B-TREATMENT -insulina, I-TREATMENT -y I-TREATMENT -por I-TREATMENT -no I-TREATMENT -tener I-TREATMENT -anticuerpos I-TREATMENT -de I-TREATMENT -tipo I-TREATMENT -IgG I-TREATMENT -anti I-TREATMENT -CMV I-TREATMENT -utilizó I-TREATMENT -ganciclovir I-TREATMENT -endovenoso I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -valganciclovir I-TREATMENT -(VGC) I-TREATMENT -oral. I-TREATMENT -Como I-TREATMENT -complicaciones I-TREATMENT -tuvo I-TREATMENT -una I-TREATMENT -infección I-TREATMENT -urinaria I-TREATMENT -y I-TREATMENT -un I-TREATMENT -urinoma, I-TREATMENT -que I-TREATMENT -requirió I-TREATMENT -de I-TREATMENT -drenaje I-TREATMENT -quirúrgico. I-TREATMENT -Egresó B-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -34 I-EVOLUTION -días, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -1, I-EVOLUTION -6 I-EVOLUTION -mg/dl. I-EVOLUTION -Una I-EVOLUTION -semana I-EVOLUTION -después, I-EVOLUTION -notó I-EVOLUTION -edema I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -superior I-EVOLUTION -derecha, I-EVOLUTION -tos I-EVOLUTION -y I-EVOLUTION -disnea I-EVOLUTION -de I-EVOLUTION -esfuerzos. I-EVOLUTION -Una B-EXPLORATION -ecotomografía I-EXPLORATION -doppler I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -axilar I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -cintigrama I-EXPLORATION -pulmonar I-EXPLORATION -mostró I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -embolia I-EXPLORATION -pulmonar. I-EXPLORATION -Inició B-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -acenocumarol. I-TREATMENT -Egresó B-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -1, I-EVOLUTION -6 I-EVOLUTION -mg/dl I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -clearence I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -35 I-EVOLUTION -ml/min. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -cuatro I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -trasplante I-EVOLUTION -renal I-EVOLUTION -(TxR) I-EVOLUTION -y I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -reducir I-EVOLUTION -la I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -MMF I-EVOLUTION -desde I-EVOLUTION -1.500 I-EVOLUTION -a I-EVOLUTION -500 I-EVOLUTION -mg/día I-EVOLUTION -por I-EVOLUTION -leucopenia, I-EVOLUTION -utilizando I-EVOLUTION -prednisona I-EVOLUTION -10 I-EVOLUTION -mg I-EVOLUTION -y I-EVOLUTION -CsA I-EVOLUTION -80 I-EVOLUTION -mg I-EVOLUTION -(obteniendo I-EVOLUTION -una I-EVOLUTION -concentración I-EVOLUTION -sanguínea I-EVOLUTION -de I-EVOLUTION -504 I-EVOLUTION -ng/ml I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -2 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -ingerida) I-EVOLUTION -la I-EVOLUTION -creatinina I-EVOLUTION -se I-EVOLUTION -elevó I-EVOLUTION -a I-EVOLUTION -4, I-EVOLUTION -9 I-EVOLUTION -mg/dl, I-EVOLUTION -el I-EVOLUTION -clearence I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -cayó I-EVOLUTION -a I-EVOLUTION -8, I-EVOLUTION -7 I-EVOLUTION -ml/min I-EVOLUTION -y I-EVOLUTION -apareció I-EVOLUTION -proteinuria I-EVOLUTION -de I-EVOLUTION -14, I-EVOLUTION -9 I-EVOLUTION -g/día. I-EVOLUTION -Se I-EVOLUTION -diagnosticó I-EVOLUTION -un I-EVOLUTION -rechazo I-EVOLUTION -agudo. I-EVOLUTION -No B-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION -por I-EXPLORATION -estar I-EXPLORATION -bajo I-EXPLORATION -terapia I-EXPLORATION -anticoagulante. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -metilprednisolona I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -días, I-TREATMENT -descendiendo I-TREATMENT -la I-TREATMENT -creatinina I-TREATMENT -a I-TREATMENT -1, I-TREATMENT -7 I-TREATMENT -mg/dl I-TREATMENT -y I-TREATMENT -la I-TREATMENT -proteinuria I-TREATMENT -a I-TREATMENT -780 I-TREATMENT -mg/día, I-TREATMENT -elevándose I-TREATMENT -el I-TREATMENT -clearence I-TREATMENT -de I-TREATMENT -creatinina I-TREATMENT -a I-TREATMENT -40 I-TREATMENT -ml/min. I-TREATMENT -La B-EXPLORATION -antigenemia I-EXPLORATION -para I-EXPLORATION -CMV I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -Egresó B-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -mismo I-EVOLUTION -esquema I-EVOLUTION -inmunosupresor. I-EVOLUTION - I-EVOLUTION -Once I-EVOLUTION -semanas I-EVOLUTION -después, I-EVOLUTION -recibiendo I-EVOLUTION -MMF I-EVOLUTION -1.000 I-EVOLUTION -mg, I-EVOLUTION -CsA I-EVOLUTION -70 I-EVOLUTION -mg I-EVOLUTION -(obteniendo I-EVOLUTION -un I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -457 I-EVOLUTION -ng/ml I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -hora I-EVOLUTION -de I-EVOLUTION -ingerida) I-EVOLUTION -y I-EVOLUTION -prednisona I-EVOLUTION -10 I-EVOLUTION -mg, I-EVOLUTION -hizo I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -rechazo I-EVOLUTION -agudo, I-EVOLUTION -tratándose I-EVOLUTION -con I-EVOLUTION -pulsos I-EVOLUTION -de I-EVOLUTION -metilprednisolona, I-EVOLUTION -descendiendo I-EVOLUTION -la I-EVOLUTION -creatinina I-EVOLUTION -desde I-EVOLUTION -2, I-EVOLUTION -9 I-EVOLUTION -a I-EVOLUTION -1, I-EVOLUTION -6 I-EVOLUTION -mg/dl. I-EVOLUTION -Posterior B-TREATMENT -a I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -la I-TREATMENT -CsA I-TREATMENT -por I-TREATMENT -tacrolimus I-TREATMENT -(TCR) I-TREATMENT -4 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h I-TREATMENT -(obteniendo I-TREATMENT -un I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -ng/ml) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -reinició I-TREATMENT -el I-TREATMENT -VGC I-TREATMENT -por I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -febrículas I-TREATMENT -asociadas I-TREATMENT -a I-TREATMENT -una I-TREATMENT -antigenemia I-TREATMENT -(+). I-TREATMENT -A I-TREATMENT -los I-TREATMENT -7 I-TREATMENT -meses I-TREATMENT -del I-TREATMENT -TxR I-TREATMENT -y I-TREATMENT -a I-TREATMENT -los I-TREATMENT -6 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -iniciada I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -anticoagulante, I-TREATMENT -ésta I-TREATMENT -se I-TREATMENT -suspendió, I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -programado I-TREATMENT -a I-TREATMENT -su I-TREATMENT -inicio. I-TREATMENT -Egresó B-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -1, I-EVOLUTION -6 I-EVOLUTION -mg/dl. I-EVOLUTION -Dos I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -del I-EVOLUTION -anticoagulante, I-EVOLUTION -cayó I-EVOLUTION -bruscamente I-EVOLUTION -en I-EVOLUTION -anuria. I-EVOLUTION -Una B-EXPLORATION -ecotomografía I-EXPLORATION -doppler I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -flujo I-EXPLORATION -arterial I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -cintigrama I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -perfusión I-EXPLORATION -renal. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -una I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal. I-EXPLORATION -Se B-TREATMENT -instalaron I-TREATMENT -nuevos I-TREATMENT -catéteres I-TREATMENT -tunelizados I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -derecha I-TREATMENT -e I-TREATMENT -inició I-TREATMENT -hemodiálisis. I-TREATMENT -Tres B-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -se I-EXPLORATION -efectuó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -infarto I-EXPLORATION -renal I-EXPLORATION -y B-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -una I-TREATMENT -nefrectomía. I-TREATMENT -Se B-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -injerto, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -intersticial I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -rechazo I-EXPLORATION -leve. I-EXPLORATION -Frente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -trombofilia I-EXPLORATION -como I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -trombosis I-EXPLORATION -arterial, I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -confirmar I-EXPLORATION -dicha I-EXPLORATION -hipótesis. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -antitrombina I-EXPLORATION -III, I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -activada, I-EXPLORATION -factor I-EXPLORATION -V I-EXPLORATION -Leiden, I-EXPLORATION -mutación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -G20210A I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -protrombina, I-EXPLORATION -proteína I-EXPLORATION -S, I-EXPLORATION -anticoagulante I-EXPLORATION -lúpico, I-EXPLORATION -anticuerpos I-EXPLORATION -anticardiolipinas I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -o I-EXPLORATION -negativos. I-EXPLORATION -La I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -PrC I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -sólo I-EXPLORATION -39, I-EXPLORATION -1% I-EXPLORATION -(VN: I-EXPLORATION -72-106%) I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -homocisteína I-EXPLORATION -total I-EXPLORATION -estuvieron I-EXPLORATION -levemente I-EXPLORATION -elevados I-EXPLORATION -16, I-EXPLORATION -6 I-EXPLORATION -umol/L I-EXPLORATION -(VN: I-EXPLORATION -4, I-EXPLORATION -5-11). I-EXPLORATION - I-EXPLORATION -Días B-EVOLUTION -después I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -trombosis I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vena I-EVOLUTION -femoral I-EVOLUTION -común I-EVOLUTION -y I-EVOLUTION -profunda I-EVOLUTION -derechas. I-EVOLUTION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -acenocumarol I-TREATMENT -permanente. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Aisén, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -realizada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -causa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -difuso I-PAST_MEDICAL_HISTORY -hipertiroideo. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -consecuencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cirugía, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -desarrolló I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hipoparatiroidismo I-PAST_MEDICAL_HISTORY -definitivo. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -indicó I-PAST_MEDICAL_HISTORY -suplemento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vitamina I-PAST_MEDICAL_HISTORY -D, I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -cumplió I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -laboratorio. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Quince I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -tarde, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1999, I-PAST_MEDICAL_HISTORY -consultó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -hospital I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -calambres, I-PAST_MEDICAL_HISTORY -parestesias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -espasmos I-PAST_MEDICAL_HISTORY -faciales, I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Chvostek I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Trousseau I-PAST_MEDICAL_HISTORY -manifiestos. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -reinició I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vitamina I-PAST_MEDICAL_HISTORY -D I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -solicitó I-PAST_MEDICAL_HISTORY -exámenes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcemia, I-PAST_MEDICAL_HISTORY -T4 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -TSH. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -regresó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -control. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Reapareció I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -noviembre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2003, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -marcado I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -general, I-PAST_MEDICAL_HISTORY -astenia, I-PAST_MEDICAL_HISTORY -debilidad I-PAST_MEDICAL_HISTORY -muscular, I-PAST_MEDICAL_HISTORY -calambres, I-PAST_MEDICAL_HISTORY -parestesias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cefalea. I-PAST_MEDICAL_HISTORY -Sus I-PAST_MEDICAL_HISTORY -menstruaciones I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -abundantes. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -físico I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -facies I-PAST_MEDICAL_HISTORY -hipotiroidea, I-PAST_MEDICAL_HISTORY -cicatriz I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tiroidectomía, I-PAST_MEDICAL_HISTORY -pulso I-PAST_MEDICAL_HISTORY -regular I-PAST_MEDICAL_HISTORY -70x', I-PAST_MEDICAL_HISTORY -presión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -110/70 I-PAST_MEDICAL_HISTORY -mmHg, I-PAST_MEDICAL_HISTORY -palidez I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Chvostek I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Trousseau; I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -cardiopulmonar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Sus I-PAST_MEDICAL_HISTORY -exámenes I-PAST_MEDICAL_HISTORY -revelaron: I-PAST_MEDICAL_HISTORY -calcemia I-PAST_MEDICAL_HISTORY -7, I-PAST_MEDICAL_HISTORY -98 I-PAST_MEDICAL_HISTORY -mg/dL I-PAST_MEDICAL_HISTORY -(probable I-PAST_MEDICAL_HISTORY -error I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -laboratorio, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -discordancia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -calcemias I-PAST_MEDICAL_HISTORY -posteriores), I-PAST_MEDICAL_HISTORY -fosfemia I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -mg/dL, I-PAST_MEDICAL_HISTORY -BUN I-PAST_MEDICAL_HISTORY -14 I-PAST_MEDICAL_HISTORY -mg/dL, I-PAST_MEDICAL_HISTORY -proteína I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -g/dL, I-PAST_MEDICAL_HISTORY -albuminemia I-PAST_MEDICAL_HISTORY -3, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -g/dL, I-PAST_MEDICAL_HISTORY -hematocrito I-PAST_MEDICAL_HISTORY -27%, I-PAST_MEDICAL_HISTORY -hemoglobina I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -g/dL, I-PAST_MEDICAL_HISTORY -microcitosis I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipocromía, I-PAST_MEDICAL_HISTORY -TSH I-PAST_MEDICAL_HISTORY -9, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -µU/ml I-PAST_MEDICAL_HISTORY -(vn: I-PAST_MEDICAL_HISTORY -0, I-PAST_MEDICAL_HISTORY -4-4, I-PAST_MEDICAL_HISTORY -8). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipoparatiroidismo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -postiroidectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -ferropriva, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -indicó I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Elcal I-PAST_MEDICAL_HISTORY -D I-PAST_MEDICAL_HISTORY -Forte® I-PAST_MEDICAL_HISTORY -(carbonato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -1.125 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -+ I-PAST_MEDICAL_HISTORY -vitamina I-PAST_MEDICAL_HISTORY -D I-PAST_MEDICAL_HISTORY -175 I-PAST_MEDICAL_HISTORY -UI) I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -Elcal® I-PAST_MEDICAL_HISTORY -(carbonato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -800 I-PAST_MEDICAL_HISTORY -mg) I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -levotiroxina I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -µg I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sulfato I-PAST_MEDICAL_HISTORY -ferroso I-PAST_MEDICAL_HISTORY -400 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Dos B-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -mínimos I-PRESENT_ILLNESS -esfuerzos, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rápida I-PRESENT_ILLNESS -progresión. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -afebril, I-EXPLORATION -con I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca I-EXPLORATION -70x' I-EXPLORATION -regular, I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -100/70 I-EXPLORATION -mmHg, I-EXPLORATION -ortopnea, I-EXPLORATION -edema I-EXPLORATION -generalizado, I-EXPLORATION -ingurgitación I-EXPLORATION -yugular, I-EXPLORATION -estertores I-EXPLORATION -pulmonares, I-EXPLORATION -ruidos I-EXPLORATION -cardíacos I-EXPLORATION -apagados, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -auscultaron I-EXPLORATION -soplos, I-EXPLORATION -hepatomegalia I-EXPLORATION -sensible I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -bajo I-EXPLORATION -el I-EXPLORATION -reborde I-EXPLORATION -costal. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -profunda. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -indicó I-EXPLORATION -hospitalización. I-EXPLORATION -En I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -destacaba: I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -cardiomegalia I-EXPLORATION -y I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -ECG: I-EXPLORATION -ritmo I-EXPLORATION -sinusal, I-EXPLORATION -83x', I-EXPLORATION -bajo I-EXPLORATION -voltaje I-EXPLORATION -generalizado, I-EXPLORATION -intervalo I-EXPLORATION -QT I-EXPLORATION -prolongado I-EXPLORATION -y I-EXPLORATION -alteraciones I-EXPLORATION -inespecíficas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -repolarización I-EXPLORATION -ventricular. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -marcada I-EXPLORATION -dilatación, I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -diastólica I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -restrictivo I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo, I-EXPLORATION -severa I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídea, I-EXPLORATION -hipertensión I-EXPLORATION -pulmonar I-EXPLORATION -sistólica I-EXPLORATION -moderada, I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION -moderado I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -aurícula I-EXPLORATION -izquierda. I-EXPLORATION -Ecotomografía I-EXPLORATION -abdominal: I-EXPLORATION -hepatomegalia I-EXPLORATION -congestiva. I-EXPLORATION -Endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta: I-EXPLORATION -gastritis I-EXPLORATION -hiperémica. I-EXPLORATION -Calcemia I-EXPLORATION -2, I-EXPLORATION -9 I-EXPLORATION -mg/dL, I-EXPLORATION -parathormona I-EXPLORATION -5, I-EXPLORATION -9 I-EXPLORATION -ng/l I-EXPLORATION -(vn: I-EXPLORATION -10-73), I-EXPLORATION -magnesio I-EXPLORATION -1, I-EXPLORATION -08 I-EXPLORATION -mEq/l I-EXPLORATION -(vn: I-EXPLORATION -1, I-EXPLORATION -4-2, I-EXPLORATION -1), I-EXPLORATION -albúmina I-EXPLORATION -3, I-EXPLORATION -3 I-EXPLORATION -g/dL, I-EXPLORATION -sodio I-EXPLORATION -140 I-EXPLORATION -mEq/l, I-EXPLORATION -potasio I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -mEq/l, I-EXPLORATION -hematocrito I-EXPLORATION -26%, I-EXPLORATION -hemoglobina I-EXPLORATION -7, I-EXPLORATION -4 I-EXPLORATION -g/dL, I-EXPLORATION -proteinuria I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -h: I-EXPLORATION -negativa, I-EXPLORATION -bilirrubinemia I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -3 I-EXPLORATION -mg/dL, I-EXPLORATION -transaminasas I-EXPLORATION -glutámico I-EXPLORATION -oxalacéticas I-EXPLORATION -63 I-EXPLORATION -U/l I-EXPLORATION -(vn: I-EXPLORATION -<35), I-EXPLORATION -creatinfosfokinasa I-EXPLORATION -total I-EXPLORATION -1.260 I-EXPLORATION -U/l I-EXPLORATION -(vn: I-EXPLORATION -<70) I-EXPLORATION -(fracción I-EXPLORATION -miocárdica I-EXPLORATION -3%), I-EXPLORATION -TSH I-EXPLORATION -18, I-EXPLORATION -1 I-EXPLORATION -µU/ml. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -cardíaca I-EXPLORATION -congestiva I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -hipocalcemia I-EXPLORATION -severa, I-EXPLORATION -descompensada I-EXPLORATION -por I-EXPLORATION -sustitución I-EXPLORATION -con I-EXPLORATION -hormona I-EXPLORATION -tiroidea I-EXPLORATION -y I-EXPLORATION -agravada I-EXPLORATION -por I-EXPLORATION -anemia I-EXPLORATION -ferropriva. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -gluconato I-TREATMENT -de I-TREATMENT -calcio I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -iv I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -carbonato I-TREATMENT -de I-TREATMENT -calcio I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -vo, I-TREATMENT -vitamina I-TREATMENT -D I-TREATMENT -175 I-TREATMENT -µ/día, I-TREATMENT -vitamina I-TREATMENT -D I-TREATMENT -300.000 I-TREATMENT -UI I-TREATMENT -por I-TREATMENT -una I-TREATMENT -vez, I-TREATMENT -l-tiroxina I-TREATMENT -100 I-TREATMENT -µg, I-TREATMENT -sulfato I-TREATMENT -ferroso I-TREATMENT -400 I-TREATMENT -mg, I-TREATMENT -furosemida I-TREATMENT -40 I-TREATMENT -mg, I-TREATMENT -cloruro I-TREATMENT -de I-TREATMENT -potasio I-TREATMENT -1, I-TREATMENT -8 I-TREATMENT -g, I-TREATMENT -captopril I-TREATMENT -12, I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -digoxina I-TREATMENT -0, I-TREATMENT -125 I-TREATMENT -mg/día. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -con I-EVOLUTION -diuresis I-EVOLUTION -intensa I-EVOLUTION -y I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -manifestaciones I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -cardíaca, I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -edema I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -hepatomegalia. I-EVOLUTION -Diez B-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -tenía I-EXPLORATION -calcemia I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mg/dL, I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -37% I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -ecocardiograma I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -reducción I-EXPLORATION -del I-EXPLORATION -grado I-EXPLORATION -del I-EXPLORATION -reflujo I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídeo, I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -sistólica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -a I-EXPLORATION -33 I-EXPLORATION -mmHg I-EXPLORATION -(vn: I-EXPLORATION -15-30) I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -derrame I-EXPLORATION -pericárdico. I-EXPLORATION -En B-EVOLUTION -controles I-EVOLUTION -posteriores, I-EVOLUTION -hasta I-EVOLUTION -los I-EVOLUTION -18 I-EVOLUTION -meses, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -cumplía I-EVOLUTION -rigurosamente I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -sólo I-EVOLUTION -presentaba I-EVOLUTION -disnea I-EVOLUTION -a I-EVOLUTION -esfuerzos I-EVOLUTION -medianos I-EVOLUTION -a I-EVOLUTION -mayores, I-EVOLUTION -su B-EXPLORATION -calcemia I-EXPLORATION -se I-EXPLORATION -mantenía I-EXPLORATION -entre I-EXPLORATION -8 I-EXPLORATION -y I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -seguimiento I-EXPLORATION -ecocardiográfico, I-EXPLORATION -se I-EXPLORATION -observó, I-EXPLORATION -además, I-EXPLORATION -una I-EXPLORATION -recuperación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -marcada I-EXPLORATION -disfunción I-EXPLORATION -diastólica I-EXPLORATION -inicial I-EXPLORATION --evaluada I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -índice I-EXPLORATION -E/A: I-EXPLORATION -relación I-EXPLORATION -entre I-EXPLORATION -fase I-EXPLORATION -de I-EXPLORATION -llene I-EXPLORATION -ventricular I-EXPLORATION -rápido I-EXPLORATION -(E) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -fase I-EXPLORATION -de I-EXPLORATION -llene I-EXPLORATION -relacionada I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -contracción I-EXPLORATION -auricular I-EXPLORATION -(A) I-EXPLORATION --, I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -desaparición I-EXPLORATION -del I-EXPLORATION -derrame I-EXPLORATION -pericárdico, I-EXPLORATION -persistiendo I-EXPLORATION -la I-EXPLORATION -dilatación I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo, I-EXPLORATION -en I-EXPLORATION -grado I-EXPLORATION -similar I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -observada I-EXPLORATION -en I-EXPLORATION -exámenes I-EXPLORATION -iniciales. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -CPT. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -biopsia I-EXPLORATION -quirúrgica I-EXPLORATION -informó I-EXPLORATION -un I-EXPLORATION -CPT I-EXPLORATION -bifocal, I-EXPLORATION -variedad I-EXPLORATION -usual, I-EXPLORATION -con I-EXPLORATION -foco I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -permea-ción I-EXPLORATION -vascular, I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -cápsula I-EXPLORATION -ni I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -borde I-EXPLORATION -quirúrgico. I-EXPLORATION -Recibió B-TREATMENT -150 I-TREATMENT -mCi I-TREATMENT -I131 I-TREATMENT -y B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -sistémica I-EXPLORATION -posdosis I-EXPLORATION -mostró I-EXPLORATION -remanente I-EXPLORATION -tiroideo I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -ganglionar I-EXPLORATION -derecho. I-EXPLORATION -Inició B-TREATMENT -terapia I-TREATMENT -supresiva I-TREATMENT -con I-TREATMENT -levotiroxina I-TREATMENT -y B-EVOLUTION -en I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -presentó I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -Tg I-EVOLUTION -indetectables I-EVOLUTION -(<0, I-EVOLUTION -2 I-EVOLUTION -ng/ml) I-EVOLUTION -en I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -AcTg I-EVOLUTION -y B-EXPLORATION -las I-EXPLORATION -ecografías I-EXPLORATION -cervicales I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -recidiva I-EXPLORATION -tumoral. I-EXPLORATION -En I-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -meses I-EXPLORATION -poscirugía I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -mostró I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -cervical I-EXPLORATION -derecha, I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -linfonodo. I-EXPLORATION -En I-EXPLORATION -forma I-EXPLORATION -simultánea, I-EXPLORATION -la I-EXPLORATION -Tg-s I-EXPLORATION -estimulada I-EXPLORATION -(TSH I-EXPLORATION -=105 I-EXPLORATION -uUI/mL) I-EXPLORATION -fue I-EXPLORATION -<0, I-EXPLORATION -2 I-EXPLORATION -ng/ml, I-EXPLORATION -en I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -AcTg. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -sistémica I-EXPLORATION -mostró I-EXPLORATION -captación I-EXPLORATION -aumentada I-EXPLORATION -en I-EXPLORATION -compartimento I-EXPLORATION -central I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -lados I-EXPLORATION -de I-EXPLORATION -línea I-EXPLORATION -media, I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -por I-EXPLORATION -punción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -CPT. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -disección I-TREATMENT -cervical, I-TREATMENT -cuya B-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -CPT I-EXPLORATION -en I-EXPLORATION -ganglio I-EXPLORATION -del I-EXPLORATION -grupo I-EXPLORATION -VI, I-EXPLORATION -intrano-dal, I-EXPLORATION -sin I-EXPLORATION -extensión I-EXPLORATION -al I-EXPLORATION -tejido I-EXPLORATION -adiposo. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -para I-EXPLORATION -Tg I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -difusa I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -coloide I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -citoplasma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -tumorales. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -Dental I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Referencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Salud I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Peñalolén, I-PRESENT_ILLNESS -Cordillera I-PRESENT_ILLNESS -Oriente, I-PRESENT_ILLNESS -Santiago, I-PRESENT_ILLNESS -Chile. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -señaló I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -crecido I-PRESENT_ILLNESS -lentamente I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ella I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -detectó. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -inspección I-EXPLORATION -clínica I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -el I-EXPLORATION -labio I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -nodular, I-EXPLORATION -irregular, I-EXPLORATION -globuloso I-EXPLORATION -(como I-EXPLORATION -racimo), I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -indoloro, I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -firme I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -más I-EXPLORATION -o I-EXPLORATION -menos I-EXPLORATION -difusos I-EXPLORATION -y I-EXPLORATION -recubierto I-EXPLORATION -por I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -anamnesis I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -pesquisaron I-EXPLORATION -otros I-EXPLORATION -procesos I-EXPLORATION -ni I-EXPLORATION -antecedentes I-EXPLORATION -mórbidos I-EXPLORATION -relevantes. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -hipótesis I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -adenoma I-TREATMENT -pleomorfo, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -la I-TREATMENT -biopsia I-TREATMENT -excisional I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local. I-TREATMENT -Se I-TREATMENT -logró I-TREATMENT -extraer I-TREATMENT -toda I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -además I-TREATMENT -de I-TREATMENT -tejido I-TREATMENT -adyacente, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -si I-TREATMENT -bien I-TREATMENT -se I-TREATMENT -observaba I-TREATMENT -algo I-TREATMENT -de I-TREATMENT -fibrosis I-TREATMENT -periférica, I-TREATMENT -ésta I-TREATMENT -se I-TREATMENT -entremezclaba I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -conjuntivo I-TREATMENT -y I-TREATMENT -capa I-TREATMENT -muscular I-TREATMENT -de I-TREATMENT -los I-TREATMENT -labios. I-TREATMENT -La B-EXPLORATION -muestra I-EXPLORATION -fue I-EXPLORATION -enviada I-EXPLORATION -a I-EXPLORATION -análisis I-EXPLORATION -histopatológico. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -capsulada, I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -vasos I-EXPLORATION -sanguíneos I-EXPLORATION -de I-EXPLORATION -paredes I-EXPLORATION -engrosadas, I-EXPLORATION -entremezclados I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -disponía I-EXPLORATION -a I-EXPLORATION -manera I-EXPLORATION -de I-EXPLORATION - I-EXPLORATION -folículos I-EXPLORATION -con I-EXPLORATION -centros I-EXPLORATION -germinativos, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -presencia I-EXPLORATION -destacada I-EXPLORATION -de I-EXPLORATION -eosinófilos. I-EXPLORATION -El I-EXPLORATION -tejido I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -tabicaciones I-EXPLORATION -por I-EXPLORATION -haces I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -colágenas. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -histopatológico I-EXPLORATION -correspondió I-EXPLORATION -a I-EXPLORATION -hiperplasia I-EXPLORATION -angiolinfoidea I-EXPLORATION -con I-EXPLORATION -eosinofilia. I-EXPLORATION -Los I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -distintos I-EXPLORATION -parámetros I-EXPLORATION -del I-EXPLORATION -hemograma I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -rangos I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -controlada I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -procedió I-EVOLUTION -al I-EVOLUTION -retiro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sutura. I-EVOLUTION -Luego I-EVOLUTION -se I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -controlar I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -realizada I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -sin I-EVOLUTION -observarse I-EVOLUTION -recidiva. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -relevancia, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -junio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2005, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -epigástrico, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -sordo, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -moderada I-PRESENT_ILLNESS -intensidad, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedió I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antiespasmó-dicos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -bloqueadores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -bomba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -protones, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -dada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -reconsultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -siguiente I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -persistencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -epigastralgia, I-PRESENT_ILLNESS -realizándose B-EXPLORATION -una I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -retroperitoneal. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC), I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -quística I-EXPLORATION -multitabicada I-EXPLORATION -de I-EXPLORATION -44 I-EXPLORATION -x I-EXPLORATION -26 I-EXPLORATION -mm, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -que I-EXPLORATION -contactaba I-EXPLORATION -caudalmente I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -cuerpo I-EXPLORATION -del I-EXPLORATION -páncreas. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometida I-TREATMENT -a I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -exploradora I-TREATMENT -subcostal I-TREATMENT -bilateral, I-TREATMENT -encontrándose I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -descrita I-TREATMENT -en I-TREATMENT -la I-TREATMENT -TAC, I-TREATMENT -íntimamente I-TREATMENT -adherida I-TREATMENT -al I-TREATMENT -páncreas, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -debió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -pancreatectomía I-TREATMENT -distal I-TREATMENT -junto I-TREATMENT -a I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -quiste, I-TREATMENT -enviándose I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -a I-TREATMENT -anatomía I-TREATMENT -patológica. I-TREATMENT - I-TREATMENT -Hallazgos I-TREATMENT -patológicos I-TREATMENT - I-TREATMENT -El I-TREATMENT -páncreas I-TREATMENT -mostraba I-TREATMENT -acinos I-TREATMENT -e I-TREATMENT -islotes I-TREATMENT -pancreáticos I-TREATMENT -de I-TREATMENT -arquitectura I-TREATMENT -normal. I-TREATMENT -Se I-TREATMENT -identificaban I-TREATMENT -además I-TREATMENT -dos I-TREATMENT -ganglios I-TREATMENT -linfáticos I-TREATMENT -peripancreáticos I-TREATMENT -sin I-TREATMENT -alteraciones. I-TREATMENT - I-TREATMENT -El I-TREATMENT -diagnóstico I-TREATMENT -histológico I-TREATMENT -fue I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -un I-TREATMENT -quiste I-TREATMENT -broncogénico I-TREATMENT -retroperitoneal. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -posopera-torio, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -décimo I-EVOLUTION -día I-EVOLUTION -posoperatorio. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcoholismo I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Emergencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Complejo I-PRESENT_ILLNESS -Asistencial I-PRESENT_ILLNESS -Barros I-PRESENT_ILLNESS -Luco I-PRESENT_ILLNESS -(CABL) I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cadera I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -intensidad. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -asoció I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuadrante I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -ipsilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lipotimia. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -asociadas. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -80/54 I-EXPLORATION -mmHg, I-EXPLORATION -pulso I-EXPLORATION -78 I-EXPLORATION -x', I-EXPLORATION -coloración I-EXPLORATION -lívida I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -infraumbilical I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores. I-EXPLORATION -Se I-EXPLORATION -aportaron I-EXPLORATION -entonces I-EXPLORATION -1.000 I-EXPLORATION -ce I-EXPLORATION -de I-EXPLORATION -solución I-EXPLORATION -cristaloide I-EXPLORATION -intravenosa I-EXPLORATION -que I-EXPLORATION -permitieron I-EXPLORATION -normalizar I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -arterial. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -aparecía I-EXPLORATION -distendido, I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -intenso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -profunda I-EXPLORATION -en I-EXPLORATION -hipocondrio, I-EXPLORATION -flanco I-EXPLORATION -y I-EXPLORATION -fosa I-EXPLORATION -ilíaca I-EXPLORATION -derecha. I-EXPLORATION -Presentaba, I-EXPLORATION -además, I-EXPLORATION -dolor I-EXPLORATION -de I-EXPLORATION -rebote I-EXPLORATION -difuso, I-EXPLORATION -resistencia I-EXPLORATION -muscular I-EXPLORATION -difusa I-EXPLORATION -y I-EXPLORATION -puño I-EXPLORATION -percusión I-EXPLORATION -derecha I-EXPLORATION -positiva. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -obtuvo: I-EXPLORATION -glicemla I-EXPLORATION -de I-EXPLORATION -250 I-EXPLORATION -mg/dl, I-EXPLORATION -nitrógeno I-EXPLORATION -ureico I-EXPLORATION -de I-EXPLORATION -17 I-EXPLORATION -mg/dl, I-EXPLORATION -creatininemia I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -17 I-EXPLORATION -mg/dl, I-EXPLORATION -amilasa I-EXPLORATION -86 I-EXPLORATION -U/1, I-EXPLORATION -lipasa I-EXPLORATION -40 I-EXPLORATION -U/1, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -2 I-EXPLORATION -mg/1, I-EXPLORATION -protrombine-mia I-EXPLORATION -83, I-EXPLORATION -5%; I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activado: I-EXPLORATION -28, I-EXPLORATION -1 I-EXPLORATION -s, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -18.200/fxl, I-EXPLORATION -hemoglobinemia I-EXPLORATION -de I-EXPLORATION -12, I-EXPLORATION -7 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -39%. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -con I-EXPLORATION -contraste, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -espontáneamente I-EXPLORATION -hiperdensa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hipocondrio I-EXPLORATION -y I-EXPLORATION -flanco I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -por I-EXPLORATION -12 I-EXPLORATION -por I-EXPLORATION -9 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -derecho I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -periferia, I-EXPLORATION -manteniendo I-EXPLORATION -un I-EXPLORATION -plano I-EXPLORATION -de I-EXPLORATION -clivaje I-EXPLORATION -con I-EXPLORATION -él. I-EXPLORATION -Se I-EXPLORATION -sugería I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -extenso I-EXPLORATION -hematoma I-EXPLORATION -mesentérico, I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartar I-EXPLORATION -también I-EXPLORATION -neoplasia I-EXPLORATION -subyacente. I-EXPLORATION -Al B-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -hemodinámicamente I-EVOLUTION -estable, I-EVOLUTION -afebril I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -menos I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -espontáneo, I-EVOLUTION -sin I-EVOLUTION -embargo, I-EVOLUTION -el I-EVOLUTION -hematocrito I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -descendió I-EVOLUTION -a I-EVOLUTION -21%, I-EVOLUTION -decidiéndose B-TREATMENT -entonces I-TREATMENT -transfundir I-TREATMENT -2 I-TREATMENT -U I-TREATMENT -de I-TREATMENT -glóbulos I-TREATMENT -rojos I-TREATMENT -e I-TREATMENT -intervenir I-TREATMENT -quirúrgicamente I-TREATMENT -al I-TREATMENT -paciente. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -efectuó I-TREATMENT -laparotomía I-TREATMENT -exploradora, I-TREATMENT -encontrándose I-TREATMENT -un I-TREATMENT -gran I-TREATMENT -hematoma I-TREATMENT -encapsulado I-TREATMENT -retrope-ritoneal I-TREATMENT -derecho, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -extendía I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -mesocolon I-TREATMENT -transverso I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -pelvis, I-TREATMENT -sin I-TREATMENT -observar I-TREATMENT -lesión I-TREATMENT -con I-TREATMENT -sangrado I-TREATMENT -activo. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -vaciamiento, I-TREATMENT -aseo, I-TREATMENT -instalación I-TREATMENT -de I-TREATMENT -drenajes I-TREATMENT -en I-TREATMENT -el I-TREATMENT -retroperito-neo I-TREATMENT -y I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -muestras I-TREATMENT -para I-TREATMENT -biopsia, I-TREATMENT -la I-TREATMENT -que, I-TREATMENT -posteriormente, I-TREATMENT -se I-TREATMENT -informó I-TREATMENT -como I-TREATMENT -hematoma I-TREATMENT -de I-TREATMENT -mesenterio I-TREATMENT -sin I-TREATMENT -evidencias I-TREATMENT -de I-TREATMENT -neoplasia. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -satisfactoriamente I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -del I-EVOLUTION -posoperatorio, I-EVOLUTION -cuando I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -salida I-EVOLUTION -de I-EVOLUTION -líquido I-EVOLUTION -fecal I-EVOLUTION -por I-EVOLUTION -los I-EVOLUTION -drenajes, I-EVOLUTION -realizándose I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -fístula I-EVOLUTION -estercorácea. I-EVOLUTION -Se B-TREATMENT -decidió, I-TREATMENT -entonces, I-TREATMENT -conectar I-TREATMENT -los I-TREATMENT -tubulares I-TREATMENT -a I-TREATMENT -aspiración I-TREATMENT -e I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -metronidazol I-TREATMENT -más I-TREATMENT -ciprofloxacina, I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -buen I-TREATMENT -control I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fístula, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -evolucionó I-TREATMENT -al I-TREATMENT -cierre I-TREATMENT -definitivo I-TREATMENT -al I-TREATMENT -vigésimo I-TREATMENT -día I-TREATMENT -desde I-TREATMENT -la I-TREATMENT -operación, I-TREATMENT -dándose I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -en I-TREATMENT -óptimas I-TREATMENT -condiciones I-TREATMENT -generales I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -en I-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -en I-EVOLUTION -policlínico I-EVOLUTION -de I-EVOLUTION -cirugía, I-EVOLUTION -permaneciendo I-EVOLUTION -asintomático I-EVOLUTION -a I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -egreso. I-EVOLUTION - I-EVOLUTION - -Familia B-PRESENT_ILLNESS -afectada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -madre. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Estudio I-PRESENT_ILLNESS -molecular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hormonal. I-PRESENT_ILLNESS -El B-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -hormonal I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -tía I-FAMILY_HISTORY -y I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -del I-FAMILY_HISTORY -probando I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II. I-FAMILY_HISTORY -2 I-FAMILY_HISTORY -y I-FAMILY_HISTORY -II. I-FAMILY_HISTORY -3) I-FAMILY_HISTORY -incluyó I-FAMILY_HISTORY -una I-FAMILY_HISTORY -prueba I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ACTH, I-FAMILY_HISTORY -cuyos I-FAMILY_HISTORY -valores I-FAMILY_HISTORY -de I-FAMILY_HISTORY -170H I-FAMILY_HISTORY -Progesterona I-FAMILY_HISTORY -basal I-FAMILY_HISTORY -y I-FAMILY_HISTORY -estimulado I-FAMILY_HISTORY -fueron I-FAMILY_HISTORY -normales, I-FAMILY_HISTORY -no I-FAMILY_HISTORY -permitiendo I-FAMILY_HISTORY -aclarar I-FAMILY_HISTORY -si I-FAMILY_HISTORY -estos I-FAMILY_HISTORY -sujetos I-FAMILY_HISTORY -eran I-FAMILY_HISTORY -heterocigotos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -una I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -del I-FAMILY_HISTORY -CYP21A2. I-FAMILY_HISTORY - I-FAMILY_HISTORY -El B-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -en I-EXPLORATION -ADN I-EXPLORATION -genómi-co I-EXPLORATION -extraído I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -siete I-EXPLORATION -mutaciones I-EXPLORATION -más I-EXPLORATION -frecuentes I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -CYP21A2 I-EXPLORATION -fueron I-EXPLORATION -estudiadas I-EXPLORATION -con I-EXPLORATION -PCR I-EXPLORATION -alelo I-EXPLORATION -específica I-EXPLORATION -(Fardella, I-EXPLORATION -1998). I-EXPLORATION -Este B-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -demostró I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II.2, I-FAMILY_HISTORY -II.4, I-FAMILY_HISTORY -II.6) I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -Q318X I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -exón I-FAMILY_HISTORY -8, I-FAMILY_HISTORY -que I-FAMILY_HISTORY -consiste I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -cambio I-FAMILY_HISTORY -de I-FAMILY_HISTORY -una I-FAMILY_HISTORY -glutamina I-FAMILY_HISTORY -por I-FAMILY_HISTORY -un I-FAMILY_HISTORY -codón I-FAMILY_HISTORY -de I-FAMILY_HISTORY -stop. I-FAMILY_HISTORY -Este I-FAMILY_HISTORY -resultado I-FAMILY_HISTORY -no I-FAMILY_HISTORY -permitió I-FAMILY_HISTORY -clasificar I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -materna I-FAMILY_HISTORY -y I-FAMILY_HISTORY -por I-FAMILY_HISTORY -ende I-FAMILY_HISTORY -decidir I-FAMILY_HISTORY -sobre I-FAMILY_HISTORY -la I-FAMILY_HISTORY -necesidad I-FAMILY_HISTORY -del I-FAMILY_HISTORY -tratamiento I-FAMILY_HISTORY -prenatal I-FAMILY_HISTORY -en I-FAMILY_HISTORY -estas I-FAMILY_HISTORY -parejas. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Posteriormente, B-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -CYP21A2fue I-EXPLORATION -secuenciado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Sao I-EXPLORATION -Paulo I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -técnicas I-EXPLORATION -clásicas I-EXPLORATION -(Wedell, I-EXPLORATION -1993). I-EXPLORATION -Usando B-FAMILY_HISTORY -esta I-FAMILY_HISTORY -metodología, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encontró I-FAMILY_HISTORY -en I-FAMILY_HISTORY -uno I-FAMILY_HISTORY -de I-FAMILY_HISTORY -los I-FAMILY_HISTORY -alelos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II.2, I-FAMILY_HISTORY -II.4, I-FAMILY_HISTORY -II.6) I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -Q318X I-FAMILY_HISTORY -junto I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -R483W, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -que I-FAMILY_HISTORY -consiste I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -sustitución I-FAMILY_HISTORY -de I-FAMILY_HISTORY -una I-FAMILY_HISTORY -arginina I-FAMILY_HISTORY -por I-FAMILY_HISTORY -triptofano I-FAMILY_HISTORY -(CGG>TGG). I-FAMILY_HISTORY -En I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -materna I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II. I-FAMILY_HISTORY -1, I-FAMILY_HISTORY -II.3, I-FAMILY_HISTORY -II.5) I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encontró I-FAMILY_HISTORY -un I-FAMILY_HISTORY -alelo I-FAMILY_HISTORY -con I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -R483->frameshift, I-FAMILY_HISTORY -también I-FAMILY_HISTORY -conocida I-FAMILY_HISTORY -como I-FAMILY_HISTORY -R483delGGinsC, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -cuál I-FAMILY_HISTORY -consiste I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -cambio I-FAMILY_HISTORY -de I-FAMILY_HISTORY -los I-FAMILY_HISTORY -nucleótidos I-FAMILY_HISTORY -GG I-FAMILY_HISTORY -por I-FAMILY_HISTORY -C, I-FAMILY_HISTORY -alterando I-FAMILY_HISTORY -la I-FAMILY_HISTORY -lectura I-FAMILY_HISTORY -del I-FAMILY_HISTORY -codón. I-FAMILY_HISTORY -De I-FAMILY_HISTORY -este I-FAMILY_HISTORY -modo I-FAMILY_HISTORY -se I-FAMILY_HISTORY -certificó I-FAMILY_HISTORY -que I-FAMILY_HISTORY -los I-FAMILY_HISTORY -seis I-FAMILY_HISTORY -cónyuges I-FAMILY_HISTORY -poseen I-FAMILY_HISTORY -mutaciones I-FAMILY_HISTORY -para I-FAMILY_HISTORY -HSC I-FAMILY_HISTORY -perdedora I-FAMILY_HISTORY -de I-FAMILY_HISTORY -sal, I-FAMILY_HISTORY -y I-FAMILY_HISTORY -por I-FAMILY_HISTORY -lo I-FAMILY_HISTORY -tanto, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encuentran I-FAMILY_HISTORY -en I-FAMILY_HISTORY -riesgo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tener I-FAMILY_HISTORY -hijas I-FAMILY_HISTORY -con I-FAMILY_HISTORY -ambigüedad I-FAMILY_HISTORY -genital. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Consejo B-TREATMENT -genético I-TREATMENT -y I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -los I-TREATMENT -embarazos. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -dar I-TREATMENT -consejo I-TREATMENT -genético I-TREATMENT -a I-TREATMENT -los I-TREATMENT -tres I-TREATMENT -matrimonios I-TREATMENT -afectados. I-TREATMENT -La B-EVOLUTION -tía I-EVOLUTION -paterna I-EVOLUTION -(sujeto I-EVOLUTION -II.2), I-EVOLUTION -mujer I-EVOLUTION -sana I-EVOLUTION -de I-EVOLUTION -34 I-EVOLUTION -años, I-EVOLUTION -suspende I-EVOLUTION -el I-EVOLUTION -método I-EVOLUTION -anticonceptivo I-EVOLUTION -por I-EVOLUTION -deseos I-EVOLUTION -de I-EVOLUTION -fertilidad I-EVOLUTION -y I-EVOLUTION -logra I-EVOLUTION -concepción I-EVOLUTION -espontánea I-EVOLUTION -en I-EVOLUTION -marzo I-EVOLUTION -2005. I-EVOLUTION -Se B-TREATMENT -explican I-TREATMENT -los I-TREATMENT -beneficios I-TREATMENT -y I-TREATMENT -riesgos I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -prenatal I-TREATMENT -con I-TREATMENT -corti-coides, I-TREATMENT -los I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -entiende I-TREATMENT -y I-TREATMENT -acepta, I-TREATMENT -firmando I-TREATMENT -un I-TREATMENT -consentimiento I-TREATMENT -en I-TREATMENT -que I-TREATMENT -opta I-TREATMENT -por I-TREATMENT -realizar I-TREATMENT -esta I-TREATMENT -terapia. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -comenzó I-TREATMENT -a I-TREATMENT -las I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -edad I-TREATMENT -gestacional I-TREATMENT -(EG) I-TREATMENT -con I-TREATMENT -dexametasona I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -µg/kg/día. I-TREATMENT - I-TREATMENT -A B-EXPLORATION -las I-EXPLORATION -13 I-EXPLORATION -semanas I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -sexo I-EXPLORATION -fetal I-EXPLORATION -masculino I-EXPLORATION -por I-EXPLORATION -ultrasonografía I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -resolución I-EXPLORATION -(Voluson I-EXPLORATION -730, I-EXPLORATION -General I-EXPLORATION -Electric, I-EXPLORATION -Austria, I-EXPLORATION -transductor I-EXPLORATION -transabdominal I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -5-5 I-EXPLORATION -MHz), I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -es I-EXPLORATION -capaz I-EXPLORATION -de I-EXPLORATION -predecir I-EXPLORATION -conectamente I-EXPLORATION -el I-EXPLORATION -sexo I-EXPLORATION -fetal I-EXPLORATION -con I-EXPLORATION -99% I-EXPLORATION -de I-EXPLORATION -certeza I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -12+6 I-EXPLORATION -semanas I-EXPLORATION -EG I-EXPLORATION -(Efrat, I-EXPLORATION -2006); I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -no I-EXPLORATION -aceptó I-EXPLORATION -técnicas I-EXPLORATION -invasivas I-EXPLORATION -de I-EXPLORATION -diagnóstico I-EXPLORATION -prenatal. I-EXPLORATION -Se B-TREATMENT -disminuyó I-TREATMENT -progresivamente I-TREATMENT -las I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -esteroides, I-TREATMENT -suspendiéndolo I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -completa I-TREATMENT -a I-TREATMENT -las I-TREATMENT -22 I-TREATMENT -semanas. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -período I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -edema I-EVOLUTION -e I-EVOLUTION -hipertensión I-EVOLUTION -arterial I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ametildo-pa. I-TREATMENT -Los B-EVOLUTION -síntomas I-EVOLUTION -revirtieron I-EVOLUTION -parcialmente I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -de I-EVOLUTION -terapia I-EVOLUTION -corticoidal, I-EVOLUTION -y I-EVOLUTION -totalmente I-EVOLUTION -posparto. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -39 I-EVOLUTION -semanas I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -cesárea I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -obtuvo I-EVOLUTION -recién I-EVOLUTION -nacido I-EVOLUTION -de I-EVOLUTION -sexo I-EVOLUTION -masculino, I-EVOLUTION -con I-EVOLUTION -peso I-EVOLUTION -adecuado I-EVOLUTION -y I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -normal. I-EVOLUTION -Los I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -170HP I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -se I-EVOLUTION -muestran I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Figura I-EVOLUTION -IB. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -tía I-EVOLUTION -materna I-EVOLUTION -(sujeto I-EVOLUTION -II.5) I-EVOLUTION -de I-EVOLUTION -37 I-EVOLUTION -años I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -embarazo I-EVOLUTION -inicial I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -EG. I-EVOLUTION -Se B-TREATMENT -ofrece I-TREATMENT -nuevamente I-TREATMENT -tratamiento I-TREATMENT -prenatal I-TREATMENT -de I-TREATMENT -HSC, I-TREATMENT -y I-TREATMENT -también I-TREATMENT -se I-TREATMENT -solicitó I-TREATMENT -firma I-TREATMENT -de I-TREATMENT -consentimiento I-TREATMENT -informado. I-TREATMENT -La I-TREATMENT -familia I-TREATMENT -optó I-TREATMENT -nuevamente I-TREATMENT -por I-TREATMENT -seguir I-TREATMENT -este I-TREATMENT -tratamiento. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -EG I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -dexametasona I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -Lig/kg/día. I-TREATMENT -La B-EXPLORATION -madre I-EXPLORATION -no I-EXPLORATION -aceptó I-EXPLORATION -las I-EXPLORATION -técnicas I-EXPLORATION -invasivas I-EXPLORATION -de I-EXPLORATION -diagnóstico I-EXPLORATION -prenatal I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -sexo I-EXPLORATION -fetal I-EXPLORATION -mediante I-EXPLORATION -ecografía I-EXPLORATION -precoz. I-EXPLORATION -En B-TREATMENT -caso I-TREATMENT -de I-TREATMENT -que I-TREATMENT -se I-TREATMENT -tratara I-TREATMENT -de I-TREATMENT -un I-TREATMENT -feto I-TREATMENT -femenino I-TREATMENT -continuarían I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -término I-TREATMENT -del I-TREATMENT -embarazo. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -12 I-TREATMENT -semanas I-TREATMENT -se I-TREATMENT -diagnosticó I-TREATMENT -sexo I-TREATMENT -fetal I-TREATMENT -masculino I-TREATMENT -y I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -suspensión I-TREATMENT -de I-TREATMENT -esteroides. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -efectos I-EVOLUTION -adversos I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -dexametasona. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -40 I-EVOLUTION -semanas I-EVOLUTION -nació I-EVOLUTION -niño I-EVOLUTION -sano, I-EVOLUTION -no I-EVOLUTION -afectado. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad. I-PRESENT_ILLNESS -Después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -varicela, I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -deglutir I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -evidencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipo I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -hipertiroidismo. I-PRESENT_ILLNESS -Su I-PRESENT_ILLNESS -velocidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -pondoestatural I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -normal I-PRESENT_ILLNESS -(5 I-PRESENT_ILLNESS -cm/año) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -ósea I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -previos. I-PAST_MEDICAL_HISTORY -Recién I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -pretérmino I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -33 I-PAST_MEDICAL_HISTORY -semanas; I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -periodo I-PAST_MEDICAL_HISTORY -neonatal I-PAST_MEDICAL_HISTORY -cursó I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -distress I-PAST_MEDICAL_HISTORY -respiratorio; I-PAST_MEDICAL_HISTORY -requirió I-PAST_MEDICAL_HISTORY -ventilación I-PAST_MEDICAL_HISTORY -mecánica I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -días. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -relevantes. I-PAST_MEDICAL_HISTORY -Actualmente I-PAST_MEDICAL_HISTORY -cursa I-PAST_MEDICAL_HISTORY -sexto I-PAST_MEDICAL_HISTORY -básico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buen I-PAST_MEDICAL_HISTORY -rendimiento I-PAST_MEDICAL_HISTORY -escolar. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Historia B-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -Hijo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -sanos, I-FAMILY_HISTORY -con I-FAMILY_HISTORY -antecedente I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tiroiditis I-FAMILY_HISTORY -de I-FAMILY_HISTORY -Hashimoto I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -abuelo I-FAMILY_HISTORY -y I-FAMILY_HISTORY -tía I-FAMILY_HISTORY -materna. I-FAMILY_HISTORY -Su I-FAMILY_HISTORY -talla I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -es I-FAMILY_HISTORY -de I-FAMILY_HISTORY -l69±5 I-FAMILY_HISTORY -cm I-FAMILY_HISTORY -(percentil I-FAMILY_HISTORY -13, I-FAMILY_HISTORY -7). I-FAMILY_HISTORY - I-FAMILY_HISTORY -Examen B-EXPLORATION -físico. I-EXPLORATION -Talla: I-EXPLORATION -146, I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -(percentil I-EXPLORATION -54), I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -Masa I-EXPLORATION -Corporal: I-EXPLORATION -18, I-EXPLORATION -2 I-EXPLORATION -kg/m2 I-EXPLORATION -(percentil I-EXPLORATION -62, I-EXPLORATION -5); I-EXPLORATION -sin I-EXPLORATION -desarrollo I-EXPLORATION -puberal I-EXPLORATION -(vello I-EXPLORATION -púbico I-EXPLORATION -Tanner I-EXPLORATION -I, I-EXPLORATION -testículos I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -ce, I-EXPLORATION -simétricos). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -faringe, I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -rojiza I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -2x2 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua, I-EXPLORATION -con I-EXPLORATION -vasos I-EXPLORATION -venosos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -superficie, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -o I-EXPLORATION -ulceración. I-EXPLORATION -Sin I-EXPLORATION -estridor I-EXPLORATION -u I-EXPLORATION -odinofagia. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -cuello I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -palpó I-EXPLORATION -tiroides I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -posición I-EXPLORATION -pre I-EXPLORATION -traqueal. I-EXPLORATION - I-EXPLORATION -Laboratorio. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -tiroidea I-EXPLORATION -revelaron I-EXPLORATION -TSH I-EXPLORATION -elevada I-EXPLORATION -10, I-EXPLORATION -79 I-EXPLORATION -UI/mL I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -=0, I-EXPLORATION -7-5, I-EXPLORATION -7 I-EXPLORATION -UI/mL), I-EXPLORATION -con I-EXPLORATION -tiroxina I-EXPLORATION -normal, I-EXPLORATION -pero I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -cuartil I-EXPLORATION -más I-EXPLORATION -bajo, I-EXPLORATION -6, I-EXPLORATION -0 I-EXPLORATION -Lig/dl I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -TT I-EXPLORATION -=5, I-EXPLORATION -5-11, I-EXPLORATION -7 I-EXPLORATION -Hg/dl) I-EXPLORATION -y I-EXPLORATION -triyodotironina I-EXPLORATION -baja I-EXPLORATION -57, I-EXPLORATION -8 I-EXPLORATION -ng/dL I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -=84, I-EXPLORATION -4-214, I-EXPLORATION -3 I-EXPLORATION -ng/dL) I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antiperoxidasa I-EXPLORATION -y I-EXPLORATION -antiroglobulina I-EXPLORATION -ausentes. I-EXPLORATION - I-EXPLORATION -Estudio I-EXPLORATION -de I-EXPLORATION -imágenes. I-EXPLORATION -La I-EXPLORATION -nasofibrolaringoscopia I-EXPLORATION -óptica I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -rojiza, I-EXPLORATION -tensa, I-EXPLORATION -redondeada, I-EXPLORATION -con I-EXPLORATION -vasos I-EXPLORATION -sanguíneos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -cuello I-EXPLORATION -confirmó I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -bien I-EXPLORATION -circunscrita I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua, I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -0 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -8 I-EXPLORATION -cm, I-EXPLORATION -hiperdensa I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -cortes I-EXPLORATION -sin I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -endovenoso, I-EXPLORATION -sin I-EXPLORATION -nodulos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -cinügrafía I-EXPLORATION -con I-EXPLORATION -Tc-99 I-EXPLORATION -mostró I-EXPLORATION -captación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -tiroides I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -localización I-EXPLORATION -normal, I-EXPLORATION -concordante I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -ectopia I-EXPLORATION -lingual I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -tiroides. I-EXPLORATION - I-EXPLORATION -Seguimiento. B-TREATMENT -Después I-TREATMENT -que I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -fue I-TREATMENT -realizado, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -L-Tiroxina I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -75 I-TREATMENT -\ig/día. I-TREATMENT -Al B-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -la I-EVOLUTION -TSH I-EVOLUTION -estaba I-EVOLUTION -suprimida I-EVOLUTION -(0, I-EVOLUTION -11 I-EVOLUTION -UI/mL) I-EVOLUTION -con I-EVOLUTION -tiroxina I-EVOLUTION -libre I-EVOLUTION -normal I-EVOLUTION -alta I-EVOLUTION -1, I-EVOLUTION -93 I-EVOLUTION -ng/dL I-EVOLUTION -(0,8-2,0). I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -gradual I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tiroides I-EXPLORATION -lingual I-EXPLORATION -y I-EXPLORATION -desaparición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -disfagia. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -actual I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esquema I-PAST_MEDICAL_HISTORY -insulínico I-PAST_MEDICAL_HISTORY -intensivo I-PAST_MEDICAL_HISTORY -(una I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -nocturna I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insulina I-PAST_MEDICAL_HISTORY -glargina I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insulina I-PAST_MEDICAL_HISTORY -lispro I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -comidas). I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -gran I-PAST_MEDICAL_HISTORY -tabaquismo, I-PAST_MEDICAL_HISTORY -dislipidemia I-PAST_MEDICAL_HISTORY -mixta I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ciprofibrato I-PAST_MEDICAL_HISTORY -100 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -microalbuminuria I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg/12 I-PAST_MEDICAL_HISTORY -h, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificada, I-PRESENT_ILLNESS -calofríos, I-PRESENT_ILLNESS -odinofagia, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -alimentarios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Se B-EXPLORATION -constató I-EXPLORATION -deshidratación I-EXPLORATION -moderada, I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION -de I-EXPLORATION -37, I-EXPLORATION -8°C I-EXPLORATION -y I-EXPLORATION -glicemia I-EXPLORATION -capilar I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -400 I-EXPLORATION -mg/dl. I-EXPLORATION -Fue B-TREATMENT -internado, I-TREATMENT -recibiendo I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -e I-TREATMENT -insulina I-TREATMENT -cristalina I-TREATMENT -en I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -minidosis. I-TREATMENT -Entre B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -obtenidos I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -destacaban I-EXPLORATION -glicemia I-EXPLORATION -549 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -1, I-EXPLORATION -67 I-EXPLORATION -mg/dl, I-EXPLORATION -pH I-EXPLORATION -6, I-EXPLORATION -91, I-EXPLORATION -BE I-EXPLORATION --27, I-EXPLORATION -HC03 I-EXPLORATION -4, I-EXPLORATION -6 I-EXPLORATION -(en I-EXPLORATION -sangre I-EXPLORATION -arterial), I-EXPLORATION -cetonemia I-EXPLORATION -+++, I-EXPLORATION -natremia I-EXPLORATION -141, I-EXPLORATION -7 I-EXPLORATION -mEq/L, I-EXPLORATION -kalemia I-EXPLORATION -5, I-EXPLORATION -92 I-EXPLORATION -mEq/L, I-EXPLORATION -cloremia I-EXPLORATION -98 I-EXPLORATION -mEq/L, I-EXPLORATION -amilasemia I-EXPLORATION -48 I-EXPLORATION -U/L, I-EXPLORATION -hematocrito I-EXPLORATION -40, I-EXPLORATION -5%, I-EXPLORATION -leucocitos I-EXPLORATION -9-100 I-EXPLORATION -mm3, I-EXPLORATION -VHS I-EXPLORATION -38 I-EXPLORATION -mm/h I-EXPLORATION -y I-EXPLORATION -urocultivo I-EXPLORATION -negativo. I-EXPLORATION -Fue B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -cetoacidosis I-EVOLUTION -diabética, I-EVOLUTION -se B-TREATMENT -le I-TREATMENT -indicó I-TREATMENT -mantener I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -insulínico I-TREATMENT -intensificado I-TREATMENT -y I-TREATMENT -asistir I-TREATMENT -a I-TREATMENT -control I-TREATMENT -ambulatorio. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -trasladó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -ciudad I-EVOLUTION -de I-EVOLUTION -Temuco, I-EVOLUTION -consultando I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -por I-EVOLUTION -sensación I-EVOLUTION -febril I-EVOLUTION -no I-EVOLUTION -cuantificada, I-EVOLUTION -sudoración I-EVOLUTION -nocturna, I-EVOLUTION -odinofagia I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -al I-EVOLUTION -movilizar I-EVOLUTION -el I-EVOLUTION -cuello. I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuello, I-EXPLORATION -sensible, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios I-EXPLORATION -ni I-EXPLORATION -crepitación, I-EXPLORATION -fetor I-EXPLORATION -pútrido I-EXPLORATION -y I-EXPLORATION -faringe I-EXPLORATION -congestiva I-EXPLORATION -con I-EXPLORATION -escaso I-EXPLORATION -exudado I-EXPLORATION -purulento. I-EXPLORATION -Se B-EVOLUTION -indicó I-EVOLUTION -hospitalización I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -DM I-EVOLUTION -descompensada, I-EVOLUTION -faringo-amigdalitis I-EVOLUTION -pultácea I-EVOLUTION -y I-EVOLUTION -masa I-EVOLUTION -cervical I-EVOLUTION -en I-EVOLUTION -estudio. I-EVOLUTION -Entre B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -destacaban I-EXPLORATION -glicemia I-EXPLORATION -270 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -mg/ I-EXPLORATION -di, I-EXPLORATION -hematocrito I-EXPLORATION -35, I-EXPLORATION -7%, I-EXPLORATION -leucocitos I-EXPLORATION -18.800 I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION -VHS I-EXPLORATION -91 I-EXPLORATION -mm/hora, I-EXPLORATION -PCR I-EXPLORATION -309 I-EXPLORATION -mg/L. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -hidratación I-TREATMENT -con I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -e I-TREATMENT -infusión I-TREATMENT -endovenosa I-TREATMENT -continua I-TREATMENT -de I-TREATMENT -insulina, I-TREATMENT -fue B-EXPLORATION -evaluado I-EXPLORATION -por I-EXPLORATION -otorrinolaringólogo I-EXPLORATION -con I-EXPLORATION -nasofaringoscopia, I-EXPLORATION -pesquisándose I-EXPLORATION -flegmón I-EXPLORATION -faríngeo. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -EV I-TREATMENT -20 I-TREATMENT -millones I-TREATMENT -U/día, I-TREATMENT -cloxacilina I-TREATMENT -12 I-TREATMENT -g I-TREATMENT -EV/ I-TREATMENT -día I-TREATMENT -y I-TREATMENT -ceftriaxona I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -EV/día. I-TREATMENT -El B-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -cervical I-EXPLORATION -fue I-EXPLORATION -estudiado I-EXPLORATION -con I-EXPLORATION -ecotomografía I-EXPLORATION -cervical, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -compartimiento I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -multicorte I-EXPLORATION -de I-EXPLORATION -cuello I-EXPLORATION -en I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -retrofa-ríngeo I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -compartimientos I-EXPLORATION -posteriores I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -flegmonoso. I-EXPLORATION - I-EXPLORATION -Evaluado B-TREATMENT -en I-TREATMENT -conjunto I-TREATMENT -con I-TREATMENT -otorrinolaringólogo I-TREATMENT -y I-TREATMENT -cirujano I-TREATMENT -de I-TREATMENT -cabeza I-TREATMENT -y I-TREATMENT -cuello, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -practicar I-TREATMENT -drenaje I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colección. I-TREATMENT -Al I-TREATMENT -segundo I-TREATMENT -día I-TREATMENT -de I-TREATMENT -hospitalización I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -2 I-TREATMENT -incisiones I-TREATMENT -en I-TREATMENT -la I-TREATMENT -región I-TREATMENT -posterior I-TREATMENT -del I-TREATMENT -cuello, I-TREATMENT -drenando I-TREATMENT -líquido I-TREATMENT -purulento. I-TREATMENT -No B-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -o I-EXPLORATION -gas. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -secreción, I-EXPLORATION -aislándose I-EXPLORATION -Streptococcus I-EXPLORATION -grupo I-EXPLORATION -B, I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Luego B-TREATMENT -de I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -EV, I-TREATMENT -los I-TREATMENT -drenajes I-TREATMENT -Penrose I-TREATMENT -dejaron I-TREATMENT -de I-TREATMENT -entregar I-TREATMENT -secreción I-TREATMENT -y I-TREATMENT -fueron I-TREATMENT -retirados. I-TREATMENT -La B-EVOLUTION -exploración I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -incisiones I-EVOLUTION -fue I-EVOLUTION -satisfactoria. I-EVOLUTION -Se B-TREATMENT -dio I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -con I-TREATMENT -antibiótico I-TREATMENT -oral I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -otra I-TREATMENT -semana I-TREATMENT -(Ampicilina/Sulbactam). I-TREATMENT - I-TREATMENT - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -(20 I-PAST_MEDICAL_HISTORY -cig/día) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -urolitiasis I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -27 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -súbito, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -irradiación, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómito I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -ocasión I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cede I-PRESENT_ILLNESS -espontáneamente. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -repitió I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -anterior. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -No B-EXPLORATION -presentó I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -140/82 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -ilíaca I-EXPLORATION -derecha I-EXPLORATION -(FID). I-EXPLORATION - I-EXPLORATION -Dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -orina I-EXPLORATION -completa I-EXPLORATION -sin I-EXPLORATION -hematuria, I-EXPLORATION -hemogra-ma I-EXPLORATION -con I-EXPLORATION -leucocitosis I-EXPLORATION -(17.200 I-EXPLORATION -x I-EXPLORATION -mm3), I-EXPLORATION -creatininemia I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -de I-EXPLORATION -1.457 I-EXPLORATION -UI/1. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -pieloTC I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -ser I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -urolitiasis, I-EXPLORATION -prosiguiéndose I-EXPLORATION -con I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -extensa I-EXPLORATION -área I-EXPLORATION -hipodensa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -cuneiforme I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION -derecho, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -parcial I-EXPLORATION -renal I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Se B-EVOLUTION -hospitalizó I-EVOLUTION -al I-EVOLUTION -paciente. I-EVOLUTION -Se B-EXPLORATION -tomaron I-EXPLORATION -exámenes I-EXPLORATION -para I-EXPLORATION -trombofilia, I-EXPLORATION -cuyos I-EXPLORATION -resultados I-EXPLORATION -fueron I-EXPLORATION -normales, I-EXPLORATION -previo I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -anticoagulación I-EXPLORATION -(Fragmin I-EXPLORATION -y I-EXPLORATION -Neosintrón I-EXPLORATION -). I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecocardiografía I-EXPLORATION -transesofágica I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -angioTC I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -dominante I-EXPLORATION -(AD) I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -polar I-EXPLORATION -de I-EXPLORATION -menor I-EXPLORATION -calibre I-EXPLORATION -con I-EXPLORATION -trayecto I-EXPLORATION -normal, I-EXPLORATION -e I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -arterial I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -renal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -prosiguió I-EXPLORATION -con I-EXPLORATION -estudio I-EXPLORATION -angiográfico, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -aortografía I-EXPLORATION -normal, I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -perfusión I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -superior, I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -riñon I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -perfusión I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -dado I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -polar I-EXPLORATION -secundaria. I-EXPLORATION -La I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -dominante I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -irregular, I-EXPLORATION -dilatada I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -que I-EXPLORATION -además I-EXPLORATION -presentó I-EXPLORATION -un I-EXPLORATION -flap I-EXPLORATION -de I-EXPLORATION -disección I-EXPLORATION -que I-EXPLORATION -comprometió I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -ramas I-EXPLORATION -interlobares, I-EXPLORATION -limitando I-EXPLORATION -así I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION -distal. I-EXPLORATION -El I-EXPLORATION -flap I-EXPLORATION -de I-EXPLORATION -disección I-EXPLORATION -fue I-EXPLORATION -descrito I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -complejidad I-EXPLORATION -sin I-EXPLORATION -posibilidades I-EXPLORATION -de I-EXPLORATION -maniobras I-EXPLORATION -endovasculares. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -presentó I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -flanco I-EVOLUTION -derecho. I-EVOLUTION -Nuevo B-EXPLORATION -angioTC I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -clara I-EXPLORATION -progresión I-EXPLORATION -del I-EXPLORATION -infarto I-EXPLORATION -renal I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -2/3 I-EXPLORATION -superiores I-EXPLORATION -del I-EXPLORATION -riñon I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -presiones I-EVOLUTION -arteriales I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -rango I-EVOLUTION -de I-EVOLUTION -160/100 I-EVOLUTION -mmHg I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -deterioro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -(creatininemia I-EVOLUTION -1, I-EVOLUTION -2 I-EVOLUTION -mg/dl). I-EVOLUTION -Fue B-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -con I-TREATMENT -terapia I-TREATMENT -antihipertensiva I-TREATMENT -(Blox I-TREATMENT -4 I-TREATMENT -mg/día) I-TREATMENT -en I-TREATMENT -buenas I-TREATMENT -condiciones I-TREATMENT -generales I-TREATMENT -para I-TREATMENT -su I-TREATMENT -manejo I-TREATMENT -ambulatorio. I-TREATMENT -En B-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -y I-EVOLUTION -diecisiete I-EVOLUTION -días I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -asintomático, I-EVOLUTION -normotenso I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -resto I-EVOLUTION -del I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -sin I-EVOLUTION -hallazgos I-EVOLUTION -patológicos. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -quien B-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -urgencia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1974 I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -lesión I-PAST_MEDICAL_HISTORY -ulcerada I-PAST_MEDICAL_HISTORY -gástrica I-PAST_MEDICAL_HISTORY -sangrante. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practicó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -gastrectomía I-PAST_MEDICAL_HISTORY -subtotal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -reconstrucción I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Billroth I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -postoperatoria I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pieza I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gastrectomía I-PAST_MEDICAL_HISTORY -subtotal I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontró I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -ulcerado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -anterior, I-PAST_MEDICAL_HISTORY -distante I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -mm I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -sección I-PAST_MEDICAL_HISTORY -gástrica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -píloro. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -medía I-PAST_MEDICAL_HISTORY -3, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -eje I-PAST_MEDICAL_HISTORY -longitudinal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -transversal, I-PAST_MEDICAL_HISTORY -comprometiendo I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -curvatura I-PAST_MEDICAL_HISTORY -menor I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -extendiéndose I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -posterior. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -corte, I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -constituido I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -tejido I-PAST_MEDICAL_HISTORY -rosado I-PAST_MEDICAL_HISTORY -pálido I-PAST_MEDICAL_HISTORY -lobulado, I-PAST_MEDICAL_HISTORY -liso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -brillante, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -reemplazaba I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -túnicas I-PAST_MEDICAL_HISTORY -submucosa, I-PAST_MEDICAL_HISTORY -muscular I-PAST_MEDICAL_HISTORY -propia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -subserosa, I-PAST_MEDICAL_HISTORY -abombando I-PAST_MEDICAL_HISTORY -levemente I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -serosa. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -histopatológico I-PAST_MEDICAL_HISTORY -demostró I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -linfoma I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -Hodgkin I-PAST_MEDICAL_HISTORY -mixto I-PAST_MEDICAL_HISTORY -linfo-histiocítico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clasificación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Rappaport I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1966, I-PAST_MEDICAL_HISTORY -vigente I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -formularon I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -clasificaciones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Kiel I-PAST_MEDICAL_HISTORY -(1974) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Lukes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Collins I-PAST_MEDICAL_HISTORY -(1974). I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontró I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -ganglios I-PAST_MEDICAL_HISTORY -linfáticos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -linfoma. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -enfermo I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -adyuvante I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -seguido I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -endoscopias I-PAST_MEDICAL_HISTORY -anuales I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -23 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observaron I-PAST_MEDICAL_HISTORY -nuevas I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -gástricas I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -demostró I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Helicobacter I-PAST_MEDICAL_HISTORY -pylori. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -período, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -desarrolló I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -tumores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Warthin I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ambas I-PAST_MEDICAL_HISTORY -glándulas I-PAST_MEDICAL_HISTORY -parótidas, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -resecó I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cáncer I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -piel I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -epidermoide I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -extremidad I-PAST_MEDICAL_HISTORY -inferior I-PAST_MEDICAL_HISTORY -derecha. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -septiembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2006, I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -operación I-PRESENT_ILLNESS -gástrica, I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -anemia. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -palidez, I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -abdominales. I-EXPLORATION -El I-EXPLORATION -hematocrito I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -34, I-EXPLORATION -5% I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -proliferativa I-EXPLORATION -y I-EXPLORATION -ulcerada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -muñón I-EXPLORATION -gástrico I-EXPLORATION -que I-EXPLORATION -obstruía I-EXPLORATION -parcialmente I-EXPLORATION -la I-EXPLORATION -anastomosis I-EXPLORATION -gastroyeyunal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -mostró I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -gástrica I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -infiltrada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -tubular I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -Helicobacter I-EXPLORATION -pylori. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -operado I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -gastrectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -disección I-TREATMENT -ganglionar. I-TREATMENT -La B-EVOLUTION -recuperación I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -tumoral I-EXPLORATION -ulcerada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -muñón I-EXPLORATION -gástrico I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -anastomosis I-EXPLORATION -gastroyeyunal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -tubular I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -subserosa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -gástrica, I-EXPLORATION -metástasis I-EXPLORATION -en I-EXPLORATION -10 I-EXPLORATION -linfonodos I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -resecados I-EXPLORATION -y I-EXPLORATION -permeaciones I-EXPLORATION -vasculares I-EXPLORATION -linfáticas I-EXPLORATION -(T2bN2M0, I-EXPLORATION -Etapa I-EXPLORATION -IIIB). I-EXPLORATION - I-EXPLORATION - -En B-PRESENT_ILLNESS -septiembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2006 I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -Dento-Máxilo-Facial I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Universidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Chile, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -estudiante, B-PAST_MEDICAL_HISTORY -derivada B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Hematología I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -blanquecinas I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -mucosa I-DERIVED_FROM/TO -bucal. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -aplásica I-PAST_MEDICAL_HISTORY -severa I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2005, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -atribuyó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -derivado I-PAST_MEDICAL_HISTORY -fenotiacínico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -médula I-PAST_MEDICAL_HISTORY -ósea I-PAST_MEDICAL_HISTORY -(TMO) I-PAST_MEDICAL_HISTORY -alogénico. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -primeras I-PRESENT_ILLNESS -manifestaciones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -EICH I-PRESENT_ILLNESS -agudo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -predominante I-PRESENT_ILLNESS -cutáneo I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -+42, I-PRESENT_ILLNESS -manifestado B-EXPLORATION -como I-EXPLORATION -lesión I-EXPLORATION -máculo-pápulo I-EXPLORATION -eritematosa I-EXPLORATION -de I-EXPLORATION -tronco I-EXPLORATION -y I-EXPLORATION -extremidades I-EXPLORATION -con I-EXPLORATION -biopsia I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -EICH I-EXPLORATION -agudo, I-EXPLORATION -momento B-TREATMENT -en I-TREATMENT -que I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -asociación I-TREATMENT -de I-TREATMENT -corticoides I-TREATMENT -(prednisona I-TREATMENT -20 I-TREATMENT -mg/dia) I-TREATMENT -con I-TREATMENT -ciclosporina, I-TREATMENT -reemplazándose I-TREATMENT -luego I-TREATMENT -la I-TREATMENT -ciclosporina I-TREATMENT -por I-TREATMENT -tacrolimus, I-TREATMENT -3 I-TREATMENT -mg/dia I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -toxicidad I-TREATMENT -neurológica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -primera. I-TREATMENT -Las B-EVOLUTION -lesiones I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mucosa I-EVOLUTION -oral I-EVOLUTION -aparecieron I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -más I-EVOLUTION -tardía I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -primera I-EVOLUTION -descripción I-EVOLUTION -aparece I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -día I-EVOLUTION -+310. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -clínico, I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -bucales I-EXPLORATION -comprometían I-EXPLORATION -casi I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -manifestaban I-EXPLORATION -mayormente I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -labios, I-EXPLORATION -cara I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -mejilla I-EXPLORATION -y I-EXPLORATION -cara I-EXPLORATION -ventral I-EXPLORATION -de I-EXPLORATION -lengua. I-EXPLORATION -Las I-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -blanquecino, I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -reticular I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -desprendían I-EXPLORATION -al I-EXPLORATION -raspado. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refería I-EXPLORATION -síntomas I-EXPLORATION -asociados. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -hipótesis I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -por I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -injerto I-EXPLORATION -contra I-EXPLORATION -huésped I-EXPLORATION -se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -realizar I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -labio I-EXPLORATION -inferior, I-EXPLORATION -lugar I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION -manifiestas. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -EIVH. I-EXPLORATION -Se I-EXPLORATION -describió I-EXPLORATION -un I-EXPLORATION -epitelio I-EXPLORATION -de I-EXPLORATION -revestimiento I-EXPLORATION -plano I-EXPLORATION -pluriestratificado I-EXPLORATION -hiperparaqueratinizado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -agujiforme. I-EXPLORATION -Un I-EXPLORATION -estrato I-EXPLORATION -basal I-EXPLORATION -con I-EXPLORATION -desorganización I-EXPLORATION -celular I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -corion I-EXPLORATION -inmediatamente I-EXPLORATION -subyacente I-EXPLORATION -infiltración I-EXPLORATION -linfocitaria I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -neoformación I-EXPLORATION -y I-EXPLORATION -proliferación I-EXPLORATION -fibroblástica. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -describió I-EXPLORATION -leve I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION -periductal I-EXPLORATION -en I-EXPLORATION -glándula I-EXPLORATION -salival I-EXPLORATION -menor I-EXPLORATION -vecina. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -medidas I-TREATMENT -locales I-TREATMENT -para I-TREATMENT -disminuir I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -infecciones I-TREATMENT -y I-TREATMENT -mantener I-TREATMENT -adecuada I-TREATMENT -humectación I-TREATMENT -del I-TREATMENT -medio I-TREATMENT -bucal; I-TREATMENT -clorhexidina I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -12% I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -sustituto I-TREATMENT -de I-TREATMENT -saliva I-TREATMENT -de I-TREATMENT -uso I-TREATMENT -diario, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -instrucción I-TREATMENT -de I-TREATMENT -higiene I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -Seis B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -controlada I-EVOLUTION -manifestando I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -algunas I-EVOLUTION -zonas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mucosa I-EVOLUTION -bucal, I-EVOLUTION -evidenciándose I-EVOLUTION -lesiones I-EVOLUTION -erosivas I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -examen I-EVOLUTION -clínico. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -incorporar I-TREATMENT -en I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -local, I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -betametasona I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -en I-TREATMENT -plastibase, I-TREATMENT -reforzando I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -de I-TREATMENT -higiene I-TREATMENT -bucal. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -permanecieron I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -aumentó, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -por I-TREATMENT -tacrolimus I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -en I-TREATMENT -aplicación I-TREATMENT -tópica I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -agregándose I-TREATMENT -además I-TREATMENT -miconazol I-TREATMENT -2% I-TREATMENT -(Daktarin I-TREATMENT -Gel) I-TREATMENT -de I-TREATMENT -aplicación I-TREATMENT -tópica, I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Además I-TREATMENT -se I-TREATMENT -sustituyó I-TREATMENT -la I-TREATMENT -clorhexidina I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -12% I-TREATMENT -por I-TREATMENT -una I-TREATMENT -concentración I-TREATMENT -más I-TREATMENT -baja, I-TREATMENT -0, I-TREATMENT -05%, I-TREATMENT -dado I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -le I-TREATMENT -costaba I-TREATMENT -tolerar I-TREATMENT -la I-TREATMENT -primera I-TREATMENT -por I-TREATMENT -provocarle I-TREATMENT -ardor I-TREATMENT -al I-TREATMENT -momento I-TREATMENT -de I-TREATMENT -usarla. I-TREATMENT -Después B-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -remitieron I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentaba I-EVOLUTION -dolor I-EVOLUTION -ni I-EVOLUTION -dificultades I-EVOLUTION -para I-EVOLUTION -alimentarse. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquista I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -paquetes/año, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -LNH I-PAST_MEDICAL_HISTORY -sistémico I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -características I-PAST_MEDICAL_HISTORY -clínicas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -SAA, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -variante I-PAST_MEDICAL_HISTORY -disección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aorta I-PAST_MEDICAL_HISTORY -descendente. I-PAST_MEDICAL_HISTORY -Se B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -emergencias I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -La B-EXPLORATION -TAC I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -blando, I-EXPLORATION -periaórtico, I-EXPLORATION -tóraco-abdominal I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -adenopatías. I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN). I-EXPLORATION -Se I-EXPLORATION -internó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Unidad I-EXPLORATION -de I-EXPLORATION -Cuidados I-EXPLORATION -Intensivos, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -disección I-EXPLORATION -aórtica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -toracocentesis, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aspiraron I-EXPLORATION -cerca I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -litros I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -hemorrágico, I-EXPLORATION -cuya I-EXPLORATION -citología I-EXPLORATION -reveló I-EXPLORATION -células I-EXPLORATION -malignas I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -LNH. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -mostró I-EXPLORATION -linfoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -pequeñas, I-EXPLORATION -fenotipo I-EXPLORATION -B. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -por I-EXPLORATION -laparotomía I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -periaórtica I-EXPLORATION -mostró I-EXPLORATION -LNH I-EXPLORATION -folicular I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -con I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -arribó I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -LP. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -CHOP-R I-TREATMENT -fue I-TREATMENT -efectiva, I-TREATMENT -con I-TREATMENT -resolución I-TREATMENT -inicial I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -objetivado I-TREATMENT -por I-TREATMENT -TAC, I-TREATMENT -pero B-EVOLUTION -desarrolló I-EVOLUTION -luego I-EVOLUTION -quilotórax, I-EVOLUTION -malnutrición I-EVOLUTION -y I-EVOLUTION -falleció. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -o B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia. I-FAMILY_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -septiembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -afebril, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tránsito I-PRESENT_ILLNESS -intestinal. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -concluyente I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -e I-EXPLORATION -imágenes. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -análisis I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -2 I-EXPLORATION -mg/dL, I-EXPLORATION -leucocitos I-EXPLORATION -8.080/mm3 I-EXPLORATION -con I-EXPLORATION -67, I-EXPLORATION -8% I-EXPLORATION -de I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -amilasemia I-EXPLORATION -normal. I-EXPLORATION -Una I-EXPLORATION -ecotomografía I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -sólido-quística I-EXPLORATION -compleja I-EXPLORATION -de I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo I-EXPLORATION -del I-EXPLORATION -hígado. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -probable I-EXPLORATION -colecistitis I-EXPLORATION -aguda I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -focal I-EXPLORATION -hepática I-EXPLORATION -sospechosa I-EXPLORATION -de I-EXPLORATION -absceso. I-EXPLORATION -Se B-TREATMENT -efectuó I-TREATMENT -colecistectomía I-TREATMENT -y I-TREATMENT -biopsia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -hepática. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -identifican I-TREATMENT -otras I-TREATMENT -lesiones I-TREATMENT -abdominales I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -exploración I-TREATMENT -quirúrgica. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -demuestra I-EXPLORATION -una I-EXPLORATION -metástasis I-EXPLORATION -hepática I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -neuroendocrino I-EXPLORATION -con I-EXPLORATION -inmunohistoquímica I-EXPLORATION -concordante. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -PET/CT I-EXPLORATION -con I-EXPLORATION -18FDG I-EXPLORATION -de I-EXPLORATION -cuerpo I-EXPLORATION -entero I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -sólo I-EXPLORATION -captación I-EXPLORATION -fisiológica I-EXPLORATION -en I-EXPLORATION -diversos I-EXPLORATION -órganos I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION -significativo I-EXPLORATION -del I-EXPLORATION -metabolismo I-EXPLORATION -glucídico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -metástasis I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo I-EXPLORATION -del I-EXPLORATION -hígado I-EXPLORATION -en I-EXPLORATION -comparación I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -hepático. I-EXPLORATION -Una I-EXPLORATION -colonoscopia I-EXPLORATION -en I-EXPLORATION -búsqueda I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -origen I-EXPLORATION -fue I-EXPLORATION -catalogada I-EXPLORATION -como I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Tres I-EXPLORATION -meses I-EXPLORATION -más I-EXPLORATION -tarde I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -examen I-EXPLORATION -PET/CT I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -nuevo I-EXPLORATION -radiofármaco I-EXPLORATION -68Ga-DOTATATE I-EXPLORATION -(CGM I-EXPLORATION -Nuclear, I-EXPLORATION -Santiago-Chile) I-EXPLORATION -recientemente I-EXPLORATION -incorporado I-EXPLORATION -a I-EXPLORATION -nuestro I-EXPLORATION -centro. I-EXPLORATION -El I-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -calidad I-EXPLORATION -del I-EXPLORATION -producto I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -pureza I-EXPLORATION -radioquímica I-EXPLORATION -superior I-EXPLORATION -al I-EXPLORATION -99%. I-EXPLORATION -Se I-EXPLORATION -inyectaron I-EXPLORATION -por I-EXPLORATION -vía I-EXPLORATION -e.v. I-EXPLORATION -111 I-EXPLORATION -MBq I-EXPLORATION -(3 I-EXPLORATION -mCi) I-EXPLORATION -del I-EXPLORATION -radiotrazador. I-EXPLORATION -Cincuenta I-EXPLORATION -minutos I-EXPLORATION -más I-EXPLORATION -tarde I-EXPLORATION -se I-EXPLORATION -registraron I-EXPLORATION -imágenes I-EXPLORATION -PET/ I-EXPLORATION -CT I-EXPLORATION -3D I-EXPLORATION -de I-EXPLORATION -cuerpo I-EXPLORATION -entero I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -aparato I-EXPLORATION -Biograph I-EXPLORATION -6 I-EXPLORATION -HiRez I-EXPLORATION -P3D I-EXPLORATION -(Siemens I-EXPLORATION -Medical I-EXPLORATION -Systems, I-EXPLORATION -USA). I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -mostró, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intensa I-EXPLORATION -captación I-EXPLORATION -del I-EXPLORATION -radiofármaco I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -metástasis I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -segundo I-EXPLORATION -foco I-EXPLORATION -de I-EXPLORATION -sobreexpresión I-EXPLORATION -de I-EXPLORATION -receptores I-EXPLORATION -de I-EXPLORATION -SST I-EXPLORATION -situado I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -asa I-EXPLORATION -de I-EXPLORATION -íleon I-EXPLORATION -distal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -ileocecal I-EXPLORATION -altamente I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -corresponder I-EXPLORATION -al I-EXPLORATION -tumor I-EXPLORATION -primario. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -otros I-EXPLORATION -focos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -cirugía I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -subcostal I-TREATMENT -identificándose I-TREATMENT -un I-TREATMENT -nodulo I-TREATMENT -de I-TREATMENT -16 I-TREATMENT -mm I-TREATMENT -en I-TREATMENT -el I-TREATMENT -íleon I-TREATMENT -terminal, I-TREATMENT -vecino I-TREATMENT -a I-TREATMENT -la I-TREATMENT -válvula I-TREATMENT -ileocecal, I-TREATMENT -sin I-TREATMENT -extensión I-TREATMENT -regional I-TREATMENT -macroscópica. I-TREATMENT -Se I-TREATMENT -efectúa I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -íleon I-TREATMENT -terminal, I-TREATMENT -ciego I-TREATMENT -y I-TREATMENT -apéndice I-TREATMENT -cecal I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -subcostal I-TREATMENT -ampliada. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -acto I-TREATMENT -se I-TREATMENT -extirpa I-TREATMENT -la I-TREATMENT -metástasis I-TREATMENT -hepática I-TREATMENT -mediante I-TREATMENT -hepatectomía I-TREATMENT -izquierda. I-TREATMENT -Como I-TREATMENT -hallazgos I-TREATMENT -intraoperatorio I-TREATMENT -se I-TREATMENT -identifica I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -metástasis I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -mm I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -VII I-TREATMENT -del I-TREATMENT -hígado I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -reseca I-TREATMENT -en I-TREATMENT -cuña. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -neuroendocrino I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -del I-EXPLORATION -íleon I-EXPLORATION -terminal I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -mm I-EXPLORATION -que I-EXPLORATION -infiltraba I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -penetración I-EXPLORATION -linfovascular, I-EXPLORATION -6 I-EXPLORATION -linfonodos I-EXPLORATION -regionales I-EXPLORATION -sin I-EXPLORATION -tumor I-EXPLORATION -y I-EXPLORATION -2 I-EXPLORATION -metástasis I-EXPLORATION -hepáticas I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -neuroendocrino I-EXPLORATION -de I-EXPLORATION -también I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado, I-EXPLORATION -la I-EXPLORATION -ya I-EXPLORATION -conocida I-EXPLORATION -de I-EXPLORATION -4, I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -cm. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sana, I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -ictericia, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -progresivo. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -hubo I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -transaminasas, I-EXPLORATION -gamaglutamiltranspeptidasas, I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -INR I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -renal. I-EXPLORATION -No B-PAST_MEDICAL_HISTORY -hubo I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fármacos I-PAST_MEDICAL_HISTORY -y B-EXPLORATION -los I-EXPLORATION -marcadores I-EXPLORATION -virales I-EXPLORATION -e I-EXPLORATION -inmunológicos I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -exceptuando, I-EXPLORATION -un I-EXPLORATION -título I-EXPLORATION -de I-EXPLORATION -intensidad I-EXPLORATION -menor I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -A. I-EXPLORATION -Evolucionó B-TREATMENT -rápidamente I-TREATMENT -a I-TREATMENT -sopor I-TREATMENT -profundo, I-TREATMENT -requirió I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasiva I-TREATMENT -y B-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -encéfalo I-EXPLORATION -(TC) I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -edema I-EXPLORATION -encefálico I-EXPLORATION -con I-EXPLORATION -elementos I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -HIC. I-EXPLORATION -La I-EXPLORATION -monitorización I-EXPLORATION -electroencefalográfica I-EXPLORATION -mostró I-EXPLORATION -ritmos I-EXPLORATION -lentos I-EXPLORATION -y I-EXPLORATION -simétricos I-EXPLORATION -bilaterales. I-EXPLORATION -El I-EXPLORATION -INR I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -5, I-EXPLORATION -0 I-EXPLORATION -se I-EXPLORATION -corrigió I-EXPLORATION -a I-EXPLORATION -1, I-EXPLORATION -6 I-EXPLORATION -con I-EXPLORATION -40 I-EXPLORATION -ug/kg I-EXPLORATION -de I-EXPLORATION -Factor I-EXPLORATION -VII I-EXPLORATION -activado I-EXPLORATION -recombinante I-EXPLORATION -(rFVIIa) I-EXPLORATION -previo I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -instalación I-EXPLORATION -de I-EXPLORATION -catéter I-EXPLORATION -intraparenquimatoso I-EXPLORATION -Raudemic® I-EXPLORATION -para I-EXPLORATION -medición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -intracraneana I-EXPLORATION -(PIC) I-EXPLORATION -y I-EXPLORATION -temperatura I-EXPLORATION -encefálica. I-EXPLORATION -Los I-EXPLORATION -valores I-EXPLORATION -iniciales I-EXPLORATION -de I-EXPLORATION -PIC I-EXPLORATION -fluctuaron I-EXPLORATION -entre I-EXPLORATION -20 I-EXPLORATION -y I-EXPLORATION -25 I-EXPLORATION -mmHg, I-EXPLORATION -con I-EXPLORATION -temperatura I-EXPLORATION -cerebral I-EXPLORATION -de I-EXPLORATION -37°C. I-EXPLORATION -El I-EXPLORATION -Doppler I-EXPLORATION -transcraneano I-EXPLORATION -determinó I-EXPLORATION -velocidad I-EXPLORATION -sistólica I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -pulsatibilidad I-EXPLORATION -normales; I-EXPLORATION -siendo I-EXPLORATION -enlistada I-EXPLORATION -para I-EXPLORATION -trasplante I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -acuerdo I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION -del I-EXPLORATION -King's I-EXPLORATION -College8. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -HIC I-TREATMENT -se I-TREATMENT -tornó I-TREATMENT -refractaria I-TREATMENT -a I-TREATMENT -medidas I-TREATMENT -de I-TREATMENT -primera I-TREATMENT -línea, I-TREATMENT -iniciándose I-TREATMENT -hipotermia I-TREATMENT -intravascular I-TREATMENT -mediante I-TREATMENT -catéter I-TREATMENT -tipo I-TREATMENT -ICY® I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -con I-TREATMENT -máquina I-TREATMENT -Alsius I-TREATMENT -CoolGard®, I-TREATMENT -disminuyendo I-TREATMENT -la I-TREATMENT -temperatura I-TREATMENT -encefálica I-TREATMENT -a I-TREATMENT -33oC. I-TREATMENT -Recibió I-TREATMENT -sedación I-TREATMENT -con I-TREATMENT -opiáceos I-TREATMENT -(Fentanyl) I-TREATMENT -e I-TREATMENT -infusión I-TREATMENT -continua I-TREATMENT -de I-TREATMENT -relajante I-TREATMENT -muscular I-TREATMENT -(vecuronium) I-TREATMENT -para I-TREATMENT -prevenir I-TREATMENT -escalofríos; I-TREATMENT -en B-EVOLUTION -3, I-EVOLUTION -5 I-EVOLUTION -h I-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -la I-EVOLUTION -meta I-EVOLUTION -de I-EVOLUTION -33oC. I-EVOLUTION -A B-TREATMENT -las I-TREATMENT -72 I-TREATMENT -h, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -ofreció I-TREATMENT -un I-TREATMENT -injerto I-TREATMENT -hepático I-TREATMENT -de I-TREATMENT -donante I-TREATMENT -cadavérico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -trasplante I-TREATMENT -ortotópico I-TREATMENT -bajo I-TREATMENT -hipotermia I-TREATMENT -intravascular I-TREATMENT -activa. I-TREATMENT -Posteriormente B-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos, I-EVOLUTION -y I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -comprobar I-EVOLUTION -la I-EVOLUTION -perfusión I-EVOLUTION -del I-EVOLUTION -injerto, I-EVOLUTION -se I-EVOLUTION -reinició I-EVOLUTION -recalentamiento I-EVOLUTION -lento I-EVOLUTION -controlado I-EVOLUTION -alcanzando I-EVOLUTION -la I-EVOLUTION -normotermia I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -76 I-EVOLUTION -h I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -continua I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -hepática, I-EVOLUTION -completando I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -manera I-EVOLUTION -122 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -hipotermia I-EVOLUTION -a I-EVOLUTION -33oC. I-EVOLUTION -Desarrolló I-EVOLUTION -mioneuropatía I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -crítico I-EVOLUTION -y I-EVOLUTION -permaneció I-EVOLUTION -en I-EVOLUTION -ventilación I-EVOLUTION -mecánica I-EVOLUTION -durante I-EVOLUTION -15 I-EVOLUTION -días, I-EVOLUTION -requiriendo B-TREATMENT -de I-TREATMENT -traqueostomía I-TREATMENT -percutánea I-TREATMENT -para I-TREATMENT -facilitar I-TREATMENT -el I-TREATMENT -destete I-TREATMENT -del I-TREATMENT -ventilador I-TREATMENT -mecánico. I-TREATMENT - I-TREATMENT -Luego I-TREATMENT -de I-TREATMENT -un I-TREATMENT -despertar I-TREATMENT -lento, I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -la I-TREATMENT -cánula I-TREATMENT -de I-TREATMENT -traqueostomía I-TREATMENT -al I-TREATMENT -día I-TREATMENT -37. I-TREATMENT -Recibió B-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -69 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -nutritivas, I-EVOLUTION -neurológicas I-EVOLUTION -y I-EVOLUTION -ligada I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -programa I-EVOLUTION -de I-EVOLUTION -rehabilitación I-EVOLUTION -física. I-EVOLUTION -Actualmente I-EVOLUTION -asiste I-EVOLUTION -a I-EVOLUTION -sus I-EVOLUTION -estudios I-EVOLUTION -secundarios I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -en I-EVOLUTION -control I-EVOLUTION -ambulatorio. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -obesa B-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensa, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -agosto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -asoció I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rápido I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ortopnea. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -mostró I-EXPLORATION -bocio I-EXPLORATION -con I-EXPLORATION -nodulo I-EXPLORATION -sólido I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -(4, I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -5, I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -4, I-EXPLORATION -5 I-EXPLORATION -cm), I-EXPLORATION -hipoecogénico, I-EXPLORATION -escasamente I-EXPLORATION -vascularizado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION -cervicales I-EXPLORATION -bilaterales I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -reactivo. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -laboratorio I-EXPLORATION -destacó I-EXPLORATION -TSH I-EXPLORATION -elevada I-EXPLORATION -y I-EXPLORATION -T4 I-EXPLORATION -disminuida. I-EXPLORATION -Se B-TREATMENT -sospechó I-TREATMENT -cáncer I-TREATMENT -de I-TREATMENT -tiroides, I-TREATMENT -inició I-TREATMENT -levotiroxina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -resección I-TREATMENT -quirúrgica. I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -cirugía, I-TREATMENT -se I-TREATMENT -seccionaron I-TREATMENT -los I-TREATMENT -músculos I-TREATMENT -pretiroideos I-TREATMENT -izquierdos I-TREATMENT -para I-TREATMENT -facilitar I-TREATMENT -la I-TREATMENT -exploración, I-TREATMENT -los I-TREATMENT -que I-TREATMENT -estaban I-TREATMENT -adheridos I-TREATMENT -a I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT -El I-TREATMENT -gran I-TREATMENT -nodulo I-TREATMENT -blanquecino I-TREATMENT -se I-TREATMENT -proyectaba I-TREATMENT -hacia I-TREATMENT -esófago I-TREATMENT -cervical. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -tiroidectomía I-TREATMENT -total. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -rápida I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -informó I-EXPLORATION -proliferación I-EXPLORATION -linfoide I-EXPLORATION -atípica I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -linfoma. I-EXPLORATION - I-EXPLORATION -Evolucionó B-EVOLUTION -con I-EVOLUTION -hipocalcemia I-EVOLUTION -sintomática I-EVOLUTION -de I-EVOLUTION -7, I-EVOLUTION -6 I-EVOLUTION -mg/dl I-EVOLUTION -que I-EVOLUTION -cedió I-EVOLUTION -con I-EVOLUTION -calcio I-EVOLUTION -oral. I-EVOLUTION -Fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -biopsia I-EXPLORATION -definitiva I-EXPLORATION -concluyó I-EXPLORATION -"infiltrado I-EXPLORATION -linfoide I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -grandes, I-EXPLORATION -con I-EXPLORATION -metaplasia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Hürtle, I-EXPLORATION -que I-EXPLORATION -comprometió I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -tiroidea I-EXPLORATION -y I-EXPLORATION -focalmente I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -muscular I-EXPLORATION -peritiroideo. I-EXPLORATION -Inmunohistoquímica: I-EXPLORATION -CD20 I-EXPLORATION -(+) I-EXPLORATION -difuso, I-EXPLORATION -CD3 I-EXPLORATION -(+) I-EXPLORATION -focal I-EXPLORATION -en I-EXPLORATION -linfocitos I-EXPLORATION -pequeños, I-EXPLORATION -CD10 I-EXPLORATION -(+) I-EXPLORATION -difuso, I-EXPLORATION -BCL2 I-EXPLORATION -(-) I-EXPLORATION -". I-EXPLORATION -Compatible I-EXPLORATION -con I-EXPLORATION -LNH I-EXPLORATION -tiroideo I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -estirpe I-EXPLORATION -B, I-EXPLORATION -tiroiditis I-EXPLORATION -de I-EXPLORATION -Hashimoto I-EXPLORATION -y I-EXPLORATION -metaplasia I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Hürtle. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -quimioterapia I-TREATMENT -pero I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -rechazó I-TREATMENT -por I-TREATMENT -motivos I-TREATMENT -religiosos. I-TREATMENT - I-TREATMENT -Seis B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -consultó I-EVOLUTION -en I-EVOLUTION -cirugía I-EVOLUTION -por I-EVOLUTION -recidiva I-EVOLUTION -local I-EVOLUTION -con I-EVOLUTION -sintomatología I-EVOLUTION -obstructiva I-EVOLUTION -de I-EVOLUTION -vía I-EVOLUTION -aérea. I-EVOLUTION -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -hematología I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -pierde I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -control. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -morbilidad I-PAST_MEDICAL_HISTORY -previa, I-PAST_MEDICAL_HISTORY -proveniente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Varas. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -colecistec-tomía I-PAST_MEDICAL_HISTORY -laparoscópica I-PAST_MEDICAL_HISTORY -electiva I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2003 I-PAST_MEDICAL_HISTORY -recibiendo I-PAST_MEDICAL_HISTORY -anestesia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -halotano. I-PAST_MEDICAL_HISTORY -Evolucionó I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -dada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alta. I-PAST_MEDICAL_HISTORY -Al B-PRESENT_ILLNESS -quinto I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -postoperatorio I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alteración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -encefalopatía I-PRESENT_ILLNESS -hepática, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -hospitalizó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hepatitis I-PRESENT_ILLNESS -fulminante. I-PRESENT_ILLNESS -El B-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -viral, I-EXPLORATION -metabólico, I-EXPLORATION -autoinmune I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -otras I-EXPLORATION -drogas I-EXPLORATION -resultó I-EXPLORATION -negativo. I-EXPLORATION -Fue B-DERIVED_FROM/TO -trasladada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Paciente I-DERIVED_FROM/TO -Crítico I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Clínico I-DERIVED_FROM/TO -San I-DERIVED_FROM/TO -Borja I-DERIVED_FROM/TO -Arriarán I-DERIVED_FROM/TO -(HCSBA) I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -5 I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -agosto I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2003 I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hepatitis I-DERIVED_FROM/TO -aguda I-DERIVED_FROM/TO -fulminante I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -halotano I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -activó I-DERIVED_FROM/TO -como I-DERIVED_FROM/TO -urgencia I-DERIVED_FROM/TO -nacional I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -trasplante I-DERIVED_FROM/TO -hepático. I-DERIVED_FROM/TO -Dada B-TREATMENT -la I-TREATMENT -emergencia I-TREATMENT -vital I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -un I-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -de I-TREATMENT -donante I-TREATMENT -cadáver I-TREATMENT -ABO I-TREATMENT -incompatible I-TREATMENT -(donante I-TREATMENT -grupo I-TREATMENT -A, I-TREATMENT -receptor I-TREATMENT -grupo I-TREATMENT -O) I-TREATMENT -el I-TREATMENT -8 I-TREATMENT -de I-TREATMENT -agosto I-TREATMENT -de I-TREATMENT -2003, I-TREATMENT -en I-TREATMENT -Clínica I-TREATMENT -Las I-TREATMENT -Condes. I-TREATMENT -El I-TREATMENT -protocolo I-TREATMENT -terapéutico I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -plasmaféresis I-TREATMENT -intra I-TREATMENT -y I-TREATMENT -postrasplante, I-TREATMENT -esplenectomía I-TREATMENT -e I-TREATMENT -inmunosupresión I-TREATMENT -cuádruple, I-TREATMENT -con I-TREATMENT -metilprednisolona, I-TREATMENT -ciclofosfamida, I-TREATMENT -timoglobulina I-TREATMENT -y I-TREATMENT -ciclosporina. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -del I-EXPLORATION -explante I-EXPLORATION -concluyó I-EXPLORATION -necrosis I-EXPLORATION -submasiva. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -5 I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -plasmaféresis, I-TREATMENT -que I-TREATMENT -disminuyó I-TREATMENT -significativamente I-TREATMENT -el I-TREATMENT -título I-TREATMENT -de I-TREATMENT -isohemoglutininas I-TREATMENT -anti I-TREATMENT -A. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -su I-TREATMENT -incremento I-TREATMENT -posterior I-TREATMENT -no I-TREATMENT -se I-TREATMENT -tradujo I-TREATMENT -en I-TREATMENT -una I-TREATMENT -injuria I-TREATMENT -significativa I-TREATMENT -al I-TREATMENT -injerto. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -temprano I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -hemoperitoneo I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -cirugía, I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -una I-TREATMENT -neumopatía I-TREATMENT -aguda. I-TREATMENT -Los B-EXPLORATION -estudios I-EXPLORATION -imagenológicos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -El B-EVOLUTION -egreso I-EVOLUTION -médico I-EVOLUTION -fue I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -54 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -trasplante, I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -y B-TREATMENT -con I-TREATMENT -terapia I-TREATMENT -inmunosupre-sora I-TREATMENT -en I-TREATMENT -base I-TREATMENT -a I-TREATMENT -ciclosporina, I-TREATMENT -ciclofosfamida I-TREATMENT -y I-TREATMENT -prednisona. I-TREATMENT -En B-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -intrahospitalaria I-EVOLUTION -presentó I-EVOLUTION -infección I-EVOLUTION -por I-EVOLUTION -citomegalovirus I-EVOLUTION -en I-EVOLUTION -dos I-EVOLUTION -oportunidades I-EVOLUTION -tratadas I-EVOLUTION -satisfactoriamente, I-EVOLUTION -un I-EVOLUTION -rechazo I-EVOLUTION -agudo I-EVOLUTION -moderado I-EVOLUTION -corticoide-sensible I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -bilioma I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -drenaje I-TREATMENT -bajo I-TREATMENT -tomografía I-TREATMENT -computarizada. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -asiste I-EVOLUTION -a I-EVOLUTION -controles I-EVOLUTION -médicos I-EVOLUTION -periódicos I-EVOLUTION -y I-EVOLUTION -cumplió I-EVOLUTION -cinco I-EVOLUTION -años I-EVOLUTION -postrasplante. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -desarrollando I-EVOLUTION -una I-EVOLUTION -vida I-EVOLUTION -laboralmente I-EVOLUTION -activa, I-EVOLUTION -con I-EVOLUTION -pruebas I-EVOLUTION -hepáticas I-EVOLUTION -normales, I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -inmunosupresión I-EVOLUTION -a I-EVOLUTION -dosis I-EVOLUTION -bajas I-EVOLUTION -(ciclosporina I-EVOLUTION -200 I-EVOLUTION -mg/día, I-EVOLUTION -azatioprina I-EVOLUTION -100 I-EVOLUTION -mg/día) I-EVOLUTION -y I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -conservada. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -NF1 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -manifestó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -abundantes I-PAST_MEDICAL_HISTORY -efélides I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -todo I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cuerpo, I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -axilar I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -inguinal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -neurofibro-mas I-PAST_MEDICAL_HISTORY -discretos. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Emergencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -Serena I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -difuso. I-PRESENT_ILLNESS -Ingresó B-EXPLORATION -en I-EXPLORATION -shock I-EXPLORATION -séptico I-EXPLORATION -y I-EXPLORATION -mala I-EXPLORATION -condición I-EXPLORATION -general. I-EXPLORATION -Después B-TREATMENT -de I-TREATMENT -estabilización I-TREATMENT -hemodi-námica I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -su I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -abdomen I-TREATMENT -agudo I-TREATMENT -de I-TREATMENT -origen I-TREATMENT -no I-TREATMENT -precisado I-TREATMENT -y I-TREATMENT -peritonitis I-TREATMENT -secundaria. I-TREATMENT -No B-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ningún I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -nuestro I-EXPLORATION -hospital I-EXPLORATION -no I-EXPLORATION -cuenta I-EXPLORATION -con I-EXPLORATION -radiólogo I-EXPLORATION -de I-EXPLORATION -turno I-EXPLORATION -y I-EXPLORATION -tampoco I-EXPLORATION -ecografía I-EXPLORATION -o I-EXPLORATION -tomografía I-EXPLORATION -de I-EXPLORATION -urgencia. I-EXPLORATION -El B-TREATMENT -abordaje I-TREATMENT -del I-TREATMENT -abdomen I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -mediana. I-TREATMENT -Se I-TREATMENT -aspiraron I-TREATMENT -3 I-TREATMENT -litros I-TREATMENT -de I-TREATMENT -exudado I-TREATMENT -purulento I-TREATMENT -y I-TREATMENT -en I-TREATMENT -la I-TREATMENT -exploración I-TREATMENT -se I-TREATMENT -evidenció I-TREATMENT -un I-TREATMENT -tumor I-TREATMENT -quístico I-TREATMENT -de I-TREATMENT -15 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -diámetro I-TREATMENT -que I-TREATMENT -se I-TREATMENT -originaba I-TREATMENT -en I-TREATMENT -la I-TREATMENT -A- I-TREATMENT -porción I-TREATMENT -del I-TREATMENT -duodeno, I-TREATMENT -perforado, I-TREATMENT -adherido I-TREATMENT -al I-TREATMENT -colon I-TREATMENT -sigmoides I-TREATMENT -y I-TREATMENT -cubierto I-TREATMENT -de I-TREATMENT -epiplón I-TREATMENT -mayor. I-TREATMENT -El I-TREATMENT -tumor I-TREATMENT -fue I-TREATMENT -resecado I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT -con I-TREATMENT -el I-TREATMENT -epiplón I-TREATMENT -y I-TREATMENT -la I-TREATMENT -A- I-TREATMENT -porción I-TREATMENT -del I-TREATMENT -duodeno. I-TREATMENT -El I-TREATMENT -tránsito I-TREATMENT -intestinal I-TREATMENT -se I-TREATMENT -reconstituyó I-TREATMENT -mediante I-TREATMENT -anastomosis I-TREATMENT -término-terminal I-TREATMENT -entre I-TREATMENT -la I-TREATMENT -3a I-TREATMENT -porción I-TREATMENT -del I-TREATMENT -duodeno I-TREATMENT -y I-TREATMENT -el I-TREATMENT -yeyuno. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -tórpida, I-EVOLUTION -con I-EVOLUTION -complicaciones: I-EVOLUTION -infección I-EVOLUTION -del I-EVOLUTION -sitio I-EVOLUTION -quirúrgico I-EVOLUTION -superficial, I-EVOLUTION -íleo I-EVOLUTION -intestinal I-EVOLUTION -prolongado I-EVOLUTION -y I-EVOLUTION -neumonía I-EVOLUTION -nosocomial. I-EVOLUTION -Después I-EVOLUTION -de I-EVOLUTION -37 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -sólido-quísti-co, I-EXPLORATION -parcialmente I-EXPLORATION -necrótico I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -bajo I-EXPLORATION -índice I-EXPLORATION -mitótico I-EXPLORATION -(1 I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -50 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -aumento I-EXPLORATION -mayor). I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION -células I-EXPLORATION -epiteloides I-EXPLORATION -y I-EXPLORATION -fusiformes, I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -CD117, I-EXPLORATION -CD34 I-EXPLORATION -y I-EXPLORATION -desmina. I-EXPLORATION -La I-EXPLORATION -reacción I-EXPLORATION -inmunohistoquímica I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -S100, I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -acüna-a I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso. I-EXPLORATION -El I-EXPLORATION -tamaño I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -de I-EXPLORATION -presentación I-EXPLORATION -(necrosis I-EXPLORATION -y I-EXPLORATION -perforación), I-EXPLORATION -constituyen I-EXPLORATION -indicaciones I-EXPLORATION -para I-EXPLORATION -terapia I-EXPLORATION -con I-EXPLORATION -imatinib I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -derivada I-EXPLORATION -al I-EXPLORATION -Comité I-EXPLORATION -Oncológico I-EXPLORATION -Regional I-EXPLORATION -para I-EXPLORATION -iniciar I-EXPLORATION -tratamiento I-EXPLORATION -pertinente. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -hace I-EVOLUTION -11 I-EVOLUTION -meses. I-EVOLUTION -Figura I-EVOLUTION -2 I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY -hospitalizada B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -peritonitis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -precisado. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -La B-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -fue I-EXPLORATION -131/76, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -126 I-EXPLORATION -x' I-EXPLORATION -y I-EXPLORATION -38, I-EXPLORATION -9eC I-EXPLORATION -de I-EXPLORATION -temperatura I-EXPLORATION -rectal. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -estaba I-EXPLORATION -distendido, I-EXPLORATION -mate I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -ruidos I-EXPLORATION -intestinales I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -auscultación. I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION -ginecológica I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -reveló I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -intraperitoneal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -quística I-EXPLORATION -adyacente I-EXPLORATION -al I-EXPLORATION -intestino I-EXPLORATION -delgado. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -abdominal I-EXPLORATION -(TAC), I-EXPLORATION -demostró I-EXPLORATION -algunas I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -rodeando I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -tubular I-EXPLORATION -quística I-EXPLORATION -y I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -peritoneal. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -revelaron I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -25.700 I-EXPLORATION -x I-EXPLORATION -mm3 I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -de I-EXPLORATION -356, I-EXPLORATION -06 I-EXPLORATION -mg/dl. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -quístico I-TREATMENT -intestinal I-TREATMENT -complicado I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -operada. I-TREATMENT -La B-EXPLORATION -cavidad I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -llena I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -seroso I-EXPLORATION -del I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -citología I-EXPLORATION -y I-EXPLORATION -cultivo. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -reveló I-EXPLORATION -múltiples I-EXPLORATION -implantes I-EXPLORATION -tumorales I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -peritoneo I-EXPLORATION -parietal I-EXPLORATION -y I-EXPLORATION -visceral, I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -extensa I-EXPLORATION -del I-EXPLORATION -epiplón I-EXPLORATION -mayor, I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -implantes I-EXPLORATION -para I-EXPLORATION -biopsia. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -mesenterio I-EXPLORATION -del I-EXPLORATION -íleon I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -quístico I-EXPLORATION -tubular I-EXPLORATION -blanquecino I-EXPLORATION -rodeado I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -intestinales, I-EXPLORATION -que I-EXPLORATION -medía I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -por I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud. I-EXPLORATION -Se B-TREATMENT -abrió I-TREATMENT -el I-TREATMENT -tumor I-TREATMENT -aspirándose I-TREATMENT -un I-TREATMENT -líquido I-TREATMENT -oscuro I-TREATMENT -y I-TREATMENT -espeso I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -enviado I-TREATMENT -a I-TREATMENT -citología. I-TREATMENT -Se I-TREATMENT -resecó I-TREATMENT -la I-TREATMENT -mayor I-TREATMENT -cantidad I-TREATMENT -posible I-TREATMENT -de I-TREATMENT -pared I-TREATMENT -tumoral I-TREATMENT -quedando I-TREATMENT -una I-TREATMENT -parte I-TREATMENT -adherida I-TREATMENT -al I-TREATMENT -mesenterio, I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -posible I-TREATMENT -por I-TREATMENT -la I-TREATMENT -diseminación I-TREATMENT -peritoneal I-TREATMENT -y I-TREATMENT -su I-TREATMENT -localización I-TREATMENT -en I-TREATMENT -el I-TREATMENT -mesenterio I-TREATMENT -del I-TREATMENT -íleon. I-TREATMENT -La B-EVOLUTION -recuperación I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -satisfactoria I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -treinta I-EVOLUTION -y I-EVOLUTION -cuatro I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -falleció. I-EVOLUTION -La B-EXPLORATION -muestras I-EXPLORATION -citológicas I-EXPLORATION -tomadas I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -contenido I-EXPLORATION -tumoral I-EXPLORATION -fueron I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -células I-EXPLORATION -neoplásicas. I-EXPLORATION -La I-EXPLORATION -histopatología I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -arquitectura I-EXPLORATION -típica I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -intestinal, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -reconocían I-EXPLORATION -capas I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso I-EXPLORATION -circular I-EXPLORATION -y I-EXPLORATION -longitudinal I-EXPLORATION -bien I-EXPLORATION -organizadas, I-EXPLORATION -identificándose I-EXPLORATION -plexos I-EXPLORATION -nerviosos I-EXPLORATION -mientéricos I-EXPLORATION -entre I-EXPLORATION -ambas I-EXPLORATION -capas I-EXPLORATION -musculares. I-EXPLORATION -La I-EXPLORATION -superficie I-EXPLORATION -interna I-EXPLORATION -estaba I-EXPLORATION -revestida I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -adeno I-EXPLORATION -carcinoma I-EXPLORATION -mucosecretor I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado I-EXPLORATION -que I-EXPLORATION -infiltraba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -en I-EXPLORATION -varias I-EXPLORATION -partes I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendió I-EXPLORATION -superficialmente I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -serosa. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -intraoperatorios I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -confirmaron I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -duplicación I-EXPLORATION -intestinal I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -paciente I-EXPLORATION -adulta. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -FQ I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -regulares I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -mayo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2000, I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -bilateral, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -2009. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -caracterizó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -descompensación I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -bronquiolitis I-PRESENT_ILLNESS -obliterante I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -hospitalizado I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -tratamiento. I-PRESENT_ILLNESS -Al B-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -refirió I-EVOLUTION -un I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -tipo I-EVOLUTION -cólico I-EVOLUTION -de I-EVOLUTION -intensidad I-EVOLUTION -progresiva, I-EVOLUTION -localizado I-EVOLUTION -mayormente I-EVOLUTION -en I-EVOLUTION -hemiabdomen I-EVOLUTION -inferior I-EVOLUTION -derecho, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -3 I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -vómitos I-EVOLUTION -alimentarios. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -palpaba I-EXPLORATION -distendido I-EXPLORATION -y I-EXPLORATION -sensible I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -bazuqueo. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -tomar I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -moderada I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -superior I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -abundante I-EXPLORATION -aire I-EXPLORATION -y I-EXPLORATION -contenido I-EXPLORATION -estercoráceo I-EXPLORATION -en I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -marco I-EXPLORATION -cólico. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -además I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -más I-EXPLORATION -alta I-EXPLORATION -del I-EXPLORATION -yeyuno I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -proximal I-EXPLORATION -del I-EXPLORATION -íleon I-EXPLORATION -que I-EXPLORATION -parecían I-EXPLORATION -ocupados I-EXPLORATION -y I-EXPLORATION -distendidos I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -fecaloideo, I-EXPLORATION -concluyendo I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -SOID. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -Gastrografin® I-TREATMENT -(100 I-TREATMENT -mi I-TREATMENT -diluidos I-TREATMENT -en I-TREATMENT -400 I-TREATMENT -mi. I-TREATMENT -de I-TREATMENT -suero I-TREATMENT -fisiológico) I-TREATMENT -presentando I-TREATMENT -al I-TREATMENT -cabo I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -horas, I-TREATMENT -gran I-TREATMENT -cantidad I-TREATMENT -de I-TREATMENT -deposiciones I-TREATMENT -líquidas I-TREATMENT -e I-TREATMENT -importante I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas. I-TREATMENT -La B-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION -distensión I-EXPLORATION -de I-EXPLORATION -algunas I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -en I-EXPLORATION -menor I-EXPLORATION -grado I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -anterior I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -intestino I-EXPLORATION -distal I-EXPLORATION -y I-EXPLORATION -marco I-EXPLORATION -colónico. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -suplemento I-EVOLUTION -de I-EVOLUTION -enzimas I-EVOLUTION -pancreáticas, I-EVOLUTION -encontrándose I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -tras I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -hospitalización I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -nuevos I-EVOLUTION -cuadros I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -distensión I-EVOLUTION -o I-EVOLUTION -constipación. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -indio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipertenso B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -ocasional, I-PAST_MEDICAL_HISTORY -quien B-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -levantó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mañana I-PRESENT_ILLNESS -previa I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hemicuerpo I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sensibilidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemicara I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -progresó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -siguientes I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -imposibilidad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -hubo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ingresar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vez I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -llevado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -departamento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -emergencias, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -constató I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -presión I-PRESENT_ILLNESS -arterial I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -165/105 I-PRESENT_ILLNESS -mmHg, I-PRESENT_ILLNESS -pulso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -92 I-PRESENT_ILLNESS -latidos I-PRESENT_ILLNESS -x' I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -x'. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -hipoestesia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -rama I-EXPLORATION -maxilar I-EXPLORATION -del I-EXPLORATION -trigémino I-EXPLORATION -derecho I-EXPLORATION -como I-EXPLORATION -único I-EXPLORATION -trastorno I-EXPLORATION -objetivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad. I-EXPLORATION -La I-EXPLORATION -fuerza I-EXPLORATION -muscular I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tono I-EXPLORATION -estaba I-EXPLORATION -conservados I-EXPLORATION -a I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -niveles, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -hiperreflexia I-EXPLORATION -osteotendinosa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemicuerpo I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -Babinski I-EXPLORATION -ipsilateral. I-EXPLORATION -Elementos I-EXPLORATION -de I-EXPLORATION -disfunción I-EXPLORATION -cerebelosa I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -al I-EXPLORATION -existir I-EXPLORATION -disdiadococinesia, I-EXPLORATION -dismetría I-EXPLORATION -y I-EXPLORATION -discronometría I-EXPLORATION -al I-EXPLORATION -movilizar I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -derechas. I-EXPLORATION -La I-EXPLORATION -marcha I-EXPLORATION -era I-EXPLORATION -imposible I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -caer I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -derecha I-EXPLORATION -al I-EXPLORATION -tratar I-EXPLORATION -de I-EXPLORATION -hacerla I-EXPLORATION -sin I-EXPLORATION -apoyo. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -mostró I-EXPLORATION -hemoglobina, I-EXPLORATION -conteo I-EXPLORATION -diferencial I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -y I-EXPLORATION -electrolitos I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -una I-EXPLORATION -hiperlipidemia I-EXPLORATION -dada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION -del I-EXPLORATION -colesterol I-EXPLORATION -total I-EXPLORATION -(7, I-EXPLORATION -42 I-EXPLORATION -mm/1). I-EXPLORATION -El I-EXPLORATION -electrocardiograma I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -transtorácico I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RMN) I-EXPLORATION -identificó I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -de I-EXPLORATION -infarto I-EXPLORATION -isquémico I-EXPLORATION -subagudo I-EXPLORATION -que I-EXPLORATION -comprendía I-EXPLORATION -el I-EXPLORATION -núcleo I-EXPLORATION -lenticular I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -interna I-EXPLORATION -izquierdos. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -anti-agregantes I-TREATMENT -plaquetarios, I-TREATMENT -estatinas I-TREATMENT -y I-TREATMENT -fisioterapia. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -egresado I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -con I-EVOLUTION -evidente I-EVOLUTION -mejoría. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inercia I-PAST_MEDICAL_HISTORY -colónica. I-PAST_MEDICAL_HISTORY -En B-TREATMENT -mayo I-TREATMENT -de I-TREATMENT -2003, I-TREATMENT -a I-TREATMENT -los I-TREATMENT -46 I-TREATMENT -años, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -colectomía I-TREATMENT -total I-TREATMENT -laparoscópica I-TREATMENT -con I-TREATMENT -anastomosis I-TREATMENT -ileorrectal I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -taquicardia, I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -e I-EVOLUTION -hipotensión. I-EVOLUTION -Se B-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -laparotomía I-EXPLORATION -exploradora I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -necrosis I-EXPLORATION -de I-EXPLORATION -yeyuno I-EXPLORATION -distal I-EXPLORATION -e I-EXPLORATION -ileon, I-EXPLORATION -realizándose I-EXPLORATION -resección I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -desde I-EXPLORATION -los I-EXPLORATION -120 I-EXPLORATION -cm I-EXPLORATION -distales I-EXPLORATION -al I-EXPLORATION -Treitz, I-EXPLORATION -además B-TREATMENT -de I-TREATMENT -una I-TREATMENT -yeyunostomía I-TREATMENT -terminal I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -del I-TREATMENT -muñón I-TREATMENT -rectal. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -informó I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -con I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -enteropatía I-EXPLORATION -isquémica I-EXPLORATION -aguda. I-EXPLORATION -Evolucionó B-EVOLUTION -con I-EVOLUTION -fujos I-EVOLUTION -de I-EVOLUTION -4.500 I-EVOLUTION -cc/día I-EVOLUTION -por I-EVOLUTION -yeyunostomía I-EVOLUTION -y I-EVOLUTION -desnutrición I-EVOLUTION -calórico-proteica. I-EVOLUTION -Manejada B-TREATMENT -inicialmente I-TREATMENT -con I-TREATMENT -NPTC, I-TREATMENT -en I-TREATMENT -el I-TREATMENT -día I-TREATMENT -12 I-TREATMENT -post I-TREATMENT -operatorio I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -alimentación I-TREATMENT -por I-TREATMENT -sonda I-TREATMENT -nasoenteral I-TREATMENT -y I-TREATMENT -en I-TREATMENT -el I-TREATMENT -día I-TREATMENT -50 I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -alimentación I-TREATMENT -oral I-TREATMENT -exclusiva. I-TREATMENT -Al B-EVOLUTION -alta I-EVOLUTION -toleró I-EVOLUTION -bien I-EVOLUTION -régimen I-EVOLUTION -oral I-EVOLUTION -con I-EVOLUTION -suplementos I-EVOLUTION -nutricionales. I-EVOLUTION -Hasta I-EVOLUTION -junio I-EVOLUTION -2008 I-EVOLUTION -presentó I-EVOLUTION -17 I-EVOLUTION -hospitalizaciones, I-EVOLUTION -4 I-EVOLUTION -por I-EVOLUTION -cuadros I-EVOLUTION -de I-EVOLUTION -íleo I-EVOLUTION -mecánico, I-EVOLUTION -todos B-TREATMENT -resueltos I-TREATMENT -sin I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -cirugía, I-TREATMENT -y B-EVOLUTION -13 I-EVOLUTION -por I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -deshidratación I-EVOLUTION -moderada I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -altos I-EVOLUTION -débitos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ostomía, I-EVOLUTION -los I-EVOLUTION -que B-TREATMENT -se I-TREATMENT -manejaron I-TREATMENT -con I-TREATMENT -reposición I-TREATMENT -hidroelectrolítica I-TREATMENT -y I-TREATMENT -ajuste I-TREATMENT -de I-TREATMENT -fármacos I-TREATMENT -para I-TREATMENT -disminuir I-TREATMENT -fujo I-TREATMENT -por I-TREATMENT -yeyunostomía I-TREATMENT -logrando B-EVOLUTION -volumen I-EVOLUTION -de I-EVOLUTION -deposiciones I-EVOLUTION -de I-EVOLUTION -2.000-3.000 I-EVOLUTION -cc/día. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -26/06/08 I-EVOLUTION -ingresó I-EVOLUTION -nuevamente I-EVOLUTION -por I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -deshidratación I-EVOLUTION -grave. I-EVOLUTION -Se I-EVOLUTION -constató I-EVOLUTION -creatininemia I-EVOLUTION -de I-EVOLUTION -4, I-EVOLUTION -39 I-EVOLUTION -mg/dl, I-EVOLUTION -objetivándose I-EVOLUTION -clearence I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -30 I-EVOLUTION -ml/min. I-EVOLUTION -Dado B-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal I-TREATMENT -y I-TREATMENT -compromiso I-TREATMENT -nutricional I-TREATMENT -de I-TREATMENT -predominio I-TREATMENT -calórico I-TREATMENT -con I-TREATMENT -IMC I-TREATMENT -de I-TREATMENT -14, I-TREATMENT -2 I-TREATMENT -kg/m2 I-TREATMENT -y I-TREATMENT -albúmina I-TREATMENT -de I-TREATMENT -ingreso I-TREATMENT -de I-TREATMENT -3, I-TREATMENT -1 I-TREATMENT -gr/dl, I-TREATMENT -se I-TREATMENT -planteó I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -un I-TREATMENT -procedimiento I-TREATMENT -de I-TREATMENT -elongación I-TREATMENT -intestinal I-TREATMENT -y I-TREATMENT -reconstitución I-TREATMENT -del I-TREATMENT -tránsito I-TREATMENT -para I-TREATMENT -mejorar I-TREATMENT -la I-TREATMENT -condición I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -calidad I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -preoperatorio I-EXPLORATION -incluyó I-EXPLORATION -una I-EXPLORATION -rectoscopia I-EXPLORATION -rígida I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -muñón I-EXPLORATION -rectal I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -cm. I-EXPLORATION -El I-EXPLORATION -tránsito I-EXPLORATION -intestinal I-EXPLORATION -demostró I-EXPLORATION -140 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -sin I-EXPLORATION -estrecheces I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas. I-EXPLORATION -Por I-EXPLORATION -sospecha I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -(AMS), I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -estenosis I-EXPLORATION -signifcativa I-EXPLORATION -(70%) I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -AMS, I-EXPLORATION -que B-TREATMENT -se I-TREATMENT -resolvió I-TREATMENT -mediante I-TREATMENT -angioplastía I-TREATMENT -y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -endoprótesis. I-TREATMENT -Con I-TREATMENT -aporte I-TREATMENT -de I-TREATMENT -régimen I-TREATMENT -hipercalórico-hiperproteico I-TREATMENT -y I-TREATMENT -NPTC I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -optimización I-TREATMENT -de I-TREATMENT -parámetros I-TREATMENT -nutricionales I-TREATMENT -(albúmina: I-TREATMENT -3, I-TREATMENT -8 I-TREATMENT -mg/dl). I-TREATMENT - I-TREATMENT -Cinco I-TREATMENT -semanas I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -endoprótesis I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -operar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -intraoperatorio I-TREATMENT -se I-TREATMENT -midió I-TREATMENT -intestino I-TREATMENT -remanente I-TREATMENT -con-frmando I-TREATMENT -una I-TREATMENT -longitud I-TREATMENT -de I-TREATMENT -140 I-TREATMENT -cm. I-TREATMENT -Se I-TREATMENT -desmanteló I-TREATMENT -la I-TREATMENT -yeyunostomía I-TREATMENT -y I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -una I-TREATMENT -anastomosis I-TREATMENT -mecánica I-TREATMENT -término-terminal I-TREATMENT -yeyunorectal. I-TREATMENT -Luego I-TREATMENT -se I-TREATMENT -hicieron I-TREATMENT -15 I-TREATMENT -secciones I-TREATMENT -transversas I-TREATMENT -parciales I-TREATMENT -con I-TREATMENT -cargas I-TREATMENT -lineales I-TREATMENT -de I-TREATMENT -3, I-TREATMENT -5 I-TREATMENT -mm I-TREATMENT -para I-TREATMENT -seccionar I-TREATMENT -la I-TREATMENT -mitad I-TREATMENT -del I-TREATMENT -lumen I-TREATMENT -del I-TREATMENT -intestino I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -de I-TREATMENT -zig-zag I-TREATMENT -según I-TREATMENT -lo I-TREATMENT -descrito I-TREATMENT -por I-TREATMENT -Kim9. I-TREATMENT -La I-TREATMENT -longitud I-TREATMENT -fnal I-TREATMENT -del I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -180 I-TREATMENT -cm, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -sumado I-TREATMENT -al I-TREATMENT -muñón I-TREATMENT -rectal I-TREATMENT -da I-TREATMENT -una I-TREATMENT -longitud I-TREATMENT -de I-TREATMENT -190 I-TREATMENT -cm I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -ano. I-TREATMENT - I-TREATMENT -Dentro B-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -eventos I-EVOLUTION -del I-EVOLUTION -postoperatorio I-EVOLUTION -destacó I-EVOLUTION -la I-EVOLUTION -formación I-EVOLUTION -de I-EVOLUTION -colecciones I-EVOLUTION -hemáticas I-EVOLUTION -intraabdominales, I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -fltración. I-EVOLUTION -Por B-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -episodios I-EXPLORATION -febriles, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -eco-cardiograma I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -trombo I-EXPLORATION -séptico I-EXPLORATION -en I-EXPLORATION -aurícula I-EXPLORATION -derecha I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -endocarditis I-TREATMENT -bacteriana. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -aporte I-EVOLUTION -por I-EVOLUTION -vía I-EVOLUTION -oral. I-EVOLUTION -El B-TREATMENT -día I-TREATMENT -34 I-TREATMENT -del I-TREATMENT -post I-TREATMENT -operatorio I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -NPTC, I-TREATMENT -logrando I-TREATMENT -balance I-TREATMENT -hidroelectrolitico I-TREATMENT -y I-TREATMENT -nutricional I-TREATMENT -adecuado I-TREATMENT -exclusivamente I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -tránsito I-EXPLORATION -intestinal I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -98 I-EXPLORATION -días I-EXPLORATION -post I-EXPLORATION -cirugía I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -enterotomías. I-EXPLORATION - I-EXPLORATION -Actualmente B-TREATMENT -en I-TREATMENT -control I-TREATMENT -ambulatorio, I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -loperamida I-TREATMENT -y I-TREATMENT -suplementos I-TREATMENT -nutricionales, I-TREATMENT -logrando I-TREATMENT -adecuado I-TREATMENT -balance I-TREATMENT -hidroelectrolítico, I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -peso I-TREATMENT -y I-TREATMENT -con I-TREATMENT -una I-TREATMENT -frecuencia I-TREATMENT -de I-TREATMENT -deposiciones I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -veces I-TREATMENT -por I-TREATMENT -día I-TREATMENT -con I-TREATMENT -escurrimiento I-TREATMENT -escaso. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -IMC B-PAST_MEDICAL_HISTORY -21, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -legrado I-PAST_MEDICAL_HISTORY -uterino I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -aborto I-PAST_MEDICAL_HISTORY -provocado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -trimestre, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -17 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -marzo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dismenorrea I-PRESENT_ILLNESS -invalidante, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pesar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -uso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -anticonceptivos I-PRESENT_ILLNESS -orales, I-PRESENT_ILLNESS -polimenorrea I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipermenorrea I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -ciclos I-PRESENT_ILLNESS -menstruales, I-PRESENT_ILLNESS -refriendo I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -dispareunia. I-PRESENT_ILLNESS -Examen B-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -ginecológico I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -primera I-EXPLORATION -consulta. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -ecotomografía I-EXPLORATION -transvaginal I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -endometrial I-EXPLORATION -ocupada I-EXPLORATION -por I-EXPLORATION -imagen I-EXPLORATION -hiperecogénica I-EXPLORATION -lineal I-EXPLORATION -con I-EXPLORATION -sombra I-EXPLORATION -acústica I-EXPLORATION -posterior, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -extensa I-EXPLORATION -metaplasia I-EXPLORATION -ósea. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -histeroscopía I-EXPLORATION -mostró I-EXPLORATION -cavidad I-EXPLORATION -uterina I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -poco I-EXPLORATION -distensible, I-EXPLORATION -revestida I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -totalidad I-EXPLORATION -por I-EXPLORATION -múltiples I-EXPLORATION -fragmentos I-EXPLORATION -espiculados I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -ósea. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -éstos I-TREATMENT -con I-TREATMENT -asa I-TREATMENT -de I-TREATMENT -resectoscopio I-TREATMENT -asistido I-TREATMENT -con I-TREATMENT -cucharilla I-TREATMENT -N° I-TREATMENT -2 I-TREATMENT -y I-TREATMENT -pinza I-TREATMENT -Randall, I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT -Posteriormente B-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -cavidad I-EVOLUTION -endometrial I-EVOLUTION -sana I-EVOLUTION -y I-EVOLUTION -ostium I-EVOLUTION -tubarios I-EVOLUTION -permeables. I-EVOLUTION - I-EVOLUTION -Su B-EXPLORATION -laparoscopía I-EXPLORATION -exploradora I-EXPLORATION -mostró I-EXPLORATION -pelvis I-EXPLORATION -sana, I-EXPLORATION -útero I-EXPLORATION -y I-EXPLORATION -anexos I-EXPLORATION -normales, I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -relación I-EXPLORATION -tubo I-EXPLORATION -ovárica. I-EXPLORATION -Trompas I-EXPLORATION -permeables I-EXPLORATION -con I-EXPLORATION -índigo I-EXPLORATION -carmín. I-EXPLORATION - I-EXPLORATION -Biopsia I-EXPLORATION -operatoria I-EXPLORATION -estuvo I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -fragmentos I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -óseo I-EXPLORATION -maduro, I-EXPLORATION -reconociéndose I-EXPLORATION -además I-EXPLORATION -colonias I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -Actinomyces. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -neoplasia. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -metaplasia I-EXPLORATION -ósea I-EXPLORATION -del I-EXPLORATION -endometrio. I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -anticonceptivos I-TREATMENT -orales I-TREATMENT -hasta I-TREATMENT -deseo I-TREATMENT -de I-TREATMENT -embarazo. I-TREATMENT - I-TREATMENT -Una B-EXPLORATION -histerosonografía I-EXPLORATION -tres I-EXPLORATION -meses I-EXPLORATION -post I-EXPLORATION -cirugía I-EXPLORATION -mostraba I-EXPLORATION -cavidad I-EXPLORATION -uterina I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -En B-TREATMENT -agosto I-TREATMENT -de I-TREATMENT -2008 I-TREATMENT -consultó I-TREATMENT -cursando I-TREATMENT -embarazo I-TREATMENT -espontáneo I-TREATMENT -único I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -gestación I-TREATMENT -confirmado I-TREATMENT -ecográficamente. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -39 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -gestación, I-TREATMENT -se I-TREATMENT -obtuvo I-TREATMENT -un I-TREATMENT -recién I-TREATMENT -nacido I-TREATMENT -sano I-TREATMENT -de I-TREATMENT -3.380 I-TREATMENT -g I-TREATMENT -mediante I-TREATMENT -operación I-TREATMENT -cesárea I-TREATMENT -por I-TREATMENT -prueba I-TREATMENT -de I-TREATMENT -trabajo I-TREATMENT -de I-TREATMENT -parto I-TREATMENT -fracasada. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -misma, I-TREATMENT -se I-TREATMENT -produjo I-TREATMENT -inercia I-TREATMENT -uterina I-TREATMENT -que I-TREATMENT -logró I-TREATMENT -ser I-TREATMENT -revertida I-TREATMENT -con I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -retractores I-TREATMENT -en I-TREATMENT -altas I-TREATMENT -dosis. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -data, I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1999 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -rechazó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -trisemanal I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2000 I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -secundaria. I-PAST_MEDICAL_HISTORY -Tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -eritropoyetina, I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -fólico, I-PAST_MEDICAL_HISTORY -atenolol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -losartan. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -pruriginosas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -manos, I-PRESENT_ILLNESS -antebrazos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -espalda. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaban I-EXPLORATION -hiperpigmentación I-EXPLORATION -difusa, I-EXPLORATION -erosiones, I-EXPLORATION -úlceras I-EXPLORATION -y I-EXPLORATION -pápulas I-EXPLORATION -costrosas, I-EXPLORATION -ubicadas I-EXPLORATION -preferentemente I-EXPLORATION -en I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -manos, I-EXPLORATION -antebrazos, I-EXPLORATION -tórax I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -región I-EXPLORATION -interescapular. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -piel I-EXPLORATION -con I-EXPLORATION -úlcera I-EXPLORATION -y I-EXPLORATION -costra I-EXPLORATION -fibrinoleucocitaria. I-EXPLORATION -El I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -úlcera I-EXPLORATION -con I-EXPLORATION -haces I-EXPLORATION -de I-EXPLORATION -colágeno I-EXPLORATION -de I-EXPLORATION -disposición I-EXPLORATION -vertical, I-EXPLORATION -epidermis I-EXPLORATION -adyacente I-EXPLORATION -con I-EXPLORATION -hiperortoqueratosis, I-EXPLORATION -acantosis I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -espongiosis. I-EXPLORATION -La I-EXPLORATION -dermis I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -disperso I-EXPLORATION -y I-EXPLORATION -perivascular I-EXPLORATION -superfcial I-EXPLORATION -linfocitario, I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -plasmocitos I-EXPLORATION -y I-EXPLORATION -neutróflos I-EXPLORATION -y I-EXPLORATION -foco I-EXPLORATION -hemorrágico. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -informados I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -colagenosis I-EXPLORATION -perforante I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -reactivo. I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -antihistamínicos I-TREATMENT -orales I-TREATMENT -y I-TREATMENT -clobetasol I-TREATMENT -0, I-TREATMENT -05% I-TREATMENT -+ I-TREATMENT -cloranfenicol I-TREATMENT -2% I-TREATMENT -con B-EVOLUTION -respuesta I-EVOLUTION -parcial I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -IX I-PAST_MEDICAL_HISTORY -región, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -conocidos. I-PAST_MEDICAL_HISTORY -Ingresó B-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -urgencia I-EXPLORATION -luego I-EXPLORATION -de I-EXPLORATION -sufrir I-EXPLORATION -accidente I-EXPLORATION -de I-EXPLORATION -tránsito I-EXPLORATION -de I-EXPLORATION -baja I-EXPLORATION -energía I-EXPLORATION -sin I-EXPLORATION -presentar I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -consideración I-EXPLORATION -secundarias I-EXPLORATION -a I-EXPLORATION -el. I-EXPLORATION -Luego I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -semana, I-EXPLORATION -consultó I-EXPLORATION -por I-EXPLORATION -presentar I-EXPLORATION -debilidad I-EXPLORATION -progresiva I-EXPLORATION -de I-EXPLORATION -extremidades I-EXPLORATION -inferiores, I-EXPLORATION -dorsalgia I-EXPLORATION -de I-EXPLORATION -moderada I-EXPLORATION -intensidad I-EXPLORATION -y I-EXPLORATION -dificultad I-EXPLORATION -para I-EXPLORATION -orinar. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -se I-EXPLORATION -constata I-EXPLORATION -con I-EXPLORATION -hipoestesia I-EXPLORATION -bilateral I-EXPLORATION -desde I-EXPLORATION -nivel I-EXPLORATION -D5 I-EXPLORATION -hacia I-EXPLORATION -distal, I-EXPLORATION -paraparesia I-EXPLORATION -moderada, I-EXPLORATION -hiperrefexia I-EXPLORATION -osteotendínea I-EXPLORATION -patelar I-EXPLORATION -y I-EXPLORATION -aquiliana I-EXPLORATION -bilateral I-EXPLORATION -con I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Babinski I-EXPLORATION -positivo I-EXPLORATION -bilateral; I-EXPLORATION -se I-EXPLORATION -hospitalizó I-EXPLORATION -planteándose I-EXPLORATION -un I-EXPLORATION -trauma I-EXPLORATION -raquimedular I-EXPLORATION -complicado. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION -con I-EXPLORATION -radiografía I-EXPLORATION -(Rx) I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -dorsal I-EXPLORATION -mostraba I-EXPLORATION -aplastamiento I-EXPLORATION -de I-EXPLORATION -cuerpo I-EXPLORATION -D3. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION -y I-EXPLORATION -resonancia I-EXPLORATION -nuclear I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -dorsal I-EXPLORATION -demostraron I-EXPLORATION -múltiples I-EXPLORATION -quistes I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -variable I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -paravertebral I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -compromete I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -y I-EXPLORATION -elementos I-EXPLORATION -posteriores I-EXPLORATION -de I-EXPLORATION -D2, I-EXPLORATION -D3 I-EXPLORATION -y I-EXPLORATION -D4 I-EXPLORATION -e I-EXPLORATION -invasión I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -raquídeo I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -aplastamiento I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -D3 I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -probable I-EXPLORATION -etiología I-EXPLORATION -hidatídica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -anamnesis I-EXPLORATION -dirigida I-EXPLORATION -donde I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -señaló I-EXPLORATION -presentar I-EXPLORATION -dorsalgia I-EXPLORATION -de I-EXPLORATION -tres I-EXPLORATION -años I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -episodio I-EXPLORATION -de I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -fuerzas I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -que I-EXPLORATION -revirtió I-EXPLORATION -espontáneamente. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -(hemograma, I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -renal) I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Si B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -albendazol I-TREATMENT -y I-TREATMENT -realizó I-TREATMENT -hemilaminectomía I-TREATMENT -D3-D4 I-TREATMENT -con I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -quistes I-TREATMENT -confirmando I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histopatológico I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -hidatidosis I-TREATMENT -ósea. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -recuperando I-EVOLUTION -movilidad I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -extremidades I-EVOLUTION -inferiores I-EVOLUTION -sin I-EVOLUTION -déficit I-EVOLUTION -esfinteriano. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -demostraron I-EXPLORATION -enfermedad I-EXPLORATION -hidatídica I-EXPLORATION -diseminada. I-EXPLORATION -Completa B-TREATMENT -cuatro I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -albendazol. I-TREATMENT - I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -fue I-EVOLUTION -nuevamente I-EVOLUTION -intervenido I-EVOLUTION -quirúrgicamente I-EVOLUTION -por I-EVOLUTION -absceso I-EVOLUTION -dorsal I-EVOLUTION -hidatídico I-EVOLUTION -y I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -por I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -paraparesia I-EVOLUTION -progresiva I-EVOLUTION -con I-EVOLUTION -nivel I-EVOLUTION -sensitivo I-EVOLUTION -en I-EVOLUTION -D5 I-EVOLUTION -realizándose I-EVOLUTION -laminectomía I-EVOLUTION -D3-D4 I-EVOLUTION -con I-EVOLUTION -exéresis I-EVOLUTION -de I-EVOLUTION -quistes. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -positivo I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -decaimiento, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -conducta I-PRESENT_ILLNESS -frontalizada. I-PRESENT_ILLNESS -La B-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -resultó I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -VDRL, I-EXPLORATION -toxoplasma I-EXPLORATION -y I-EXPLORATION -VEB I-EXPLORATION -(por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -PCR). I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -hematológicos I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -leve I-EXPLORATION -con I-EXPLORATION -Hb I-EXPLORATION -de I-EXPLORATION -10, I-EXPLORATION -3 I-EXPLORATION -g/dL I-EXPLORATION -(ref. I-EXPLORATION -13, I-EXPLORATION -5-17, I-EXPLORATION -5 I-EXPLORATION -g/dL), I-EXPLORATION -Hto I-EXPLORATION -30% I-EXPLORATION -(ref. I-EXPLORATION -41-53%), I-EXPLORATION -leucopenia I-EXPLORATION -con I-EXPLORATION -3.100 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -(ref. I-EXPLORATION -4.500-11.000/mm3) I-EXPLORATION -y I-EXPLORATION -linfopenia I-EXPLORATION -con I-EXPLORATION -800/mm3 I-EXPLORATION -(ref. I-EXPLORATION -1.000-4.800/mm3). I-EXPLORATION -LDH I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales I-EXPLORATION -(133 I-EXPLORATION -U/L I-EXPLORATION -[ref. I-EXPLORATION -135-225 I-EXPLORATION -U/L] I-EXPLORATION -y I-EXPLORATION -0, I-EXPLORATION -1 I-EXPLORATION -mg/dL I-EXPLORATION -[ref. I-EXPLORATION -0-1 I-EXPLORATION -mg/dL], I-EXPLORATION -respectivamente). I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -además I-EXPLORATION -severo I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -inmunosupresión I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -CD4 I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -9/mm3. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION -revelaron I-EXPLORATION -2 I-EXPLORATION -nódulos I-EXPLORATION -córtico-subcorticales I-EXPLORATION -en I-EXPLORATION -zonas I-EXPLORATION -frontal I-EXPLORATION -media I-EXPLORATION -y I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -inflamatorio. I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION -compromiso I-EXPLORATION -pulmonar I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -sitios I-EXPLORATION -anatómicos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -estereotáxica I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -tejido I-EXPLORATION -cerebral I-EXPLORATION -con I-EXPLORATION -gliosis I-EXPLORATION -reactiva I-EXPLORATION -y I-EXPLORATION -extenso I-EXPLORATION -infiltrado I-EXPLORATION -celular I-EXPLORATION -mixto, I-EXPLORATION -predominantemente I-EXPLORATION -perivascular I-EXPLORATION -y I-EXPLORATION -zonas I-EXPLORATION -con I-EXPLORATION -angiotropismo I-EXPLORATION -y I-EXPLORATION -angiodestruccción I-EXPLORATION -compuestas I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -pequeños I-EXPLORATION -inmunorreactivos I-EXPLORATION -para I-EXPLORATION -CD3 I-EXPLORATION -(linfocitos I-EXPLORATION -T). I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -abundantes I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -atípicas I-EXPLORATION -medianas I-EXPLORATION -y I-EXPLORATION -grandes, I-EXPLORATION -de I-EXPLORATION -núcleos I-EXPLORATION -vesiculosos I-EXPLORATION -y I-EXPLORATION -pleomórficos I-EXPLORATION -inmunorreactivas I-EXPLORATION -para I-EXPLORATION -CD20 I-EXPLORATION -(linfocitos I-EXPLORATION -B). I-EXPLORATION -Los I-EXPLORATION -linfocitos I-EXPLORATION -mostraron I-EXPLORATION -reacción I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -pequeña I-EXPLORATION -de I-EXPLORATION -ARN I-EXPLORATION -asociado I-EXPLORATION -al I-EXPLORATION -VEB I-EXPLORATION -EBER-1 I-EXPLORATION -mediante I-EXPLORATION -hibridización I-EXPLORATION -in I-EXPLORATION -situ. I-EXPLORATION -Estas I-EXPLORATION -células I-EXPLORATION -mostraron I-EXPLORATION -reacción I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -CD30, I-EXPLORATION -CD68 I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -S-100. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -microorganismos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -con I-EXPLORATION -tinciones I-EXPLORATION -de I-EXPLORATION -Gram, I-EXPLORATION -PAS, I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -y I-EXPLORATION -Warthin-Starry. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -citometría I-EXPLORATION -de I-EXPLORATION -flujo I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -cerebral I-EXPLORATION -reveló I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -atípicas I-EXPLORATION -medianas I-EXPLORATION -de I-EXPLORATION -estirpe I-EXPLORATION -B I-EXPLORATION -con I-EXPLORATION -restricción I-EXPLORATION -de I-EXPLORATION -cadena I-EXPLORATION -ligera I-EXPLORATION -Kappa, I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -linfoproliferativo. I-EXPLORATION -El I-EXPLORATION -mielograma I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -conjunto, I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -GL I-EXPLORATION -cerebral I-EXPLORATION -grado I-EXPLORATION -3 I-EXPLORATION -(linfoma I-EXPLORATION -B I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -grandes). I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -caso I-TREATMENT -comunicado I-TREATMENT -en I-TREATMENT -el I-TREATMENT -presente I-TREATMENT -artículo I-TREATMENT -fue I-TREATMENT -confirmado I-TREATMENT -como I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -inmunodeficiencia I-TREATMENT -por I-TREATMENT -virus I-TREATMENT -VIH I-TREATMENT -etapa I-TREATMENT -C3 I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -antirretroviral. I-TREATMENT -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -solicitó I-DERIVED_FROM/TO -posteriormente I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -traslado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -continuar I-DERIVED_FROM/TO -manejo. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -neumonía. I-PRESENT_ILLNESS -Los B-EXPLORATION -cultivos I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -y I-EXPLORATION -CMV I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -previos. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -empírico. I-TREATMENT -A B-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -presentó I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -empeoramiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -radiológicas I-EXPLORATION -basales I-EXPLORATION -derechas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -BAL I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -crecimiento I-EXPLORATION -bacteriano. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -desarrolló I-EXPLORATION -paulatinamente I-EXPLORATION -citopenias I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -series: I-EXPLORATION -Hb: I-EXPLORATION -7 I-EXPLORATION -g/l; I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos: I-EXPLORATION -1.600/ I-EXPLORATION -mm3; I-EXPLORATION -plaquetas: I-EXPLORATION -49.000 I-EXPLORATION -/mm3. I-EXPLORATION -La I-EXPLORATION -ferritina I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -4.000 I-EXPLORATION -µg/l, I-EXPLORATION -trigliceridos I-EXPLORATION -607 I-EXPLORATION -mg/dl, I-EXPLORATION -fibrinógeno I-EXPLORATION -111%. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -PAMO I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -macrófagos I-EXPLORATION -en I-EXPLORATION -10% I-EXPLORATION -con I-EXPLORATION -hemofa-gocitosis. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -solo I-EXPLORATION -presentó I-EXPLORATION -ligera I-EXPLORATION -hepato I-EXPLORATION -esplenomegalia. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -administró I-TREATMENT -metilprednisona I-TREATMENT -a I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -g/día I-TREATMENT -por I-TREATMENT -tres I-TREATMENT -días I-TREATMENT -y I-TREATMENT -gammaglobulina I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -400 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -5 I-TREATMENT -días. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -persistente I-EVOLUTION -y B-TREATMENT -requerimiento I-TREATMENT -de I-TREATMENT -asistencia I-TREATMENT -respiratoria I-TREATMENT -mecánica. I-TREATMENT -Las B-EVOLUTION -citopenias I-EVOLUTION -no I-EVOLUTION -mejoraron. I-EVOLUTION -Se B-EXPLORATION -repitieron I-EXPLORATION -cultivos I-EXPLORATION -que I-EXPLORATION -siempre I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -BAL I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -el I-EXPLORATION -crecimiento I-EXPLORATION -significativo I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -Acinetobacter I-EXPLORATION -baumannii I-EXPLORATION -multirresistente I-EXPLORATION -que B-TREATMENT -recibió I-TREATMENT -tratamiento. I-TREATMENT -Falleció B-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -44 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -con I-EVOLUTION -falla I-EVOLUTION -multiorgánica. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -candidato I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -hepático. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -hepatorenal I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -motivó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -aporte I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -furosemida, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -obtener I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -diurética. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esto I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -donante. I-PRESENT_ILLNESS -En B-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -soporoso, I-EXPLORATION -con I-EXPLORATION -escasa I-EXPLORATION -respuesta I-EXPLORATION -a I-EXPLORATION -estímulos I-EXPLORATION -verbales, I-EXPLORATION -PA I-EXPLORATION -110/60, I-EXPLORATION -FC I-EXPLORATION -115 I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -35x'. I-EXPLORATION -Un I-EXPLORATION -ecocardiograma I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -mostró I-EXPLORATION -buena I-EXPLORATION -función I-EXPLORATION -ventricular I-EXPLORATION -global, I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cuatro I-EXPLORATION -cavidades I-EXPLORATION -y I-EXPLORATION -presión I-EXPLORATION -sistólica I-EXPLORATION -de I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -(PSAP) I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -mmHg. I-EXPLORATION -En I-EXPLORATION -pabellón, I-EXPLORATION -se I-EXPLORATION -intubó I-EXPLORATION -e I-EXPLORATION -instaló I-EXPLORATION -sonda I-EXPLORATION -para I-EXPLORATION -ETE I-EXPLORATION -y I-EXPLORATION -CAP I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -PVC I-EXPLORATION -de I-EXPLORATION -25 I-EXPLORATION -mmHg, I-EXPLORATION -PCP I-EXPLORATION -26 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -RVSI I-EXPLORATION -de I-EXPLORATION -987 I-EXPLORATION -dinas*segundo/cm5/m2. I-EXPLORATION -El I-EXPLORATION -IC I-EXPLORATION -y I-EXPLORATION -PSAP I-EXPLORATION -medidas I-EXPLORATION -por I-EXPLORATION -CAP I-EXPLORATION -y I-EXPLORATION -ETE I-EXPLORATION -fueron I-EXPLORATION -respectivamente I-EXPLORATION -4, I-EXPLORATION -7 I-EXPLORATION -y I-EXPLORATION -5, I-EXPLORATION -3 I-EXPLORATION -1/ I-EXPLORATION -m2, I-EXPLORATION -y I-EXPLORATION -49/32 I-EXPLORATION -y I-EXPLORATION -48. I-EXPLORATION -El I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -fin I-EXPLORATION -de I-EXPLORATION -diástole I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -indexado I-EXPLORATION -(VFDVII) I-EXPLORATION -fue I-EXPLORATION -98 I-EXPLORATION -ml/m2 I-EXPLORATION -(valor I-EXPLORATION -normal: I-EXPLORATION -35-75 I-EXPLORATION -ml/m2). I-EXPLORATION -Se B-TREATMENT -aportaron I-TREATMENT -fluidos I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -muy I-TREATMENT -restringida, I-TREATMENT -observándose I-TREATMENT -durante I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -buena I-TREATMENT -concordancia I-TREATMENT -entre I-TREATMENT -los I-TREATMENT -valores I-TREATMENT -de I-TREATMENT -IC I-TREATMENT -y I-TREATMENT -PSAP I-TREATMENT -medidos I-TREATMENT -con I-TREATMENT -CAP I-TREATMENT -y I-TREATMENT -ETE. I-TREATMENT -Al B-EXPLORATION -término I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cirugía I-EXPLORATION -la I-EXPLORATION -PVC I-EXPLORATION -era I-EXPLORATION -14 I-EXPLORATION -mmHg, I-EXPLORATION -PCP I-EXPLORATION -19 I-EXPLORATION -mmHg, I-EXPLORATION -PAP I-EXPLORATION -33/22 I-EXPLORATION -e I-EXPLORATION -IC I-EXPLORATION -5, I-EXPLORATION -1/ I-EXPLORATION -m2. I-EXPLORATION -El I-EXPLORATION -ETE I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -PSAP I-EXPLORATION -de I-EXPLORATION -32, I-EXPLORATION -IC I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -1/ I-EXPLORATION -m2, I-EXPLORATION -y I-EXPLORATION -VFDVI67ml/m2. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipertenso B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabáquico, I-PAST_MEDICAL_HISTORY -programado B-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -tiroidectomía I-PRESENT_ILLNESS -total. I-PRESENT_ILLNESS -Inducción B-EXPLORATION -anestésica I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -hemodinámicas, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -modificación I-EXPLORATION -de I-EXPLORATION -onda I-EXPLORATION -T I-EXPLORATION -y I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -isquemia. I-EXPLORATION -La I-EXPLORATION -ETE I-EXPLORATION -no I-EXPLORATION -mostraba I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -motilidad I-EXPLORATION -ventricular. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -suspender I-EXPLORATION -y I-EXPLORATION -realizar I-EXPLORATION -coronariografía I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -antecedentes I-PRESENT_ILLNESS -mórbidos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -importancia, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rápida I-PRESENT_ILLNESS -progresión, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -hemoptoica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -AngioTAC I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -tumoral, I-EXPLORATION -intracavitaria I-EXPLORATION -en I-EXPLORATION -aurícula I-EXPLORATION -izquierda I-EXPLORATION -infiltrativa I-EXPLORATION -a I-EXPLORATION -venas I-EXPLORATION -pulmonares. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION -con I-EXPLORATION -ecocardiograma I-EXPLORATION -confirmando I-EXPLORATION -masa I-EXPLORATION -hiperdensa I-EXPLORATION -de I-EXPLORATION -43 I-EXPLORATION -x I-EXPLORATION -38 I-EXPLORATION -mm I-EXPLORATION -ocupando I-EXPLORATION -el I-EXPLORATION -75% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -izquierda. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -resecó I-EXPLORATION -quirúrgicamente I-EXPLORATION -cerca I-EXPLORATION -de I-EXPLORATION -95% I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -por I-EXPLORATION -infiltración I-EXPLORATION -a I-EXPLORATION -venas I-EXPLORATION -pulmonares. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -histológico I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -fusado I-EXPLORATION -con I-EXPLORATION -algunas I-EXPLORATION -células I-EXPLORATION -ovaladas, I-EXPLORATION -pericitos, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -disponían I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -sólido, I-EXPLORATION -interrumpido I-EXPLORATION -por I-EXPLORATION -espacios I-EXPLORATION -vasculares I-EXPLORATION -delgados, I-EXPLORATION -revestidos I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -endoteliales I-EXPLORATION -y I-EXPLORATION -aplanadas. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -inmuno-histoquímica I-EXPLORATION -demostró I-EXPLORATION -reactividad I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -vimentina I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -proliferantes, I-EXPLORATION -CD-34 I-EXPLORATION -positivo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -endotelio I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -y I-EXPLORATION -pericitos, I-EXPLORATION -factor I-EXPLORATION -VIII I-EXPLORATION -positivo I-EXPLORATION -sólo I-EXPLORATION -en I-EXPLORATION -endotelio, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -S-100 I-EXPLORATION -y I-EXPLORATION -CD-68. I-EXPLORATION -Estos I-EXPLORATION -hallazgos, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -claro I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -reticulina I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -técnicas I-EXPLORATION -argénticas, I-EXPLORATION -indicaron I-EXPLORATION -el I-EXPLORATION -carácter I-EXPLORATION -pericítico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neoplasia I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -su I-EXPLORATION -carácter I-EXPLORATION -benigno I-EXPLORATION -histológico, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -mitótico I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -tres I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -10 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -mayor I-EXPLORATION -aumento. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -satisfactoriamente I-EVOLUTION -post I-EVOLUTION -cirugía I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -el I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -mes I-EVOLUTION -siguiente, I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -consultar I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -dolor I-EVOLUTION -cervical I-EVOLUTION -intenso I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -odinofagia. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -diseminación I-EXPLORATION -con I-EXPLORATION -PET-CP I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -zonas I-EXPLORATION -hipermetabólicas I-EXPLORATION -en I-EXPLORATION -pulmón, I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -cráneo, I-EXPLORATION -hígado, I-EXPLORATION -amígdala I-EXPLORATION -izquierda, I-EXPLORATION -aurícula I-EXPLORATION -izquierda, I-EXPLORATION -suprarrenal I-EXPLORATION -izquierda, I-EXPLORATION -cola I-EXPLORATION -de I-EXPLORATION -páncreas I-EXPLORATION -y I-EXPLORATION -colon I-EXPLORATION -descendente. I-EXPLORATION -Esto I-EXPLORATION -se I-EXPLORATION -explicó I-EXPLORATION -por I-EXPLORATION -embolización I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -circulación I-EXPLORATION -sistémica. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -presentó I-TREATMENT -caso I-TREATMENT -a I-TREATMENT -comité I-TREATMENT -oncológico I-TREATMENT -que I-TREATMENT -decidió I-TREATMENT -manejo I-TREATMENT -paliativo I-TREATMENT -y I-TREATMENT -del I-TREATMENT -dolor. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -de I-EVOLUTION -falla I-EVOLUTION -multiorgánica. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -73 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -valsartán I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hidroclorotiazida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -trombocitemia I-PAST_MEDICAL_HISTORY -esencial I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -inicialmente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hidroxiurea I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -anagrelide. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -mediados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diciembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -porque I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -fatigabilidad, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca I-PRESENT_ILLNESS -frecuente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -productiva. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -tenido I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -prurito. I-PRESENT_ILLNESS -El B-EXPLORATION -electrocardiograma I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fueron I-EXPLORATION -normales, I-EXPLORATION -salvo I-EXPLORATION -elongación I-EXPLORATION -aórtica I-EXPLORATION -moderada I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -mostró I-EXPLORATION -insuficiencia I-EXPLORATION -aórtica I-EXPLORATION -leve, I-EXPLORATION -aurícula I-EXPLORATION -y I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -conservada. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -destacaba I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -29%, I-EXPLORATION -macrocitosis, I-EXPLORATION -rouleaux I-EXPLORATION -++, I-EXPLORATION -VHS I-EXPLORATION -49 I-EXPLORATION -mm/hora I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -de I-EXPLORATION -717.000 I-EXPLORATION -mm3. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Una B-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -presentó I-EVOLUTION -esputo I-EVOLUTION -hemoptoico I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -por I-EVOLUTION -sospecha I-EVOLUTION -de I-EVOLUTION -embolia I-EVOLUTION -pulmonar. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -AngioTAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -trombos I-EXPLORATION -pero I-EXPLORATION -mostró I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -ascendente, I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -plano I-EXPLORATION -valvular I-EXPLORATION -aórtico, I-EXPLORATION -estaba I-EXPLORATION -cubierta I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -hipodenso, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -abdominal I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -inferior. I-EXPLORATION -También I-EXPLORATION -presentaban I-EXPLORATION -un I-EXPLORATION -halo I-EXPLORATION -similar I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -subclavia I-EXPLORATION -izquierda, I-EXPLORATION -renales I-EXPLORATION -y I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -(AMS). I-EXPLORATION -Las I-EXPLORATION -arterias I-EXPLORATION -renales I-EXPLORATION -y I-EXPLORATION -mesentéricas I-EXPLORATION -estaban I-EXPLORATION -estenosadas, I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION -celíaco I-EXPLORATION -presentaba I-EXPLORATION -dilatación I-EXPLORATION -post-estenótica I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION -sanguíneo I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -AMS I-EXPLORATION -era I-EXPLORATION -filiforme. I-EXPLORATION -Existía I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -derrame I-EXPLORATION -pericárdico, I-EXPLORATION -esplenomegalia I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -edema I-EXPLORATION -perinéfrico I-EXPLORATION -bilateral. I-EXPLORATION -El I-EXPLORATION -cintigrama I-EXPLORATION -renal I-EXPLORATION -mostró I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -perfusión I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -(RD I-EXPLORATION -62%, I-EXPLORATION -RI I-EXPLORATION -38%). I-EXPLORATION -Los I-EXPLORATION -vasos I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -eran I-EXPLORATION -normales I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -angioresonancia I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -periaórtico I-EXPLORATION -se I-EXPLORATION -reforzó I-EXPLORATION -con I-EXPLORATION -gadolinio I-EXPLORATION -concluyéndose I-EXPLORATION -que I-EXPLORATION -era I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -inflamatorio-fibroso. I-EXPLORATION -La I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -AMS I-EXPLORATION -era I-EXPLORATION -crítica; I-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -arterias I-EXPLORATION -renales I-EXPLORATION -izquierdas I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION -celíaco I-EXPLORATION -presentaban I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -70% I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -mesentérica I-EXPLORATION -inferior, I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -50%. I-EXPLORATION -Los I-EXPLORATION -senos I-EXPLORATION -renales I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -perinéfricas I-EXPLORATION -estaban I-EXPLORATION -ocupados I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -que I-EXPLORATION -envolvía I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -aorta. I-EXPLORATION -Se B-TREATMENT -instaló I-TREATMENT -stents I-TREATMENT -en I-TREATMENT -AMS I-TREATMENT -y I-TREATMENT -en I-TREATMENT -ambas I-TREATMENT -arterias I-TREATMENT -renales, I-TREATMENT -mejorando B-EVOLUTION -la I-EVOLUTION -perfusión. I-EVOLUTION -El B-EXPLORATION -radiólogo I-EXPLORATION -planteó I-EXPLORATION -ECD. I-EXPLORATION -El I-EXPLORATION -cintigrama I-EXPLORATION -óseo I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -dicho I-EXPLORATION -diagnóstico I-EXPLORATION -al I-EXPLORATION -mostrar I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -captación I-EXPLORATION -en I-EXPLORATION -fémures I-EXPLORATION -y I-EXPLORATION -tibias. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -60 I-TREATMENT -mg/día I-TREATMENT -y I-TREATMENT -metotrexato I-TREATMENT -10 I-TREATMENT -mg I-TREATMENT -semanales, I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -sintomática I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -redujo I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -gradual I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -corticoides I-TREATMENT -hasta I-TREATMENT -10 I-TREATMENT -mg. I-TREATMENT -Tres B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -(marzo I-EVOLUTION -de I-EVOLUTION -2008) I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -por I-EVOLUTION -neumonía I-EVOLUTION -y I-EVOLUTION -tuvo I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -(diciembre I-EVOLUTION -de I-EVOLUTION -2008) I-EVOLUTION -y I-EVOLUTION -estando I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -prácticamente I-EVOLUTION -asintomático, I-EVOLUTION -salvo I-EVOLUTION -edema I-EVOLUTION -de I-EVOLUTION -piernas I-EVOLUTION -atribuido I-EVOLUTION -al I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -anagrelide, I-EVOLUTION -persistía I-EVOLUTION -anémico I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -leucocitosis. I-EVOLUTION -Un B-EXPLORATION -scanner I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -grosor I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -periaórtico I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -aorta I-EXPLORATION -ascendente I-EXPLORATION -como I-EXPLORATION -descendente I-EXPLORATION -y I-EXPLORATION -prolongación I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -arterias I-EXPLORATION -ilíacas I-EXPLORATION -primitivas. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -meses I-EXPLORATION -(julio I-EXPLORATION -de I-EXPLORATION -2009), I-EXPLORATION -por I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -rodillas I-EXPLORATION -se I-EXPLORATION -tomó I-EXPLORATION -radiografías I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -osteoesclerosis I-EXPLORATION -en I-EXPLORATION -fémures I-EXPLORATION -y I-EXPLORATION -tibias I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -localización I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -alteraciones I-EXPLORATION -del I-EXPLORATION -cintigrama I-EXPLORATION -óseo I-EXPLORATION -y I-EXPLORATION -calcificaciones I-EXPLORATION -del I-EXPLORATION -cartílago I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -condrocalcinosis. I-EXPLORATION -Un I-EXPLORATION -nuevo I-EXPLORATION -scanner, I-EXPLORATION -mostró I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -previos I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -(70%) I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -inferior. I-EXPLORATION -A B-EVOLUTION -28 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -(abril I-EVOLUTION -de I-EVOLUTION -2010), I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -cardiaca I-EVOLUTION -congestiva. I-EVOLUTION -El B-EXPLORATION -scanner I-EXPLORATION -mostró I-EXPLORATION -acentuación I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -perirrenal, I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pleuras I-EXPLORATION -bibasales I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pericardio. I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -iniciales I-EXPLORATION -de I-EXPLORATION -taponamiento I-EXPLORATION -y I-EXPLORATION -superficie I-EXPLORATION -pericárdica I-EXPLORATION -irregular I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -tumoral. I-EXPLORATION -El I-EXPLORATION -electrocardiograma I-EXPLORATION -mostró I-EXPLORATION -bajo I-EXPLORATION -voltaje. I-EXPLORATION -Fue B-TREATMENT -hospitalizado I-TREATMENT -efectuándose I-TREATMENT -una I-TREATMENT -ventana I-TREATMENT -pleuro-pericárdica. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -operación I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -el I-TREATMENT -pericardio I-TREATMENT -a I-TREATMENT -tensión I-TREATMENT -drenando I-TREATMENT -1.200 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -un I-TREATMENT -líquido I-TREATMENT -amarillo I-TREATMENT -pardusco. I-TREATMENT -El B-EXPLORATION -pericardio I-EXPLORATION -parietal I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -visceral I-EXPLORATION -estaba I-EXPLORATION -infiltrado I-EXPLORATION -difusamente I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -duro. I-EXPLORATION -El I-EXPLORATION -líquido I-EXPLORATION -pericárdico I-EXPLORATION -tenía I-EXPLORATION -abundantes I-EXPLORATION -histiocitos I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -pericárdico I-EXPLORATION -parietal I-EXPLORATION -resecado, I-EXPLORATION -que I-EXPLORATION -tenía I-EXPLORATION -infiltración I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -citoplasma I-EXPLORATION -granular I-EXPLORATION -y I-EXPLORATION -espumoso I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -inmunohistoquímico I-EXPLORATION -confirmó I-EXPLORATION -que I-EXPLORATION -dichas I-EXPLORATION -células I-EXPLORATION -correspondían I-EXPLORATION -a I-EXPLORATION -histiocitos, I-EXPLORATION -CD68 I-EXPLORATION -(+), I-EXPLORATION -CD1a I-EXPLORATION -(-) I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -S100 I-EXPLORATION -(-), I-EXPLORATION -confirmando I-EXPLORATION -la I-EXPLORATION -ECD. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -clara I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -procedimiento. I-EVOLUTION - I-EVOLUTION - -Paciente B-PAST_MEDICAL_HISTORY -chileno, I-PAST_MEDICAL_HISTORY -masculino, B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -viaje I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Cuzco, I-PRESENT_ILLNESS -Perú, I-PRESENT_ILLNESS -inicia I-PRESENT_ILLNESS -súbitamente I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -reposo I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agrega I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general. I-PRESENT_ILLNESS -Se B-TREATMENT -diagnostica I-TREATMENT -mal I-TREATMENT -de I-TREATMENT -altura I-TREATMENT -agudo, I-TREATMENT -recibiendo I-TREATMENT -furosemida, I-TREATMENT -acetazolamida, I-TREATMENT -dexametasona, I-TREATMENT -ranitidina I-TREATMENT -y I-TREATMENT -ceftriaxona. I-TREATMENT - B-EVOLUTION -En I-EVOLUTION -Chile, I-EVOLUTION -6 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -persistir I-EVOLUTION -con I-EVOLUTION -idéntica I-EVOLUTION -sintomatología I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -derivado I-EVOLUTION -al I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencia I-EVOLUTION -del I-EVOLUTION -Hospital I-EVOLUTION -Clínico I-EVOLUTION -Universidad I-EVOLUTION -de I-EVOLUTION -Chile I-EVOLUTION -por I-EVOLUTION -sospecha I-EVOLUTION -de I-EVOLUTION -tromboembolismo I-EVOLUTION -pulmonar. I-EVOLUTION -Ingresó B-EXPLORATION -afebril, I-EXPLORATION -disneico, I-EXPLORATION -con I-EXPLORATION -tope I-EXPLORATION -inspiratorio I-EXPLORATION -y I-EXPLORATION -distensión I-EXPLORATION -abdominal. I-EXPLORATION -Tenía B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -apnea-hipopnea I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -sueño, I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -bipolar I-PAST_MEDICAL_HISTORY -manejado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -valproico, I-PAST_MEDICAL_HISTORY -rinitis I-PAST_MEDICAL_HISTORY -alérgica, I-PAST_MEDICAL_HISTORY -várices I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -miembros I-PAST_MEDICAL_HISTORY -inferiores, I-PAST_MEDICAL_HISTORY -apendicectomizado, I-PAST_MEDICAL_HISTORY -tabáquico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -paquetes-año, I-PAST_MEDICAL_HISTORY -bebedor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -copas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vino I-PAST_MEDICAL_HISTORY -diarias I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Signos B-EXPLORATION -vitales: I-EXPLORATION -Pulso I-EXPLORATION -81, I-EXPLORATION -ventilación I-EXPLORATION -18 I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -102-67 I-EXPLORATION -mmHg, I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION -36°C. I-EXPLORATION -Al I-EXPLORATION -examen: I-EXPLORATION -en I-EXPLORATION -decúbito I-EXPLORATION -dorsal, I-EXPLORATION -consciente, I-EXPLORATION -hidratado, I-EXPLORATION -bien I-EXPLORATION -perfundido, I-EXPLORATION -piel I-EXPLORATION -blanca, I-EXPLORATION -pálida. I-EXPLORATION -Destacaba I-EXPLORATION -abdomen I-EXPLORATION -doloroso I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -bazo I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño, I-EXPLORATION -várices I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -inferiores. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio: I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -hematocrito I-EXPLORATION -27, I-EXPLORATION -1%, I-EXPLORATION -hemoglobina I-EXPLORATION -8, I-EXPLORATION -7 I-EXPLORATION -g/dl, I-EXPLORATION -VCM I-EXPLORATION -y I-EXPLORATION -CHCM I-EXPLORATION -normales, I-EXPLORATION -leucocitos I-EXPLORATION -10.100/uL, I-EXPLORATION -VHS I-EXPLORATION -28 I-EXPLORATION -mm/hr, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -y I-EXPLORATION -TTPK I-EXPLORATION -normales. I-EXPLORATION -Dímero I-EXPLORATION -D I-EXPLORATION -4.683 I-EXPLORATION -ng/ml I-EXPLORATION -(normal I-EXPLORATION -< I-EXPLORATION -500), I-EXPLORATION -LDH I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -1.247 I-EXPLORATION -(rango: I-EXPLORATION -313-618), I-EXPLORATION -proBNP, I-EXPLORATION -CK, I-EXPLORATION -CK-MB I-EXPLORATION -y I-EXPLORATION -troponinas I-EXPLORATION -normales. I-EXPLORATION -Angio-TAC I-EXPLORATION -pulmonar I-EXPLORATION -descartó I-EXPLORATION -tromboembolismo I-EXPLORATION -y I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -periesplénico, I-EXPLORATION -subcapsular I-EXPLORATION -de I-EXPLORATION -17 I-EXPLORATION -cm, I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -ingresado I-EVOLUTION -a I-EVOLUTION -cuidados I-EVOLUTION -intermedios I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -probable I-EVOLUTION -de I-EVOLUTION -infarto I-EVOLUTION -esplénico I-EVOLUTION -con I-EVOLUTION -transformación I-EVOLUTION -hemorrágica. I-EVOLUTION - I-EVOLUTION -Hemogramas B-EXPLORATION -seriados I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -cambios, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecocardiografía I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -crecimiento I-EXPLORATION -del I-EXPLORATION -hematoma I-EXPLORATION -esplénico I-EXPLORATION -a I-EXPLORATION -19 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -Ante B-EVOLUTION -estabilidad I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -trasladado I-EVOLUTION -a I-EVOLUTION -sala I-EVOLUTION -en I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -laboratorio I-EXPLORATION -no I-EXPLORATION -sugerían I-EXPLORATION -etiologías I-EXPLORATION -infecciosas I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -hematoma I-EXPLORATION -esplénico, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -elementos I-EXPLORATION -sospechosos I-EXPLORATION -de I-EXPLORATION -síndromes I-EXPLORATION -mieloproliferativos, I-EXPLORATION -linfoproliferativos I-EXPLORATION -u I-EXPLORATION -otra I-EXPLORATION -neoplasia I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -tomografía I-EXPLORATION -y I-EXPLORATION -bioquímicos. I-EXPLORATION -Hemogramas I-EXPLORATION -previos I-EXPLORATION -a I-EXPLORATION -este I-EXPLORATION -evento I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -Ante I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -esplénico, I-EXPLORATION -pese I-EXPLORATION -a I-EXPLORATION -ser I-EXPLORATION -una I-EXPLORATION -causa I-EXPLORATION -rara, I-EXPLORATION -fue I-EXPLORATION -estudiado I-EXPLORATION -para I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -rasgo I-EXPLORATION -falciforme I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -inducción I-EXPLORATION -de I-EXPLORATION -drepanocitos I-EXPLORATION -con I-EXPLORATION -metabisulfito I-EXPLORATION -de I-EXPLORATION -sodio I-EXPLORATION -al I-EXPLORATION -2%, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positiva. I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -intrahospitalaria I-TREATMENT -favorable, I-TREATMENT -acompañado I-TREATMENT -de I-TREATMENT -laboratorio I-TREATMENT -general I-TREATMENT -y I-TREATMENT -estudios I-TREATMENT -radiológicos I-TREATMENT -sin I-TREATMENT -progresión, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -intervenir I-TREATMENT -quirúrgicamente I-TREATMENT -y B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -control I-EXPLORATION -ambulatorio I-EXPLORATION -por I-EXPLORATION -hematología I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -electroforesis I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -en I-EXPLORATION -medio I-EXPLORATION -alcalino I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -hemoglobina I-EXPLORATION -normal I-EXPLORATION -A I-EXPLORATION -54, I-EXPLORATION -8% I-EXPLORATION -y I-EXPLORATION -41, I-EXPLORATION -8% I-EXPLORATION -de I-EXPLORATION -fracción I-EXPLORATION -3, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -hemoglobina I-EXPLORATION -S I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -rasgo I-EXPLORATION -falciforme. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos, I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -consultó I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sufrir I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -baja I-PAST_MEDICAL_HISTORY -intensidad I-PAST_MEDICAL_HISTORY -(pelotazo) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -genital. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -dolor I-EXPLORATION -que I-EXPLORATION -dificultaba I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -evidenciándose I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -asimétrico I-EXPLORATION -testicular I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -lesiones I-EXPLORATION -asociadas. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -ecotomografía I-EXPLORATION -testicular I-EXPLORATION -presentándose I-EXPLORATION -a I-EXPLORATION -control I-EXPLORATION -luego I-EXPLORATION -de I-EXPLORATION -transcurridos I-EXPLORATION -5 I-EXPLORATION -meses, I-EXPLORATION -constatándose I-EXPLORATION -clínicamente I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -indurada I-EXPLORATION -en I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -no I-EXPLORATION -dolorosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -escrotal; I-EXPLORATION -testículo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -pene I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -ultrasonografía I-EXPLORATION -demostró I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -18 I-EXPLORATION -x I-EXPLORATION -19 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -mm, I-EXPLORATION -bien I-EXPLORATION -delimitado, I-EXPLORATION -de I-EXPLORATION -paredes I-EXPLORATION -hiperecogénicas I-EXPLORATION -con I-EXPLORATION -sombra I-EXPLORATION -acústica I-EXPLORATION -posterior. I-EXPLORATION -El I-EXPLORATION -testículo I-EXPLORATION -derecho, I-EXPLORATION -epidídimos I-EXPLORATION -y I-EXPLORATION -cordones I-EXPLORATION -espermáticos I-EXPLORATION -no I-EXPLORATION -presentan I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -ecoestructura. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -serológico I-EXPLORATION -para I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -(α-feto I-EXPLORATION -proteína I-EXPLORATION -y I-EXPLORATION -hormona I-EXPLORATION -gonadotropina I-EXPLORATION -coriónica I-EXPLORATION -sub-unidad I-EXPLORATION -β) I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -pelvis, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -tórax I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -demostraron I-EXPLORATION -lesiones I-EXPLORATION -secundarias. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -efectuó I-TREATMENT -enucleación I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -y I-TREATMENT -biopsia I-TREATMENT -intra-operatoria. I-TREATMENT -Se B-EXPLORATION -examinó I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -testicular I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -g I-EXPLORATION -de I-EXPLORATION -35 I-EXPLORATION -x I-EXPLORATION -17 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION -presentando I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -subcapsular I-EXPLORATION -redondeada, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -amarillenta, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -firme I-EXPLORATION -de I-EXPLORATION -22 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -grumosas I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -arenoso. I-EXPLORATION -El I-EXPLORATION -corte I-EXPLORATION -histológico I-EXPLORATION -por I-EXPLORATION -congelaci��n I-EXPLORATION -y I-EXPLORATION -diferido I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -que I-EXPLORATION -presentaba I-EXPLORATION -nidos I-EXPLORATION -y I-EXPLORATION -cordones I-EXPLORATION -conformados I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -ovales I-EXPLORATION -a I-EXPLORATION -poligonales I-EXPLORATION -de I-EXPLORATION -núcleos I-EXPLORATION -grandes, I-EXPLORATION -excéntricos I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -nucléolo I-EXPLORATION -prominente, I-EXPLORATION -el I-EXPLORATION -citoplasma I-EXPLORATION -es I-EXPLORATION -eosinófilo I-EXPLORATION -y I-EXPLORATION -abundante, I-EXPLORATION -apreciándose I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -polimorfonuclear I-EXPLORATION -neutrófilo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -central I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -y I-EXPLORATION -linfocitos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -periferia I-EXPLORATION -en I-EXPLORATION -partes I-EXPLORATION -formando I-EXPLORATION -agregados I-EXPLORATION -linfoides. I-EXPLORATION -El I-EXPLORATION -estroma I-EXPLORATION -es I-EXPLORATION -en I-EXPLORATION -partes I-EXPLORATION -hialino I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -degeneración I-EXPLORATION -mixoide I-EXPLORATION -y I-EXPLORATION -abundantes I-EXPLORATION -calcificaciones I-EXPLORATION -dispuestas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -intersticial I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lumen I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -nidos I-EXPLORATION -tumorales, I-EXPLORATION -concluyéndose I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -contemporánea I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Sertoli I-EXPLORATION -calcificado. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -extensión I-EXPLORATION -tumoral I-EXPLORATION -intratubular, I-EXPLORATION -figuras I-EXPLORATION -mitóticas, I-EXPLORATION -necrosis, I-EXPLORATION -acentuada I-EXPLORATION -atipía I-EXPLORATION -citológica I-EXPLORATION -ni I-EXPLORATION -extensión I-EXPLORATION -tumoral I-EXPLORATION -extra-testicular. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -demostró I-EXPLORATION -intensa I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -α-inhibina, I-EXPLORATION -S-100 I-EXPLORATION -y I-EXPLORATION -vimentina; I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -(Ki-67) I-EXPLORATION -bajo I-EXPLORATION -(< I-EXPLORATION -1%). I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -completó I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -realizándose I-TREATMENT -orquiectomía I-TREATMENT -radical. I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -registraron I-EVOLUTION -complicaciones I-EVOLUTION -post-operatorias. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -post-cirugía, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -sano, I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -en I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -tórax-abdomen I-EVOLUTION -y I-EVOLUTION -pelvis; I-EVOLUTION -descartándose I-EVOLUTION -en I-EVOLUTION -este I-EVOLUTION -paciente I-EVOLUTION -la I-EVOLUTION -asociación I-EVOLUTION -con I-EVOLUTION -complejo I-EVOLUTION -de I-EVOLUTION -Carney I-EVOLUTION -y I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -Peutz-Jeghers. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -domiciliada B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Calama, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -causa I-PAST_MEDICAL_HISTORY -desconocida, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -período I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -agregó I-PAST_MEDICAL_HISTORY -baja I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -kg, I-PAST_MEDICAL_HISTORY -cefalea, I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -polineuropático I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -guante I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -calcetín I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -poliartralgias. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -aparecido I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -blando, I-PRESENT_ILLNESS -indoloro, I-PRESENT_ILLNESS -progresivo, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -hombros, I-PRESENT_ILLNESS -antebrazo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -muslos, I-PRESENT_ILLNESS -inmovilidad I-PRESENT_ILLNESS -articular I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -manos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rodillas, I-PRESENT_ILLNESS -postración I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -posible I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -reumatológica. I-DERIVED_FROM/TO -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -paciente I-EXPLORATION -caquéctica, I-EXPLORATION -pálida, I-EXPLORATION -postrada. I-EXPLORATION -Destacó I-EXPLORATION -macroglosia I-EXPLORATION -con I-EXPLORATION -lengua I-EXPLORATION -geográfica, I-EXPLORATION -masas I-EXPLORATION -gomosas I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hombros I-EXPLORATION -(periarticulares) I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm: I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -shoulder I-EXPLORATION -pad, I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -antebrazo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -muslos, I-EXPLORATION -manos I-EXPLORATION -contracturadas I-EXPLORATION -en I-EXPLORATION -flexión I-EXPLORATION -y I-EXPLORATION -rigidez I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -rodillas. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -hemoglobina I-EXPLORATION -8, I-EXPLORATION -7 I-EXPLORATION -g/dL, I-EXPLORATION -creatinina I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -mg/dL, I-EXPLORATION -calcemia I-EXPLORATION -12 I-EXPLORATION -mg/dL, I-EXPLORATION -albúmina I-EXPLORATION -1, I-EXPLORATION -9 I-EXPLORATION -g/L, I-EXPLORATION -proteína I-EXPLORATION -total I-EXPLORATION -5, I-EXPLORATION -4 I-EXPLORATION -g/dL I-EXPLORATION -y I-EXPLORATION -triglicéridos I-EXPLORATION -450 I-EXPLORATION -mg/dL. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -fuerte I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -mieloma I-EXPLORATION -múltiple I-EXPLORATION -y I-EXPLORATION -amiloidosis I-EXPLORATION -asociada, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -mielograma I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -infiltrado I-EXPLORATION -de I-EXPLORATION -25% I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -plasmáticas. I-EXPLORATION -El I-EXPLORATION -inmunofenotipo I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -mostró I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -con I-EXPLORATION -restricción I-EXPLORATION -de I-EXPLORATION -cadena I-EXPLORATION -liviana I-EXPLORATION -lambda I-EXPLORATION -y I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -mieloma. I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION -de I-EXPLORATION -proteínas I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -pequeño I-EXPLORATION -componente I-EXPLORATION -M I-EXPLORATION -en I-EXPLORATION -G1 I-EXPLORATION -y I-EXPLORATION -cuantificación I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -muy I-EXPLORATION -disminuidas, I-EXPLORATION -IgA I-EXPLORATION -27, I-EXPLORATION -7 I-EXPLORATION -mg/dL, I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -8 I-EXPLORATION -mg/dL. I-EXPLORATION -No I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -estudiar I-EXPLORATION -proteinuria I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -diuresis. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -muslo I-EXPLORATION -izquierdo, I-EXPLORATION -informó I-EXPLORATION -tejido I-EXPLORATION -fibroadiposo, I-EXPLORATION -escaso I-EXPLORATION -tejido I-EXPLORATION -muscular I-EXPLORATION -estriado I-EXPLORATION -y I-EXPLORATION -depósitos I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Rojo I-EXPLORATION -Congo, I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -amiloidosis. I-EXPLORATION -Las I-EXPLORATION -radiografías I-EXPLORATION -óseas I-EXPLORATION -mostraron I-EXPLORATION -lesiones I-EXPLORATION -líticas I-EXPLORATION -en I-EXPLORATION -cadera I-EXPLORATION -y I-EXPLORATION -fémur I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -en I-EXPLORATION -correspondencia I-EXPLORATION -a I-EXPLORATION -masas I-EXPLORATION -descritas I-EXPLORATION -anteriormente, I-EXPLORATION -sin I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -estructuras I-EXPLORATION -óseas. I-EXPLORATION -Una I-EXPLORATION -electromiografía I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -neuropatía I-EXPLORATION -por I-EXPLORATION -atrapamiento I-EXPLORATION -de I-EXPLORATION -nervio I-EXPLORATION -peroneo I-EXPLORATION -y I-EXPLORATION -nervio I-EXPLORATION -mediano I-EXPLORATION -derecho. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -depósitos I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -en I-EXPLORATION -hombros I-EXPLORATION -(periarticulares), I-EXPLORATION -pericardio, I-EXPLORATION -pared I-EXPLORATION -intestinal, I-EXPLORATION -hepatomegalia I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -cabeza I-EXPLORATION -de I-EXPLORATION -páncreas. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecocardiograma. I-EXPLORATION -Se I-EXPLORATION -concluyó I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -mieloma I-EXPLORATION -múltiple, I-EXPLORATION -amiloidosis I-EXPLORATION -asociada I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -terminal. I-EXPLORATION -Recibió B-TREATMENT -bisfosfonatos, I-TREATMENT -con I-TREATMENT -reducción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hipercalcemia I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -melfalan I-TREATMENT -10 I-TREATMENT -mg/día I-TREATMENT -y I-TREATMENT -prednisona I-TREATMENT -40 I-TREATMENT -mg/día I-TREATMENT -por I-TREATMENT -4 I-TREATMENT -días. I-TREATMENT -Luego I-TREATMENT -se I-TREATMENT -agregó I-TREATMENT -talidomida I-TREATMENT -50 I-TREATMENT -mg/día. I-TREATMENT -Lamentablemente, B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -ingeniero, B-PAST_MEDICAL_HISTORY -previamente I-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -presentó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -curso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas, I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -retención I-PRESENT_ILLNESS -urinaria, I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -déficits I-PRESENT_ILLNESS -sensoriales I-PRESENT_ILLNESS -irregulares I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tórax I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -abdomen. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -antecedente, I-PAST_MEDICAL_HISTORY -comunicó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tos I-PAST_MEDICAL_HISTORY -leve I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -4-5 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -admisión I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clínica. I-PAST_MEDICAL_HISTORY -Una I-PAST_MEDICAL_HISTORY -evaluación I-PAST_MEDICAL_HISTORY -urológica I-PAST_MEDICAL_HISTORY -descartó I-PAST_MEDICAL_HISTORY -uropatía I-PAST_MEDICAL_HISTORY -obstructiva. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -estaba I-EXPLORATION -alerta, I-EXPLORATION -febril I-EXPLORATION -(38°C), I-EXPLORATION -sin I-EXPLORATION -déficits I-EXPLORATION -en I-EXPLORATION -nervios I-EXPLORATION -craneales. I-EXPLORATION -La I-EXPLORATION -fuerza I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION -superiores I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -debilidad I-EXPLORATION -moderada I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -con I-EXPLORATION -incapacidad I-EXPLORATION -para I-EXPLORATION -levantarse I-EXPLORATION -desde I-EXPLORATION -una I-EXPLORATION -posición I-EXPLORATION -sentada. I-EXPLORATION -Los I-EXPLORATION -reflejos I-EXPLORATION -plantares I-EXPLORATION -eran I-EXPLORATION -extensores, I-EXPLORATION -había I-EXPLORATION -déficit I-EXPLORATION -sensorial I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -dermatoma I-EXPLORATION -D6. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -rutina: I-EXPLORATION -hemograma, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva, I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -urocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -mostró I-EXPLORATION -35 I-EXPLORATION -glóbulos I-EXPLORATION -blancos I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION -con I-EXPLORATION -predominio I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -mononucleares. I-EXPLORATION -La I-EXPLORATION -proteínorraquia I-EXPLORATION -fue I-EXPLORATION -75 I-EXPLORATION -mg/dl. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectaron I-EXPLORATION -bandas I-EXPLORATION -oligoclonales. I-EXPLORATION -La I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -ARN I-EXPLORATION -viral I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -PCR-Microarray I-EXPLORATION -(Entherpex®, I-EXPLORATION -Genomica, I-EXPLORATION -España), I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -LCR I-EXPLORATION -sólo I-EXPLORATION -para I-EXPLORATION -VHH-7. I-EXPLORATION -Los I-EXPLORATION -herpes I-EXPLORATION -virus I-EXPLORATION -VHS-1, I-EXPLORATION -VHS-2, I-EXPLORATION -VHH-6, I-EXPLORATION -Epstein-Barr, I-EXPLORATION -VVZ, I-EXPLORATION -citomegalovirus I-EXPLORATION -y I-EXPLORATION -también I-EXPLORATION -anterovirus I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -test I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -y I-EXPLORATION -HTLV-1 I-EXPLORATION -fue I-EXPLORATION -negativo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -pruebas I-EXPLORATION -inmunológicas I-EXPLORATION -para I-EXPLORATION -vasculitis I-EXPLORATION -y I-EXPLORATION -test I-EXPLORATION -serológico I-EXPLORATION -para I-EXPLORATION -Mycoplasma I-EXPLORATION -pneumoniae. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RNM) I-EXPLORATION -cerebral I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -RNM I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -evidenció I-EXPLORATION -lesiones I-EXPLORATION -inflamatorias, I-EXPLORATION -difusas, I-EXPLORATION -extensas I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -cervical, I-EXPLORATION -y I-EXPLORATION -dorsal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -médula I-EXPLORATION -(ver I-EXPLORATION -Figuras I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -2). I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -metilprednisolona I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -ganciclovir I-TREATMENT -iv I-TREATMENT -300 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -recuperó I-TREATMENT -la I-TREATMENT -fuerza I-TREATMENT -en I-TREATMENT -extremidades I-TREATMENT -por I-TREATMENT -completo; I-TREATMENT -la B-EVOLUTION -retención I-EVOLUTION -urinaria I-EVOLUTION -persistió I-EVOLUTION -por I-EVOLUTION -1 I-EVOLUTION -mes I-EVOLUTION -para I-EVOLUTION -resolverse I-EVOLUTION -por I-EVOLUTION -completo I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -días I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -PCR I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -Herpesviridae. I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION -15 I-EXPLORATION -células I-EXPLORATION -con I-EXPLORATION -proteinas I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -repetición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -PCR I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -LCR, I-EXPLORATION -tomada I-EXPLORATION -al I-EXPLORATION -ingreso, I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -fue I-EXPLORATION -mielitis I-EXPLORATION -viral I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -HHV-7. I-EXPLORATION - I-EXPLORATION -Los B-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -evidenciaron I-EVOLUTION -un I-EVOLUTION -paciente I-EVOLUTION -sano, I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -desarrollado I-EVOLUTION -inmunodeficiencia. I-EVOLUTION - I-EVOLUTION - -Sexo B-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -VIH B-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2000, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -marcadoras I-PAST_MEDICAL_HISTORY -etapa I-PAST_MEDICAL_HISTORY -SIDA, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -antirretroviral I-PAST_MEDICAL_HISTORY -(TARV) I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -con: I-PAST_MEDICAL_HISTORY -zidovudina, I-PAST_MEDICAL_HISTORY -lamivudina, I-PAST_MEDICAL_HISTORY -indinavir/ritonavir, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -migraña. I-PAST_MEDICAL_HISTORY -Cuarenta B-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta, I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -tensionales, I-PRESENT_ILLNESS -automedicándose I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ibuprofeno/ergotamina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -agregando I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas: I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -parestesias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tercio I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba: I-EXPLORATION -palidez I-EXPLORATION -cutánea I-EXPLORATION -alternante I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -cianosis I-EXPLORATION -y I-EXPLORATION -frialdad I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -tobillos I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -tibial I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -pedio.. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -originario B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Tamaulipas, I-PAST_MEDICAL_HISTORY -México, I-PAST_MEDICAL_HISTORY -evaluado B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -xerosis I-PRESENT_ILLNESS -generalizada, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -incierto. I-PRESENT_ILLNESS -Producto B-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -pareja I-PAST_MEDICAL_HISTORY -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -aparentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -consanguineidad, I-FAMILY_HISTORY -se B-PAST_MEDICAL_HISTORY -caracteriza I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -intolerancia I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -calor I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -sudoración I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nacimiento. I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -refierían I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -heredofamiliares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia. I-FAMILY_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -frenteprominente, I-EXPLORATION -hipoplasia I-EXPLORATION -del I-EXPLORATION -puente I-EXPLORATION -nasal, I-EXPLORATION -dos I-EXPLORATION -incisivos I-EXPLORATION -únicos I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -cono, I-EXPLORATION -pigmentación I-EXPLORATION -periorbitaria, I-EXPLORATION -pelo I-EXPLORATION -escaso, I-EXPLORATION -fino, I-EXPLORATION -disperso I-EXPLORATION -y I-EXPLORATION -frágil I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -cejas I-EXPLORATION -y I-EXPLORATION -pestañas. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -dermatosis I-EXPLORATION -diseminada I-EXPLORATION -a I-EXPLORATION -cabeza, I-EXPLORATION -tronco I-EXPLORATION -y I-EXPLORATION -principalmente I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -pápulas I-EXPLORATION -puntiformes I-EXPLORATION -eritematosas, I-EXPLORATION -con I-EXPLORATION -eritema I-EXPLORATION -difuso I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -piel I-EXPLORATION -xerótica. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -palma I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -glándulas I-EXPLORATION -sudoríparas I-EXPLORATION -y I-EXPLORATION -sebáceas. I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -obtener I-EXPLORATION -el I-EXPLORATION -consentimiento I-EXPLORATION -informado, I-EXPLORATION -obtuvimos I-EXPLORATION -sangre I-EXPLORATION -periférica I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -cariotipo I-EXPLORATION -reportándose I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -vez, I-EXPLORATION -obtuvimos I-EXPLORATION -sangre I-EXPLORATION -no I-EXPLORATION -coagulada I-EXPLORATION -en I-EXPLORATION -tubos I-EXPLORATION -de I-EXPLORATION -EDTA I-EXPLORATION -(ácido I-EXPLORATION -etilendiaminotetraacético) I-EXPLORATION -de I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -siguiendo I-EXPLORATION -los I-EXPLORATION -Principios I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Declaración I-EXPLORATION -de I-EXPLORATION -Helsinki. I-EXPLORATION -Se I-EXPLORATION -extrajo I-EXPLORATION -ADN I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -sanguíneas I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -PUREGENER I-EXPLORATION -(Systema I-EXPLORATION -Gentra). I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mutaciones I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -exones I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -secuencias I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -uniones I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -intrones-exones I-EXPLORATION -fueron I-EXPLORATION -amplificados I-EXPLORATION -por I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -(reacción I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -polimerasa) I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -EDA-A1 I-EXPLORATION -en I-EXPLORATION -condiciones I-EXPLORATION -reportadas I-EXPLORATION -previamente. I-EXPLORATION -Las I-EXPLORATION -condiciones I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -amplificación I-EXPLORATION -de I-EXPLORATION -cada I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -94 I-EXPLORATION -°C I-EXPLORATION -por I-EXPLORATION -2 I-EXPLORATION -minutos, I-EXPLORATION -seguido I-EXPLORATION -por I-EXPLORATION -35 I-EXPLORATION -ciclos I-EXPLORATION -de I-EXPLORATION -94°C I-EXPLORATION -durante I-EXPLORATION -30 I-EXPLORATION -segundos, I-EXPLORATION -55°C I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -segundos I-EXPLORATION -y I-EXPLORATION -72°C I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -segundos I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -extensión I-EXPLORATION -final I-EXPLORATION -a I-EXPLORATION -72°C I-EXPLORATION -durante I-EXPLORATION -7 I-EXPLORATION -minutos. I-EXPLORATION -Los I-EXPLORATION -productos I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION -colocados I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -gel I-EXPLORATION -de I-EXPLORATION -agarosa I-EXPLORATION -al I-EXPLORATION -1% I-EXPLORATION -y I-EXPLORATION -posteriormente I-EXPLORATION -fueron I-EXPLORATION -analizados I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -Secuenciadora I-EXPLORATION -Automática I-EXPLORATION -Directa I-EXPLORATION -ABI I-EXPLORATION -Prism I-EXPLORATION -310, I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -de I-EXPLORATION -Reacción I-EXPLORATION -"ABI I-EXPLORATION -PRISM® I-EXPLORATION -BigDye™ I-EXPLORATION -Terminator I-EXPLORATION -Cycle I-EXPLORATION -Sequencing' I-EXPLORATION -(PE I-EXPLORATION -Biosystem) I-EXPLORATION -8. I-EXPLORATION - I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -comúnmente I-EXPLORATION -la I-EXPLORATION -displasia I-EXPLORATION -ectodérmica I-EXPLORATION -hipohidrótica I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -ligada I-EXPLORATION -a I-EXPLORATION -X, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -obtener I-EXPLORATION -ADN I-EXPLORATION -genómico, I-EXPLORATION -logrando I-EXPLORATION -identificar I-EXPLORATION -la I-EXPLORATION -mutación I-EXPLORATION -sinsentido I-EXPLORATION -Ala349Thr I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -EDA, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -la I-EXPLORATION -correlación I-EXPLORATION -clínico-patológica, I-EXPLORATION -concluyendo I-EXPLORATION -así I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -displasia I-EXPLORATION -ectodérmica I-EXPLORATION -hipohidrótica.. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -ictal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -cuantitativo I-PRESENT_ILLNESS -progresivo. I-PRESENT_ILLNESS -Consultó B-EXPLORATION -inicialmente I-EXPLORATION -en I-EXPLORATION -otro I-EXPLORATION -hospital I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -mediante I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -encéfalo I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -intraparenquimatoso I-EXPLORATION -parietal I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -42 I-EXPLORATION -ml, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -hidrocefalia I-EXPLORATION -aguda. I-EXPLORATION -En I-EXPLORATION -pabellón I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -urgente, I-EXPLORATION -se I-EXPLORATION -instaló I-EXPLORATION -un I-EXPLORATION -drenaje I-EXPLORATION -ventricular I-EXPLORATION -externo I-EXPLORATION -(DVE). I-EXPLORATION -Se I-EXPLORATION -registróuna I-EXPLORATION -presión I-EXPLORATION -intracraneana I-EXPLORATION -(PIC) I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -H2O. I-EXPLORATION -Se I-EXPLORATION -conectó I-EXPLORATION -a I-EXPLORATION -ventilación I-EXPLORATION -mecánica I-EXPLORATION -(VM) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -indicó I-EXPLORATION -sedación I-EXPLORATION -profunda. I-EXPLORATION -Inicialmente, B-EVOLUTION -la I-EVOLUTION -hipertensión I-EVOLUTION -intracraneana I-EVOLUTION -se I-EVOLUTION -trató I-EVOLUTION -con I-EVOLUTION -drenaje I-EVOLUTION -de I-EVOLUTION -líquido I-EVOLUTION -cefalorraquídeo I-EVOLUTION -y I-EVOLUTION -sodio I-EVOLUTION -hipertónico I-EVOLUTION -intravenoso I-EVOLUTION -en I-EVOLUTION -bolos, I-EVOLUTION -según I-EVOLUTION -necesidad. I-EVOLUTION -Se I-EVOLUTION -trasladó I-EVOLUTION -a I-EVOLUTION -nuestro I-EVOLUTION -servicio I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde. I-EVOLUTION - I-EVOLUTION -Ingresó I-EVOLUTION -intubado I-EVOLUTION -y I-EVOLUTION -conectado I-EVOLUTION -a I-EVOLUTION -VM, I-EVOLUTION -sedado I-EVOLUTION -con I-EVOLUTION -propofol I-EVOLUTION -0, I-EVOLUTION -71 I-EVOLUTION -mg/kg/h, I-EVOLUTION -y I-EVOLUTION -hemodinamia I-EVOLUTION -apoyada I-EVOLUTION -con I-EVOLUTION -noradrenalina I-EVOLUTION -a I-EVOLUTION -0, I-EVOLUTION -06 I-EVOLUTION -μg/kg/min, I-EVOLUTION -PIC I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -cm I-EVOLUTION -de I-EVOLUTION -H2O I-EVOLUTION -y I-EVOLUTION -presión I-EVOLUTION -de I-EVOLUTION -perfusión I-EVOLUTION -cerebral I-EVOLUTION -(PPC) I-EVOLUTION -de I-EVOLUTION -80 I-EVOLUTION -mmHg. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -coma, I-EXPLORATION -con I-EXPLORATION -midriasis I-EXPLORATION -fija I-EXPLORATION -a I-EXPLORATION -derecha, I-EXPLORATION -reflejos I-EXPLORATION -corneales I-EXPLORATION -abolidos, I-EXPLORATION -reflejos I-EXPLORATION -oculocefálicos I-EXPLORATION -esbozados, I-EXPLORATION -tono I-EXPLORATION -y I-EXPLORATION -reflejos I-EXPLORATION -osteotendíneos I-EXPLORATION -disminuidos, I-EXPLORATION -reflejos I-EXPLORATION -plantares I-EXPLORATION -indiferentes I-EXPLORATION -bilaterales. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -generales I-EXPLORATION -de I-EXPLORATION -ingreso: I-EXPLORATION -Na+ I-EXPLORATION -146 I-EXPLORATION -mEq/L, I-EXPLORATION -K+ I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -mEq/L, I-EXPLORATION -hematocrito I-EXPLORATION -31%, I-EXPLORATION -lactato I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -mmol/L, I-EXPLORATION -leucocitos I-EXPLORATION -9.600 I-EXPLORATION -por I-EXPLORATION -mm3 I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -11, I-EXPLORATION -4 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -angiografía I-EXPLORATION -cerebral I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -vasos I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -malformación I-EXPLORATION -arteriovenosa I-EXPLORATION -(MAV) I-EXPLORATION -parietal I-EXPLORATION -mesial I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -rotura I-EXPLORATION -reciente, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -tres I-EXPLORATION -aneurismas I-EXPLORATION -paranidales. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -embolización I-TREATMENT -con I-TREATMENT -N-butil-cianocrilato I-TREATMENT -(Histoacryl®, I-TREATMENT -Braun, I-TREATMENT -Alemania), I-TREATMENT -logrando I-TREATMENT -reducir I-TREATMENT -el I-TREATMENT -nido I-TREATMENT -de I-TREATMENT -la I-TREATMENT -MAV I-TREATMENT -y I-TREATMENT -excluir I-TREATMENT -sus I-TREATMENT -aneurismas. I-TREATMENT -Después I-TREATMENT -del I-TREATMENT -procedimiento, I-TREATMENT -la I-TREATMENT -TC I-TREATMENT -de I-TREATMENT -encéfalo I-TREATMENT -mostró I-TREATMENT -el I-TREATMENT -Histoacryl® I-TREATMENT -correctamente I-TREATMENT -situado. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -un I-EVOLUTION -incremento I-EVOLUTION -del I-EVOLUTION -hematoma I-EVOLUTION -con I-EVOLUTION -acentuado I-EVOLUTION -efecto I-EVOLUTION -de I-EVOLUTION -masa I-EVOLUTION -y I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -edema I-EVOLUTION -cerebral I-EVOLUTION -difuso I-EVOLUTION -con I-EVOLUTION -obliteración I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -surcos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -convexidad, I-EVOLUTION -además I-EVOLUTION -de I-EVOLUTION -herniaciones I-EVOLUTION -subfalcina I-EVOLUTION -y I-EVOLUTION -uncal I-EVOLUTION -con I-EVOLUTION -desviación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -línea I-EVOLUTION -media I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -mm, I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -glándula I-EVOLUTION -pineal. I-EVOLUTION -Se B-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -evacuación I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT -y I-TREATMENT -una I-TREATMENT -craniectomía I-TREATMENT -descompresiva I-TREATMENT -frontoparietoccipital I-TREATMENT -derecha I-TREATMENT -extensa I-TREATMENT -de I-TREATMENT -10, I-TREATMENT -2 I-TREATMENT -x I-TREATMENT -9, I-TREATMENT -3 I-TREATMENT -cm. I-TREATMENT -La I-TREATMENT -TC I-TREATMENT -de I-TREATMENT -encéfalo I-TREATMENT -de I-TREATMENT -control I-TREATMENT -al I-TREATMENT -día I-TREATMENT -siguiente I-TREATMENT -mostró I-TREATMENT -una I-TREATMENT -reducción I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT -a I-TREATMENT -11 I-TREATMENT -ml, I-TREATMENT -pero I-TREATMENT -aún I-TREATMENT -se I-TREATMENT -mantenía I-TREATMENT -un I-TREATMENT -importante I-TREATMENT -efecto I-TREATMENT -de I-TREATMENT -masa, I-TREATMENT -con I-TREATMENT -desviación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -media I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mm. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -craniectomía I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -PIC I-EVOLUTION -mayores I-EVOLUTION -a I-EVOLUTION -20 I-EVOLUTION -cm I-EVOLUTION -H2O I-EVOLUTION -(23 I-EVOLUTION -± I-EVOLUTION -5 I-EVOLUTION -cm I-EVOLUTION -H2O; I-EVOLUTION -media I-EVOLUTION -± I-EVOLUTION -DS). I-EVOLUTION -Se B-TREATMENT -instauró I-TREATMENT -un I-TREATMENT -manejo I-TREATMENT -médico I-TREATMENT -escalonado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -HEC, I-TREATMENT -con I-TREATMENT -sedación I-TREATMENT -profunda I-TREATMENT -(fentanilo I-TREATMENT -2, I-TREATMENT -86 I-TREATMENT -μg/kg/h, I-TREATMENT -midazolam I-TREATMENT -0, I-TREATMENT -11 I-TREATMENT -mg/kg/h I-TREATMENT -y I-TREATMENT -propofol I-TREATMENT -1, I-TREATMENT -43 I-TREATMENT -mg/kg/h), I-TREATMENT -bloqueo I-TREATMENT -neuromuscular I-TREATMENT -(vecuronio I-TREATMENT -0, I-TREATMENT -09 I-TREATMENT -mg/kg/h), I-TREATMENT -además I-TREATMENT -del I-TREATMENT -uso I-TREATMENT -frecuente I-TREATMENT -de I-TREATMENT -bolos I-TREATMENT -de I-TREATMENT -sodio I-TREATMENT -hipertónico I-TREATMENT -frente I-TREATMENT -a I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -PIC I-TREATMENT -> I-TREATMENT -30 I-TREATMENT -cm I-TREATMENT -H2O. I-TREATMENT -Se B-EVOLUTION -descartó I-EVOLUTION -actividad I-EVOLUTION -epiléptica I-EVOLUTION -no I-EVOLUTION -convulsiva I-EVOLUTION -mediante I-EVOLUTION -un I-EVOLUTION -electroencefalograma I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -encéfalo I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -post I-EVOLUTION -craniectomía I-EVOLUTION -no I-EVOLUTION -mostró I-EVOLUTION -cambios I-EVOLUTION -significativos. I-EVOLUTION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -PIC I-TREATMENT -> I-TREATMENT -a I-TREATMENT -20 I-TREATMENT -cm I-TREATMENT -H2O, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -hipotermia I-TREATMENT -terapéutica. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -empleó I-TREATMENT -hipotermia I-TREATMENT -moderada, I-TREATMENT -con I-TREATMENT -temperatura I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -33°C, I-TREATMENT -mediante I-TREATMENT -técnica I-TREATMENT -intravascular I-TREATMENT -(Alsius, I-TREATMENT -Zoll, I-TREATMENT -Chelmsford, I-TREATMENT -Massachusetts, I-TREATMENT -EEUU). I-TREATMENT -Se I-TREATMENT -midió I-TREATMENT -la I-TREATMENT -temperatura I-TREATMENT -central I-TREATMENT -con I-TREATMENT -catéter I-TREATMENT -intravesical. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -conseguida I-TREATMENT -la I-TREATMENT -hipotermia I-TREATMENT -(~12 I-TREATMENT -h I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -HEC I-TREATMENT -refractaria), I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -un I-TREATMENT -rápido I-TREATMENT -control I-TREATMENT -de I-TREATMENT -la I-TREATMENT -PIC I-TREATMENT -con I-TREATMENT -cifras I-TREATMENT -entre I-TREATMENT -9 I-TREATMENT -a I-TREATMENT -12 I-TREATMENT -cm I-TREATMENT -H2O I-TREATMENT -(~3 I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -procedimiento). I-TREATMENT -El I-TREATMENT -bloqueo I-TREATMENT -neuromuscular I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -en I-TREATMENT -infusión I-TREATMENT -continua I-TREATMENT -los I-TREATMENT -primeros I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -de I-TREATMENT -hipotermia, I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -los I-TREATMENT -calofríos. I-TREATMENT - I-TREATMENT -Luego I-TREATMENT -de I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -en I-TREATMENT -hipotermia, I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -intentos I-TREATMENT -programados I-TREATMENT -de I-TREATMENT -recalentamiento I-TREATMENT -a I-TREATMENT -una I-TREATMENT -tasa I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -5°C/h. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -todos I-TREATMENT -ellos I-TREATMENT -fueron I-TREATMENT -interrumpidos I-TREATMENT -por I-TREATMENT -rebote I-TREATMENT -de I-TREATMENT -la I-TREATMENT -PIC. I-TREATMENT -A B-EVOLUTION -partir I-EVOLUTION -del I-EVOLUTION -día I-EVOLUTION -20 I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -edema I-EVOLUTION -cerebral I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -neuroimágenes, I-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -definitivo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -PIC. I-EVOLUTION -Completó I-EVOLUTION -~13 I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -hipotermia I-EVOLUTION -moderada, I-EVOLUTION -sin I-EVOLUTION -evidenciarse I-EVOLUTION -arritmias, I-EVOLUTION -trastornos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -coagulación I-EVOLUTION -o I-EVOLUTION -electrolíticos. I-EVOLUTION -Presentó B-TREATMENT -una I-TREATMENT -traqueobronquitis I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica, I-TREATMENT -resuelta I-TREATMENT -satisfactoriamente I-TREATMENT -con I-TREATMENT -antibioticoterapia. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -suspendió I-TREATMENT -progresivamente I-TREATMENT -la I-TREATMENT -sedación, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -adquirió I-TREATMENT -vigilia I-TREATMENT -y B-EVOLUTION -se I-EVOLUTION -objetivó I-EVOLUTION -una I-EVOLUTION -hemiparesia I-EVOLUTION -leve I-EVOLUTION -con I-EVOLUTION -heminegligencia I-EVOLUTION -y I-EVOLUTION -hemianopsia I-EVOLUTION -homónima I-EVOLUTION -izquierda. I-EVOLUTION -Una I-EVOLUTION -vez I-EVOLUTION -extubado I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -lenguaje I-EVOLUTION -apropiado. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -neurorrehabilitación I-TREATMENT -y B-EVOLUTION -finalmente, I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -40 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION -Dos I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -se I-EVOLUTION -encuentraen I-EVOLUTION -Rankin I-EVOLUTION -2, I-EVOLUTION -con I-EVOLUTION -hemiparesia I-EVOLUTION -izquierda I-EVOLUTION -espástica I-EVOLUTION -leve I-EVOLUTION -y I-EVOLUTION -completando I-EVOLUTION -sus I-EVOLUTION -estudios I-EVOLUTION -universitarios. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -conocidos. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -odinofagia, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -reposo. I-PRESENT_ILLNESS -Consultó B-EXPLORATION -en I-EXPLORATION -centro I-EXPLORATION -de I-EXPLORATION -atención I-EXPLORATION -primaria I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -solicita I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -destacando I-EXPLORATION -gran I-EXPLORATION -cardiomegalia I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -Se B-PAST_MEDICAL_HISTORY -contaba I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -físico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -radiografía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tórax I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -alteración. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Fue B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -atención I-DERIVED_FROM/TO -terciaria I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -cuarto I-DERIVED_FROM/TO -día I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -cuadro. I-DERIVED_FROM/TO -Hemodinamia B-EVOLUTION -siempre I-EVOLUTION -estable. I-EVOLUTION -Se B-EXPLORATION -objetivó I-EXPLORATION -en I-EXPLORATION -electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION -taquicardia I-EXPLORATION -auricular I-EXPLORATION -intermitente, I-EXPLORATION -tratada I-EXPLORATION -inicialmente I-EXPLORATION -con I-EXPLORATION -amiodarona. I-EXPLORATION - I-EXPLORATION -Ingresó I-EXPLORATION -a I-EXPLORATION -nuestro I-EXPLORATION -servicio I-EXPLORATION -hipotenso I-EXPLORATION -(84/56 I-EXPLORATION -mmHg), I-EXPLORATION -taquicárdico I-EXPLORATION -(116 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -irregular), I-EXPLORATION -afebril, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -de I-EXPLORATION -18 I-EXPLORATION -por I-EXPLORATION -minuto I-EXPLORATION -y I-EXPLORATION -saturando I-EXPLORATION -92% I-EXPLORATION -con I-EXPLORATION -oxígeno I-EXPLORATION -ambiental, I-EXPLORATION -bien I-EXPLORATION -perfundido. I-EXPLORATION -La I-EXPLORATION -faringe I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -algo I-EXPLORATION -enrojecida, I-EXPLORATION -yugulares I-EXPLORATION -ingurgitadas. I-EXPLORATION -Sin I-EXPLORATION -congestión I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -examen I-EXPLORATION -cardíaco I-EXPLORATION -demostró I-EXPLORATION -tercer I-EXPLORATION -ruido I-EXPLORATION -y I-EXPLORATION -ritmo I-EXPLORATION -de I-EXPLORATION -galope. I-EXPLORATION -Extremidades I-EXPLORATION -sin I-EXPLORATION -edema. I-EXPLORATION - I-EXPLORATION -De I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -discreta I-EXPLORATION -leucocitosis, I-EXPLORATION -PCR I-EXPLORATION -baja, I-EXPLORATION -enzimas I-EXPLORATION -cardíacas I-EXPLORATION -y I-EXPLORATION -troponinas I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -realizado I-EXPLORATION -en I-EXPLORATION -nuestra I-EXPLORATION -unidad I-EXPLORATION -mostró I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -(VI) I-EXPLORATION -severamente I-EXPLORATION -dilatado I-EXPLORATION -(82/74 I-EXPLORATION -mm) I-EXPLORATION -con I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -global I-EXPLORATION -severa I-EXPLORATION -[fracción I-EXPLORATION -de I-EXPLORATION -eyección I-EXPLORATION -(FE): I-EXPLORATION -20%], I-EXPLORATION -hipokinesia I-EXPLORATION -difusa, I-EXPLORATION -disfunción I-EXPLORATION -diastólica I-EXPLORATION -tipo I-EXPLORATION -III I-EXPLORATION -de I-EXPLORATION -IV. I-EXPLORATION -AI I-EXPLORATION -de I-EXPLORATION -49 I-EXPLORATION -mm, I-EXPLORATION -con I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -ventricular I-EXPLORATION -derecha, I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -derechas I-EXPLORATION -e I-EXPLORATION -hipertensión I-EXPLORATION -pulmonar I-EXPLORATION -(HTP) I-EXPLORATION -moderada. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -cardiaca I-EXPLORATION -que I-EXPLORATION -concluyó I-EXPLORATION -miocardiopatía I-EXPLORATION -dilatada, I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -ni I-EXPLORATION -necrosis, I-EXPLORATION -con I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -severa. I-EXPLORATION - I-EXPLORATION -Paciente B-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -taquicárdico, I-EVOLUTION -presión I-EVOLUTION -arterial I-EVOLUTION -en I-EVOLUTION -límite I-EVOLUTION -bajo, I-EVOLUTION -en I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -inhibi I-EVOLUTION -dores I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enzima I-EVOLUTION -convertidora I-EVOLUTION -de I-EVOLUTION -angiotensina I-EVOLUTION -(IECA) I-EVOLUTION -y I-EVOLUTION -betabloqueo I-EVOLUTION -en I-EVOLUTION -dosis I-EVOLUTION -bajas. I-EVOLUTION - I-EVOLUTION -Dentro B-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -solicitado: I-EXPLORATION -función I-EXPLORATION -tiroidea I-EXPLORATION -normal; I-EXPLORATION -VHB I-EXPLORATION -(-), I-EXPLORATION -VHC I-EXPLORATION -(-), I-EXPLORATION -VIH I-EXPLORATION -(-), I-EXPLORATION -citomegalovirus I-EXPLORATION -(-), I-EXPLORATION -Chagas I-EXPLORATION -(-), I-EXPLORATION -IgM I-EXPLORATION -Mycoplasma I-EXPLORATION -pneumoniae I-EXPLORATION -(+) I-EXPLORATION -Se I-EXPLORATION -trato I-EXPLORATION -con I-EXPLORATION -azitromicina I-EXPLORATION -por I-EXPLORATION -5 I-EXPLORATION -días. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -endomiocárdica I-EXPLORATION -que I-EXPLORATION -concluyó I-EXPLORATION -cambios I-EXPLORATION -inespecíficos, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -miocardiopatía I-EXPLORATION -dilatada, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -inflamatoria I-EXPLORATION -activa. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -Holter I-EXPLORATION -de I-EXPLORATION -ECG I-EXPLORATION -evidenció I-EXPLORATION -taquicardia I-EXPLORATION -auricular I-EXPLORATION -incesante I-EXPLORATION -sobre I-EXPLORATION -90% I-EXPLORATION -del I-EXPLORATION -tiempo. I-EXPLORATION -Se I-EXPLORATION -planteo I-EXPLORATION -el I-EXPLORATION -diagnostico I-EXPLORATION -de I-EXPLORATION -taquicardiomiopatía. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona, I-TREATMENT -bisoprolol I-TREATMENT -y I-TREATMENT -digitálicos I-TREATMENT -no I-TREATMENT -fueron I-TREATMENT -efectivas I-TREATMENT -en I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -taquiarritmia. I-TREATMENT -Se I-TREATMENT -decidió I-TREATMENT -mapeo I-TREATMENT -y I-TREATMENT -ablación I-TREATMENT -de I-TREATMENT -taquicardia I-TREATMENT -auricular I-TREATMENT -incesante I-TREATMENT -usando I-TREATMENT -el I-TREATMENT -sistema I-TREATMENT -EnSite I-TREATMENT -Navx™. I-TREATMENT -Se I-TREATMENT -identificó I-TREATMENT -y I-TREATMENT -realizó I-TREATMENT -ablación I-TREATMENT -a I-TREATMENT -foco I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -superior I-TREATMENT -y I-TREATMENT -vena I-TREATMENT -pulmonar I-TREATMENT -superior I-TREATMENT -derecha, I-TREATMENT -convirtiendo I-TREATMENT -a I-TREATMENT -ritmo I-TREATMENT -sinusal I-TREATMENT -con I-TREATMENT -85 I-TREATMENT -latidos I-TREATMENT -por I-TREATMENT -minuto. I-TREATMENT - I-TREATMENT -Dado B-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -21 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -admisión. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -en I-EVOLUTION -capacidad I-EVOLUTION -funcional I-EVOLUTION -I, I-EVOLUTION -ritmo I-EVOLUTION -sinusal, I-EVOLUTION -con I-EVOLUTION -frecuencia I-EVOLUTION -cardíaca I-EVOLUTION -alrededor I-EVOLUTION -de I-EVOLUTION -70 I-EVOLUTION -latidos I-EVOLUTION -por I-EVOLUTION -minuto, I-EVOLUTION -regular I-EVOLUTION -y I-EVOLUTION -normotenso. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION -posterior I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -ablación, I-EVOLUTION -el I-EVOLUTION -ecocardiograma I-EVOLUTION -evidenció I-EVOLUTION -marcada I-EVOLUTION -reducción I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -cámaras I-EVOLUTION -cardiacas I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -sistólica I-EVOLUTION -del I-EVOLUTION -VI I-EVOLUTION -y I-EVOLUTION -mínimo I-EVOLUTION -reflujo I-EVOLUTION -mitral. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -capacidad I-EVOLUTION -funcional I-EVOLUTION -I I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -ecocardiograma I-EVOLUTION -en I-EVOLUTION -límite I-EVOLUTION -normal I-EVOLUTION -con I-EVOLUTION -radiografía I-EVOLUTION -de I-EVOLUTION -tórax I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -IX I-PAST_MEDICAL_HISTORY -región. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -manifestaciones I-PRESENT_ILLNESS -clínicas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -hipertensión I-PRESENT_ILLNESS -intracraneana I-PRESENT_ILLNESS -(cefalea I-PRESENT_ILLNESS -holocránea I-PRESENT_ILLNESS -recurrente I-PRESENT_ILLNESS -[2-3 I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -semana], I-PRESENT_ILLNESS -mareos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -ocasionales) I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -irritativa I-PRESENT_ILLNESS -(dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -convulsivas I-PRESENT_ILLNESS -tónico-clónicas I-PRESENT_ILLNESS -generalizadas). I-PRESENT_ILLNESS -El B-EXPLORATION -electroencefalograma I-EXPLORATION -(EEG) I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION -cerebral I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -quiste I-EXPLORATION -intraxial I-EXPLORATION -temporal I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -65 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -bien I-EXPLORATION -delimitado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -severo I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa, I-EXPLORATION -desviación I-EXPLORATION -de I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -mm, I-EXPLORATION -herniación I-EXPLORATION -uncal I-EXPLORATION -e I-EXPLORATION -hidrocefalia. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -mostró I-EXPLORATION -además I-EXPLORATION -un I-EXPLORATION -doble I-EXPLORATION -contorno I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -periferia, I-EXPLORATION -por I-EXPLORATION -desprendimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -membrana I-EXPLORATION -germinal, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -ligera I-EXPLORATION -impregnación I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -gadolinio. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -demostró I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -papila I-EXPLORATION -bilateral, I-EXPLORATION -sin I-EXPLORATION -evidenciarse I-EXPLORATION -déficit I-EXPLORATION -motor I-EXPLORATION -ni I-EXPLORATION -sensitivo I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico. I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -resultaron I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -demostrarse I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -quísticas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -(Rx) I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal. I-EXPLORATION -Se B-TREATMENT -planteó I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -hidatidosis I-TREATMENT -cerebral I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -completa I-TREATMENT -e I-TREATMENT -intacta I-TREATMENT -del I-TREATMENT -quiste, I-TREATMENT -confirmando I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histopatológico I-TREATMENT -la I-TREATMENT -etiología I-TREATMENT -hidatídica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -asintomático, I-EVOLUTION -sin I-EVOLUTION -déficit I-EVOLUTION -neurológico I-EVOLUTION -ni I-EVOLUTION -complicaciones I-EVOLUTION -post I-EVOLUTION -operatorias. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -19 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -IX I-PAST_MEDICAL_HISTORY -región, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipertensión I-PRESENT_ILLNESS -intracraneana I-PRESENT_ILLNESS -(cefalea I-PRESENT_ILLNESS -recurrente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -refractaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -papilar I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -acentuado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -fondo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ojo). I-PRESENT_ILLNESS -La B-EXPLORATION -TC I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -RM I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -formación I-EXPLORATION -quística I-EXPLORATION -intraxial I-EXPLORATION -temporal I-EXPLORATION -izquierda, I-EXPLORATION -de I-EXPLORATION -60 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -anteriores I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -moderado I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -adyacente I-EXPLORATION -y I-EXPLORATION -sistema I-EXPLORATION -ventricular, I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -de I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -5, I-EXPLORATION -5 I-EXPLORATION -mm. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -lesiones I-EXPLORATION -quísticas. I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -eosinofilia I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -hidatídico I-EXPLORATION -temporal I-EXPLORATION -izquierdo. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -intacta I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -confirmando I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histopatológico I-TREATMENT -la I-TREATMENT -etiología I-TREATMENT -hidatídica. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -sin I-EVOLUTION -déficit I-EVOLUTION -neurológico I-EVOLUTION -ni I-EVOLUTION -complicaciones I-EVOLUTION -post I-EVOLUTION -operatorias. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -Child-Pugh I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2004 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -várices I-PAST_MEDICAL_HISTORY -esofágicas I-PAST_MEDICAL_HISTORY -ligadas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -erradicadas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -2009 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -desorientación, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -demostrándose I-PRESENT_ILLNESS -anemia I-PRESENT_ILLNESS -severa I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hemoglobina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4, I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -g/dL. I-PRESENT_ILLNESS -Una B-EXPLORATION -primera I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -(EDA) I-EXPLORATION -mostró I-EXPLORATION -EVA I-EXPLORATION -tipo I-EXPLORATION -watermelon I-EXPLORATION -stomach I-EXPLORATION -manejándose B-TREATMENT -con I-TREATMENT -APC I-TREATMENT -y I-TREATMENT -transfusiones I-TREATMENT -de I-TREATMENT -plaquetas, I-TREATMENT -plasma I-TREATMENT -y I-TREATMENT -glóbulos I-TREATMENT -rojos, I-TREATMENT -en I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intermedios. I-TREATMENT - I-TREATMENT -Dos B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -reinició I-EVOLUTION -la I-EVOLUTION -disnea, I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -nueva I-EXPLORATION -EDA I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -EVA, I-EXPLORATION -realizándose B-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -sesión I-TREATMENT -de I-TREATMENT -APC. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -3, I-EVOLUTION -5 I-EVOLUTION -y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -presentó I-EVOLUTION -otros I-EVOLUTION -tres I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -hematemesis, I-EVOLUTION -requiriendo B-TREATMENT -en I-TREATMENT -todos I-TREATMENT -hospitalización, I-TREATMENT -transfusiones I-TREATMENT -y B-EXPLORATION -EDA, I-EXPLORATION -encontrando I-EXPLORATION -siempre I-EXPLORATION -la I-EXPLORATION -EVA I-EXPLORATION -sangrando I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -hicieron I-TREATMENT -3 I-TREATMENT -sesiones I-TREATMENT -más I-TREATMENT -de I-TREATMENT -APC. I-TREATMENT - I-TREATMENT -De B-EXPLORATION -la I-EXPLORATION -última I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -dio I-EXPLORATION -el I-EXPLORATION -alta I-EXPLORATION -programando I-EXPLORATION -un I-EXPLORATION -control I-EXPLORATION -endoscópico I-EXPLORATION -ambulatorio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -estómago I-EXPLORATION -con I-EXPLORATION -sangre I-EXPLORATION -fresca I-EXPLORATION -y I-EXPLORATION -EVA, I-EXPLORATION -realizando B-TREATMENT -ligadura I-TREATMENT -endoscópica I-TREATMENT -con I-TREATMENT -8 I-TREATMENT -bandas. I-TREATMENT - I-TREATMENT -Un B-EXPLORATION -mes I-EXPLORATION -despuês I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -EDA I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -franca I-EXPLORATION -reducción I-EXPLORATION -del I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -watermelon I-EXPLORATION -stomach, I-EXPLORATION -realizando B-TREATMENT -nuevas I-TREATMENT -ligaduras I-TREATMENT -al I-TREATMENT -antro. I-TREATMENT - I-TREATMENT - -Los B-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -fueron I-PRESENT_ILLNESS -recolectados I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -retrospectiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentan I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Tabla1; I-PRESENT_ILLNESS -sólo I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -detalla I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último. I-PRESENT_ILLNESS -Eran I-PRESENT_ILLNESS -hombres I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -media, I-PRESENT_ILLNESS -4/5 I-PRESENT_ILLNESS -heterosexuales, I-PRESENT_ILLNESS -todos I-PRESENT_ILLNESS -VIH I-PRESENT_ILLNESS -negativos. I-PRESENT_ILLNESS -Presentaron I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -subagudo; I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -destacó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apatía, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ánimo I-PRESENT_ILLNESS -subido. I-PRESENT_ILLNESS -Todos I-PRESENT_ILLNESS -tenían I-PRESENT_ILLNESS -amnesias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Korsakoff. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -existían I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -piramidales I-PRESENT_ILLNESS -discretos; I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -retención I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -orina, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -uno I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ellos I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ataxia. I-PRESENT_ILLNESS -Cuando I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -aplicaron I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -pruebas I-PRESENT_ILLNESS -Minimental I-PRESENT_ILLNESS -test I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Folstein I-PRESENT_ILLNESS -(MM), I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -mide I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -eficiencia I-PRESENT_ILLNESS -cognitiva I-PRESENT_ILLNESS -global, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Frontal I-PRESENT_ILLNESS -Assessment I-PRESENT_ILLNESS -Battery I-PRESENT_ILLNESS -(FAB), I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -evalúa I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -funciones I-PRESENT_ILLNESS -frontales, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esta I-PRESENT_ILLNESS -confirmó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -disejecutivo. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -existía I-PRESENT_ILLNESS -laconismo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -afasia. I-PRESENT_ILLNESS -Dos I-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -isquemia I-PRESENT_ILLNESS -cerebral I-PRESENT_ILLNESS -tenían I-PRESENT_ILLNESS -factores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -riesgo I-PRESENT_ILLNESS -vascular. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-EXPLORATION -líquido I-EXPLORATION -cefaloraquídeo I-EXPLORATION -(LCR) I-EXPLORATION -fue I-EXPLORATION -siempre I-EXPLORATION -inflamatorio I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -VDRL I-EXPLORATION -reactivo; I-EXPLORATION -en I-EXPLORATION -uno I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -electroencefalograma I-EXPLORATION -(EEG) I-EXPLORATION -estuvo I-EXPLORATION -alterado I-EXPLORATION -en I-EXPLORATION -3/3 I-EXPLORATION -casos; I-EXPLORATION -en I-EXPLORATION -cambio I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -estructurales I-EXPLORATION -no I-EXPLORATION -siempre I-EXPLORATION -fueron I-EXPLORATION -anormales. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -caso I-EXPLORATION -T I-EXPLORATION -una I-EXPLORATION -angiografía I-EXPLORATION -(indicada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -infarto I-EXPLORATION -cerebral I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -hombre I-EXPLORATION -joven I-EXPLORATION -con I-EXPLORATION -VDRL I-EXPLORATION -no I-EXPLORATION -reactivo I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -antes I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -LCR) I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -vasculitis. I-EXPLORATION -Todos B-TREATMENT -recibieron I-TREATMENT -altas I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -ev, I-TREATMENT -pero B-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -fue I-EVOLUTION -parcial I-EVOLUTION -y I-EVOLUTION -quedaron I-EVOLUTION -con I-EVOLUTION -secuelas I-EVOLUTION -cognitivas. I-EVOLUTION - I-EVOLUTION -W B-PRESENT_ILLNESS -tenía I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -era B-PAST_MEDICAL_HISTORY -supervisor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ventas, I-PAST_MEDICAL_HISTORY -soltero; I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -promiscuo; I-PAST_MEDICAL_HISTORY -fumaba I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bebía I-PAST_MEDICAL_HISTORY -poco, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consumía I-PAST_MEDICAL_HISTORY -drogas. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -2° I-PRESENT_ILLNESS -semestre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2008 I-PRESENT_ILLNESS -aparecieron I-PRESENT_ILLNESS -tendencia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -aislarse, I-PRESENT_ILLNESS -olvidos, I-PRESENT_ILLNESS -insomnio, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -libido, I-PRESENT_ILLNESS -disartria, I-PRESENT_ILLNESS -cefaleas. I-PRESENT_ILLNESS -Existía I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mezcla I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -labilidad I-PRESENT_ILLNESS -emocional I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -apatía. I-PRESENT_ILLNESS -Perdió I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -trabajo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -abril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2009. I-PRESENT_ILLNESS -En B-DERIVED_FROM/TO -mayo I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -psiquiatra I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -neurólogo, I-DERIVED_FROM/TO -quien I-DERIVED_FROM/TO -pidió I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -batería I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -exámenes, I-DERIVED_FROM/TO -entre I-DERIVED_FROM/TO -ellos I-DERIVED_FROM/TO -VDRL I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -sangre I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -reactivo. I-DERIVED_FROM/TO -El B-EXPLORATION -examen I-EXPLORATION -general I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -mostraba I-EXPLORATION -alerta I-EXPLORATION -y I-EXPLORATION -colaboraba I-EXPLORATION -al I-EXPLORATION -examen; I-EXPLORATION -destacaban I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -frontal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -afasia I-EXPLORATION -no I-EXPLORATION -fluente I-EXPLORATION -mixta. I-EXPLORATION -Existían I-EXPLORATION -nistagmo I-EXPLORATION -en I-EXPLORATION -miradas I-EXPLORATION -extremas, I-EXPLORATION -paramimesis, I-EXPLORATION -enganche I-EXPLORATION -digital, I-EXPLORATION -tics I-EXPLORATION -de I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -hombros. I-EXPLORATION -Una I-EXPLORATION -discreta I-EXPLORATION -ataxia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -marcha, I-EXPLORATION -arreflexia I-EXPLORATION -tendinosa I-EXPLORATION -de I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -retención I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -configuraban I-EXPLORATION -una I-EXPLORATION -tabes I-EXPLORATION -dorsal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -síndrome I-EXPLORATION -frontal I-EXPLORATION -se I-EXPLORATION -expresaba I-EXPLORATION -en I-EXPLORATION -apatía, I-EXPLORATION -abulia I-EXPLORATION -y I-EXPLORATION -conducta I-EXPLORATION -de I-EXPLORATION -imitación. I-EXPLORATION -Fue I-EXPLORATION -incapaz I-EXPLORATION -de I-EXPLORATION -comprender I-EXPLORATION -escenas I-EXPLORATION -complejas I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -interpretar I-EXPLORATION -proverbios; I-EXPLORATION -perseveraba I-EXPLORATION -con I-EXPLORATION -frecuencia. I-EXPLORATION -Tenía I-EXPLORATION -defectos I-EXPLORATION -atencionales I-EXPLORATION -(cálculo, I-EXPLORATION -retención I-EXPLORATION -de I-EXPLORATION -cifras, I-EXPLORATION -inversión I-EXPLORATION -de I-EXPLORATION -series I-EXPLORATION -automáticas) I-EXPLORATION -y I-EXPLORATION -existía I-EXPLORATION -una I-EXPLORATION -afasia I-EXPLORATION -no I-EXPLORATION -fluente I-EXPLORATION -mixta. I-EXPLORATION -En I-EXPLORATION -MM I-EXPLORATION -obtuvo I-EXPLORATION -9/30 I-EXPLORATION -puntos, I-EXPLORATION -en I-EXPLORATION -FAB I-EXPLORATION -3/18 I-EXPLORATION -puntos; I-EXPLORATION -fue I-EXPLORATION -incapaz I-EXPLORATION -de I-EXPLORATION -abstraer. I-EXPLORATION -Rindió I-EXPLORATION -mejor I-EXPLORATION -en I-EXPLORATION -Matrices I-EXPLORATION -Progresivas I-EXPLORATION -Coloreadas I-EXPLORATION -(MPC, I-EXPLORATION -25/36 I-EXPLORATION -puntos) I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -asociación I-EXPLORATION -semántica I-EXPLORATION -del I-EXPLORATION -4° I-EXPLORATION -excluido I-EXPLORATION -(acertó I-EXPLORATION -en I-EXPLORATION -7/8 I-EXPLORATION -ensayos). I-EXPLORATION -No I-EXPLORATION -existían I-EXPLORATION -agnosias I-EXPLORATION -visuales I-EXPLORATION -ni I-EXPLORATION -espaciales, I-EXPLORATION -apraxia I-EXPLORATION -constructiva, I-EXPLORATION -ideatoria, I-EXPLORATION -ideomotora I-EXPLORATION -ni I-EXPLORATION -del I-EXPLORATION -vestir. I-EXPLORATION -Tampoco I-EXPLORATION -tenía I-EXPLORATION -agnosia I-EXPLORATION -digital I-EXPLORATION -ni I-EXPLORATION -desorientación I-EXPLORATION -derecha-izquierda. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -LCR I-EXPLORATION -mostró I-EXPLORATION -pleocitosis I-EXPLORATION -(130 I-EXPLORATION -mononuclea-res, I-EXPLORATION -88% I-EXPLORATION -de I-EXPLORATION -linfocitos, I-EXPLORATION -10% I-EXPLORATION -de I-EXPLORATION -polinucleares I-EXPLORATION -y I-EXPLORATION -2% I-EXPLORATION -de I-EXPLORATION -monocitos), I-EXPLORATION -glucosa I-EXPLORATION -21 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -180 I-EXPLORATION -mg/dL. I-EXPLORATION -El I-EXPLORATION -VRDL I-EXPLORATION -fue I-EXPLORATION -reactivo I-EXPLORATION -1/128. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -mostró I-EXPLORATION -atrofia I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -frontotemporal I-EXPLORATION -izquierdo, I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -EEG I-EXPLORATION -actividad I-EXPLORATION -irritativa I-EXPLORATION -y I-EXPLORATION -lenta I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -zona. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -fue I-EXPLORATION -negativa, I-EXPLORATION -y I-EXPLORATION -otros I-EXPLORATION -exámenes I-EXPLORATION -humorales I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -(función I-EXPLORATION -hepática, I-EXPLORATION -coagulación, I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -VHS, I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -vitamina I-EXPLORATION -B12, I-EXPLORATION -Na, I-EXPLORATION -K I-EXPLORATION -y I-EXPLORATION -Cl, I-EXPLORATION -perfil I-EXPLORATION -bioquímico, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva, I-EXPLORATION -PCR I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simple I-EXPLORATION -en I-EXPLORATION -LCR). I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -4.000.000 I-TREATMENT -ui I-TREATMENT -ev I-TREATMENT -c/4 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días, I-TREATMENT -betametasona I-TREATMENT -4 I-TREATMENT -mg I-TREATMENT -ev I-TREATMENT -c/8 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -fenitoina I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -c/8 I-TREATMENT -horas. I-TREATMENT -El B-EVOLUTION -tratamiento I-EVOLUTION -fue I-EVOLUTION -bien I-EVOLUTION -tolerado I-EVOLUTION -y I-EVOLUTION -parcialmente I-EVOLUTION -eficaz. I-EVOLUTION -A B-EXPLORATION -comienzos I-EXPLORATION -de I-EXPLORATION -2010 I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -básico I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -en I-EXPLORATION -MM I-EXPLORATION -obtuvo I-EXPLORATION -28/30 I-EXPLORATION -puntos, I-EXPLORATION -en I-EXPLORATION -MPC I-EXPLORATION -31/36, I-EXPLORATION -en I-EXPLORATION -FAB I-EXPLORATION -13/18. I-EXPLORATION -Persistía I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -frontal, I-EXPLORATION -con I-EXPLORATION -actitud I-EXPLORATION -pueril, I-EXPLORATION -fallas I-EXPLORATION -de I-EXPLORATION -juicio I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -coherencia I-EXPLORATION -del I-EXPLORATION -discurso. I-EXPLORATION -El I-EXPLORATION -LCR I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -con I-EXPLORATION -serología I-EXPLORATION -reactiva I-EXPLORATION -a I-EXPLORATION -1/32, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -unido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -de I-EXPLORATION -crisis I-EXPLORATION -convulsivas I-EXPLORATION -llevó B-TREATMENT -a I-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -penicilina, I-TREATMENT -de I-TREATMENT -21 I-TREATMENT -días, I-TREATMENT -y I-TREATMENT -a I-TREATMENT -indicar I-TREATMENT -ácido I-TREATMENT -valproico I-TREATMENT -en I-TREATMENT -vez I-TREATMENT -de I-TREATMENT -fenitoína. I-TREATMENT -Fue B-EVOLUTION -jubilado I-EVOLUTION -por I-EVOLUTION -invalidez I-EVOLUTION -y I-EVOLUTION -vive I-EVOLUTION -con I-EVOLUTION -sus I-EVOLUTION -padres. I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Brasil, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dermatitis I-PAST_MEDICAL_HISTORY -seborreica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -lupus I-PAST_MEDICAL_HISTORY -cutáneo I-PAST_MEDICAL_HISTORY -subagudo, I-PAST_MEDICAL_HISTORY -fue B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -desarrollo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -cutáneo I-DERIVED_FROM/TO -abrupto I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -semana I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -localizado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -región I-DERIVED_FROM/TO -centrofacial I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -torácica I-DERIVED_FROM/TO -anterior. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -aplicado I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -corticoide I-PRESENT_ILLNESS -tópico I-PRESENT_ILLNESS -(mometasona I-PRESENT_ILLNESS -furoato I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -1%) I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -intentar I-PRESENT_ILLNESS -controlar I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -lesiones. I-PRESENT_ILLNESS -Reseñaba B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -pustulosas I-PAST_MEDICAL_HISTORY -aisladas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -ocasionales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enrojecimiento I-PAST_MEDICAL_HISTORY -facial I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -calor I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alcohol. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Clínicamente B-EXPLORATION -mostraba, I-EXPLORATION -eritema I-EXPLORATION -facial I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -pápulo-pustulosas I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -frente, I-EXPLORATION -mejillas, I-EXPLORATION -región I-EXPLORATION -perioral I-EXPLORATION -y I-EXPLORATION -tórax. I-EXPLORATION -Además I-EXPLORATION -presentaba I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -comedones I-EXPLORATION -y I-EXPLORATION -padecía I-EXPLORATION -afectación I-EXPLORATION -ocular I-EXPLORATION -con I-EXPLORATION -inyección I-EXPLORATION -conjuntival I-EXPLORATION -acompañado I-EXPLORATION -de I-EXPLORATION -fotofobia I-EXPLORATION -y I-EXPLORATION -lagrimeo. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -fiebre I-EXPLORATION -ni I-EXPLORATION -otra I-EXPLORATION -clínica I-EXPLORATION -sistémica. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -bioquímica I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -hemograma I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -juicio I-TREATMENT -clínico I-TREATMENT -de I-TREATMENT -rosácea I-TREATMENT -fulminans I-TREATMENT -con I-TREATMENT -afectación I-TREATMENT -ocular I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -40 I-TREATMENT -mg/día, I-TREATMENT -metronidazol I-TREATMENT -500 I-TREATMENT -mg/12 I-TREATMENT -horas, I-TREATMENT -isotretinoína I-TREATMENT -50 I-TREATMENT -mg/día I-TREATMENT -(0, I-TREATMENT -7 I-TREATMENT -mg/kg/día), I-TREATMENT -y I-TREATMENT -lágrimas I-TREATMENT -artificiales. I-TREATMENT -El I-TREATMENT -metronidazol I-TREATMENT -y I-TREATMENT -la I-TREATMENT -prednisona I-TREATMENT -se I-TREATMENT -suspendieron I-TREATMENT -tras I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -(la I-TREATMENT -última I-TREATMENT -en I-TREATMENT -pauta I-TREATMENT -descendente). I-TREATMENT -Por I-TREATMENT -último, I-TREATMENT -la I-TREATMENT -isotretinoína I-TREATMENT -oral I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -tras I-TREATMENT -tres I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -realizando I-TREATMENT -descenso I-TREATMENT -progresivo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -dosis. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -importante I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -completa I-EVOLUTION -tras I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -recaídas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -posteriores I-EVOLUTION -seis I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcoholismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -policonsumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -drogas, I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ánimo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2005. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Infectología I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -febrero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -tumores I-PRESENT_ILLNESS -eritemato-violáceos I-PRESENT_ILLNESS -dolorosos, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociados I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna, I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea. I-PRESENT_ILLNESS -Por B-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -inicialmente I-EXPLORATION -sarcoma I-EXPLORATION -de I-EXPLORATION -Kaposi I-EXPLORATION -(SK) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -ELISA I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -y I-EXPLORATION -confirmado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION -de I-EXPLORATION -Chile. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -extensión I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -cutáneas I-TREATMENT -y I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -fiebre I-TREATMENT -se I-TREATMENT -hospitalizó I-TREATMENT -para I-TREATMENT -mayor I-TREATMENT -estudio. I-TREATMENT -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -en I-EXPLORATION -regulares I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -hipotenso, I-EXPLORATION -febril, I-EXPLORATION -enflaquecido I-EXPLORATION -(índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -17), I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION -inguinales I-EXPLORATION -induradas, I-EXPLORATION -indoloras I-EXPLORATION -y I-EXPLORATION -poco I-EXPLORATION -móviles. I-EXPLORATION -Presentaba I-EXPLORATION -tumores I-EXPLORATION -eritemato-violáceos I-EXPLORATION -de I-EXPLORATION -hasta I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -supraciliar I-EXPLORATION -derecho, I-EXPLORATION -en I-EXPLORATION -mentón I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -pierna I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -cara, I-EXPLORATION -paladar, I-EXPLORATION -tronco I-EXPLORATION -y I-EXPLORATION -extremidades I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -pápulas I-EXPLORATION -erite-matosas I-EXPLORATION -brillantes I-EXPLORATION -y I-EXPLORATION -nódulos I-EXPLORATION -dolorosos I-EXPLORATION -subcutáneos I-EXPLORATION -sin I-EXPLORATION -cambios I-EXPLORATION -de I-EXPLORATION -coloración. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -pesquisó I-EXPLORATION -visceromegalia. I-EXPLORATION -De I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -destacaba: I-EXPLORATION -hematocrito I-EXPLORATION -28, I-EXPLORATION -3%; I-EXPLORATION -leucocitos I-EXPLORATION -6.200 I-EXPLORATION -céls/mm3, I-EXPLORATION -sin I-EXPLORATION -desviación I-EXPLORATION -izquierda; I-EXPLORATION -VHS I-EXPLORATION -100 I-EXPLORATION -mm/h; I-EXPLORATION -PCR I-EXPLORATION -9, I-EXPLORATION -1 I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -1); I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -normal; I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -normales, I-EXPLORATION -excepto I-EXPLORATION -por I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -elevada I-EXPLORATION -(211 I-EXPLORATION -U/L); I-EXPLORATION -albúmina I-EXPLORATION -3 I-EXPLORATION -g/dl; I-EXPLORATION -LDH I-EXPLORATION -159 I-EXPLORATION -U/L. I-EXPLORATION -Del I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -patología I-EXPLORATION -de I-EXPLORATION -base I-EXPLORATION -tenía I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -de I-EXPLORATION -875.000 I-EXPLORATION -copias I-EXPLORATION -ARN I-EXPLORATION -viral/ml I-EXPLORATION -y I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -CD4 I-EXPLORATION -de I-EXPLORATION -87, I-EXPLORATION -6 I-EXPLORATION -céls/ I-EXPLORATION -mm3. I-EXPLORATION -Los I-EXPLORATION -hemocultivos, I-EXPLORATION -urocultivos, I-EXPLORATION -RPR, I-EXPLORATION -PPD I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION -IgG I-EXPLORATION -para I-EXPLORATION -toxoplasma I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -reevaluar I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -AB. I-EXPLORATION -Al B-PAST_MEDICAL_HISTORY -preguntar I-PAST_MEDICAL_HISTORY -dirigidamente I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -extranjero: I-PAST_MEDICAL_HISTORY -Bolivia I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -Perú I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -México I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Además I-PAST_MEDICAL_HISTORY -vivió I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -casa I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -gatos, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -rasguñaban I-PAST_MEDICAL_HISTORY -ocasionalmente. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -solicitó I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -Bartonella I-EXPLORATION -henselae I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -negativa. I-EXPLORATION -La I-EXPLORATION -nasofibroscopia I-EXPLORATION -informó I-EXPLORATION -lesiones I-EXPLORATION -angiomatosas I-EXPLORATION -en I-EXPLORATION -fosas I-EXPLORATION -nasales, I-EXPLORATION -rinofaringe I-EXPLORATION -y I-EXPLORATION -laringe. I-EXPLORATION -La I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -no I-EXPLORATION -detectó I-EXPLORATION -lesiones. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -mostró I-EXPLORATION -hígado I-EXPLORATION -normal, I-EXPLORATION -leve I-EXPLORATION -esplenomegalia, I-EXPLORATION -adenopatías I-EXPLORATION -inguinales I-EXPLORATION -izquierdas I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -secundario I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -musculatura I-EXPLORATION -paravertebral I-EXPLORATION -lumbar. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -de I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores I-EXPLORATION -mostró I-EXPLORATION -nódulos I-EXPLORATION -hipervascularizados I-EXPLORATION -inespecíficos I-EXPLORATION -en I-EXPLORATION -dermis, I-EXPLORATION -tejido I-EXPLORATION -subcutáneo I-EXPLORATION -y I-EXPLORATION -plano I-EXPLORATION -muscular. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -cutáneas I-EXPLORATION -mostró I-EXPLORATION -orto-queratosis, I-EXPLORATION -hipogranulosis, I-EXPLORATION -atrofia I-EXPLORATION -epidérmica, I-EXPLORATION -exocitosis I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -e I-EXPLORATION -hiperpigmentación I-EXPLORATION -basal; I-EXPLORATION -dermis I-EXPLORATION -reticular I-EXPLORATION -con I-EXPLORATION -proliferación I-EXPLORATION -vascular, I-EXPLORATION -nodular, I-EXPLORATION -multifocal, I-EXPLORATION -compuesta I-EXPLORATION -por I-EXPLORATION -vasos I-EXPLORATION -capilares I-EXPLORATION -pequeños, I-EXPLORATION -endotelio I-EXPLORATION -prominente, I-EXPLORATION -con I-EXPLORATION -extravasación I-EXPLORATION -de I-EXPLORATION -eritrocitos I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION -leve I-EXPLORATION -disperso I-EXPLORATION -de I-EXPLORATION -linfocitos, I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -eritrocitos. I-EXPLORATION -Además, I-EXPLORATION -había I-EXPLORATION -acúmulos I-EXPLORATION -eosinófilos, I-EXPLORATION -extracelulares, I-EXPLORATION -granulares, I-EXPLORATION -multifocales. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Warthin-Starry I-EXPLORATION -mostró I-EXPLORATION -numerosos I-EXPLORATION -bacilos, I-EXPLORATION -siendo I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -AB. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -envió I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -al I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -microbiología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -Católica I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION -PCR I-EXPLORATION -universal I-EXPLORATION -con I-EXPLORATION -amplificación I-EXPLORATION -y I-EXPLORATION -secuenciación I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -que I-EXPLORATION -codifica I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -subu-nidad I-EXPLORATION -ribosomal I-EXPLORATION -16S. I-EXPLORATION -La I-EXPLORATION -extracción I-EXPLORATION -del I-EXPLORATION -ADN I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -subcutáneo I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -utilizando I-EXPLORATION -un I-EXPLORATION -método I-EXPLORATION -comercial I-EXPLORATION -(QIAamp I-EXPLORATION -Tissue I-EXPLORATION -kit, I-EXPLORATION -Qiagen®), I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -recomendaciones I-EXPLORATION -del I-EXPLORATION -fabricante. I-EXPLORATION -La I-EXPLORATION -amplificación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -que I-EXPLORATION -codifica I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -16S I-EXPLORATION -ARNr I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -con I-EXPLORATION -partidores I-EXPLORATION -universales. I-EXPLORATION -Posteriormente, I-EXPLORATION -se I-EXPLORATION -secuenció I-EXPLORATION -el I-EXPLORATION -producto I-EXPLORATION -amplificado I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -evaluó I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -analizador I-EXPLORATION -genético I-EXPLORATION -ABI-310 I-EXPLORATION -(Applied-Biosystems, I-EXPLORATION -Foster I-EXPLORATION -City, I-EXPLORATION -CA). I-EXPLORATION -Para I-EXPLORATION -la I-EXPLORATION -comparación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -nucleotídica I-EXPLORATION -obtenida I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -secuencias I-EXPLORATION -depositadas I-EXPLORATION -en I-EXPLORATION -banco I-EXPLORATION -de I-EXPLORATION -genes I-EXPLORATION -Genebank, I-EXPLORATION -se I-EXPLORATION -utilizó I-EXPLORATION -al I-EXPLORATION -programa I-EXPLORATION -BLAST. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -homología I-EXPLORATION -de I-EXPLORATION -100% I-EXPLORATION -sobre I-EXPLORATION -421 I-EXPLORATION -pares I-EXPLORATION -de I-EXPLORATION -bases I-EXPLORATION -depositadas I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -especie I-EXPLORATION -B. I-EXPLORATION -quintana I-EXPLORATION -cepa I-EXPLORATION -Toulouse. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antiretroviral I-TREATMENT -para I-TREATMENT -el I-TREATMENT -VIH I-TREATMENT -y I-TREATMENT -profilaxis I-TREATMENT -para I-TREATMENT -Pneumocystis I-TREATMENT -jiroveci. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -AB I-TREATMENT -con I-TREATMENT -Azitromicina I-TREATMENT -500 I-TREATMENT -mg/ I-TREATMENT -día I-TREATMENT -vo I-TREATMENT -y I-TREATMENT -Ciprofloxacino I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h I-TREATMENT -vo. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -con I-EVOLUTION -regresión I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -síntomas I-EVOLUTION -sistémicos I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -lesiones I-EVOLUTION -cutáneas I-EVOLUTION -en I-EVOLUTION -pocos I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -detenido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -flegmón I-PAST_MEDICAL_HISTORY -apendicular I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Dos B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -consultar I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -predominio I-PRESENT_ILLNESS -vespertino, I-PRESENT_ILLNESS -postprandiales I-PRESENT_ILLNESS -mediatos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -kilos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -período. I-PRESENT_ILLNESS -La B-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -prominentes I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -difusa, I-EXPLORATION -lesiones I-EXPLORATION -solevantadas I-EXPLORATION -sésiles I-EXPLORATION -con I-EXPLORATION -ulceración I-EXPLORATION -central I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -rojo I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -ulceradas I-EXPLORATION -duodenales, I-EXPLORATION -con I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -ureasa I-EXPLORATION -positivo. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -biopsias I-EXPLORATION -informadas I-EXPLORATION -como I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -inespecífica I-EXPLORATION -y I-EXPLORATION -duodenitis. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostró: I-EXPLORATION -GOT I-EXPLORATION -50 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -56 I-EXPLORATION -UI/L, I-EXPLORATION -GGT I-EXPLORATION -85 I-EXPLORATION -UI/L, I-EXPLORATION -FA I-EXPLORATION -81 I-EXPLORATION -UI/L, I-EXPLORATION -hematocrito I-EXPLORATION -55%, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -100%, I-EXPLORATION -creatininemia I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -g/dL, I-EXPLORATION -calcio I-EXPLORATION -total I-EXPLORATION -7, I-EXPLORATION -8 I-EXPLORATION -mg/ I-EXPLORATION -dL, I-EXPLORATION -proteinemia I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -g/dL, I-EXPLORATION -albuminemia I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -g/dL I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -229 I-EXPLORATION -UI/ml. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -esteatosis I-EXPLORATION -hepática. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -erradicación I-TREATMENT -para I-TREATMENT -Helicobacter I-TREATMENT -pylori I-TREATMENT -durante I-TREATMENT -14 I-TREATMENT -días, I-TREATMENT -observándose B-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -vómitos, I-EVOLUTION -con I-EVOLUTION -intolerancia I-EVOLUTION -a I-EVOLUTION -alimentación I-EVOLUTION -oral, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -hospitalizar I-EVOLUTION -para I-EVOLUTION -manejo I-EVOLUTION -nutricional I-EVOLUTION -y I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -macrobiopsias I-EVOLUTION -gástricas. I-EVOLUTION - I-EVOLUTION -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -Gastroenterología I-EXPLORATION -de I-EXPLORATION -nuestro I-EXPLORATION -Hospital I-EXPLORATION -destacaba I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -hemodinamia I-EXPLORATION -estable, I-EXPLORATION -afebril, I-EXPLORATION -mesomorfo, I-EXPLORATION -sin I-EXPLORATION -edema, I-EXPLORATION -ni I-EXPLORATION -palidez. I-EXPLORATION -Sin I-EXPLORATION -signos I-EXPLORATION -carenciales I-EXPLORATION -en I-EXPLORATION -piel, I-EXPLORATION -mucosas I-EXPLORATION -ni I-EXPLORATION -fanéreos. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -confirmaron I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -g/dL, I-EXPLORATION -albuminemia I-EXPLORATION -1, I-EXPLORATION -9 I-EXPLORATION -g/dL, I-EXPLORATION -proteinuria I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -hemograma I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Evolución I-EXPLORATION -y I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -posteriores I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -abdomen-pelvis I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -prominentes, I-EXPLORATION -enteroclisis I-EXPLORATION -por I-EXPLORATION -TAC I-EXPLORATION -informó I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -radiológicas I-EXPLORATION -en I-EXPLORATION -intestino I-EXPLORATION -delgado. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -difusamente I-EXPLORATION -engrosados, I-EXPLORATION -algunos I-EXPLORATION -erosionados, I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -ureasa I-EXPLORATION -negativo. I-EXPLORATION -Las I-EXPLORATION -biopsias I-EXPLORATION -fueron I-EXPLORATION -informadas I-EXPLORATION -como I-EXPLORATION -mucosa I-EXPLORATION -gástrica I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -foveolar I-EXPLORATION -difusa, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -atrofia I-EXPLORATION -glandular I-EXPLORATION -con I-EXPLORATION -dilataciones I-EXPLORATION -quísticas I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -mucinosas. I-EXPLORATION -Erosión I-EXPLORATION -epitelial I-EXPLORATION -superficial I-EXPLORATION -focal I-EXPLORATION -con I-EXPLORATION -acúmulos I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -polimorfonucleares, I-EXPLORATION -lámina I-EXPLORATION -propia I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -escaso I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -linfoplasmocitario, I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -eosinófilos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -endosonografía I-EXPLORATION -demostrándose I-EXPLORATION -engrosamiento I-EXPLORATION -gástrico I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -profunda I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -quísticas. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -extensión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -transformación I-TREATMENT -neoplásica I-TREATMENT -y I-TREATMENT -la I-TREATMENT -no I-TREATMENT -disponibilidad I-TREATMENT -de I-TREATMENT -cetuximab, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -tratamiento I-TREATMENT -quirúrgico. I-TREATMENT -Se B-EVOLUTION -solicitó I-EVOLUTION -evaluación I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION -de I-EVOLUTION -nutrición, I-EVOLUTION -demostrándose I-EVOLUTION -preal-búmina, I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -vitamina I-EVOLUTION -B12 I-EVOLUTION -y I-EVOLUTION -folato I-EVOLUTION -eritrocitario I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -rangos I-EVOLUTION -normales. I-EVOLUTION -Se B-TREATMENT -controlaron I-TREATMENT -los I-TREATMENT -vómitos I-TREATMENT -con I-TREATMENT -ondasentron, I-TREATMENT -logrando I-TREATMENT -ingesta I-TREATMENT -oral I-TREATMENT -adecuada, I-TREATMENT -se I-TREATMENT -apoyó I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -por I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -aumentó I-TREATMENT -la I-TREATMENT -albuminemia I-TREATMENT -a I-TREATMENT -2, I-TREATMENT -3 I-TREATMENT -gr/dl. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -gastrectomía I-TREATMENT -total, I-TREATMENT -sin I-TREATMENT -incidentes I-TREATMENT -y B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -macroscópico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -operatoria I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -pared I-EXPLORATION -gástrica I-EXPLORATION -de I-EXPLORATION -espesor I-EXPLORATION -engrosado I-EXPLORATION -homogéneamente, I-EXPLORATION -mucosa I-EXPLORATION -con I-EXPLORATION -pliegues I-EXPLORATION -difusamente I-EXPLORATION -engrosados, I-EXPLORATION -congestivos, I-EXPLORATION -algunos I-EXPLORATION -con I-EXPLORATION -erosión I-EXPLORATION -superficial; I-EXPLORATION -rodete I-EXPLORATION -duodenal I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -centímetros I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -con I-EXPLORATION -lesión I-EXPLORATION -polipoide I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -centímetro I-EXPLORATION -de I-EXPLORATION -eje I-EXPLORATION -mayor. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -histología I-EXPLORATION -se I-EXPLORATION -confirmaron I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -descritos I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -endoscópicas, I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -gástrico I-EXPLORATION -difuso, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -duodeno I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -descrita I-EXPLORATION -de I-EXPLORATION -lesión I-EXPLORATION -polipoide I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -metaplasia I-EXPLORATION -fúndica I-EXPLORATION -focal I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -foveolar I-EXPLORATION -y I-EXPLORATION -atrofia I-EXPLORATION -glandular, I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -quística I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -mucinosas. I-EXPLORATION -Se I-EXPLORATION -concluyó I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Ménétrier I-EXPLORATION -gástrica I-EXPLORATION -difusa I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -duodenal I-EXPLORATION -focal. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -oriundo B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Marchigüe, I-PAST_MEDICAL_HISTORY -VI I-PAST_MEDICAL_HISTORY -Región I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Chile, I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -laboral I-PAST_MEDICAL_HISTORY -trabajó I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -faenador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -corderos. I-PAST_MEDICAL_HISTORY -Tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -dislipidemia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -quiste I-PAST_MEDICAL_HISTORY -hidatídico I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1996. I-PAST_MEDICAL_HISTORY -Quince I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después, I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY -encefálico, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -referir I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sintomatología I-PAST_MEDICAL_HISTORY -cardiovascular. I-PAST_MEDICAL_HISTORY -Dentro B-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -(TAC) I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -quística I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -ruptura. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -además I-EXPLORATION -una I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -quistes I-EXPLORATION -hepáticos. I-EXPLORATION -Tampoco B-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -sugerentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anafilaxia. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Posteriormente, B-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -precordial I-EVOLUTION -opresivo I-EVOLUTION -sin I-EVOLUTION -irradiación, I-EVOLUTION -de I-EVOLUTION -intensidad I-EVOLUTION -EVA I-EVOLUTION -6/10. I-EVOLUTION -Evaluado B-TREATMENT -por I-TREATMENT -cardiología I-TREATMENT -en I-TREATMENT -su I-TREATMENT -hospital I-TREATMENT -base I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -anticoagulación I-TREATMENT -oral I-TREATMENT -siendo B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Instituto I-DERIVED_FROM/TO -Nacional I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Tórax I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hidatidosis I-DERIVED_FROM/TO -cardiaca. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El B-EXPLORATION -paciente I-EXPLORATION -ingresó I-EXPLORATION -en I-EXPLORATION -buenas I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -afebril I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -hemodinámicas, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -130/85 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -90 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -min. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -ingurgitación I-EXPLORATION -yugular, I-EXPLORATION -roces I-EXPLORATION -ni I-EXPLORATION -soplos I-EXPLORATION -cardiacos I-EXPLORATION -(que I-EXPLORATION -fueron I-EXPLORATION -exhaustivamente I-EXPLORATION -buscados) I-EXPLORATION -ni I-EXPLORATION -tampoco I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -cardiaca. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -pulmonar I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -eosinofilia I-EXPLORATION -de I-EXPLORATION -21%, I-EXPLORATION -sin I-EXPLORATION -leucocitosis. I-EXPLORATION -El I-EXPLORATION -perfil I-EXPLORATION -bioquímico I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -IgG I-EXPLORATION -anti-Echinococcus I-EXPLORATION -granulosus I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -realizada. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -electrocardiograma I-EXPLORATION -presentaba I-EXPLORATION -ritmo I-EXPLORATION -sinusal, I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -negativas I-EXPLORATION -en I-EXPLORATION -DII I-EXPLORATION -y I-EXPLORATION -alteraciones I-EXPLORATION -inespecíficas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -repolarización. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecocardiografía I-EXPLORATION -realizada I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -servicio I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -poliquística, I-EXPLORATION -ovalada I-EXPLORATION -y I-EXPLORATION -adherida I-EXPLORATION -al I-EXPLORATION -macizo I-EXPLORATION -de I-EXPLORATION -músculos I-EXPLORATION -papilares I-EXPLORATION -anterolaterales, I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -bien I-EXPLORATION -delimitados I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -libre I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -medía I-EXPLORATION -4, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -2 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -7 I-EXPLORATION -cm, I-EXPLORATION -sin I-EXPLORATION -derrame I-EXPLORATION -pericárdico. I-EXPLORATION -Estos I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -confirmados I-EXPLORATION -por I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RNM). I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -preoperatorio I-EXPLORATION -fue I-EXPLORATION -completado I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -coronariografía, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -cirugía I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -bajo I-TREATMENT -esternotomía I-TREATMENT -media I-TREATMENT -y I-TREATMENT -circulación I-TREATMENT -extracorpórea, I-TREATMENT -poniendo I-TREATMENT -principal I-TREATMENT -atención I-TREATMENT -en I-TREATMENT -la I-TREATMENT -manipulación I-TREATMENT -cardiaca I-TREATMENT -para I-TREATMENT -no I-TREATMENT -lesionar I-TREATMENT -el I-TREATMENT -quiste. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -puesto I-TREATMENT -el I-TREATMENT -clamp I-TREATMENT -aórtico, I-TREATMENT -se I-TREATMENT -disecó I-TREATMENT -la I-TREATMENT -superficie I-TREATMENT -del I-TREATMENT -quiste, I-TREATMENT -se I-TREATMENT -aisló I-TREATMENT -el I-TREATMENT -campo I-TREATMENT -con I-TREATMENT -compresas I-TREATMENT -embebidas I-TREATMENT -en I-TREATMENT -cloruro I-TREATMENT -de I-TREATMENT -sodio I-TREATMENT -al I-TREATMENT -10% I-TREATMENT -y I-TREATMENT -se I-TREATMENT -puncionó I-TREATMENT -el I-TREATMENT -quiste I-TREATMENT -vaciándolo I-TREATMENT -parcialmente I-TREATMENT -e I-TREATMENT -inyectando I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -hipertónica I-TREATMENT -al I-TREATMENT -30%. I-TREATMENT -Posteriormente, I-TREATMENT -se I-TREATMENT -abrió I-TREATMENT -el I-TREATMENT -quiste I-TREATMENT -hacia I-TREATMENT -la I-TREATMENT -cara I-TREATMENT -anterior I-TREATMENT -del I-TREATMENT -ventrículo I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -se I-TREATMENT -vació, I-TREATMENT -retirando I-TREATMENT -las I-TREATMENT -membranas I-TREATMENT -y I-TREATMENT -vesículas I-TREATMENT -hijas. I-TREATMENT -Se I-TREATMENT -completó I-TREATMENT -el I-TREATMENT -aseo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -con I-TREATMENT -sodio I-TREATMENT -hipertónico I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -quistectomía I-TREATMENT -parcial I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -por I-TREATMENT -capitonaje I-TREATMENT -del I-TREATMENT -remanente. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -complicaciones I-EVOLUTION -intraoperatorias I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -fue I-EVOLUTION -favorable. I-EVOLUTION -En I-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -post-quirúrgico, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomático, I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -complicaciones I-EVOLUTION -o I-EVOLUTION -recidivas I-EVOLUTION -y B-EXPLORATION -se I-EXPLORATION -controlará I-EXPLORATION -semestralmente I-EXPLORATION -con I-EXPLORATION -ecocardiografía I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -E. I-EXPLORATION -granulosus. I-EXPLORATION - I-EXPLORATION - -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -índice I-PRESENT_ILLNESS -(PAF19) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -(2004) I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -anémico. I-PRESENT_ILLNESS -Como B-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -completa I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -pólipos I-EXPLORATION -sésiles I-EXPLORATION -(más I-EXPLORATION -de I-EXPLORATION -100) I-EXPLORATION -y I-EXPLORATION -pediculados I-EXPLORATION -(más I-EXPLORATION -de I-EXPLORATION -15), I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -margen I-EXPLORATION -anal I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -ciego. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -cecal I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -proliferativa I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -cuya I-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -tubular I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -preliminar I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -PAF I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -cecal. I-EXPLORATION -El B-TREATMENT -estudio I-TREATMENT -de I-TREATMENT -etapificación I-TREATMENT -con I-TREATMENT -TAC I-TREATMENT -(tomografía I-TREATMENT -abdominal I-TREATMENT -computarizada) I-TREATMENT -de I-TREATMENT -abdomen I-TREATMENT -y I-TREATMENT -pelvis I-TREATMENT -no I-TREATMENT -mostró I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -diseminación I-TREATMENT -tumoral, I-TREATMENT -realizándose I-TREATMENT -una I-TREATMENT -colectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -íleorrectoanastomosis. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -tumoral I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -con I-EXPLORATION -invasión I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -subserosa I-EXPLORATION -y I-EXPLORATION -compromiso I-EXPLORATION -linfonodal. I-EXPLORATION -La I-EXPLORATION -mucosa I-EXPLORATION -del I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -resecada I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -centenar I-EXPLORATION -de I-EXPLORATION -pólipos I-EXPLORATION -sésiles I-EXPLORATION -y I-EXPLORATION -pediculados, I-EXPLORATION -abollonados I-EXPLORATION -y I-EXPLORATION -lisos I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -2 I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor. I-EXPLORATION -Por B-TREATMENT -tratarse I-TREATMENT -de I-TREATMENT -una I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -etapa I-TREATMENT -III I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT -adyuvante I-TREATMENT -en I-TREATMENT -base I-TREATMENT -a I-TREATMENT -5-fluorouracilo I-TREATMENT -y I-TREATMENT -leucovorina. I-TREATMENT -Hasta B-EVOLUTION -la I-EVOLUTION -fecha I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -completado I-EVOLUTION -70 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION -Debido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -historia I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -(poliposis I-DERIVED_FROM/TO -colónica I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -CCR I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -edad I-DERIVED_FROM/TO -temprana), I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -registro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tumores I-DERIVED_FROM/TO -hereditarios I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -definir I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -genético I-DERIVED_FROM/TO -apropiado. I-DERIVED_FROM/TO -Este I-DERIVED_FROM/TO -registro I-DERIVED_FROM/TO -incorpora I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -pacientes I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -enfermedades I-DERIVED_FROM/TO -hereditarias I-DERIVED_FROM/TO -(poliposis I-DERIVED_FROM/TO -adenomatosa I-DERIVED_FROM/TO -familiar, I-DERIVED_FROM/TO -síndrome I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Lynch, I-DERIVED_FROM/TO -síndrome I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Peutz-Jeghers, I-DERIVED_FROM/TO -entre I-DERIVED_FROM/TO -otros) I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -finalidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -educar I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -pacientes I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -familiares I-DERIVED_FROM/TO -respecto I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -enfermedad, I-DERIVED_FROM/TO -predisposición I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -desarrollarla I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -transmitirla I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -descendencia, I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -este I-DERIVED_FROM/TO -modo I-DERIVED_FROM/TO -prevenir I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -desarrollo I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -CCR I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -aquellos I-DERIVED_FROM/TO -familiares I-DERIVED_FROM/TO -asintomáticos. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El B-FAMILY_HISTORY -análisis I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -genealogía I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -índice I-FAMILY_HISTORY -demostró I-FAMILY_HISTORY -consanguinidad I-FAMILY_HISTORY -de I-FAMILY_HISTORY -los I-FAMILY_HISTORY -padres, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -historia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -poliposis I-FAMILY_HISTORY -o I-FAMILY_HISTORY -CCR I-FAMILY_HISTORY -en I-FAMILY_HISTORY -ellos. I-FAMILY_HISTORY -Además I-FAMILY_HISTORY -permitió I-FAMILY_HISTORY -identificar I-FAMILY_HISTORY -a I-FAMILY_HISTORY -una I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -(de I-FAMILY_HISTORY -un I-FAMILY_HISTORY -total I-FAMILY_HISTORY -de I-FAMILY_HISTORY -12 I-FAMILY_HISTORY -hermanos) I-FAMILY_HISTORY -que I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -CCR, I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -que I-FAMILY_HISTORY -identificamos I-FAMILY_HISTORY -como I-FAMILY_HISTORY -PAF585. I-FAMILY_HISTORY -Ella I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -un I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -de I-FAMILY_HISTORY -colon I-FAMILY_HISTORY -derecho I-FAMILY_HISTORY -con I-FAMILY_HISTORY -invasión I-FAMILY_HISTORY -hasta I-FAMILY_HISTORY -la I-FAMILY_HISTORY -subserosa I-FAMILY_HISTORY -y I-FAMILY_HISTORY -compromiso I-FAMILY_HISTORY -linfonodal I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -53 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -que I-FAMILY_HISTORY -fue I-FAMILY_HISTORY -tratado I-FAMILY_HISTORY -con I-FAMILY_HISTORY -cirugía I-FAMILY_HISTORY -y I-FAMILY_HISTORY -quimioterapia I-FAMILY_HISTORY -adyuvante. I-FAMILY_HISTORY -Un I-FAMILY_HISTORY -año I-FAMILY_HISTORY -después, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -colonoscopia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -control I-FAMILY_HISTORY -mostró I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -nuevos I-FAMILY_HISTORY -tumores I-FAMILY_HISTORY -sincrónicos, I-FAMILY_HISTORY -uno I-FAMILY_HISTORY -en I-FAMILY_HISTORY -colon I-FAMILY_HISTORY -sigmoides I-FAMILY_HISTORY -a I-FAMILY_HISTORY -35 I-FAMILY_HISTORY -cm I-FAMILY_HISTORY -del I-FAMILY_HISTORY -margen I-FAMILY_HISTORY -anal I-FAMILY_HISTORY -y I-FAMILY_HISTORY -otro I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -en I-FAMILY_HISTORY -recto I-FAMILY_HISTORY -inferior I-FAMILY_HISTORY -(adenocarcinoma I-FAMILY_HISTORY -tubular I-FAMILY_HISTORY -invasor). I-FAMILY_HISTORY -Cabe I-FAMILY_HISTORY -destacar I-FAMILY_HISTORY -que I-FAMILY_HISTORY -el I-FAMILY_HISTORY -informe I-FAMILY_HISTORY -médico I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -no I-FAMILY_HISTORY -registra I-FAMILY_HISTORY -la I-FAMILY_HISTORY -presencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -poliposis I-FAMILY_HISTORY -adenomatosa I-FAMILY_HISTORY -colónica. I-FAMILY_HISTORY -La I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -evolucionó I-FAMILY_HISTORY -tórpidamente I-FAMILY_HISTORY -falleciendo I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -4 I-FAMILY_HISTORY -meses I-FAMILY_HISTORY -posterior I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -cirugía I-FAMILY_HISTORY -debido I-FAMILY_HISTORY -a I-FAMILY_HISTORY -un I-FAMILY_HISTORY -cuadro I-FAMILY_HISTORY -séptico I-FAMILY_HISTORY -secundario. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Con I-FAMILY_HISTORY -respecto I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -demás I-FAMILY_HISTORY -hermanos, I-FAMILY_HISTORY -cinco I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ellos I-FAMILY_HISTORY -fallecieron I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -infancia I-FAMILY_HISTORY -por I-FAMILY_HISTORY -accidentes I-FAMILY_HISTORY -y I-FAMILY_HISTORY -enfermedades I-FAMILY_HISTORY -no I-FAMILY_HISTORY -relacionadas I-FAMILY_HISTORY -al I-FAMILY_HISTORY -cáncer. I-FAMILY_HISTORY -En I-FAMILY_HISTORY -los I-FAMILY_HISTORY -cinco I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -vivos, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -índice I-FAMILY_HISTORY -no I-FAMILY_HISTORY -declara I-FAMILY_HISTORY -más I-FAMILY_HISTORY -casos I-FAMILY_HISTORY -afectados I-FAMILY_HISTORY -de I-FAMILY_HISTORY -poliposis I-FAMILY_HISTORY -o I-FAMILY_HISTORY -CCR, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -embargo, I-FAMILY_HISTORY -desconocemos I-FAMILY_HISTORY -si I-FAMILY_HISTORY -ellos I-FAMILY_HISTORY -se I-FAMILY_HISTORY -han I-FAMILY_HISTORY -realizado I-FAMILY_HISTORY -estudios I-FAMILY_HISTORY -colonoscópicos. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Estudio B-EXPLORATION -genético I-EXPLORATION - I-EXPLORATION -Obtención I-EXPLORATION -del I-EXPLORATION -ADN I-EXPLORATION -genómico I-EXPLORATION -desde I-EXPLORATION -sangre I-EXPLORATION -periférica: I-EXPLORATION -el I-EXPLORATION -ADN I-EXPLORATION -genómico I-EXPLORATION -fue I-EXPLORATION -aislado I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -ml I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -venosa I-EXPLORATION -periférica, I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -protocolo I-EXPLORATION -descrito I-EXPLORATION -por I-EXPLORATION -Lahiri I-EXPLORATION -y I-EXPLORATION -Nurnberger I-EXPLORATION -(1991 I-EXPLORATION -) I-EXPLORATION -9. I-EXPLORATION - I-EXPLORATION -Este I-EXPLORATION -ADN I-EXPLORATION -fue I-EXPLORATION -previamente I-EXPLORATION -estudiado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -molecular I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -APC, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -resultó I-EXPLORATION -negativo8. I-EXPLORATION - I-EXPLORATION -Análisis I-EXPLORATION -mutacional I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -MUTYH: I-EXPLORATION -Los I-EXPLORATION -16 I-EXPLORATION -exones I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -MUTYH I-EXPLORATION -fueron I-EXPLORATION -amplificados I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -(reacción I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -polimerasa) I-EXPLORATION -usando I-EXPLORATION -los I-EXPLORATION -partidores I-EXPLORATION -descritos I-EXPLORATION -por I-EXPLORATION -Kim I-EXPLORATION -y I-EXPLORATION -colaboradores, I-EXPLORATION -en I-EXPLORATION -200610. I-EXPLORATION -Reacciones I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION -realizadas I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -volumen I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -Ql I-EXPLORATION -que I-EXPLORATION -contiene I-EXPLORATION -100 I-EXPLORATION -ng I-EXPLORATION -de I-EXPLORATION -ADN I-EXPLORATION -genómico, I-EXPLORATION -25 I-EXPLORATION -pmoles I-EXPLORATION -de I-EXPLORATION -cada I-EXPLORATION -partidor, I-EXPLORATION -0, I-EXPLORATION -2 I-EXPLORATION -mM I-EXPLORATION -de I-EXPLORATION -cada I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dNTPs, I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -mM I-EXPLORATION -MgCl2 I-EXPLORATION -1X I-EXPLORATION -del I-EXPLORATION -amortiguador I-EXPLORATION -suministrado I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -enzima I-EXPLORATION -y I-EXPLORATION -1U I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enzima I-EXPLORATION -Platinum I-EXPLORATION -Taq I-EXPLORATION -ADN I-EXPLORATION -polimerasa I-EXPLORATION -(Invitrogen, I-EXPLORATION -Sao I-EXPLORATION -Paulo, I-EXPLORATION -Brasil). I-EXPLORATION -La I-EXPLORATION -amplificación I-EXPLORATION -fue I-EXPLORATION -realizada I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -protocolo: I-EXPLORATION -una I-EXPLORATION -desnaturación I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -min I-EXPLORATION -a I-EXPLORATION -95°C, I-EXPLORATION -seguido I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -ciclos I-EXPLORATION -de I-EXPLORATION -30 I-EXPLORATION -seg I-EXPLORATION -a I-EXPLORATION -95°C, I-EXPLORATION -30 I-EXPLORATION -seg I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -de I-EXPLORATION -apareamiento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -partidores I-EXPLORATION -(rango I-EXPLORATION -50-58°C), I-EXPLORATION -30 I-EXPLORATION -seg I-EXPLORATION -a I-EXPLORATION -72°C, I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -paso I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -final I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -min I-EXPLORATION -a I-EXPLORATION -72°C. I-EXPLORATION -Los I-EXPLORATION -productos I-EXPLORATION -amplificados I-EXPLORATION -fueron I-EXPLORATION -posteriormente I-EXPLORATION -analizados I-EXPLORATION -mediante I-EXPLORATION -dos I-EXPLORATION -técnicas I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -sensibilidad I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -del I-EXPLORATION -ADN, I-EXPLORATION -que I-EXPLORATION -incluye I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -SSCP I-EXPLORATION -(single I-EXPLORATION -strand I-EXPLORATION -conformation I-EXPLORATION -polymorphism) I-EXPLORATION -y I-EXPLORATION -secuenciación I-EXPLORATION -de I-EXPLORATION -ADN. I-EXPLORATION -Brevemente, I-EXPLORATION -los I-EXPLORATION -productos I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION -desnaturados I-EXPLORATION -a I-EXPLORATION -95°C I-EXPLORATION -por I-EXPLORATION -5 I-EXPLORATION -min, I-EXPLORATION -enfriados I-EXPLORATION -en I-EXPLORATION -hielo I-EXPLORATION -por I-EXPLORATION -5 I-EXPLORATION -min, I-EXPLORATION -y I-EXPLORATION -resueltos I-EXPLORATION -por I-EXPLORATION -electroforesis I-EXPLORATION -en I-EXPLORATION -geles I-EXPLORATION -de I-EXPLORATION -poliacrilamida I-EXPLORATION -MDE I-EXPLORATION -0, I-EXPLORATION -5X I-EXPLORATION - I-EXPLORATION -(FMC I-EXPLORATION -Bioproducts), I-EXPLORATION -aplicando I-EXPLORATION -una I-EXPLORATION -corriente I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -W I-EXPLORATION -a I-EXPLORATION -18°C I-EXPLORATION -por I-EXPLORATION -12 I-EXPLORATION -h. I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -electroforesis, I-EXPLORATION -los I-EXPLORATION -geles I-EXPLORATION -fueron I-EXPLORATION -teñidos I-EXPLORATION -con I-EXPLORATION -nitrato I-EXPLORATION -de I-EXPLORATION -plata I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -fin I-EXPLORATION -de I-EXPLORATION -visualizar I-EXPLORATION -las I-EXPLORATION -bandas I-EXPLORATION -de I-EXPLORATION -ADN. I-EXPLORATION -Los I-EXPLORATION -productos I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -que I-EXPLORATION -presentaron I-EXPLORATION -una I-EXPLORATION -migración I-EXPLORATION -anormal I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -al I-EXPLORATION -control, I-EXPLORATION -fueron I-EXPLORATION -secuenciados. I-EXPLORATION -Las I-EXPLORATION -mutaciones I-EXPLORATION -fueron I-EXPLORATION -analizadas I-EXPLORATION -y I-EXPLORATION -confirmadas I-EXPLORATION -por I-EXPLORATION -dos I-EXPLORATION -reacciones I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -independientes I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -secuenciación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -hebras I-EXPLORATION -de I-EXPLORATION -ADN. I-EXPLORATION -La I-EXPLORATION -mutación I-EXPLORATION -se I-EXPLORATION -nombró I-EXPLORATION -de I-EXPLORATION -acuerdo I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -nomenclatura I-EXPLORATION -propuesta I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -Human I-EXPLORATION -Genome I-EXPLORATION -Variation I-EXPLORATION -Society I-EXPLORATION -(www. I-EXPLORATION -hgvs.org/mutnomen/). I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -suspendido I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -aspirina I-PAST_MEDICAL_HISTORY -caracterizado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -eritema I-PAST_MEDICAL_HISTORY -generalizado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -edema I-PAST_MEDICAL_HISTORY -glótico. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -ocasión I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -1974 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -vuelve I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -repetir I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -única I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -1983, I-PAST_MEDICAL_HISTORY -motivo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -vuelve I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -recibir I-PAST_MEDICAL_HISTORY -aspirina. I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -noviembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2010 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -angina I-PRESENT_ILLNESS -inestable. I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -coronariografía I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -estenosis I-EXPLORATION -significativa I-EXPLORATION -en I-EXPLORATION -arteria I-EXPLORATION -descendente I-EXPLORATION -anterior, I-EXPLORATION -ante I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -procede I-EXPLORATION -a I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -angioplastía I-EXPLORATION -con I-EXPLORATION -stent I-EXPLORATION -en I-EXPLORATION -dicho I-EXPLORATION -vaso. I-EXPLORATION -Por B-TREATMENT -antecedentes I-TREATMENT -de I-TREATMENT -alergia I-TREATMENT -a I-TREATMENT -la I-TREATMENT -aspirina I-TREATMENT -se I-TREATMENT -deja I-TREATMENT -con I-TREATMENT -clopidogrel I-TREATMENT -y I-TREATMENT -cilostazol. I-TREATMENT -Tres B-EVOLUTION -semanas I-EVOLUTION -posterior I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -alta, I-EVOLUTION -presenta I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -torácico I-EVOLUTION -retroesternal I-EVOLUTION -opresivo I-EVOLUTION -prolongado I-EVOLUTION -y B-EXPLORATION -la I-EXPLORATION -corona-riografía I-EXPLORATION -demuestra I-EXPLORATION -una I-EXPLORATION -trombosis I-EXPLORATION -intra-stent. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -angioplastía I-TREATMENT -con I-TREATMENT -balón, I-TREATMENT -bajo I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -tirofibán I-TREATMENT -endovenoso, I-TREATMENT -consiguiendo B-EVOLUTION -un I-EVOLUTION -buen I-EVOLUTION -resultado I-EVOLUTION -clínico. I-EVOLUTION -Posterior B-TREATMENT -a I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -protocolo I-TREATMENT -de I-TREATMENT -desensibilización I-TREATMENT -a I-TREATMENT -aspirina, I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT -Desde I-TREATMENT -entonces I-TREATMENT -se I-TREATMENT -mantiene I-TREATMENT -con I-TREATMENT -aspirina I-TREATMENT -y I-TREATMENT -clopidrogel. I-TREATMENT -Completado B-EVOLUTION -1 I-EVOLUTION -año I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -adherencia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -terapia, I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -efectos I-EVOLUTION -adversos, I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -sin I-EVOLUTION -angina I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -HAAS. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -(20 I-PAST_MEDICAL_HISTORY -paquetes/año) I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Endoscopia B-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -(EDA) I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -estenosante I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION -a I-EXPLORATION -30 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arcada I-EXPLORATION -dentaria. I-EXPLORATION -Biopsia I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -escamoso I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -etapi-ficación I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -infiltrante I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -largo, I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -cayado I-EXPLORATION -aórtico I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -venas I-EXPLORATION -pulmonares I-EXPLORATION -derechas; I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -aspecto I-EXPLORATION -posterior I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -que I-EXPLORATION -rodeaba I-EXPLORATION -y I-EXPLORATION -aparentemente I-EXPLORATION -infiltraba I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -en I-EXPLORATION -más I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -50% I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -circunferencia. I-EXPLORATION -Presentaba I-EXPLORATION -además I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -pulmonar I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -x I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -caudado, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -localizaciones I-EXPLORATION -secundarias I-EXPLORATION -(T4NxM1). I-EXPLORATION -Considerando B-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -tenía I-TREATMENT -un I-TREATMENT -cáncer I-TREATMENT -metastásico, I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -paliativo I-TREATMENT -para I-TREATMENT -alivio I-TREATMENT -de I-TREATMENT -su I-TREATMENT -disfagia I-TREATMENT -con I-TREATMENT -QRT I-TREATMENT -concomitante I-TREATMENT -con I-TREATMENT -cisplatino I-TREATMENT -(radioterapia I-TREATMENT -51 I-TREATMENT -Gy I-TREATMENT -en I-TREATMENT -17 I-TREATMENT -fracciones I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -Gy I-TREATMENT -y I-TREATMENT -cisplatino I-TREATMENT -40 I-TREATMENT -mg/ I-TREATMENT -m2 I-TREATMENT -semanales). I-TREATMENT - I-TREATMENT -Dos B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -completado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -consultó I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencia I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -hematemesis; I-EVOLUTION -al I-EVOLUTION -ingreso I-EVOLUTION -hipotenso I-EVOLUTION -y I-EVOLUTION -taquicárdico I-EVOLUTION -recuperando I-EVOLUTION -su I-EVOLUTION -hemodinamia I-EVOLUTION -mediante I-EVOLUTION -aporte I-EVOLUTION -de I-EVOLUTION -cristaloides. I-EVOLUTION -Hematocrito B-EXPLORATION -de I-EXPLORATION -21%. I-EXPLORATION -AngioTAC I-EXPLORATION -mostró I-EXPLORATION -reducción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -tumoral I-EXPLORATION -esofágica I-EXPLORATION -con I-EXPLORATION -componente I-EXPLORATION -necrótico I-EXPLORATION -central I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aorta, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -activo; I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -eran I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -FAE. I-EXPLORATION -Fue B-TREATMENT -llevado I-TREATMENT -a I-TREATMENT -pabellón I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -implantó I-TREATMENT -una I-TREATMENT -endoprótesis I-TREATMENT -Valiant I-TREATMENT -28 I-TREATMENT -x I-TREATMENT -15 I-TREATMENT -(Medtronic, I-TREATMENT -Minnesota, I-TREATMENT -Estados I-TREATMENT -Unidos I-TREATMENT -de I-TREATMENT -Norteamérica) I-TREATMENT -en I-TREATMENT -aorta I-TREATMENT -torácica I-TREATMENT -descendente I-TREATMENT -proximal, I-TREATMENT -distal I-TREATMENT -a I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -subclavia I-TREATMENT -izquierda, I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -cobertura I-TREATMENT -antibiótica I-TREATMENT -en I-TREATMENT -base I-TREATMENT -a I-TREATMENT -ce-ftriaxona I-TREATMENT -y I-TREATMENT -clindamicina. I-TREATMENT -No B-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -hemorragia I-EVOLUTION -digestiva, I-EVOLUTION -iniciando I-EVOLUTION -alimentación I-EVOLUTION -oral I-EVOLUTION -progresiva I-EVOLUTION -el I-EVOLUTION -4° I-EVOLUTION -día I-EVOLUTION -postoperatorio, I-EVOLUTION -bien I-EVOLUTION -tolerado I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -disfagia. I-EVOLUTION -Fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -8° I-EVOLUTION -día I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -oral I-EVOLUTION -y I-EVOLUTION -afebril. I-EVOLUTION -Completó B-TREATMENT -14 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -antibióticos I-TREATMENT -endovenosos I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -amoxicilina/ácido I-TREATMENT -clavulánico I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -amoxicilina I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -indefinida. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -controles I-EVOLUTION -ambulatorios I-EVOLUTION -evolucionó I-EVOLUTION -adecuadamente, I-EVOLUTION -sin I-EVOLUTION -disfagia I-EVOLUTION -ni I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -kg. I-EVOLUTION -AngioTAC I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION -mostró I-EVOLUTION -adecuada I-EVOLUTION -posición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -endoprótesis I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -fugas, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -metástasis I-EVOLUTION -hepática I-EVOLUTION -conocida. I-EVOLUTION -Continuó I-EVOLUTION -con I-EVOLUTION -cuidados I-EVOLUTION -paliativos I-EVOLUTION -y I-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -importantes I-EVOLUTION -hasta I-EVOLUTION -un I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -11 I-EVOLUTION -meses I-EVOLUTION -post I-EVOLUTION -procedimiento I-EVOLUTION -en I-EVOLUTION -que I-EVOLUTION -refirió I-EVOLUTION -compromiso I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -disfagia I-EVOLUTION -a I-EVOLUTION -sólidos I-EVOLUTION -y I-EVOLUTION -baja I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -kilos. I-EVOLUTION -EDA B-EXPLORATION -demostró I-EXPLORATION -lesión I-EXPLORATION -esofágica I-EXPLORATION -estenosante I-EXPLORATION -desde I-EXPLORATION -los I-EXPLORATION -30 I-EXPLORATION -a I-EXPLORATION -35 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arcada I-EXPLORATION -dentaria I-EXPLORATION -con I-EXPLORATION -exposición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -endoprótesis I-EXPLORATION -aórtica. I-EXPLORATION -Mantuvo B-EVOLUTION -manejo I-EVOLUTION -paliativo, I-EVOLUTION -falleciendo I-EVOLUTION -finalmente I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -13 I-EVOLUTION -meses I-EVOLUTION -post I-EVOLUTION -cirugía I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -sepsis I-EVOLUTION -ni I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -sangrado. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -adenopat��as I-PRESENT_ILLNESS -occipitales, I-PRESENT_ILLNESS -yugulares, I-PRESENT_ILLNESS -submandibulares I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inguinales I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sensibles, I-PRESENT_ILLNESS -asociadas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -fatiga, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -máculo-petequiales I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -pies. I-PRESENT_ILLNESS -El B-EXPLORATION -hemograma I-EXPLORATION -mostraba I-EXPLORATION -3.400 I-EXPLORATION -leucocitos I-EXPLORATION -x I-EXPLORATION -mm3, I-EXPLORATION -46% I-EXPLORATION -de I-EXPLORATION -linfo I-EXPLORATION -citos I-EXPLORATION -y I-EXPLORATION -50% I-EXPLORATION -de I-EXPLORATION -neutro I-EXPLORATION -filos. I-EXPLORATION -La I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -(VHS) I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -2 I-EXPLORATION -mg/L I-EXPLORATION -y I-EXPLORATION -28 I-EXPLORATION -mm/h, I-EXPLORATION -respectivamente. I-EXPLORATION -El I-EXPLORATION -perfil I-EXPLORATION -hepático, I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -complementario I-EXPLORATION -fue I-EXPLORATION -negativo: I-EXPLORATION -hemocultivos, I-EXPLORATION -urocultivo, I-EXPLORATION -coprocultivo, I-EXPLORATION -inmunofluorescencia I-EXPLORATION -directa I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -respiratorios, I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -Epstein-Barr I-EXPLORATION -(VEB), I-EXPLORATION -Bartonella I-EXPLORATION -hensenlae, I-EXPLORATION -parvovirus I-EXPLORATION -B-19, I-EXPLORATION -citomegalovirus I-EXPLORATION -(CMV), I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii I-EXPLORATION -y I-EXPLORATION -ELISA I-EXPLORATION -para I-EXPLORATION -VIH. I-EXPLORATION -No I-EXPLORATION -hubo I-EXPLORATION -hallazgos I-EXPLORATION -significativos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -eco I-EXPLORATION -cardiografía I-EXPLORATION -transtorácica. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -mostró I-EXPLORATION -adenopatías I-EXPLORATION -bilaterales, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -triángulos I-EXPLORATION -cervicales I-EXPLORATION -anteriores I-EXPLORATION -y I-EXPLORATION -posteriores, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -inespecífico. I-EXPLORATION - I-EXPLORATION -Durante B-EVOLUTION -la I-EVOLUTION -hospitalización I-EVOLUTION -apareció I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -máculo-papular I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -malar, I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -extremidades I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -artralgias. I-EVOLUTION -Los B-EXPLORATION -anticuerpos I-EXPLORATION -anti-nucleares I-EXPLORATION -(ANA) I-EXPLORATION -y I-EXPLORATION -anti-DNA I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -anti-antígenos I-EXPLORATION -nucleares I-EXPLORATION -extraíbles I-EXPLORATION -(ENA) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -(FR) I-EXPLORATION -no I-EXPLORATION -presentaron I-EXPLORATION -alteraciones. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -complemento I-EXPLORATION -C3 I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -131 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -45 I-EXPLORATION -mg/dL I-EXPLORATION -respectivamente. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -adenopatía I-EXPLORATION -cervical I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -distorsión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arquitectura, I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -fibrinoide I-EXPLORATION -y I-EXPLORATION -restos I-EXPLORATION -apoptóticos I-EXPLORATION -rodeados I-EXPLORATION -de I-EXPLORATION -abundantes I-EXPLORATION -histiocitos, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -linfadenitis I-EXPLORATION -necrotizante I-EXPLORATION -histiocitaria. I-EXPLORATION -El B-EVOLUTION -cuadro I-EVOLUTION -se I-EVOLUTION -resolvió I-EVOLUTION -espontáneamente I-EVOLUTION -en I-EVOLUTION -1 I-EVOLUTION -mes I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -recurrencias. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -poliartralgias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -activo. I-PAST_MEDICAL_HISTORY -Refiere B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -sudo-ración I-PRESENT_ILLNESS -nocturna, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -poliartralgias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -sensible. I-PRESENT_ILLNESS -Relata B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hermana I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -EKF I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -contacto I-PAST_MEDICAL_HISTORY -directo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -gato. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -realizaron I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -mostraba I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -linfonodos I-PRESENT_ILLNESS -cervicales I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Le B-TREATMENT -indicaron I-TREATMENT -amoxicilina-ácido I-TREATMENT -clavulánico I-TREATMENT -durante I-TREATMENT -5 I-TREATMENT -días I-TREATMENT -sin I-TREATMENT -mejoría I-TREATMENT -clínica I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -hospitalizó. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -cervical I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -sensible I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -visceromegalia. I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -mostró I-EXPLORATION -VHS I-EXPLORATION -de I-EXPLORATION -56 I-EXPLORATION -mm/h I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -ferritina I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -77 I-EXPLORATION -mg/L I-EXPLORATION -y I-EXPLORATION -1.789 I-EXPLORATION -ng/mL I-EXPLORATION -respectivamente. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cuello, I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -constatar I-EXPLORATION -adenopatías I-EXPLORATION -cervicales I-EXPLORATION -y I-EXPLORATION -mediastínicas, I-EXPLORATION -reveló I-EXPLORATION -opacidades I-EXPLORATION -pulmonares I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado. I-EXPLORATION -Paralelamente, I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -VIH, I-EXPLORATION -VEB, I-EXPLORATION -CMV, I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -sífilis I-EXPLORATION -y I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii. I-EXPLORATION -La I-EXPLORATION -IgM I-EXPLORATION -para I-EXPLORATION -Bartonella I-EXPLORATION -hensenlae I-EXPLORATION -fue I-EXPLORATION -negativa, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -IgG I-EXPLORATION -resultó I-EXPLORATION -positiva I-EXPLORATION -(1/64). I-EXPLORATION -Se I-EXPLORATION -indicó I-EXPLORATION -azitromicina I-EXPLORATION -lg I-EXPLORATION -al I-EXPLORATION -día I-EXPLORATION -durante I-EXPLORATION -6 I-EXPLORATION -días, I-EXPLORATION -sin I-EXPLORATION -respuesta. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunológico I-EXPLORATION -fue I-EXPLORATION -prácticamente I-EXPLORATION -normal, I-EXPLORATION -solamente I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -ANA I-EXPLORATION -positivo I-EXPLORATION -a I-EXPLORATION -título I-EXPLORATION -bajo I-EXPLORATION -(1/40). I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -adenopatía I-EXPLORATION -cervical. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -para I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -bacterias I-EXPLORATION -resultaron I-EXPLORATION -negativos, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -reveló I-EXPLORATION -linfadenitis I-EXPLORATION -necrotizante I-EXPLORATION -histiocitaria. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -prednisona I-TREATMENT -30 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT -con I-TREATMENT -disminución I-TREATMENT -progresiva I-TREATMENT -de I-TREATMENT -las I-TREATMENT -dosis I-TREATMENT -completando I-TREATMENT -45 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -terapia. I-TREATMENT -Los B-EVOLUTION -síntomas I-EVOLUTION -desaparecen I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION -Dos B-EXPLORATION -meses I-EXPLORATION -después I-EXPLORATION -asiste I-EXPLORATION -a I-EXPLORATION -control I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -pulmonar I-EXPLORATION -revelando I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -neumonía I-EXPLORATION -intersticial I-EXPLORATION -usual I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -tardía. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -sintoma-tología I-EVOLUTION -respiratoria I-EVOLUTION -ni I-EVOLUTION -alteraciones I-EVOLUTION -significativas I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -pulmonar. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION -mostró I-EXPLORATION -tumor I-EXPLORATION -ovárico I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -13 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -ascitis. I-EXPLORATION -Resto I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Cal25 I-EXPLORATION -= I-EXPLORATION -2.526 I-EXPLORATION -(U/ml). I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -cirugía I-TREATMENT -oncoló I-TREATMENT -gica. I-TREATMENT -Cal25 B-EXPLORATION -post-operatorio I-EXPLORATION -174 I-EXPLORATION -(U/ml). I-EXPLORATION -Biopsia I-EXPLORATION -mostró I-EXPLORATION -adenocarcinoma I-EXPLORATION -endometrioide I-EXPLORATION -Grado I-EXPLORATION -3. I-EXPLORATION -Etapificada I-EXPLORATION -como I-EXPLORATION -IC, I-EXPLORATION -se I-EXPLORATION -tomó I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -ascitis I-EXPLORATION -para I-EXPLORATION -block I-EXPLORATION -celular I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -cultivó I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -QS I-EXPLORATION -in I-EXPLORATION -vitro. I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -QMT I-TREATMENT -de I-TREATMENT -carboplatino-paclitaxel, I-TREATMENT -con I-TREATMENT -normalización I-TREATMENT -del I-TREATMENT -Cal25. I-TREATMENT -El B-EVOLUTION -seguimiento I-EVOLUTION -a I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION -Estudio B-EXPLORATION -in I-EXPLORATION -vitro I-EXPLORATION -mostró I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -citotoxicidad I-EXPLORATION -al I-EXPLORATION -esquema I-EXPLORATION -carboplatino-paclitaxel I-EXPLORATION -mayor I-EXPLORATION -al I-EXPLORATION -70%, I-EXPLORATION -correlacionándose I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -respuesta I-EXPLORATION -clínica. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -(IMC I-PAST_MEDICAL_HISTORY -32) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -suspendido. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -persistentes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -kilos I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -período. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -hubo I-PRESENT_ILLNESS -evidencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -gastrointestinal I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -anemia. I-PRESENT_ILLNESS - B-EXPLORATION -La I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -gástrico I-EXPLORATION -submucoso, I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -antro I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -curvatura I-EXPLORATION -menor I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -lumen I-EXPLORATION -antral. I-EXPLORATION -La I-EXPLORATION -mucosa, I-EXPLORATION -examinada I-EXPLORATION -por I-EXPLORATION -endoscopia, I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -biopsias. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -gástrica I-EXPLORATION -homogénea, I-EXPLORATION -hiperecogénica I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -definidos. I-EXPLORATION -El I-EXPLORATION -estudió I-EXPLORATION -se I-EXPLORATION -completó I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -con I-EXPLORATION -densidad I-EXPLORATION -grasa, I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -ocupando I-EXPLORATION -una I-EXPLORATION -parte I-EXPLORATION -importante I-EXPLORATION -del I-EXPLORATION -lumen I-EXPLORATION -antral I-EXPLORATION -gástrico, I-EXPLORATION -con I-EXPLORATION -baja I-EXPLORATION -captura I-EXPLORATION -de I-EXPLORATION -contraste. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -sospechosa I-EXPLORATION -de I-EXPLORATION -GIST I-EXPLORATION -con I-EXPLORATION -diferenciación I-EXPLORATION -lipomatosa I-EXPLORATION -o I-EXPLORATION -un I-EXPLORATION -lipoma I-EXPLORATION -gástrico. I-EXPLORATION -La I-EXPLORATION -resección I-EXPLORATION -quirúrgica I-EXPLORATION -fue I-EXPLORATION -recomendada. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -gastrectomía I-TREATMENT -subtotal I-TREATMENT -distal I-TREATMENT -laparoscópica. I-TREATMENT -Se I-TREATMENT -utilizaron I-TREATMENT -5 I-TREATMENT -trocares; I-TREATMENT -supraumbilical I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mm I-TREATMENT -para I-TREATMENT -el I-TREATMENT -laparoscopio, I-TREATMENT -subxifoideo I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mm I-TREATMENT -para I-TREATMENT -separación I-TREATMENT -hepática I-TREATMENT -y I-TREATMENT -trocares I-TREATMENT -subcostal I-TREATMENT -izquierdo I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mm, I-TREATMENT -flanco I-TREATMENT -derecho I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -flanco I-TREATMENT -izquierdo I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mm. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -intraoperatorio, I-TREATMENT -se I-TREATMENT -confirmó I-TREATMENT -una I-TREATMENT -gran I-TREATMENT -masa I-TREATMENT -antral I-TREATMENT -sin I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -serosa. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -endoscopia I-TREATMENT -intraoperatoria I-TREATMENT -para I-TREATMENT -definir I-TREATMENT -el I-TREATMENT -margen I-TREATMENT -proximal I-TREATMENT -de I-TREATMENT -resección. I-TREATMENT -Se I-TREATMENT -seccionó I-TREATMENT -el I-TREATMENT -duodeno I-TREATMENT -y I-TREATMENT -el I-TREATMENT -estómago I-TREATMENT -con I-TREATMENT -cargas I-TREATMENT -lineares I-TREATMENT -de I-TREATMENT -60 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -linfadenectomía I-TREATMENT -D1. I-TREATMENT -La I-TREATMENT -pieza I-TREATMENT -fue I-TREATMENT -extraída I-TREATMENT -por I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -Pfannenstiel I-TREATMENT -y I-TREATMENT -los I-TREATMENT -márgenes I-TREATMENT -negativos I-TREATMENT -fueron I-TREATMENT -confirmados I-TREATMENT -por I-TREATMENT -biopsia I-TREATMENT -rápida. I-TREATMENT -Se I-TREATMENT -reconstruyó I-TREATMENT -el I-TREATMENT -tránsito I-TREATMENT -con I-TREATMENT -una I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux I-TREATMENT -de I-TREATMENT -50 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -largo, I-TREATMENT -realizando I-TREATMENT -la I-TREATMENT -anastomosis I-TREATMENT -gastro-yeyunal I-TREATMENT -y I-TREATMENT -yeyuno-yeyunal I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -mecánica I-TREATMENT -e I-TREATMENT -intracorpórea. I-TREATMENT -El B-EVOLUTION -tiempo I-EVOLUTION -operatorio I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -h I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -sangrado I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -200 I-EVOLUTION -cc. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -recuperación I-EVOLUTION -post I-EVOLUTION -operatoria I-EVOLUTION -fue I-EVOLUTION -sin I-EVOLUTION -incidentes. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -realimentó I-EVOLUTION -con I-EVOLUTION -líquidos I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -5o I-EVOLUTION -día I-EVOLUTION -post I-EVOLUTION -operatorio. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -macroscópico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -consistente I-EXPLORATION -con I-EXPLORATION -tumor I-EXPLORATION -gástrico I-EXPLORATION -submucoso, I-EXPLORATION -de I-EXPLORATION -11, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -6x7 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -apariencia I-EXPLORATION -lipomatosa. I-EXPLORATION -La I-EXPLORATION -microscopía I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -lipoma I-EXPLORATION -gástrico I-EXPLORATION -benigno I-EXPLORATION -con I-EXPLORATION -márgenes I-EXPLORATION -libres I-EXPLORATION -y I-EXPLORATION -15 I-EXPLORATION -linfonodos I-EXPLORATION -perigástricos I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -institución I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síncope I-PRESENT_ILLNESS -recurrente. I-PRESENT_ILLNESS -Estando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -reposo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -casa, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hora I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -finalizado I-PRESENT_ILLNESS -entrenamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -boxeo, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -súbito I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -minuto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -recuperación I-PRESENT_ILLNESS -completa I-PRESENT_ILLNESS -posterior. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -siguientes I-PRESENT_ILLNESS -repitió I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -sincopales I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -oportunidades. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hall I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -acceso I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -sincopal, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -trasladado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -box I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -evaluación I-PRESENT_ILLNESS -inmediata. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -126/82 I-EXPLORATION -mmHg, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -82 I-EXPLORATION -lpm, I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -99% I-EXPLORATION -y I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION -de I-EXPLORATION -36°C. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refería I-EXPLORATION -comorbilidades I-EXPLORATION -significativas I-EXPLORATION -ni I-EXPLORATION -antecedentes I-EXPLORATION -familiares I-EXPLORATION -de I-EXPLORATION -cardiopatía. I-EXPLORATION -Durante I-EXPLORATION -realización I-EXPLORATION -del I-EXPLORATION -ECG I-EXPLORATION -inicial I-EXPLORATION -paciente I-EXPLORATION -repitió I-EXPLORATION -síncope, I-EXPLORATION -objetivándose I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -trazado I-EXPLORATION -fibrilación I-EXPLORATION -ventricular. I-EXPLORATION -Se I-EXPLORATION -iniciaron I-EXPLORATION -maniobras I-EXPLORATION -de I-EXPLORATION -reanimación I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -convirtió I-EXPLORATION -a I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -segundos. I-EXPLORATION -Se I-EXPLORATION -repitió I-EXPLORATION -un I-EXPLORATION -ECG, I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -bloqueo I-EXPLORATION -incompleto I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -derecha, I-EXPLORATION -supradesnivel I-EXPLORATION -del I-EXPLORATION -ST I-EXPLORATION -e I-EXPLORATION -inversión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -T I-EXPLORATION -en I-EXPLORATION -precordiales I-EXPLORATION -derechas, I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -patrón I-EXPLORATION -Bragada I-EXPLORATION -tipo I-EXPLORATION -1. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -pocos I-EXPLORATION -minutos I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -nuevo I-EXPLORATION -episodio I-EXPLORATION -de I-EXPLORATION -fibrilación I-EXPLORATION -ventricular I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -inmediata I-EXPLORATION -desfibrilación I-EXPLORATION -con I-EXPLORATION -200 I-EXPLORATION -Joules I-EXPLORATION -de I-EXPLORATION -corriente I-EXPLORATION -bifásica, I-EXPLORATION -dando I-EXPLORATION -salida I-EXPLORATION -a I-EXPLORATION -ritmo I-EXPLORATION -sinusal. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -hospitalizado I-TREATMENT -en I-TREATMENT -Unidad I-TREATMENT -Coronaria, I-TREATMENT -donde I-TREATMENT -fue I-TREATMENT -sedado I-TREATMENT -con I-TREATMENT -lorazepam I-TREATMENT -y I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -isoproterenol I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -25 I-TREATMENT -ug/min. I-TREATMENT -Se B-EXPLORATION -registra I-EXPLORATION -ECG I-EXPLORATION -durante I-EXPLORATION -infusión I-EXPLORATION -de I-EXPLORATION -isoproterenol, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -regresión I-EXPLORATION -del I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -Brugada I-EXPLORATION -dado I-EXPLORATION -por I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION -en I-EXPLORATION -V1-V2, I-EXPLORATION -desaparición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -bloqueo I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -restauración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -polaridad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -T. I-EXPLORATION -Ecocardiograma I-EXPLORATION -descartó I-EXPLORATION -patología I-EXPLORATION -estructural I-EXPLORATION -y I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones I-EXPLORATION -significativas I-EXPLORATION -del I-EXPLORATION -medio I-EXPLORATION -interno. I-EXPLORATION -Evolucionó B-EVOLUTION -favorablemente, I-EVOLUTION -suspendiendo I-EVOLUTION -infusión I-EVOLUTION -antiarrítmica I-EVOLUTION -al I-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -e I-EVOLUTION -implantando I-EVOLUTION -cardiodesfibrilador I-EVOLUTION -bicameral I-EVOLUTION -(Protecta I-EVOLUTION -CRT-D, I-EVOLUTION -Medtronic) I-EVOLUTION -sin I-EVOLUTION -incidentes. I-EVOLUTION -Fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -sin I-EVOLUTION -medicación I-EVOLUTION -antiarrítmica. I-EVOLUTION -En I-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -registraron I-EVOLUTION -eventos I-EVOLUTION -arrítmicos I-EVOLUTION -en I-EVOLUTION -chequeo I-EVOLUTION -del I-EVOLUTION -dispositivo. I-EVOLUTION - I-EVOLUTION - -La B-EXPLORATION -isquemia I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -es I-EXPLORATION -una I-EXPLORATION -complicación I-EXPLORATION -a I-EXPLORATION -largo I-EXPLORATION -plazo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -diabetes. I-EXPLORATION -Los I-EXPLORATION -pacientes I-EXPLORATION -evolucionan I-EXPLORATION -con I-EXPLORATION -claudicación I-EXPLORATION -intermitente I-EXPLORATION -y, I-EXPLORATION -posteriormente, I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -de I-EXPLORATION -reposo I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad10, I-EXPLORATION -11. I-EXPLORATION -Pueden I-EXPLORATION -presentar I-EXPLORATION -alteraciones I-EXPLORATION -tróficas I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades, I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -uñas, I-EXPLORATION -xerosis, I-EXPLORATION -edema, I-EXPLORATION -linfangitis, I-EXPLORATION -pulsos I-EXPLORATION -disminuidos, I-EXPLORATION -piel I-EXPLORATION -fría, I-EXPLORATION -eritema, I-EXPLORATION -palidez I-EXPLORATION -o I-EXPLORATION -cianosis. I-EXPLORATION -Finalmente, I-EXPLORATION -aparecen I-EXPLORATION -úlceras I-EXPLORATION -y I-EXPLORATION -necrosis12, I-EXPLORATION -13. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -angiografía I-EXPLORATION -permiten I-EXPLORATION -cuantificar I-EXPLORATION -la I-EXPLORATION -magnitud I-EXPLORATION -del I-EXPLORATION -deterioro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -circulación I-EXPLORATION -arterial. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -incluye I-TREATMENT -ejercicio I-TREATMENT -físico, I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -diabetes I-TREATMENT -y I-TREATMENT -de I-TREATMENT -los I-TREATMENT -otros I-TREATMENT -factores I-TREATMENT -de I-TREATMENT -riesgo14. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -definitivo I-TREATMENT -es I-TREATMENT -la I-TREATMENT -revascularización15. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -opresivo, I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -10/10, I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -epigastrio, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -min I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -palpitaciones. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Refería I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes, I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -motivó I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -evaluada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -electrocardiograma I-PRESENT_ILLNESS -(ECG) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -enzimas I-PRESENT_ILLNESS -cardiacas; I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -impresionando I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -coronario, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -derivó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio. I-PRESENT_ILLNESS -Dentro B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -data I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -precisada, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -atenolol I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cáncer I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mama I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -radioterapia. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -ni B-FAMILY_HISTORY -tenía I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -cardiopatía I-FAMILY_HISTORY -coronaria. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Al B-EXPLORATION -ingreso, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -sudorosa, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -dolor. I-EXPLORATION -La I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -era I-EXPLORATION -100/60 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -87 I-EXPLORATION -lpm. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaban I-EXPLORATION -yugulares I-EXPLORATION -colapsables I-EXPLORATION -en I-EXPLORATION -inspiración, I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -cardiaca I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -soplos I-EXPLORATION -ni I-EXPLORATION -galope I-EXPLORATION -y I-EXPLORATION -había I-EXPLORATION -sensibilidad I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -epigástrica. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -no I-EXPLORATION -era I-EXPLORATION -destacable. I-EXPLORATION -Al B-PRESENT_ILLNESS -interrogatorio, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -clara I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -esfuerzos I-PRESENT_ILLNESS -físicos, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -principio I-PRESENT_ILLNESS -eran I-PRESENT_ILLNESS -esporádicos I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -hicieron I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -frecuentes, I-PRESENT_ILLNESS -casi I-PRESENT_ILLNESS -diarios. I-PRESENT_ILLNESS -El B-EXPLORATION -ECG I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -discreto I-EXPLORATION -supradesnivel I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION -(SDST) I-EXPLORATION -anteroseptal I-EXPLORATION -con I-EXPLORATION -inversión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -T I-EXPLORATION -de I-EXPLORATION -V1 I-EXPLORATION -a I-EXPLORATION -V3, I-EXPLORATION -que I-EXPLORATION -ya I-EXPLORATION -era I-EXPLORATION -evidente I-EXPLORATION -en I-EXPLORATION -ECG I-EXPLORATION -tomado I-EXPLORATION -2 I-EXPLORATION -días I-EXPLORATION -antes I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -evolutivo. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -silueta I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -admitida I-TREATMENT -a I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -coronaria, I-TREATMENT -con I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -síndrome I-TREATMENT -coronario I-TREATMENT -agudo I-TREATMENT -sin I-TREATMENT -SDST. I-TREATMENT -La B-EXPLORATION -troponina I-EXPLORATION -I I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -07 I-EXPLORATION -pg/ml I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -05) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -CK I-EXPLORATION -total I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -117 I-EXPLORATION -U/L I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -fracción I-EXPLORATION -MB I-EXPLORATION -de I-EXPLORATION -25. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -crisis I-EVOLUTION -de I-EVOLUTION -angor I-EVOLUTION -intenso, I-EVOLUTION -10/10, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -disnea, I-EVOLUTION -palpitaciones, I-EVOLUTION -cefalea, I-EVOLUTION -sudoración I-EVOLUTION -y I-EVOLUTION -enrojecimiento I-EVOLUTION -facial. I-EVOLUTION -Se B-EXPLORATION -constató I-EXPLORATION -alza I-EXPLORATION -de I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -hasta I-EXPLORATION -260/130 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -monitor I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -taquicardia I-EXPLORATION -sinusal I-EXPLORATION -con I-EXPLORATION -extrasistolía I-EXPLORATION -supraventricular I-EXPLORATION -y I-EXPLORATION -ventricular I-EXPLORATION -frecuentes, I-EXPLORATION -y I-EXPLORATION -conducción I-EXPLORATION -aberrante I-EXPLORATION -con I-EXPLORATION -morfología I-EXPLORATION -de I-EXPLORATION -bloqueo I-EXPLORATION -completo I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -5 I-EXPLORATION -min I-EXPLORATION -de I-EXPLORATION -duración. I-EXPLORATION -No I-EXPLORATION -hubo I-EXPLORATION -episodios I-EXPLORATION -de I-EXPLORATION -hipotensión I-EXPLORATION -ni I-EXPLORATION -síncope. I-EXPLORATION -Dado I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -del I-EXPLORATION -episodio I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -feocromocitoma. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -heparina, I-TREATMENT -se I-TREATMENT -aportó I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -doxazosina I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h. I-TREATMENT -Se B-EXPLORATION -midió I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -crisis I-EXPLORATION -catecolaminas I-EXPLORATION -plasmáticas I-EXPLORATION -y I-EXPLORATION -metanefrinas I-EXPLORATION -urinarias I-EXPLORATION -(previo I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -doxazosina), I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -marcadamente I-EXPLORATION -elevadas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -de I-EXPLORATION -abdomen, I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico, I-EXPLORATION -evidenciando I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -cintigrama I-EXPLORATION -con I-EXPLORATION -123-I-metaiodobencilguanidina I-EXPLORATION -(MIBG) I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -captación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -descrita I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -metástasis. I-EXPLORATION - I-EXPLORATION -Adicionalmente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -transtorácico, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda I-EXPLORATION -leve I-EXPLORATION -y I-EXPLORATION -compromiso I-EXPLORATION -leve I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -global, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -fracción I-EXPLORATION -de I-EXPLORATION -eyección I-EXPLORATION -(FE) I-EXPLORATION -estimada I-EXPLORATION -por I-EXPLORATION -Simpson I-EXPLORATION -de I-EXPLORATION -42%, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -coronariografía I-EXPLORATION -sin I-EXPLORATION -incidentes I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -procedimiento, I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -coronaria. I-EXPLORATION -La I-EXPLORATION -disfunción I-EXPLORATION -ventricular I-EXPLORATION -fue I-EXPLORATION -asumida I-EXPLORATION -en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -daño I-EXPLORATION -miocárdico I-EXPLORATION -por I-EXPLORATION -catecolaminas. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -preparó I-TREATMENT -para I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -bloqueo I-TREATMENT -α I-TREATMENT -y I-TREATMENT -β-adrenérgico I-TREATMENT -escalonado I-TREATMENT -con I-TREATMENT -doxazosina I-TREATMENT -y, I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -días, I-TREATMENT -propanolol. I-TREATMENT -La I-TREATMENT -cirugía I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -11 I-TREATMENT -días I-TREATMENT -después, I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -hemodinámicas I-TREATMENT -significativas I-TREATMENT -y I-TREATMENT -cursó I-TREATMENT -con I-TREATMENT -un I-TREATMENT -postoperatorio I-TREATMENT -favorable. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION -Desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -clínico, I-EVOLUTION -cursó I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -progresiva I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -antihipertensivos I-EVOLUTION -y I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -ventricular I-EVOLUTION -en I-EVOLUTION -ecocardiografía I-EVOLUTION -de I-EVOLUTION -control. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -suspendido, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -celiaca, I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -iodo I-PAST_MEDICAL_HISTORY -radioactivo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Graves. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -julio I-EXPLORATION -de I-EXPLORATION -2007 I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -vasculitis I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -ANCA I-EXPLORATION -(GPA), I-EXPLORATION -en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -vías I-EXPLORATION -aéreas I-EXPLORATION -superiores I-EXPLORATION -(VAS), I-EXPLORATION -masa I-EXPLORATION -palpable I-EXPLORATION -supraclavicular I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hipogastrio10. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -incluyen I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -eritrosedimentación I-EXPLORATION -(VSG) I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -120 I-EXPLORATION -mm, I-EXPLORATION -ANCA I-EXPLORATION -c I-EXPLORATION -positivos, I-EXPLORATION -el I-EXPLORATION -enzimoinmunoensayo I-EXPLORATION -(ELISA) I-EXPLORATION -reveló I-EXPLORATION -especificidad I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -antígeno I-EXPLORATION -proteinasa I-EXPLORATION -3 I-EXPLORATION -(PR3), I-EXPLORATION -sin I-EXPLORATION -microhematuria I-EXPLORATION -o I-EXPLORATION -insuficiencia I-EXPLORATION -renal. I-EXPLORATION -Presentó I-EXPLORATION -masa I-EXPLORATION -pulmonar I-EXPLORATION -apical I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -central I-EXPLORATION -sin I-EXPLORATION -cavitación. I-EXPLORATION -Se I-EXPLORATION -tomó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -supraclavicular I-EXPLORATION -cuya I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informó I-EXPLORATION -infamación I-EXPLORATION -granulomatosa I-EXPLORATION -necrotizante. I-EXPLORATION -En I-EXPLORATION -base I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -expuesto I-EXPLORATION -previamente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -GPA I-EXPLORATION -temprana I-EXPLORATION -sistémica I-EXPLORATION -del I-EXPLORATION -EUVAS I-EXPLORATION -(Registro I-EXPLORATION -Europeo I-EXPLORATION -de I-EXPLORATION -vasculitis) I-EXPLORATION -o I-EXPLORATION -localizada I-EXPLORATION -dado I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION -renal. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciclofosfamida I-TREATMENT -y I-TREATMENT -prednisolona I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -clínica. I-TREATMENT - I-TREATMENT -Presentó B-EVOLUTION -recaídas I-EVOLUTION -con I-EVOLUTION -síntomas I-EVOLUTION -respiratorios I-EVOLUTION -y I-EVOLUTION -nódulos I-EVOLUTION -pulmonares, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -curva I-EVOLUTION -flujo I-EVOLUTION -volumen I-EVOLUTION -(CFV) I-EVOLUTION -normal, I-EVOLUTION -estando I-EVOLUTION -bajo I-EVOLUTION -tratamiento I-EVOLUTION -inmunosupresor I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -años I-EVOLUTION -2008, I-EVOLUTION -2009 I-EVOLUTION -y I-EVOLUTION -2010. I-EVOLUTION -Se B-TREATMENT -interpretó I-TREATMENT -como I-TREATMENT -enfermedad I-TREATMENT -refractaria I-TREATMENT -y I-TREATMENT -se I-TREATMENT -rotó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -micofenolato I-TREATMENT -3 I-TREATMENT -g/día I-TREATMENT -que I-TREATMENT -es I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -está I-TREATMENT -en I-TREATMENT -la I-TREATMENT -actualidad. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -inicios I-EVOLUTION -de I-EVOLUTION -mayo I-EVOLUTION -de I-EVOLUTION -2011 I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -disnea I-EVOLUTION -de I-EVOLUTION -esfuerzo, I-EVOLUTION -estridor I-EVOLUTION -inspiratorio, I-EVOLUTION -sibilancias I-EVOLUTION -y I-EVOLUTION -expectoración I-EVOLUTION -hemoptoica. I-EVOLUTION -Presentó B-EXPLORATION -analítica I-EXPLORATION -normal I-EXPLORATION -que I-EXPLORATION -incluyó I-EXPLORATION -VSG I-EXPLORATION -y I-EXPLORATION -ANCA. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -CFV I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -aplanamiento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -flujos I-EXPLORATION -inspiratorio I-EXPLORATION -y I-EXPLORATION -espiratorio, I-EXPLORATION -descripto I-EXPLORATION -como I-EXPLORATION -curva I-EXPLORATION -cajón. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -laringe I-EXPLORATION -y I-EXPLORATION -tráquea I-EXPLORATION -mostró I-EXPLORATION -ESG I-EXPLORATION -con I-EXPLORATION -indemnidad I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -anillos I-EXPLORATION -traqueales. I-EXPLORATION -La I-EXPLORATION -fibrobroncoscopía I-EXPLORATION -mostró I-EXPLORATION -indemnidad I-EXPLORATION -de I-EXPLORATION -cuerdas I-EXPLORATION -vocales I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -sub-glótico I-EXPLORATION -mucosa I-EXPLORATION -friable I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -granulomas I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -actividad I-EXPLORATION -local I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -mm. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -encontrarse I-EXPLORATION -con I-EXPLORATION -altas I-EXPLORATION -dosis I-EXPLORATION -de I-EXPLORATION -inmunosupresores, I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -intercurrencia I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -ESG, I-EXPLORATION -siendo I-EXPLORATION -dificultoso I-EXPLORATION -diferenciar, I-EXPLORATION -si I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -recaída I-EXPLORATION -o I-EXPLORATION -la I-EXPLORATION -cicatrización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -prexistente. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -duda I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tres I-TREATMENT -pulsos I-TREATMENT -de I-TREATMENT -solumedrol I-TREATMENT -de I-TREATMENT -un I-TREATMENT -gramo I-TREATMENT -e I-TREATMENT -inició I-TREATMENT -plasmáferesis I-TREATMENT -con I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -remover I-TREATMENT -complejos I-TREATMENT -antígeno-anticuerpo. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -analítica I-TREATMENT -tuvo I-TREATMENT -recuento I-TREATMENT -de I-TREATMENT -CD20 I-TREATMENT -normales I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -4 I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -rituximab I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -375 I-TREATMENT -mg/m2/semana I-TREATMENT -durante I-TREATMENT -4 I-TREATMENT -semanas I-TREATMENT -con I-TREATMENT -excelente I-TREATMENT -tolerancia. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -broncoscopia I-TREATMENT -rígida I-TREATMENT -terapéutica I-TREATMENT -(con I-TREATMENT -dilatación I-TREATMENT -y I-TREATMENT -electrocauterio). I-TREATMENT -Normalizó B-EVOLUTION -la I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -espirometría I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -a I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -del I-EVOLUTION -evento. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -multípara B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -5, I-PAST_MEDICAL_HISTORY -IMC I-PAST_MEDICAL_HISTORY -25, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -kg/m2, I-PAST_MEDICAL_HISTORY -puérpera I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -(parto I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -institución), I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -levotiroxina I-PAST_MEDICAL_HISTORY -75 I-PAST_MEDICAL_HISTORY -mcg/día. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Santiago I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -opresivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -súbito I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -máxima I-PRESENT_ILLNESS -intensidad. I-PRESENT_ILLNESS -Ingresa B-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -hemodinámico, I-EXPLORATION -afebril, I-EXPLORATION -con I-EXPLORATION -examen I-EXPLORATION -cardiopulmonar I-EXPLORATION -normal. I-EXPLORATION -Electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION -muestra I-EXPLORATION -infradesnivel I-EXPLORATION -del I-EXPLORATION -ST I-EXPLORATION -difuso. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -manejo I-TREATMENT -médico I-TREATMENT -con I-TREATMENT -aspirina, I-TREATMENT -morfina I-TREATMENT -y I-TREATMENT -nitroglicerina I-TREATMENT -sublingual; I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -solicitan I-EXPLORATION -enzimas I-EXPLORATION -cardíacas I-EXPLORATION -y I-EXPLORATION -dímero I-EXPLORATION -D. I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -evidencian: I-EXPLORATION -hemoglobina I-EXPLORATION -14, I-EXPLORATION -9 I-EXPLORATION -g/dL, I-EXPLORATION -hematocrito I-EXPLORATION -43, I-EXPLORATION -7%, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -288.000/uL, I-EXPLORATION -eosinóflos I-EXPLORATION -2, I-EXPLORATION -9%, I-EXPLORATION -VHS I-EXPLORATION -17 I-EXPLORATION -mm/h, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -43 I-EXPLORATION -mg/dL, I-EXPLORATION -troponina I-EXPLORATION -0, I-EXPLORATION -45 I-EXPLORATION -ng/ml, I-EXPLORATION -creatincinasa I-EXPLORATION -(CK) I-EXPLORATION -72 I-EXPLORATION -U/L, I-EXPLORATION -Ck-mb I-EXPLORATION -2, I-EXPLORATION -8 I-EXPLORATION -U/L; I-EXPLORATION -dímero I-EXPLORATION -D I-EXPLORATION -554 I-EXPLORATION -ng/ml. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicita I-EXPLORATION -AngioTAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -dímero I-EXPLORATION -D I-EXPLORATION -elevado, I-EXPLORATION -que I-EXPLORATION -descarta I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar. I-EXPLORATION - I-EXPLORATION -Persiste I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -y I-EXPLORATION -ECG I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -evidencia I-EXPLORATION -QS I-EXPLORATION -en I-EXPLORATION -AVL, I-EXPLORATION -qR I-EXPLORATION -en I-EXPLORATION -DI I-EXPLORATION -y I-EXPLORATION -cambios I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -amplitud I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -R I-EXPLORATION -en I-EXPLORATION -V4-V6. I-EXPLORATION -Enzimas I-EXPLORATION -cardiacas I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -con I-EXPLORATION -troponina I-EXPLORATION -> I-EXPLORATION -50 I-EXPLORATION -ng/ml, I-EXPLORATION -CK I-EXPLORATION -3.800 I-EXPLORATION -U/L I-EXPLORATION -y I-EXPLORATION -Ck-mb I-EXPLORATION -> I-EXPLORATION -300 I-EXPLORATION -U/L. I-EXPLORATION -Coronariografía I-EXPLORATION -muestra I-EXPLORATION -disección I-EXPLORATION -de I-EXPLORATION -tronco I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -coronaria I-EXPLORATION -izquierda, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -circunfleja I-EXPLORATION -(Cx) I-EXPLORATION -proximal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -rama I-EXPLORATION -marginal I-EXPLORATION -pequeña. I-EXPLORATION -Arteria I-EXPLORATION -descendente I-EXPLORATION -anterior I-EXPLORATION -(ADA) I-EXPLORATION -y I-EXPLORATION -coronaria I-EXPLORATION -derecha I-EXPLORATION -sin I-EXPLORATION -lesiones. I-EXPLORATION -Se B-TREATMENT -instala I-TREATMENT -balón I-TREATMENT -de I-TREATMENT -contrapulsación I-TREATMENT -aórtica I-TREATMENT -y I-TREATMENT -se I-TREATMENT -traslada I-TREATMENT -a I-TREATMENT -cirugía, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -bypass I-TREATMENT -con I-TREATMENT -arteria I-TREATMENT -mamaria I-TREATMENT -interna I-TREATMENT -(LIMA) I-TREATMENT -a I-TREATMENT -ADA I-TREATMENT -y I-TREATMENT -puente I-TREATMENT -safeno I-TREATMENT -a I-TREATMENT -lateral I-TREATMENT -Cx, I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT - I-TREATMENT -Evoluciona B-EVOLUTION -favorablemente I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -post I-EVOLUTION -operatorio, I-EVOLUTION -con B-TREATMENT -retiro I-TREATMENT -de I-TREATMENT -drogas I-TREATMENT -vasoactivas I-TREATMENT -y I-TREATMENT -balón I-TREATMENT -de I-TREATMENT -contrapulsación I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h. I-TREATMENT - I-TREATMENT -Ecocardiograma B-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -con I-EXPLORATION -acinesia I-EXPLORATION -no I-EXPLORATION -adelgazada I-EXPLORATION -anterolateral I-EXPLORATION -con I-EXPLORATION -fracción I-EXPLORATION -de I-EXPLORATION -eyección I-EXPLORATION -de I-EXPLORATION -42%. I-EXPLORATION -Se B-TREATMENT -optimiza I-TREATMENT -control I-TREATMENT -farmacológico I-TREATMENT -de I-TREATMENT -insuficiencia I-TREATMENT -cardíaca I-TREATMENT -con I-TREATMENT -bisoprolol I-TREATMENT -1, I-TREATMENT -25 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -espironolactona I-TREATMENT -25 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -enalapril I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -atorvastatina I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Se B-DERIVED_FROM/TO -traslada I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -quinto I-DERIVED_FROM/TO -día I-DERIVED_FROM/TO -post I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -motivos I-DERIVED_FROM/TO -previsionales. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Se B-EVOLUTION -controla I-EVOLUTION -en I-EVOLUTION -policlínico I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta, I-EVOLUTION -encontrándose I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -asintomática, I-EVOLUTION -sin I-EVOLUTION -angina, I-EVOLUTION -en I-EVOLUTION -capacidad I-EVOLUTION -funcional I-EVOLUTION -I, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -ya I-EVOLUTION -descrito, I-EVOLUTION -sin I-EVOLUTION -lactancia I-EVOLUTION -materna. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -intensas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -impedían I-PRESENT_ILLNESS -deambular. I-PRESENT_ILLNESS -Destacaba B-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -T4 I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mcg/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bypass I-PAST_MEDICAL_HISTORY -intestinal I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -adelgazamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -70 I-PAST_MEDICAL_HISTORY -Kg I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -entonces. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -deposiciones I-PAST_MEDICAL_HISTORY -pastosas I-PAST_MEDICAL_HISTORY -diarias. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -vigil, I-EXPLORATION -eupneica I-EXPLORATION -y I-EXPLORATION -apirética. I-EXPLORATION -Presentaba I-EXPLORATION -adelgazamiento I-EXPLORATION -con I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -(IMC) I-EXPLORATION -de I-EXPLORATION -19. I-EXPLORATION -Tenía I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -hidratación I-EXPLORATION -y I-EXPLORATION -sus I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -(TA) I-EXPLORATION -eran I-EXPLORATION -120/70 I-EXPLORATION -mmHg. I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION -neuromuscular I-EXPLORATION -mostró I-EXPLORATION -hipotonía I-EXPLORATION -generalizada, I-EXPLORATION -paresia I-EXPLORATION -de I-EXPLORATION -cuatro I-EXPLORATION -miembros I-EXPLORATION -sin I-EXPLORATION -fasciculaciones I-EXPLORATION -y I-EXPLORATION -reflejos I-EXPLORATION -osteotendinosos I-EXPLORATION -presentes. I-EXPLORATION -Presentaba I-EXPLORATION -un I-EXPLORATION -potasio I-EXPLORATION -plasmático I-EXPLORATION -(K+pl) I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -1 I-EXPLORATION -mEq/L I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -CK. I-EXPLORATION -La I-EXPLORATION -dosificación I-EXPLORATION -de I-EXPLORATION -TSH I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -inició I-EXPLORATION -reposición I-EXPLORATION -hidroelectrolítica I-EXPLORATION -con I-EXPLORATION -mejoría I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paresia I-EXPLORATION -muscular, I-EXPLORATION -disminución I-EXPLORATION -progresiva I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mialgias I-EXPLORATION -y I-EXPLORATION -normalización I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -K+pl I-EXPLORATION -y I-EXPLORATION -CK. I-EXPLORATION -La I-EXPLORATION -hipopotasemia I-EXPLORATION -se I-EXPLORATION -atribuyó I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -pérdidas I-EXPLORATION -de I-EXPLORATION -origen I-EXPLORATION -digestivo, I-EXPLORATION -secundarias I-EXPLORATION -al I-EXPLORATION -procedimiento I-EXPLORATION -quirúrgico. I-EXPLORATION -Si I-EXPLORATION -bien I-EXPLORATION -la I-EXPLORATION -severidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -puede I-EXPLORATION -ser I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -manifestaciones I-EXPLORATION -neuromusculares, I-EXPLORATION -el I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -niveles I-EXPLORATION -elevados I-EXPLORATION -de I-EXPLORATION -CK I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -RM I-EXPLORATION -asociada. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -paresia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -distal I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -instalación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -Destacaba B-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -hipertensa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril, I-PAST_MEDICAL_HISTORY -atenolol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -furosemida. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -hipopotasemia I-PAST_MEDICAL_HISTORY -asintomática I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -indicó I-PAST_MEDICAL_HISTORY -suplemento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -potasio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -Presentaba B-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -apirética I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -TA I-EXPLORATION -de I-EXPLORATION -150/90 I-EXPLORATION -mmHg. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -valoración I-EXPLORATION -neuromuscular I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -cuadriparesia I-EXPLORATION -a I-EXPLORATION -predominio I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -con I-EXPLORATION -reflejos I-EXPLORATION -osteotendinosos I-EXPLORATION -conservados. I-EXPLORATION -El I-EXPLORATION -K+pl I-EXPLORATION -era I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -mEq/L, I-EXPLORATION -con I-EXPLORATION -potasiuria I-EXPLORATION -en I-EXPLORATION -muestra I-EXPLORATION -aislada I-EXPLORATION -de I-EXPLORATION -26, I-EXPLORATION -7 I-EXPLORATION -mEq/L I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -CK. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -diurético I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -reposición I-TREATMENT -hidroelectrolítica I-TREATMENT -obteniéndose B-EVOLUTION -una I-EVOLUTION -rápida I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -K+pl I-EVOLUTION -y I-EVOLUTION -CK. I-EVOLUTION -En B-EXPLORATION -este I-EXPLORATION -caso, I-EXPLORATION -a I-EXPLORATION -diferencia I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -anteriores, I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hipopotasemia I-EXPLORATION -fueron I-EXPLORATION -las I-EXPLORATION -pérdidas I-EXPLORATION -renales I-EXPLORATION -de I-EXPLORATION -potasio, I-EXPLORATION -secundarias I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -diuréticos I-EXPLORATION -de I-EXPLORATION -asa. I-EXPLORATION -El I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -26, I-EXPLORATION -7 I-EXPLORATION -mEq/L I-EXPLORATION -de I-EXPLORATION -potasiuria I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -aislada, I-EXPLORATION -es I-EXPLORATION -concordante I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -renal I-EXPLORATION -del I-EXPLORATION -disturbio. I-EXPLORATION - I-EXPLORATION - -Mujer, B-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Cinco B-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -trató I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cáncer I-PAST_MEDICAL_HISTORY -cervicouterino. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -rutinario, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -hidronefrosis I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -atrofia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -riñón I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Se B-TREATMENT -instalaron I-TREATMENT -catéteres I-TREATMENT -ureterales I-TREATMENT -y I-TREATMENT -se I-TREATMENT -intentó I-TREATMENT -infructuosamente I-TREATMENT -efectuar I-TREATMENT -ureterolisis. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -retroperitoneal I-EXPLORATION -reveló I-EXPLORATION -FRP I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -tumor. I-EXPLORATION -Se B-TREATMENT -prescribió I-TREATMENT -defazacort I-TREATMENT -30 I-TREATMENT -mg/día I-TREATMENT -y I-TREATMENT -colchicina I-TREATMENT -1, I-TREATMENT -0 I-TREATMENT -mg/día. I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -la I-EVOLUTION -masa I-EVOLUTION -retroperitoneal I-EVOLUTION -había I-EVOLUTION -desaparecido I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -era I-EVOLUTION -normal. I-EVOLUTION -A I-EVOLUTION -16 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -FRP, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -cáncer. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -IC I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -2008 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -VI I-PAST_MEDICAL_HISTORY -(FE I-PAST_MEDICAL_HISTORY -35%) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ecocardiograma. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -coronariografía I-PRESENT_ILLNESS -demostró I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -vasos, I-PRESENT_ILLNESS -realizándose I-PRESENT_ILLNESS -angioplastía I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -arteria I-PRESENT_ILLNESS -descendente I-PRESENT_ILLNESS -anterior. I-PRESENT_ILLNESS -En B-EXPLORATION -enero I-EXPLORATION -de I-EXPLORATION -2013 I-EXPLORATION -se I-EXPLORATION -hospitalizó I-EXPLORATION -con I-EXPLORATION -IC I-EXPLORATION -descompensada, I-EXPLORATION -con I-EXPLORATION -FE I-EXPLORATION -20% I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ecocardiograma. I-EXPLORATION -Un I-EXPLORATION -SPECT I-EXPLORATION -miocàrdico I-EXPLORATION -descartó I-EXPLORATION -isquemia. I-EXPLORATION -En B-EVOLUTION -julio I-EVOLUTION -de I-EVOLUTION -2013 I-EVOLUTION -se I-EVOLUTION -re-hospitalizó, I-EVOLUTION -en I-EVOLUTION -CF I-EVOLUTION -IV, I-EVOLUTION -compensándose B-TREATMENT -con I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -levosimendan I-TREATMENT -0, I-TREATMENT -1 I-TREATMENT -mg/kg/min. I-TREATMENT -En I-TREATMENT -agosto I-TREATMENT -de I-TREATMENT -2013, I-TREATMENT -por I-TREATMENT -la I-TREATMENT -severa I-TREATMENT -disfunción I-TREATMENT -ventricular I-TREATMENT -y I-TREATMENT -escasa I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -trasplante, I-TREATMENT -se I-TREATMENT -implantó I-TREATMENT -un I-TREATMENT -HVAD I-TREATMENT -con I-TREATMENT -técnica I-TREATMENT -mínimamente I-TREATMENT -invasiva. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -post I-EVOLUTION -operatoria I-EVOLUTION -ocurrió I-EVOLUTION -sin I-EVOLUTION -incidentes, I-EVOLUTION -alcanzando I-EVOLUTION -un I-EVOLUTION -índice I-EVOLUTION -cardiaco I-EVOLUTION -de I-EVOLUTION -2, I-EVOLUTION -5 I-EVOLUTION -L/m2 I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -post-implante. I-EVOLUTION -Egresó I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -post-cirugía, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -9 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -permanece I-EVOLUTION -en I-EVOLUTION -CF I-EVOLUTION -I. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mesenquimopatía I-PAST_MEDICAL_HISTORY -indiferenciada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -nariz I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -silla I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -montar, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -condritis. I-PAST_MEDICAL_HISTORY -Anticuerpos I-PAST_MEDICAL_HISTORY -antinucleares I-PAST_MEDICAL_HISTORY -(ANA) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti-Ro I-PAST_MEDICAL_HISTORY -+. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -alopecia, I-PRESENT_ILLNESS -artritis, I-PRESENT_ILLNESS -úlceras I-PRESENT_ILLNESS -orales I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -nasales. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -soplo I-EXPLORATION -aórtico I-EXPLORATION -sistólico I-EXPLORATION -V/VI I-EXPLORATION -irradiado I-EXPLORATION -al I-EXPLORATION -cuello. I-EXPLORATION -Tenía I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -eritrosedimentación I-EXPLORATION -(VHS) I-EXPLORATION -64 I-EXPLORATION -mm/h, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -5 I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -10 I-EXPLORATION -mg/L), I-EXPLORATION -creatininemia I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -mg/dl, I-EXPLORATION -ANA I-EXPLORATION -1/160 I-EXPLORATION -moteado, I-EXPLORATION -anti-Ro I-EXPLORATION -22, I-EXPLORATION -5 I-EXPLORATION -U I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -15), I-EXPLORATION -anti-B2 I-EXPLORATION -glicoproteína I-EXPLORATION -1 I-EXPLORATION -IgM I-EXPLORATION -31, I-EXPLORATION -2 I-EXPLORATION -MPL I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -8) I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -17 I-EXPLORATION -GPL I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -8), I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -normal. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -aceleración I-EXPLORATION -del I-EXPLORATION -flujo I-EXPLORATION -de I-EXPLORATION -aorta I-EXPLORATION -torácica I-EXPLORATION -y I-EXPLORATION -vasos I-EXPLORATION -del I-EXPLORATION -cuello. I-EXPLORATION -aTAC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -cuello I-EXPLORATION -y I-EXPLORATION -cerebral: I-EXPLORATION -engrosamiento I-EXPLORATION -segmentario I-EXPLORATION -y I-EXPLORATION -realce I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -aórtica I-EXPLORATION -y I-EXPLORATION -sus I-EXPLORATION -ramas I-EXPLORATION -principales, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -estenosis I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -alternadas. I-EXPLORATION -Estenosis I-EXPLORATION -moderada I-EXPLORATION -de I-EXPLORATION -carótida I-EXPLORATION -derecha, I-EXPLORATION -origen I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -celíaco I-EXPLORATION -y I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -superior. I-EXPLORATION -Vasos I-EXPLORATION -cerebrales I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -corticoides, I-TREATMENT -hidroxicloroquina I-TREATMENT -y I-TREATMENT -6 I-TREATMENT -pulsos I-TREATMENT -de I-TREATMENT -ciclofosfamida, I-TREATMENT -luego I-TREATMENT -azatioprina I-TREATMENT -y I-TREATMENT -prednisona. I-TREATMENT -El B-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -demostró I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -inflamación I-EVOLUTION -de I-EVOLUTION -aorta I-EVOLUTION -abdominal, I-EVOLUTION -tronco I-EVOLUTION -celíaco I-EVOLUTION -y I-EVOLUTION -arteria I-EVOLUTION -mesentérica I-EVOLUTION -superior, I-EVOLUTION -estenosis I-EVOLUTION -de I-EVOLUTION -50% I-EVOLUTION -del I-EVOLUTION -origen I-EVOLUTION -del I-EVOLUTION -tronco I-EVOLUTION -celíaco I-EVOLUTION -con I-EVOLUTION -dilatación I-EVOLUTION -post I-EVOLUTION -estenótica I-EVOLUTION -y I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios. I-EVOLUTION -A I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -exámenes I-EVOLUTION -normales. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumador B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -cigarrillos/día I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -adolescencia, I-PAST_MEDICAL_HISTORY -hospitalizado B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síncope I-PRESENT_ILLNESS -recurrente. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso, I-EXPLORATION -se I-EXPLORATION -registró I-EXPLORATION -TV I-EXPLORATION -monoforma I-EXPLORATION -con I-EXPLORATION -frecuencia I-EXPLORATION -de I-EXPLORATION -233 I-EXPLORATION -lpm I-EXPLORATION -en I-EXPLORATION -trazado I-EXPLORATION -de I-EXPLORATION -monitor, I-EXPLORATION -que I-EXPLORATION -convirtió I-EXPLORATION -espontáneamente I-EXPLORATION -a I-EXPLORATION -ritmo I-EXPLORATION -sinusal. I-EXPLORATION -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -consumidor I-PAST_MEDICAL_HISTORY -ocasional I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso. I-PAST_MEDICAL_HISTORY -Negó B-PRESENT_ILLNESS -tener I-PRESENT_ILLNESS -angina I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -ECG I-EXPLORATION -post-conversión I-EXPLORATION -a I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -(-) I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION -precordiales I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -inferior. I-EXPLORATION -La I-EXPLORATION -troponina I-EXPLORATION -I I-EXPLORATION -alcanzó I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -máximo I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -ng/ml I-EXPLORATION -[VN I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -4 I-EXPLORATION -ng/ml]. I-EXPLORATION -Un I-EXPLORATION -ecocardiograma I-EXPLORATION -reveló I-EXPLORATION -leve I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -diámetros I-EXPLORATION -internos I-EXPLORATION -del I-EXPLORATION -VI, I-EXPLORATION -disquinesia I-EXPLORATION -apical I-EXPLORATION -y I-EXPLORATION -lateroapical I-EXPLORATION -con I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -global I-EXPLORATION -levemente I-EXPLORATION -disminuida I-EXPLORATION -[FE I-EXPLORATION -45%, I-EXPLORATION -Simpson]. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -anormalidades. I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -presuntivo I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -coronaria, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -angiográfico I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -arterias I-EXPLORATION -coronarias I-EXPLORATION -normales. I-EXPLORATION -Para I-EXPLORATION -avanzar I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -diagnóstico, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -RC. I-EXPLORATION -Las I-EXPLORATION -imágenes I-EXPLORATION -con I-EXPLORATION -secuencias I-EXPLORATION -de I-EXPLORATION -eco-gradiente I-EXPLORATION -en I-EXPLORATION -4-cavidades I-EXPLORATION -y I-EXPLORATION -eje I-EXPLORATION -corto, I-EXPLORATION -mostraron I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -[VDVD/ASC I-EXPLORATION -122/m2] I-EXPLORATION -con I-EXPLORATION -acentuada I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -espesor I-EXPLORATION -parietal I-EXPLORATION -especialmente I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -lateral, I-EXPLORATION -microaneurismas I-EXPLORATION -(flechas I-EXPLORATION -amarillas), I-EXPLORATION -disquinesia I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -basal I-EXPLORATION -e I-EXPLORATION -inferior I-EXPLORATION -(flechas I-EXPLORATION -azules) I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -global I-EXPLORATION -severamente I-EXPLORATION -disminuida I-EXPLORATION -(FE I-EXPLORATION -19%). I-EXPLORATION -Al I-EXPLORATION -mismo I-EXPLORATION -tiempo, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -leve I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -diámetros I-EXPLORATION -internos I-EXPLORATION -del I-EXPLORATION -VI I-EXPLORATION -con I-EXPLORATION -moderada I-EXPLORATION -diminución I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -global I-EXPLORATION -(FE I-EXPLORATION -38%), I-EXPLORATION -dos I-EXPLORATION -zonas I-EXPLORATION -con I-EXPLORATION -disquinesia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -apical I-EXPLORATION -con I-EXPLORATION -adelgazamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -miocárdica I-EXPLORATION -(flechas I-EXPLORATION -azules) I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -aquinesia I-EXPLORATION -con I-EXPLORATION -miocardio I-EXPLORATION -adelgazado I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -(flecha I-EXPLORATION -roja) I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -grasa I-EXPLORATION -adyacente I-EXPLORATION -(flecha I-EXPLORATION -verde). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -axial I-EXPLORATION -potenciada I-EXPLORATION -en I-EXPLORATION -T1, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -infiltración I-EXPLORATION -grasa I-EXPLORATION -subepicárdica I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -del I-EXPLORATION -VD, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -y I-EXPLORATION -ápex I-EXPLORATION -del I-EXPLORATION -VI I-EXPLORATION -(flechas I-EXPLORATION -verdes). I-EXPLORATION -A I-EXPLORATION -su I-EXPLORATION -vez, I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -4-cavidades I-EXPLORATION -con I-EXPLORATION -secuencias I-EXPLORATION -de I-EXPLORATION -inversión-recuperación I-EXPLORATION -para I-EXPLORATION -evaluar I-EXPLORATION -viabilidad, I-EXPLORATION -luego I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -gadolinio I-EXPLORATION -endovenoso, I-EXPLORATION -mostró I-EXPLORATION -extensa I-EXPLORATION -área I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -(realce I-EXPLORATION -tardío) I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -y I-EXPLORATION -región I-EXPLORATION -subtricuspídea I-EXPLORATION -(flechas I-EXPLORATION -naranjas). I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -descritos I-EXPLORATION -son I-EXPLORATION -diagnósticos I-EXPLORATION -para I-EXPLORATION -DAVD I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -VI, I-EXPLORATION -en I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tres I-EXPLORATION -criterios I-EXPLORATION -diagnósticos I-EXPLORATION -mayores: I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -invertidas I-EXPLORATION -en I-EXPLORATION -derivaciones I-EXPLORATION -precordiales I-EXPLORATION -derechas I-EXPLORATION -(V1 I-EXPLORATION -a I-EXPLORATION -V6) I-EXPLORATION -en I-EXPLORATION -individuo I-EXPLORATION -> I-EXPLORATION -14 I-EXPLORATION -años I-EXPLORATION -sin I-EXPLORATION -bloqueo I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -derecho, I-EXPLORATION -disquinesia I-EXPLORATION -regionales I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -más I-EXPLORATION -cociente I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -telediastólico I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -> I-EXPLORATION -110 I-EXPLORATION -ml/m2 I-EXPLORATION -(varones); I-EXPLORATION -TV I-EXPLORATION -documentada. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -incluyó I-TREATMENT -la I-TREATMENT -implantación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -CDI. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -coronaria, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -uropatía I-PAST_MEDICAL_HISTORY -obstructiva, I-PAST_MEDICAL_HISTORY -portador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cistostomía I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -fue B-PRESENT_ILLNESS -hospitalizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -medicina I-PRESENT_ILLNESS -interna I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cambio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -catéter I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemodiálisis, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -catéter I-PRESENT_ILLNESS -disfuncional; I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -llamó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cistostomía I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -estado, I-PRESENT_ILLNESS -objetivándose I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -orina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -color I-PRESENT_ILLNESS -púrpura I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -bolsa I-PRESENT_ILLNESS -colectora. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Dentro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -medicamentos I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -usaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -crónica, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -destacó I-PRESENT_ILLNESS -ninguno I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -pudiese I-PRESENT_ILLNESS -relacionarse I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cambio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -coloración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -orina. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -buenas I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -afebril, I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable, I-EXPLORATION -con I-EXPLORATION -cistostomía I-EXPLORATION -in I-EXPLORATION -situ, I-EXPLORATION -funcionante, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -deficiente I-EXPLORATION -autocuidado, I-EXPLORATION -sucia I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -muy I-EXPLORATION -mal I-EXPLORATION -olor. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -sedimento I-EXPLORATION -urinario I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -leucocitos I-EXPLORATION -5-10 I-EXPLORATION -x I-EXPLORATION -campo I-EXPLORATION -[valor I-EXPLORATION -normal I-EXPLORATION -(VN): I-EXPLORATION -1-5], I-EXPLORATION -abundantes I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -fosfatos I-EXPLORATION -amorfos I-EXPLORATION -abundantes I-EXPLORATION -x I-EXPLORATION -campo. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -completo I-EXPLORATION -destacó I-EXPLORATION -el I-EXPLORATION -color I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -turbio, I-EXPLORATION -pH I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -8 I-EXPLORATION -[VN: I-EXPLORATION -4, I-EXPLORATION -5-8, I-EXPLORATION -0] I-EXPLORATION -y I-EXPLORATION -nitritos I-EXPLORATION -positivos. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -urocultivo I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -un I-EXPLORATION -recuento I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -100.000 I-EXPLORATION -UFC/ml I-EXPLORATION -de I-EXPLORATION -Citrobacter I-EXPLORATION -freundii I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -cefadroxilo, I-EXPLORATION -ciprofloxacino I-EXPLORATION -y I-EXPLORATION -nitrofurantoína. I-EXPLORATION -Entre I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -sangre, I-EXPLORATION -destacó I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -10.600 I-EXPLORATION -x I-EXPLORATION -mm3 I-EXPLORATION -[VN: I-EXPLORATION -4.000-9.000], I-EXPLORATION -una I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -34 I-EXPLORATION -mg/dL I-EXPLORATION -[VN: I-EXPLORATION -0-5] I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -VHS I-EXPLORATION -de I-EXPLORATION -54 I-EXPLORATION -mm/h I-EXPLORATION -[VN: I-EXPLORATION -2-10]. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -prostática, I-EXPLORATION -procedimiento I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -técnicamente I-EXPLORATION -limitado I-EXPLORATION -por I-EXPLORATION -parcial I-EXPLORATION -distensión I-EXPLORATION -vesical, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -volumen I-EXPLORATION -al I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -26 I-EXPLORATION -cc, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -evaluar I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -prostática. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -2 I-TREATMENT -g/día I-TREATMENT -endovenoso I-TREATMENT -y I-TREATMENT -se I-TREATMENT -solicitó I-TREATMENT -evaluación I-TREATMENT -por I-TREATMENT -urología, I-TREATMENT -quienes I-TREATMENT -decidieron I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -recambio I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cistostomía, I-TREATMENT -en I-TREATMENT -contexto I-TREATMENT -de I-TREATMENT -la I-TREATMENT -infección I-TREATMENT -urinaria I-TREATMENT -y I-TREATMENT -el I-TREATMENT -aspecto I-TREATMENT -mal I-TREATMENT -cuidado I-TREATMENT -de I-TREATMENT -ésta. I-TREATMENT - I-TREATMENT -Con B-EVOLUTION -el I-EVOLUTION -transcurso I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -días, I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -un I-EVOLUTION -aclaramiento I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -color I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -orina, I-EVOLUTION -retornando I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -color I-EVOLUTION -natural I-EVOLUTION -tras I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -antibioterapia. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -chofer, B-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -pantorrilla I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -poplítea I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -metros I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -marcha. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -claudicación I-PAST_MEDICAL_HISTORY -intermitente. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destaca I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -temperatura I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -pierna I-EXPLORATION -y I-EXPLORATION -pie I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -poplíteo I-EXPLORATION -y I-EXPLORATION -distal I-EXPLORATION -en I-EXPLORATION -esa I-EXPLORATION -extremidad. I-EXPLORATION -En I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION -derecha I-EXPLORATION -pulsos I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -vascular I-EXPLORATION -no I-EXPLORATION -invasivo I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -de I-EXPLORATION -obliteración I-EXPLORATION -femoro-poplítea I-EXPLORATION -izquierda, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -hospitaliza I-EXPLORATION -para I-EXPLORATION -angiografía. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -estudio I-EXPLORATION -angiográfico I-EXPLORATION -; I-EXPLORATION -observándose I-EXPLORATION -en I-EXPLORATION -arteria I-EXPLORATION -poplítea I-EXPLORATION -izquierda I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -largo, I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -hasta I-EXPLORATION -93%, I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -lisa, I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -compresión I-EXPLORATION -extrínseca. I-EXPLORATION -Resto I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -arterial I-EXPLORATION -sano, I-EXPLORATION -sin I-EXPLORATION -imágenes I-EXPLORATION -endoluminales. I-EXPLORATION - I-EXPLORATION -Llama B-EVOLUTION -la I-EVOLUTION -atención I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -pulso I-EVOLUTION -poplíteo I-EVOLUTION -y I-EVOLUTION -distal I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -afectada I-EVOLUTION -al I-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -del I-EVOLUTION -estudio. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -post I-EVOLUTION -angiografía I-EVOLUTION -se I-EVOLUTION -indica I-EVOLUTION -marcha I-EVOLUTION -al I-EVOLUTION -paciente, I-EVOLUTION -reproduciendo I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -pantorrilla I-EVOLUTION -izquierda. I-EVOLUTION -Examinado B-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -se I-EXPLORATION -pesquisa I-EXPLORATION -nuevamente I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -poplíteo I-EXPLORATION -y I-EXPLORATION -distal. I-EXPLORATION -Estudio I-EXPLORATION -no I-EXPLORATION -invasivo I-EXPLORATION -PVR I-EXPLORATION -(registro I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -pulsos) I-EXPLORATION -y I-EXPLORATION -PPG I-EXPLORATION -muestra I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -morfología I-EXPLORATION -de I-EXPLORATION -curvas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -poplítea I-EXPLORATION -a I-EXPLORATION -distal I-EXPLORATION -con I-EXPLORATION -PPG I-EXPLORATION -plano I-EXPLORATION -en I-EXPLORATION -ortejos.. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -hipótesis I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -atrapamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -poplítea I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -muestra I-EXPLORATION -compresión I-EXPLORATION -extrínseca I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -por I-EXPLORATION -estructura I-EXPLORATION -alguna, I-EXPLORATION -destacando I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -pared I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -hiperintensa I-EXPLORATION -en I-EXPLORATION -secuencia I-EXPLORATION -T1que I-EXPLORATION -determina I-EXPLORATION -estenosis I-EXPLORATION -y I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -hematoma. I-EXPLORATION -Estudio I-EXPLORATION -con I-EXPLORATION -angiografía I-EXPLORATION -por I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -(AngioTC I-EXPLORATION -de I-EXPLORATION -EEII) I-EXPLORATION -muestra I-EXPLORATION -en I-EXPLORATION -arteria I-EXPLORATION -poplítea I-EXPLORATION -izquierda, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -estenosis, I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -baja I-EXPLORATION -densidad I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -pared, I-EXPLORATION -sin I-EXPLORATION -realce I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -contraste I-EXPLORATION -endovenoso, I-EXPLORATION -que I-EXPLORATION -hace I-EXPLORATION -plantear I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -degeneración I-EXPLORATION -quística I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -poplítea. I-EXPLORATION - I-EXPLORATION -Intervenido B-TREATMENT -quirúrgicamente I-TREATMENT -mediante I-TREATMENT -abordaje I-TREATMENT -posterior, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -puente I-TREATMENT -poplíteo I-TREATMENT -con I-TREATMENT -vena I-TREATMENT -safena I-TREATMENT -invertida, I-TREATMENT -resecando I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -poplítea I-TREATMENT -en I-TREATMENT -su I-TREATMENT -tercio I-TREATMENT -medio, I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -aprecia I-TREATMENT -de I-TREATMENT -coloración I-TREATMENT -violácea I-TREATMENT -y I-TREATMENT -contorno I-TREATMENT -irregular. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -enviada I-EXPLORATION -a I-EXPLORATION -biopsia I-EXPLORATION -concluye I-EXPLORATION -“degeneración I-EXPLORATION -quística I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -media”. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -con I-EVOLUTION -pulsos I-EVOLUTION -conservados I-EVOLUTION -y I-EVOLUTION -simétricos I-EVOLUTION -en I-EVOLUTION -ambas I-EVOLUTION -EEII, I-EVOLUTION -sin I-EVOLUTION -claudicación I-EVOLUTION -intermitente I-EVOLUTION -y I-EVOLUTION -pudiendo I-EVOLUTION -reintegrarse I-EVOLUTION -rápidamente I-EVOLUTION -a I-EVOLUTION -sus I-EVOLUTION -labores I-EVOLUTION -habituales. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático, I-EVOLUTION -con I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -y I-EVOLUTION -estudio I-EVOLUTION -vascular I-EVOLUTION -no I-EVOLUTION -invasivo I-EVOLUTION -normal I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -sonarse I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -nariz I-PRESENT_ILLNESS -(maniobra I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Valsalva). I-PRESENT_ILLNESS -Esa I-PRESENT_ILLNESS -misma I-PRESENT_ILLNESS -madrugada I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sufrido I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -altura I-PRESENT_ILLNESS -golpeándose I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -lateral I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -nariz, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -altura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -huesos I-PRESENT_ILLNESS -propios, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -epistaxis I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -autolimitada. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -oftalmológico I-EXPLORATION -reveló I-EXPLORATION -visión I-EXPLORATION -20/20 I-EXPLORATION -en I-EXPLORATION -cada I-EXPLORATION -ojo, I-EXPLORATION -reflejos I-EXPLORATION -pupilares I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -conservada, I-EXPLORATION -sin I-EXPLORATION -edema I-EXPLORATION -ni I-EXPLORATION -hiperemia I-EXPLORATION -conjuntival, I-EXPLORATION -sólo I-EXPLORATION -discreta I-EXPLORATION -equimosis I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -medial I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hemicara I-EXPLORATION -izquierda I-EXPLORATION -acompañada I-EXPLORATION -de I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -palpebral I-EXPLORATION -crepitante I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -El I-EXPLORATION -marco I-EXPLORATION -óseo I-EXPLORATION -orbitario I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -pirámide I-EXPLORATION -nasal I-EXPLORATION -estaban I-EXPLORATION -sin I-EXPLORATION -dolor. I-EXPLORATION -Los I-EXPLORATION -signos I-EXPLORATION -vitales I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -cráneo-facial I-EXPLORATION -corroboró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -y I-EXPLORATION -orbitario, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -fractura I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lámina I-EXPLORATION -papirácea I-EXPLORATION -del I-EXPLORATION -etmoides I-EXPLORATION -ipsilateral. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -y I-EVOLUTION -observado I-EVOLUTION -por I-EVOLUTION -24 I-EVOLUTION -h, I-EVOLUTION -posteriormente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -precaución I-EVOLUTION -de I-EVOLUTION -evitar I-EVOLUTION -maniobras I-EVOLUTION -que I-EVOLUTION -pudieran I-EVOLUTION -aumentar I-EVOLUTION -la I-EVOLUTION -presión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vía I-EVOLUTION -aérea I-EVOLUTION -superior, I-EVOLUTION -durante I-EVOLUTION -dos I-EVOLUTION -semanas. I-EVOLUTION -El I-EVOLUTION -enfisema I-EVOLUTION -se I-EVOLUTION -resolvió I-EVOLUTION -espontáneamente I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -durante I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -siguientes I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -desarrolló I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -caucásico, I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -CUC I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -compatible. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -mesalazina I-PAST_MEDICAL_HISTORY -1.000 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -c/8 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -prednisona I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -decrecientes I-PAST_MEDICAL_HISTORY -(5 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -actividad I-PAST_MEDICAL_HISTORY -inflamatoria I-PAST_MEDICAL_HISTORY -actual. I-PAST_MEDICAL_HISTORY -Tres B-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -intensa I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -agregándose I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -trastorno I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lenguaje. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -fotofobia I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -visuales. I-PRESENT_ILLNESS -No B-EXPLORATION -se I-EXPLORATION -evidenciaba I-EXPLORATION -signología I-EXPLORATION -focal I-EXPLORATION -ni I-EXPLORATION -movimientos I-EXPLORATION -anormales. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -examen, I-EXPLORATION -afebril, I-EXPLORATION -normotenso, I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -98% I-EXPLORATION -ambiental, I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -perfusión. I-EXPLORATION -Ritmo I-EXPLORATION -cardiaco I-EXPLORATION -regular I-EXPLORATION -de I-EXPLORATION -88 I-EXPLORATION -lpm. I-EXPLORATION -Sin I-EXPLORATION -alteraciones I-EXPLORATION -pleuropulmonares. I-EXPLORATION -Abdomen I-EXPLORATION -indoloro. I-EXPLORATION -Neurológicamente I-EXPLORATION -estaba I-EXPLORATION -vigil I-EXPLORATION -pero I-EXPLORATION -confuso, I-EXPLORATION -con I-EXPLORATION -afasia I-EXPLORATION -fluente I-EXPLORATION -y I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -comprensión. I-EXPLORATION -Sin I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -oculomotricidad. I-EXPLORATION -Sector I-EXPLORATION -espinal I-EXPLORATION -y I-EXPLORATION -meníngeo I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -Valoración I-EXPLORATION -general I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -a I-EXPLORATION -destacar. I-EXPLORATION - I-EXPLORATION -Tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -encéfalo I-EXPLORATION -mostró I-EXPLORATION -imagen I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -cortical I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -parenquimatoso I-EXPLORATION -temporo-basal I-EXPLORATION -izquierdo. I-EXPLORATION -Resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -con I-EXPLORATION -angiorresonancia I-EXPLORATION -en I-EXPLORATION -tiempo I-EXPLORATION -venoso I-EXPLORATION -informó I-EXPLORATION -infarto I-EXPLORATION -hemorrágico I-EXPLORATION -temporal I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -vena I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -seno I-EXPLORATION -venoso I-EXPLORATION -sigmoideo I-EXPLORATION -homolateral.. I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -búsqueda I-EXPLORATION -de I-EXPLORATION -trombofilias I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -(proteínas I-EXPLORATION -C, I-EXPLORATION -S, I-EXPLORATION -antitrombina I-EXPLORATION -III, I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -activada, I-EXPLORATION -homocisteinemia, I-EXPLORATION -factor I-EXPLORATION -20210A, I-EXPLORATION -FV I-EXPLORATION -Leiden, I-EXPLORATION -metil I-EXPLORATION -tetra I-EXPLORATION -hidro I-EXPLORATION -folato I-EXPLORATION -reductasa, I-EXPLORATION -lipoproteína I-EXPLORATION -(a), I-EXPLORATION -factor I-EXPLORATION -VIII, I-EXPLORATION -anticuerpos I-EXPLORATION -anticardiolipinas, I-EXPLORATION -anti I-EXPLORATION -beta2 I-EXPLORATION -glicoproteína, I-EXPLORATION -inhibidor I-EXPLORATION -lúpico, I-EXPLORATION -inhibidor I-EXPLORATION -del I-EXPLORATION -activador I-EXPLORATION -tisular I-EXPLORATION -del I-EXPLORATION -plasminógeno). I-EXPLORATION -Todos I-EXPLORATION -fueron I-EXPLORATION -solicitados I-EXPLORATION -posteriormente I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -del I-EXPLORATION -tratamiento I-EXPLORATION -anticoagulante. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -anticoagulación I-TREATMENT -con I-TREATMENT -enoxaparina I-TREATMENT -(1 I-TREATMENT -mg/Kg I-TREATMENT -subcutánea I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h) I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -evolución. I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -CUC I-TREATMENT -con I-TREATMENT -mesalazina I-TREATMENT -y I-TREATMENT -prednisona. I-TREATMENT -Se B-EVOLUTION -otorgó I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -10º I-EVOLUTION -día, I-EVOLUTION -asintomático, I-EVOLUTION -continuando B-TREATMENT -anticoagulación I-TREATMENT -con I-TREATMENT -enoxaparina I-TREATMENT -subcutánea I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -con I-TREATMENT -dicumarínicos I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT - I-TREATMENT - -Paciente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sexo I-PAST_MEDICAL_HISTORY -masculino I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol. I-PAST_MEDICAL_HISTORY -Diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2002 I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -48 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -estudió I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2004, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -PCR I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -VHC I-PAST_MEDICAL_HISTORY -positiva, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -carga I-PAST_MEDICAL_HISTORY -viral I-PAST_MEDICAL_HISTORY -280.998 I-PAST_MEDICAL_HISTORY -UI/ml I-PAST_MEDICAL_HISTORY -(Log I-PAST_MEDICAL_HISTORY -5, I-PAST_MEDICAL_HISTORY -45) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -genotipo I-PAST_MEDICAL_HISTORY -3a. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -Derivado B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -2005 I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -compatibles I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -hepatocarcinoma. I-DERIVED_FROM/TO -Quimioembolización B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -octubre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2005, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -quimioembolizaciones I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alcoholizaciones I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2006 I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -trasplantado. I-PAST_MEDICAL_HISTORY -Post B-TREATMENT -trasplante I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -inmunosupresión I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -y I-TREATMENT -ciclosporina. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -meses I-EVOLUTION -post I-EVOLUTION -trasplante, I-EVOLUTION -con I-EVOLUTION -transaminasas I-EVOLUTION -hasta I-EVOLUTION -12 I-EVOLUTION -veces I-EVOLUTION -el I-EVOLUTION -valor I-EVOLUTION -normal, I-EVOLUTION -se I-EVOLUTION -planteó I-EVOLUTION -rechazo I-EVOLUTION -vs I-EVOLUTION -reactivación I-EVOLUTION -de I-EVOLUTION -VHC. I-EVOLUTION -Se B-TREATMENT -agregó I-TREATMENT -sirolimus. I-TREATMENT -Biopsia B-EXPLORATION -hepática I-EXPLORATION -mostró I-EXPLORATION -esteatosis I-EXPLORATION -y I-EXPLORATION -hepatitis I-EXPLORATION -aguda I-EXPLORATION -leve, I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -de I-EXPLORATION -especificidad. I-EXPLORATION -Carga I-EXPLORATION -viral I-EXPLORATION -3.000.694 I-EXPLORATION -UI/ml I-EXPLORATION -(Log I-EXPLORATION -6, I-EXPLORATION -48). I-EXPLORATION -Persistió B-EVOLUTION -con I-EVOLUTION -transaminasas I-EVOLUTION -1, I-EVOLUTION -5 I-EVOLUTION -a I-EVOLUTION -3 I-EVOLUTION -veces I-EVOLUTION -el I-EVOLUTION -valor I-EVOLUTION -normal. I-EVOLUTION -Debido I-EVOLUTION -a I-EVOLUTION -pancitopenia I-EVOLUTION -se I-EVOLUTION -suspendió I-EVOLUTION -sirolimus. I-EVOLUTION -A B-TREATMENT -los I-TREATMENT -3 I-TREATMENT -años I-TREATMENT -y I-TREATMENT -medio I-TREATMENT -post I-TREATMENT -trasplante I-TREATMENT -se I-TREATMENT -vuelve I-TREATMENT -a I-TREATMENT -plantear I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -VHC I-TREATMENT -con B-EXPLORATION -nueva I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -hepatitis I-EXPLORATION -crónica I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -inflamación I-EXPLORATION -portal I-EXPLORATION -de I-EXPLORATION -interfase I-EXPLORATION -y I-EXPLORATION -lobulillar, I-EXPLORATION -fibrosis I-EXPLORATION -perisinusoideal I-EXPLORATION -leve, I-EXPLORATION -colangitis I-EXPLORATION -linfocítica I-EXPLORATION -focal I-EXPLORATION -y I-EXPLORATION -esteatosis I-EXPLORATION -hepática I-EXPLORATION -mínima. I-EXPLORATION -En B-EVOLUTION -ese I-EVOLUTION -momento I-EVOLUTION -evoluciona I-EVOLUTION -con I-EVOLUTION -colestasia, I-EVOLUTION -que I-EVOLUTION -resulta I-EVOLUTION -ser I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -estenosis I-EVOLUTION -de I-EVOLUTION -anastomosis I-EVOLUTION -biliar. I-EVOLUTION -Se I-EVOLUTION -controló I-EVOLUTION -con I-EVOLUTION -nueva I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -con I-EVOLUTION -355.882 I-EVOLUTION -UI/ml I-EVOLUTION -(Log I-EVOLUTION -5, I-EVOLUTION -55) I-EVOLUTION -en I-EVOLUTION -octubre I-EVOLUTION -de I-EVOLUTION -2010. I-EVOLUTION -Con B-EXPLORATION -intención I-EXPLORATION -de I-EXPLORATION -iniciar I-EXPLORATION -tratamiento I-EXPLORATION -en I-EXPLORATION -marzo I-EXPLORATION -de I-EXPLORATION -2011 I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -nueva I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -negativa; I-EXPLORATION -además I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -PCR I-EXPLORATION -para I-EXPLORATION -VHC, I-EXPLORATION -también I-EXPLORATION -negativa, I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -con I-EXPLORATION -nueva I-EXPLORATION -muestra. I-EXPLORATION -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -perfil I-TREATMENT -hepático I-TREATMENT -normal, I-TREATMENT -recibiendo I-TREATMENT -inmunosupresión I-TREATMENT -con I-TREATMENT -ciclosporina I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Se B-EVOLUTION -interpretó I-EVOLUTION -como I-EVOLUTION -eliminación I-EVOLUTION -espontánea I-EVOLUTION -del I-EVOLUTION -VHC. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -cutáneas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -que, I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -dos, I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -piodermitis, I-PAST_MEDICAL_HISTORY -sarna I-PAST_MEDICAL_HISTORY -corporis, I-PAST_MEDICAL_HISTORY -candidiasis I-PAST_MEDICAL_HISTORY -esofágica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -cuadros I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abscesos I-PAST_MEDICAL_HISTORY -cutáneos I-PAST_MEDICAL_HISTORY -ubicados I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -codo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -dorso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mano I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -deja I-PAST_MEDICAL_HISTORY -secuelas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -movilidad I-PAST_MEDICAL_HISTORY -extensora I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -tendinoso, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dorso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mano I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -escapular I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cultivo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -resultó I-PAST_MEDICAL_HISTORY -positivo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -Staphylococcus I-PAST_MEDICAL_HISTORY -aureus I-PAST_MEDICAL_HISTORY -multisensible. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -glúteo I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -se B-TREATMENT -diagnosticó I-TREATMENT -celulitis I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -clindamicina I-TREATMENT -y I-TREATMENT -cefazolina. I-TREATMENT -Al B-EVOLUTION -séptimo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -presentó I-EVOLUTION -necrosis I-EVOLUTION -distal I-EVOLUTION -del I-EVOLUTION -pulpejo I-EVOLUTION -del I-EVOLUTION -cuarto I-EVOLUTION -dedo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mano I-EVOLUTION -derecha, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -dejó I-EVOLUTION -a I-EVOLUTION -evolución I-EVOLUTION -natural I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -encontrarse I-EVOLUTION -fuera I-EVOLUTION -de I-EVOLUTION -alcance I-EVOLUTION -quirúrgico. I-EVOLUTION -Luego B-TREATMENT -de I-TREATMENT -12 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -esquema I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -mala I-TREATMENT -respuesta I-TREATMENT -clínica, I-TREATMENT -iniciándose I-TREATMENT -metronidazol, I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -vancomicina. I-TREATMENT -Se B-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -inmunológicos I-EXPLORATION -e I-EXPLORATION -infecciosos, I-EXPLORATION -en I-EXPLORATION -busca I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -patología I-EXPLORATION -subyacente, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Tabla I-EXPLORATION -1 I-EXPLORATION -(A), I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -del I-EXPLORATION -factor I-EXPLORATION -reumatoide, I-EXPLORATION -ANCA-p, I-EXPLORATION -ANCA-c, I-EXPLORATION -anti I-EXPLORATION -ANA, I-EXPLORATION -anti I-EXPLORATION -ENA, I-EXPLORATION -anti-DNA, I-EXPLORATION -anticardiolipina, I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Coombs I-EXPLORATION -indirecto, I-EXPLORATION -antígenos I-EXPLORATION -de I-EXPLORATION -VHB I-EXPLORATION -y I-EXPLORATION -VHC I-EXPLORATION -fueron I-EXPLORATION -negativos; I-EXPLORATION -destacaron I-EXPLORATION -valores I-EXPLORATION -elevados I-EXPLORATION -de I-EXPLORATION -IgE I-EXPLORATION -sérica I-EXPLORATION -(3.740 I-EXPLORATION -UI/ml) I-EXPLORATION -y I-EXPLORATION -precipitación I-EXPLORATION -en I-EXPLORATION -frío I-EXPLORATION -de I-EXPLORATION -crioglobulinas I-EXPLORATION -positiva. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -además I-EXPLORATION -ecografía I-EXPLORATION -glútea I-EXPLORATION -izquierda, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -inflamatorio, I-EXPLORATION -sin I-EXPLORATION -colecciones. I-EXPLORATION -Tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -sugirió I-EXPLORATION -fibrosis I-EXPLORATION -basal I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -pleural I-EXPLORATION -e I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -periférica I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hemitórax. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -manos, I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -cintura I-EXPLORATION -escapular, I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -dorsolumbar, I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -codos, I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -ecocardiograma I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -Biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -zona I-EXPLORATION -medial I-EXPLORATION -del I-EXPLORATION -brazo I-EXPLORATION -derecho I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -dermatitis I-EXPLORATION -crónica I-EXPLORATION -en I-EXPLORATION -granulación I-EXPLORATION -con I-EXPLORATION -calcificación I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -distrófica, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -vasculitis. I-EXPLORATION -Una B-EVOLUTION -vez I-EVOLUTION -completado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico I-EVOLUTION -se I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -sospecha I-EVOLUTION -diagnóstica I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -hiper I-EVOLUTION -IgE I-EVOLUTION -y I-EVOLUTION -crioglobulinemia. I-EVOLUTION - I-EVOLUTION -Un I-EVOLUTION -mes I-EVOLUTION -posterior I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -nuevo I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -glúteo I-EVOLUTION -izquierdo, I-EVOLUTION -calor I-EVOLUTION -local I-EVOLUTION -y I-EVOLUTION -supuración. I-EVOLUTION -Se B-TREATMENT -realizó I-TREATMENT -drenaje I-TREATMENT -manual I-TREATMENT -y I-TREATMENT -pasivo I-TREATMENT -con I-TREATMENT -penrose. I-TREATMENT -Fue I-TREATMENT -hospitalizado I-TREATMENT -por I-TREATMENT -absceso I-TREATMENT -en I-TREATMENT -glúteo I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -clindamicina. I-TREATMENT -Se B-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Tabla I-EXPLORATION -1 I-EXPLORATION -(B) I-EXPLORATION -donde I-EXPLORATION -nuevamente I-EXPLORATION -destacó I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -IgE I-EXPLORATION -elevados, I-EXPLORATION -una I-EXPLORATION -primera I-EXPLORATION -muestra I-EXPLORATION -con I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -4.170 I-EXPLORATION -UI/ml I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -muestra I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -siguiente I-EXPLORATION -de I-EXPLORATION -4.210 I-EXPLORATION -UI/ml. I-EXPLORATION -Se I-EXPLORATION -aplicó I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -Grimbacher9 I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -consignó I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -IgE, I-EXPLORATION -candidiasis I-EXPLORATION -sistémica, I-EXPLORATION -infecciones I-EXPLORATION -graves, I-EXPLORATION -infecciones I-EXPLORATION -cutáneas I-EXPLORATION -recurrentes, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -paladar I-EXPLORATION -alto, I-EXPLORATION -dientes I-EXPLORATION -primarios I-EXPLORATION -retenidos, I-EXPLORATION -hiperextensibilidad I-EXPLORATION -articular, I-EXPLORATION -nariz I-EXPLORATION -amplia I-EXPLORATION -con I-EXPLORATION -distancia I-EXPLORATION -interalar I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -DS I-EXPLORATION -y I-EXPLORATION -facies I-EXPLORATION -característica, I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -dio I-EXPLORATION -un I-EXPLORATION -resultado I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -puntos, I-EXPLORATION -confirmándose I-EXPLORATION -clínicamente I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION -Tras B-TREATMENT -21 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -se I-TREATMENT -dio I-TREATMENT -de I-TREATMENT -alta, I-TREATMENT -utilizando I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT -con I-TREATMENT -trimetoprim/sulfametoxazol. I-TREATMENT -En B-EVOLUTION -1 I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable I-EVOLUTION -sin I-EVOLUTION -nuevos I-EVOLUTION -cuadros I-EVOLUTION -de I-EVOLUTION -infecciones I-EVOLUTION -cutáneas, I-EVOLUTION -sistémicas I-EVOLUTION -o I-EVOLUTION -eventos I-EVOLUTION -trombóticos. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -diabetes, I-FAMILY_HISTORY -comenzó B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -temblor, I-PRESENT_ILLNESS -sudoración, I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síncope I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -aparecían I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ayunas, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ejercicio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cedían I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -comer. I-PRESENT_ILLNESS -Estuvo B-TREATMENT -en I-TREATMENT -control I-TREATMENT -neurológico I-TREATMENT -por I-TREATMENT -probable I-TREATMENT -epilepsia, I-TREATMENT -tratándose I-TREATMENT -con I-TREATMENT -carbamazepina I-TREATMENT -algunas I-TREATMENT -semanas, I-TREATMENT -sin I-TREATMENT -otros I-TREATMENT -fármacos. I-TREATMENT -Por B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -pesquisándose I-PRESENT_ILLNESS -hipoglicemia I-PRESENT_ILLNESS -recurrente, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -menor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -mg/dl, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -hospitalizado. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -sin I-EXPLORATION -acantosis I-EXPLORATION -nigricans I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -25, I-EXPLORATION -6 I-EXPLORATION -kg/m2. I-EXPLORATION -La I-EXPLORATION -función I-EXPLORATION -tiroidea I-EXPLORATION -y I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -cortisol I-EXPLORATION -matinal I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Una I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -tolerancia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -glucosa I-EXPLORATION -oral I-EXPLORATION -(PTGO) I-EXPLORATION -informó I-EXPLORATION -glicemia I-EXPLORATION -basal I-EXPLORATION -de I-EXPLORATION -88 I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -120 I-EXPLORATION -min I-EXPLORATION -185 I-EXPLORATION -mg/dl, I-EXPLORATION -e I-EXPLORATION -insulinemia I-EXPLORATION -basal I-EXPLORATION -de I-EXPLORATION -2.759 I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -120 I-EXPLORATION -min I-EXPLORATION -de I-EXPLORATION -5.942 I-EXPLORATION -µUI/ml I-EXPLORATION -(MEIA, I-EXPLORATION -Axym, I-EXPLORATION -Abbott). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -ayuno I-EXPLORATION -presentando I-EXPLORATION -glicemia I-EXPLORATION -de I-EXPLORATION -46 I-EXPLORATION -mg/dl I-EXPLORATION -e I-EXPLORATION -insulinemia I-EXPLORATION -de I-EXPLORATION -588 I-EXPLORATION -µUI/ml I-EXPLORATION -(RIA, I-EXPLORATION -Diagnostic I-EXPLORATION -Products, I-EXPLORATION -Co I-EXPLORATION -[DPC]) I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -15 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -ayuno, I-EXPLORATION -con I-EXPLORATION -sintomatología I-EXPLORATION -asociada. I-EXPLORATION -Una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -estimulación I-EXPLORATION -intraarterial I-EXPLORATION -selectiva I-EXPLORATION -con I-EXPLORATION -calcio I-EXPLORATION -para I-EXPLORATION -localización I-EXPLORATION -de I-EXPLORATION -insulinomas I-EXPLORATION -según I-EXPLORATION -protocolo2, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -permitió I-EXPLORATION -la I-EXPLORATION -localización I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -arteriografía I-EXPLORATION -se I-EXPLORATION -describió I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -lesión I-EXPLORATION -nodular I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -páncreas, I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -cm, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -laparatomía I-EXPLORATION -exploratoria I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tumor. I-EXPLORATION -Se I-EXPLORATION -midieron I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -antiinsulina I-EXPLORATION -mediante I-EXPLORATION -inmunoensayo I-EXPLORATION -enzimático I-EXPLORATION -(ELISA) I-EXPLORATION -con I-EXPLORATION -kits I-EXPLORATION -comerciales I-EXPLORATION -Medizym® I-EXPLORATION -(Medipan I-EXPLORATION -GmbH, I-EXPLORATION -Berlín, I-EXPLORATION -Alemania) I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -positivos. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antitiroideos I-EXPLORATION -y I-EXPLORATION -antinucleares I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -No I-EXPLORATION -presentó I-EXPLORATION -manifestaciones I-EXPLORATION -de I-EXPLORATION -otra I-EXPLORATION -enfermedad I-EXPLORATION -autoinmune. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -dieta I-TREATMENT -restringida I-TREATMENT -en I-TREATMENT -carbohidratos I-TREATMENT -refinados I-TREATMENT -y I-TREATMENT -comidas I-TREATMENT -frecuentes I-TREATMENT -en I-TREATMENT -pequeñas I-TREATMENT -cantidades, I-TREATMENT -manteniéndose I-TREATMENT -asintomático, I-TREATMENT -sin I-TREATMENT -presentar I-TREATMENT -nuevas I-TREATMENT -hipoglicemias. I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -PTGO I-EVOLUTION -que I-EVOLUTION -informó I-EVOLUTION -glicemia I-EVOLUTION -basal I-EVOLUTION -84 I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -120 I-EVOLUTION -min I-EVOLUTION -240 I-EVOLUTION -mg/dl I-EVOLUTION -e I-EVOLUTION -insulinemia I-EVOLUTION -basal I-EVOLUTION -de I-EVOLUTION -434 I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -120 I-EVOLUTION -min I-EVOLUTION -de I-EVOLUTION -793 I-EVOLUTION -µUI/ml I-EVOLUTION -(RIA). I-EVOLUTION -Se I-EVOLUTION -mantenía I-EVOLUTION -asintomático I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sana I-PAST_MEDICAL_HISTORY -ingresó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alteración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pruebas I-PRESENT_ILLNESS -hepáticas. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -decaída I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -pancitopenia I-EXPLORATION -(hemoglobina I-EXPLORATION -10 I-EXPLORATION -gr%, I-EXPLORATION -leucocitos I-EXPLORATION -1.900/uL, I-EXPLORATION -plaquetas I-EXPLORATION -43.000/mL) I-EXPLORATION -y I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -(GOT I-EXPLORATION -1.800 I-EXPLORATION -U/L, I-EXPLORATION -GPT I-EXPLORATION -1.300 I-EXPLORATION -U/L). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -enfermedades I-EXPLORATION -infecciosas I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -(hemocultivo, I-EXPLORATION -urocultivo, I-EXPLORATION -virus I-EXPLORATION -hepatotropos, I-EXPLORATION -mycoplasma, I-EXPLORATION -toxoplasma, I-EXPLORATION -leptospira, I-EXPLORATION -bartonella, I-EXPLORATION -brucella, I-EXPLORATION -rubéola, I-EXPLORATION -sarampión, I-EXPLORATION -VIH, I-EXPLORATION -parvovirus I-EXPLORATION -B19, I-EXPLORATION -citomegalovirus I-EXPLORATION -y I-EXPLORATION -Epstein I-EXPLORATION -Barr). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -reumatológico I-EXPLORATION -donde I-EXPLORATION -resultó I-EXPLORATION -ANA I-EXPLORATION -1: I-EXPLORATION -40 I-EXPLORATION -patrón I-EXPLORATION -moteado I-EXPLORATION -y I-EXPLORATION -anti I-EXPLORATION -DNA I-EXPLORATION -por I-EXPLORATION -FARR, I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -ENA I-EXPLORATION -negativos I-EXPLORATION -con I-EXPLORATION -complemento I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -continuó I-EXPLORATION -con I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -en I-EXPLORATION -deterioro. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -linfonodos I-EXPLORATION -pequeños I-EXPLORATION -difusos, I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -laminar I-EXPLORATION -bilateral I-EXPLORATION -y I-EXPLORATION -hepatoesplenomegalia. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -linfonodos I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -adenitis I-EXPLORATION -no I-EXPLORATION -específica. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -ferritina I-EXPLORATION -resultaron I-EXPLORATION -en I-EXPLORATION -23.460 I-EXPLORATION -U/L. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -medular I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -hiperplasia I-EXPLORATION -linfoide I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -abundantes I-EXPLORATION -hemofagocitos. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -protocolo I-TREATMENT -HLH I-TREATMENT -04 I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica, I-TREATMENT -con I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -pruebas I-TREATMENT -hepáticas I-TREATMENT -y I-TREATMENT -descenso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ferritina I-TREATMENT -hasta I-TREATMENT -valores I-TREATMENT -normales. I-TREATMENT -Al B-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -redactar I-EVOLUTION -este I-EVOLUTION -reporte I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -lleva I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -dispone I-EVOLUTION -de I-EVOLUTION -hermanos I-EVOLUTION -HLA I-EVOLUTION -compatibles. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos; I-PAST_MEDICAL_HISTORY -consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -asintomática I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Se B-TREATMENT -trató I-TREATMENT -como I-TREATMENT -piodermia I-TREATMENT -con I-TREATMENT -múltiples I-TREATMENT -antibióticos I-TREATMENT -orales, I-TREATMENT -sin I-TREATMENT -respuesta. I-TREATMENT -Al B-EXPLORATION -examen, I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -eritematoso I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -8 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -pequeñas I-EXPLORATION -ulceraciones I-EXPLORATION -y I-EXPLORATION -erosiones. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -compresión I-EXPLORATION -no I-EXPLORATION -hubo I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -exudado I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -granos. I-EXPLORATION -Además, I-EXPLORATION -presentaba I-EXPLORATION -dos I-EXPLORATION -adenopatías I-EXPLORATION -inguinales I-EXPLORATION -ipsilaterales, I-EXPLORATION -no I-EXPLORATION -dolorosas, I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -1 I-EXPLORATION -cm. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palparon I-EXPLORATION -otras I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -visceromegalia. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -cutáneo I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -actinomicetoma, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -exámenes I-EXPLORATION -serológicos, I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -(TAC-TAP), I-EXPLORATION -múltiples I-EXPLORATION -cultivos I-EXPLORATION -bacterianos-micológicos I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel. I-EXPLORATION -Tenía I-EXPLORATION -hemograma, I-EXPLORATION -deshidrogensa I-EXPLORATION -láctica I-EXPLORATION -(LDH) I-EXPLORATION -y I-EXPLORATION -calcio I-EXPLORATION -sérico I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -rangos I-EXPLORATION -normales; I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -HTLV-1 I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -TAC-TAP I-EXPLORATION -mostró I-EXPLORATION -sólo I-EXPLORATION -las I-EXPLORATION -adenopatías I-EXPLORATION -ipsilaterales I-EXPLORATION -pesquisadas I-EXPLORATION -clínicamente. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -histopatología I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -dérmico I-EXPLORATION -ulcerado, I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -grandes, I-EXPLORATION -con I-EXPLORATION -pleomorfismo I-EXPLORATION -nuclear I-EXPLORATION -y I-EXPLORATION -mitosis I-EXPLORATION -atípicas. I-EXPLORATION -Además, I-EXPLORATION -había I-EXPLORATION -abundantes I-EXPLORATION -eosinófilos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -(IHQ) I-EXPLORATION -mostró I-EXPLORATION -reacción I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -CD30 I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -y I-EXPLORATION -reacción I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -ALK-1 I-EXPLORATION -y I-EXPLORATION -CD25. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -además I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -arquitectura I-EXPLORATION -y I-EXPLORATION -celularidad I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -todos I-EXPLORATION -estos I-EXPLORATION -elementos I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -un I-EXPLORATION -LACGPC. I-EXPLORATION -Se B-TREATMENT -planteó I-TREATMENT -realizar I-TREATMENT -radioterapia I-TREATMENT -(RT) I-TREATMENT -local, I-TREATMENT -pero I-TREATMENT -cuando I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -volvió I-TREATMENT -a I-TREATMENT -consultar I-TREATMENT -al I-TREATMENT -mes, I-TREATMENT -presentaba I-TREATMENT -clara I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -del I-TREATMENT -muslo, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento. I-TREATMENT -Se B-EVOLUTION -controló I-EVOLUTION -cada I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -en I-EVOLUTION -regresión I-EVOLUTION -total. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -comunica I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -fumador, I-PRESENT_ILLNESS -evaluado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sala I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -moderada. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -rinitis I-PAST_MEDICAL_HISTORY -alérgica, I-PAST_MEDICAL_HISTORY -tampoco I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -medicamentos; I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -niega I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antiinflamatorios I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -esteroidales, I-PAST_MEDICAL_HISTORY -antibioterapia I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -u I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abuso. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -hemodinamia I-EXPLORATION -y I-EXPLORATION -oximetría I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -segmentario I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -crépitos I-EXPLORATION -en I-EXPLORATION -base I-EXPLORATION -pulmonar I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -sibilancias I-EXPLORATION -ni I-EXPLORATION -otros I-EXPLORATION -ruidos I-EXPLORATION -agregados; I-EXPLORATION -sin I-EXPLORATION -hipocratismo I-EXPLORATION -digital I-EXPLORATION -ni I-EXPLORATION -otros I-EXPLORATION -signos I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION -pulmonar I-EXPLORATION -previa I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -foco I-EXPLORATION -de I-EXPLORATION -consolidación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -inferior I-EXPLORATION -izquierdo I-EXPLORATION -(LII). I-EXPLORATION -Dentro I-EXPLORATION -de I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -destacaba I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -13.200 I-EXPLORATION -cel/dL, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -eritrosedimentación I-EXPLORATION -(VHS) I-EXPLORATION -de I-EXPLORATION -65 I-EXPLORATION -mm, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -5), I-EXPLORATION -perfil I-EXPLORATION -bioquímico I-EXPLORATION -normal. I-EXPLORATION -Con B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -hospitalización I-TREATMENT -y I-TREATMENT -se I-TREATMENT -dio I-TREATMENT -inicio I-TREATMENT -a I-TREATMENT -antibioterapia I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -2 I-TREATMENT -g/día I-TREATMENT -ev I-TREATMENT -y I-TREATMENT -levofloxacino I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -vo. I-TREATMENT -Posterior B-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -tratamiento, I-EVOLUTION -no I-EVOLUTION -hubo I-EVOLUTION -mejoría I-EVOLUTION -clínica. I-EVOLUTION -Estudios B-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -con I-EXPLORATION -hemograma I-EXPLORATION -mostraron I-EXPLORATION -hematocrito I-EXPLORATION -38%, I-EXPLORATION -hemoglobina I-EXPLORATION -12 I-EXPLORATION -g/dL, I-EXPLORATION -VCM I-EXPLORATION -89, I-EXPLORATION -leucocitos I-EXPLORATION -12.500 I-EXPLORATION -cel/mm3, I-EXPLORATION -eosinófilos I-EXPLORATION -16, I-EXPLORATION -9%, I-EXPLORATION -plaquetas I-EXPLORATION -234, I-EXPLORATION -000 I-EXPLORATION -cel/mm3, I-EXPLORATION -VHS I-EXPLORATION -35 I-EXPLORATION -mm, I-EXPLORATION -PCR I-EXPLORATION -15 I-EXPLORATION -(límite I-EXPLORATION -< I-EXPLORATION -5) I-EXPLORATION -Ig I-EXPLORATION -E I-EXPLORATION -128, I-EXPLORATION -2 I-EXPLORATION -UI/ml. I-EXPLORATION -Tomografía I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -(TAC) I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -mayor I-EXPLORATION -consolidación I-EXPLORATION -de I-EXPLORATION -LII I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -(LSI), I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -opacidades I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -izquierdo I-EXPLORATION -moderado. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -broncoscopia I-EXPLORATION -flexible I-EXPLORATION -con I-EXPLORATION -lavado I-EXPLORATION -broncoalveolar I-EXPLORATION -(LBA) I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -107 I-EXPLORATION -células, I-EXPLORATION -con I-EXPLORATION -95% I-EXPLORATION -de I-EXPLORATION -eosinófilos I-EXPLORATION -; I-EXPLORATION -los I-EXPLORATION -cultivos, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -medios I-EXPLORATION -corrientes I-EXPLORATION -como I-EXPLORATION -micobacterias, I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -galactomanano I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -transbronquial I-EXPLORATION -mostró I-EXPLORATION -numerosos I-EXPLORATION -granulocitos I-EXPLORATION -eosinófilos I-EXPLORATION -en I-EXPLORATION -alvéolos I-EXPLORATION -e I-EXPLORATION -intersticio, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -cierto I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -intersticial. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -arrojó I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -x I-EXPLORATION -103 I-EXPLORATION -células, I-EXPLORATION -con I-EXPLORATION -85% I-EXPLORATION -de I-EXPLORATION -eosinófilos, I-EXPLORATION -proteínas I-EXPLORATION -4, I-EXPLORATION -1 I-EXPLORATION -mg/dL, I-EXPLORATION -glucosa I-EXPLORATION -75 I-EXPLORATION -mg/dL, I-EXPLORATION -lactato I-EXPLORATION -deshidrogenasa I-EXPLORATION -232 I-EXPLORATION -y I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -37. I-EXPLORATION - I-EXPLORATION -Dentro I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -complementario, I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -anticuerpo I-EXPLORATION -antinucleares I-EXPLORATION -(ANA), I-EXPLORATION -anti I-EXPLORATION -DNA, I-EXPLORATION -anti-citoplasma I-EXPLORATION -de I-EXPLORATION -neutrófilos I-EXPLORATION -(ANCA), I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -(VIH) I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -descarto I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -parásitos I-EXPLORATION -(Ascaris I-EXPLORATION -lumbricoide, I-EXPLORATION -Trichinella, I-EXPLORATION -Fasciola, I-EXPLORATION -Schistosoma I-EXPLORATION -y I-EXPLORATION -Strongyloides), I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -Aspergillus I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -Dado B-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -neumonía I-TREATMENT -eosinofílica, I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -al I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -eosinofilia I-TREATMENT -periférica, I-TREATMENT -en I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -causas I-TREATMENT -infecciosas I-TREATMENT -o I-TREATMENT -secundarias I-TREATMENT -a I-TREATMENT -drogas I-TREATMENT -o I-TREATMENT -fármacos, I-TREATMENT -se I-TREATMENT -planteó I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -NEC, I-TREATMENT -iniciándose I-TREATMENT -prednisona I-TREATMENT -1 I-TREATMENT -mg/kg I-TREATMENT -peso, I-TREATMENT -obteniendo I-TREATMENT -una I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fiebre I-TREATMENT -al I-TREATMENT -segundo I-TREATMENT -día I-TREATMENT -y I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -los I-TREATMENT -requerimientos I-TREATMENT -de I-TREATMENT -oxígeno I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -eosinofilia I-TREATMENT -a I-TREATMENT -los I-TREATMENT -5 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -una I-TREATMENT -resolución I-TREATMENT -de I-TREATMENT -las I-TREATMENT -condensaciones I-TREATMENT -pulmonares I-TREATMENT -y I-TREATMENT -al I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -tratamiento, I-TREATMENT -logrando I-TREATMENT -suspender I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -escalonada I-TREATMENT -los I-TREATMENT -corticoides. I-TREATMENT -Dentro B-EVOLUTION -del I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -recurrencias I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -respiratorio, I-EVOLUTION -de I-EVOLUTION -similares I-EVOLUTION -características, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -a I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -corticoides. I-EVOLUTION -Actualmente B-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -con I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -mantención I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -de I-TREATMENT -prednisona, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -confirma I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -NEC. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -chilena, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Sjögren, I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -únicamente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lágrimas I-PAST_MEDICAL_HISTORY -artificiales. I-PAST_MEDICAL_HISTORY -Tiene I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -vitíligo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hermana I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Sjögren. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -medicamentos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -tabaquismo. I-PAST_MEDICAL_HISTORY -Sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -digestivo. I-FAMILY_HISTORY -Niega B-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -digestiva, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -diarrea, I-PRESENT_ILLNESS -fatiga I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -Reumatología I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Padre I-DERIVED_FROM/TO -Hurtado I-DERIVED_FROM/TO -debido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -aparición I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -bandas I-DERIVED_FROM/TO -hiperpigmentadas I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -uñas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -pies I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -hacía I-DERIVED_FROM/TO -5 I-DERIVED_FROM/TO -años, I-DERIVED_FROM/TO -seguidas I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -uñas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -manos. I-DERIVED_FROM/TO -Hacía B-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -habían I-PRESENT_ILLNESS -aparecido I-PRESENT_ILLNESS -máculas I-PRESENT_ILLNESS -color I-PRESENT_ILLNESS -café I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mucosa I-PRESENT_ILLNESS -oral, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hiperpigmentación I-PRESENT_ILLNESS -periungueal I-PRESENT_ILLNESS -progresiva. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -mácula I-EXPLORATION -café I-EXPLORATION -en I-EXPLORATION -labio I-EXPLORATION -inferior I-EXPLORATION -hacia I-EXPLORATION -comisura I-EXPLORATION -labial I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -uñas I-EXPLORATION -de I-EXPLORATION -manos I-EXPLORATION -y I-EXPLORATION -pies I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -máculas I-EXPLORATION -café I-EXPLORATION -periungueales I-EXPLORATION -y I-EXPLORATION -melanoniquia. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -histopatología I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -mostró I-EXPLORATION -acantosis I-EXPLORATION -leve I-EXPLORATION -e I-EXPLORATION -hipermelanosis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -dermoepidérmica I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -numerosos I-EXPLORATION -melanófagos, I-EXPLORATION -con I-EXPLORATION -capilares I-EXPLORATION -prominentes I-EXPLORATION -en I-EXPLORATION -dermis. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron: I-EXPLORATION -Leucopenia I-EXPLORATION -leve I-EXPLORATION -(3, I-EXPLORATION -700/uL I-EXPLORATION -con I-EXPLORATION -1, I-EXPLORATION -370/uL I-EXPLORATION -linfocitos). I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -hemograma, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -eritrosedimentasión, I-EXPLORATION -hormonas I-EXPLORATION -tiroideas, I-EXPLORATION -cortisol I-EXPLORATION -plasmático I-EXPLORATION -y I-EXPLORATION -ACTH I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -anti-Ro I-EXPLORATION -(43, I-EXPLORATION -7 I-EXPLORATION -U/mL) I-EXPLORATION -y I-EXPLORATION -anti-La I-EXPLORATION -(> I-EXPLORATION -48 I-EXPLORATION -U/mL) I-EXPLORATION -fueron I-EXPLORATION -positivos, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -también I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(1/2560) I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION -moteado. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -anti-dsDNA, I-EXPLORATION -anti-Sm I-EXPLORATION -y I-EXPLORATION -anticardiolipinas I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -factor I-EXPLORATION -reumatoideo, I-EXPLORATION -anticoagulante I-EXPLORATION -lúpico I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cuantificación I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -resultaron I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -rangos I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -y I-EXPLORATION -colonoscopía, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -muestran I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -pólipos, I-EXPLORATION -hiperpigmentación I-EXPLORATION -u I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -clínico, I-EVOLUTION -sin I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -lesiones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -género I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -excepción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -proctitis I-PAST_MEDICAL_HISTORY -ulcerosa I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -1994. I-PAST_MEDICAL_HISTORY -Inicialmente B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mucosidades. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -colonoscopia I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION -inflamatorio I-EXPLORATION -continuo I-EXPLORATION -del I-EXPLORATION -recto I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -friable I-EXPLORATION -y I-EXPLORATION -pequeñas I-EXPLORATION -erosiones I-EXPLORATION -cubiertas I-EXPLORATION -por I-EXPLORATION -fibrina I-EXPLORATION -(Subíndice I-EXPLORATION -Endoscópico I-EXPLORATION -Mayo I-EXPLORATION -2). I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -aguda I-EXPLORATION -(criptitis I-EXPLORATION -y I-EXPLORATION -abscesos I-EXPLORATION -crípticos) I-EXPLORATION -y I-EXPLORATION -crónica I-EXPLORATION -reflejada I-EXPLORATION -como I-EXPLORATION -alteraciones I-EXPLORATION -estructurales I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -criptas I-EXPLORATION -(acortamiento I-EXPLORATION -y I-EXPLORATION -ramificación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -glándulas I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -caliciformes). I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -mesalazina I-TREATMENT -oral I-TREATMENT -(3 I-TREATMENT -g/día) I-TREATMENT -y I-TREATMENT -rectal I-TREATMENT -(supositorios I-TREATMENT -de I-TREATMENT -500 I-TREATMENT -mg/noche), I-TREATMENT -con I-TREATMENT -remisión I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -endoscópica I-TREATMENT -(curación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mucosa) I-TREATMENT -(colonoscopia I-TREATMENT -2007, I-TREATMENT -Subíndice I-TREATMENT -Endoscópico I-TREATMENT -Mayo I-TREATMENT -0). I-TREATMENT -Posteriormente, B-EVOLUTION -abandona I-EVOLUTION -tratamiento I-EVOLUTION -y I-EVOLUTION -control, I-EVOLUTION -manteniéndose I-EVOLUTION -asintomática I-EVOLUTION -hasta I-EVOLUTION -agosto I-EVOLUTION -de I-EVOLUTION -2015 I-EVOLUTION -donde I-EVOLUTION -consulta I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -desde I-EVOLUTION -hace I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -malestar I-EVOLUTION -abdominal I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -deposiciones I-EVOLUTION -líquidas I-EVOLUTION -una I-EVOLUTION -a I-EVOLUTION -dos I-EVOLUTION -veces I-EVOLUTION -al I-EVOLUTION -día I-EVOLUTION -sin I-EVOLUTION -sangre I-EVOLUTION -ni I-EVOLUTION -mucosidades. I-EVOLUTION -No I-EVOLUTION -refería I-EVOLUTION -compromiso I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -fiebre, I-EVOLUTION -baja I-EVOLUTION -de I-EVOLUTION -peso, I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y/o I-EVOLUTION -articular. I-EVOLUTION -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo, I-PAST_MEDICAL_HISTORY -transgresión I-PAST_MEDICAL_HISTORY -alimentaria I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fármacos I-PAST_MEDICAL_HISTORY -(específicamente I-PAST_MEDICAL_HISTORY -antiinflamatorios I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -esteroidales, I-PAST_MEDICAL_HISTORY -antibióticos, I-PAST_MEDICAL_HISTORY -inhibidores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -bomba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -protones, I-PAST_MEDICAL_HISTORY -hormonas I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -antidepresivos). I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -solicitaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -que I-EXPLORATION -incluyó I-EXPLORATION -hemograma, I-EXPLORATION -VHS, I-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -hepático, I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -enfermedad I-EXPLORATION -celíaca I-EXPLORATION -con I-EXPLORATION -anticuerpos I-EXPLORATION -anti-transglutaminasa I-EXPLORATION -negativos I-EXPLORATION -e I-EXPLORATION -inmunoglobulina I-EXPLORATION -A I-EXPLORATION -en I-EXPLORATION -valores I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -completa I-EXPLORATION -donde I-EXPLORATION -sólo I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -erosiones I-EXPLORATION -mínimas I-EXPLORATION -e I-EXPLORATION -inespecíficas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -recto. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -escalonadas I-EXPLORATION -de I-EXPLORATION -íleon, I-EXPLORATION -colon I-EXPLORATION -y I-EXPLORATION -recto I-EXPLORATION -en I-EXPLORATION -frascos I-EXPLORATION -separados I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -fueron I-EXPLORATION -consistentes I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -CL I-EXPLORATION -dado I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -> I-EXPLORATION -40 I-EXPLORATION -linfocitos/100 I-EXPLORATION -células I-EXPLORATION -epiteliales I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -obtenidas I-EXPLORATION -desde I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -a I-EXPLORATION -recto. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -describieron I-EXPLORATION -alteraciones I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -CU I-EXPLORATION -(leve I-EXPLORATION -distorsión I-EXPLORATION -de I-EXPLORATION -arquitectura I-EXPLORATION -glandular, I-EXPLORATION -criptitis I-EXPLORATION -y I-EXPLORATION -microabscesos) I-EXPLORATION -exclusivamente I-EXPLORATION -en I-EXPLORATION -sigmoides I-EXPLORATION -y I-EXPLORATION -recto. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -budesonida I-TREATMENT -9 I-TREATMENT -mg/día, I-TREATMENT -presentando I-TREATMENT -una I-TREATMENT -respuesta I-TREATMENT -favorable I-TREATMENT -a I-TREATMENT -la I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -un I-TREATMENT -descenso I-TREATMENT -progresivo I-TREATMENT -del I-TREATMENT -fármaco I-TREATMENT -hasta I-TREATMENT -suspenderlo I-TREATMENT -al I-TREATMENT -tercer I-TREATMENT -mes. I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomática I-EVOLUTION -(remisión I-EVOLUTION -clínica) I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -control I-EVOLUTION -con I-EVOLUTION -calprotectina I-EVOLUTION -fecal I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -rango I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dermatitis I-PAST_MEDICAL_HISTORY -seborreica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuero I-PAST_MEDICAL_HISTORY -cabelludo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -viaje I-PAST_MEDICAL_HISTORY -reciente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Ilhabela, I-PAST_MEDICAL_HISTORY -Brasil. I-PAST_MEDICAL_HISTORY -Después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -permanecer I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -fuera I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -país, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -retornó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Chile. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dermatólogo I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -regreso, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo I-PRESENT_ILLNESS -parieto I-PRESENT_ILLNESS -occipital, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -objetos I-PRESENT_ILLNESS -extraños I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mueven I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -cabeza. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -se I-EXPLORATION -identificaro I-EXPLORATION -3 I-EXPLORATION -úlceras I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -aproximadamente, I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -supuraba I-EXPLORATION -abundante I-EXPLORATION -contenido I-EXPLORATION -seropurulento, I-EXPLORATION -en I-EXPLORATION -cuyos I-EXPLORATION -fondos I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -múltiples I-EXPLORATION -larvas I-EXPLORATION -vivas I-EXPLORATION -y I-EXPLORATION -móviles. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -extracción I-TREATMENT -manual I-TREATMENT -en I-TREATMENT -la I-TREATMENT -sala I-TREATMENT -de I-TREATMENT -atención, I-TREATMENT -mediante I-TREATMENT -pinzas, I-TREATMENT -con I-TREATMENT -bastante I-TREATMENT -facilidad I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -molestias I-TREATMENT -para I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -procedimiento, I-TREATMENT -obteniéndose I-TREATMENT -25 I-TREATMENT -especímenes. I-TREATMENT -Se I-TREATMENT -indicó I-TREATMENT -ivermectina I-TREATMENT -oral I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -única I-TREATMENT -de I-TREATMENT -200 I-TREATMENT -ug/kg. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -sintomatología, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -cirugía I-TREATMENT -exploratoria I-TREATMENT -y I-TREATMENT -aseo I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local, I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -extraer I-TREATMENT -4 I-TREATMENT -larvas I-TREATMENT -más. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas, I-EXPLORATION -no I-EXPLORATION -evidenciándose I-EXPLORATION -más I-EXPLORATION -larvas, I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -cráneo, I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -compromiso I-EXPLORATION -óseo. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -antibioterapia I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -curaciones I-TREATMENT -de I-TREATMENT -sitio I-TREATMENT -operatorio, I-TREATMENT -presentando B-EVOLUTION -una I-EVOLUTION -rápida I-EVOLUTION -y I-EVOLUTION -favorable I-EVOLUTION -respuesta I-EVOLUTION -clínica, I-EVOLUTION -logrando I-EVOLUTION -cierre I-EVOLUTION -por I-EVOLUTION -segunda I-EVOLUTION -intención I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -heridas I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -recurrencias I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -fecha. I-EVOLUTION - I-EVOLUTION -Todas B-EXPLORATION -las I-EXPLORATION -larvas I-EXPLORATION -obtenidas I-EXPLORATION -fueron I-EXPLORATION -analizadas I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -Parasitología I-EXPLORATION -Básico-Clínico I-EXPLORATION -del I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Ciencias I-EXPLORATION -Biomédicas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Facultad I-EXPLORATION -de I-EXPLORATION -Medicina I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Chile, I-EXPLORATION -identificándose I-EXPLORATION -larvas I-EXPLORATION -en I-EXPLORATION -estado I-EXPLORATION -L2 I-EXPLORATION -y I-EXPLORATION -L3 I-EXPLORATION -de I-EXPLORATION -Cochliomyia I-EXPLORATION -hominivorax. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -DM1 I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -hemoglobina I-PAST_MEDICAL_HISTORY -glicosilada I-PAST_MEDICAL_HISTORY -(HbA1c) I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8, I-PAST_MEDICAL_HISTORY -5%. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS -ingiriendo I-PRESENT_ILLNESS -alimentos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cantidad I-PRESENT_ILLNESS -adecuada, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -omitió I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -insulina I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mismo I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Dirigidamente, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -ayuno I-PRESENT_ILLNESS -prolongado, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alcohol I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -riesgo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -embarazo I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -síntomas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -vigil, I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -leve I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -extra I-EXPLORATION -celular I-EXPLORATION -(VEC). I-EXPLORATION -Su I-EXPLORATION -Índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -era I-EXPLORATION -29 I-EXPLORATION -Kg/m2. I-EXPLORATION -En I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -al I-EXPLORATION -ingreso, I-EXPLORATION -destacaba: I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -26.000 I-EXPLORATION -x I-EXPLORATION -mm3, I-EXPLORATION -glicemia I-EXPLORATION -200 I-EXPLORATION -mg/dl, I-EXPLORATION -gases I-EXPLORATION -arteriales I-EXPLORATION -con I-EXPLORATION -acidosis I-EXPLORATION -metabólica I-EXPLORATION -severa I-EXPLORATION -(pH I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -bicarbonato I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -meq/L), I-EXPLORATION -cetonemia++++++ I-EXPLORATION -(no I-EXPLORATION -se I-EXPLORATION -dispone I-EXPLORATION -de I-EXPLORATION -medición I-EXPLORATION -cuantitativa), I-EXPLORATION -cetonuria I-EXPLORATION -+++, I-EXPLORATION -glucosuria. I-EXPLORATION -La I-EXPLORATION -proteína I-EXPLORATION -c I-EXPLORATION -reactiva, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -amilasemia I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -electrolitos I-EXPLORATION -plasmáticos I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -resultó I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Ingresó B-TREATMENT -a I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Cuidados I-TREATMENT -Intensivos I-TREATMENT -(UCI), I-TREATMENT -iniciándose I-TREATMENT -hidratación I-TREATMENT -parenteral I-TREATMENT -e I-TREATMENT -insulina I-TREATMENT -cristalina I-TREATMENT -endovenosa, I-TREATMENT -en I-TREATMENT -infusión I-TREATMENT -continua. I-TREATMENT -Evolucionó B-EVOLUTION -favorablemente. I-EVOLUTION -Dada I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -Cetoacidosis I-EVOLUTION -diabética I-EVOLUTION -(CAD) I-EVOLUTION -sin I-EVOLUTION -un I-EVOLUTION -desencadenante I-EVOLUTION -claro I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -glucosuria I-EVOLUTION -inapropiadamente I-EVOLUTION -alta I-EVOLUTION -para I-EVOLUTION -tal I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -hiperglicemia, I-EVOLUTION -se I-EVOLUTION -reinterroga I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -acerca I-EVOLUTION -del I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -otros I-EVOLUTION -medicamentos; I-EVOLUTION -entonces B-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -iniciado I-PAST_MEDICAL_HISTORY -canaglifozina I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -cuadro. I-PAST_MEDICAL_HISTORY -Una B-TREATMENT -vez I-TREATMENT -estabilizada, I-TREATMENT -se I-TREATMENT -reajustó I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -insulina I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -dada I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -de I-TREATMENT -hospitalización. I-TREATMENT - I-TREATMENT -Se B-EVOLUTION -realizó I-EVOLUTION -la I-EVOLUTION -notificación I-EVOLUTION -al I-EVOLUTION -Instituto I-EVOLUTION -de I-EVOLUTION -Salud I-EVOLUTION -Pública I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -informó I-EVOLUTION -al I-EVOLUTION -Laboratorio I-EVOLUTION -Janssen I-EVOLUTION -Chile, I-EVOLUTION -constituyéndose I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -caso I-EVOLUTION -descrito I-EVOLUTION -de I-EVOLUTION -CAD I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -estos I-EVOLUTION -medicamentos I-EVOLUTION -en I-EVOLUTION -nuestro I-EVOLUTION -país. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -conocidos, I-PAST_MEDICAL_HISTORY -consulta B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Emergencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -palidez, I-PRESENT_ILLNESS -mialgias, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -escalofríos. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacan I-EXPLORATION -en I-EXPLORATION -paladar I-EXPLORATION -numerosas I-EXPLORATION -lesiones I-EXPLORATION -herpetiformes, I-EXPLORATION -hemograma I-EXPLORATION -evidencia I-EXPLORATION -pancitopenia, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -hospitalizar. I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -mielograma, I-EXPLORATION -inmunofenotipo I-EXPLORATION -y I-EXPLORATION -cariograma, I-EXPLORATION -diagnosticándose I-EXPLORATION -LMA I-EXPLORATION -indiferenciada I-EXPLORATION -con I-EXPLORATION -expresión I-EXPLORATION -aberrante I-EXPLORATION -CD7. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -quimioterapia I-TREATMENT -de I-TREATMENT -inducción I-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -3+7 I-TREATMENT -(daunorrubicina I-TREATMENT -+ I-TREATMENT -citarabina) I-TREATMENT -presentando I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -del I-TREATMENT -primer I-TREATMENT -ciclo I-TREATMENT -diarrea I-TREATMENT -y I-TREATMENT -fiebre, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -toman I-TREATMENT -hemocultivos I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -terapia I-TREATMENT -antibiótica I-TREATMENT -empírica I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro. I-TREATMENT -Los B-EXPLORATION -hemocultivos I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Klebsiella I-EXPLORATION -pneumoniae I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -cefalosporinas I-EXPLORATION -de I-EXPLORATION -tercera I-EXPLORATION -generación, I-EXPLORATION -manteniéndose I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -antibiótico I-EXPLORATION -inicial. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -persiste I-EVOLUTION -febril I-EVOLUTION -sin I-EVOLUTION -clínica I-EVOLUTION -que I-EVOLUTION -sugiera I-EVOLUTION -el I-EVOLUTION -foco I-EVOLUTION -infeccioso; I-EVOLUTION -cursa I-EVOLUTION -con I-EVOLUTION -neutropenia I-EVOLUTION -grave I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -prolonga I-EVOLUTION -por I-EVOLUTION -20 I-EVOLUTION -días, I-EVOLUTION -con I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios I-EVOLUTION -en I-EVOLUTION -ascenso I-EVOLUTION -y I-EVOLUTION -alteración I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -hepáticas I-EVOLUTION -con I-EVOLUTION -patrón I-EVOLUTION -colestásico. I-EVOLUTION -Se B-TREATMENT -decide I-TREATMENT -agregar I-TREATMENT -tratamiento I-TREATMENT -antifúngico I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -anidulafungina I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -tomografia I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -en I-EXPLORATION -que I-EXPLORATION -destaca I-EXPLORATION -hepatoesplenomegalia I-EXPLORATION -con I-EXPLORATION -lesiones I-EXPLORATION -focales I-EXPLORATION -esplénicas I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION -inflamatorio-infeccioso. I-EXPLORATION -Además I-EXPLORATION -presenta I-EXPLORATION -coriorretinitis I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -micosis. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -hemocultivo I-EXPLORATION -de I-EXPLORATION -hongos I-EXPLORATION -(medio I-EXPLORATION -Sabourand) I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -negativos, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -MALDI I-EXPLORATION -TOF I-EXPLORATION -MS I-EXPLORATION -(Matrix-Assisted I-EXPLORATION -Laser I-EXPLORATION -Desorption/Ionization I-EXPLORATION -time I-EXPLORATION -of I-EXPLORATION -flight I-EXPLORATION -mass I-EXPLORATION -espectrometry) I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -resulta I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -S. I-EXPLORATION -capitata, I-EXPLORATION -agregándose I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -voriconazol I-EXPLORATION -(200 I-EXPLORATION -mg/12 I-EXPLORATION -h). I-EXPLORATION -Por B-TREATMENT -falta I-TREATMENT -de I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -se I-TREATMENT -reemplaza I-TREATMENT -la I-TREATMENT -anidulafungina I-TREATMENT -por I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -liposomal I-TREATMENT -(50 I-TREATMENT -mg/día), I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -ecocardiografía I-TREATMENT -que I-TREATMENT -descarta I-TREATMENT -endocarditis. I-TREATMENT -Nuevo B-EXPLORATION -TC I-EXPLORATION -muestra I-EXPLORATION -múltiples I-EXPLORATION -áreas I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -pulmonares I-EXPLORATION -superiores I-EXPLORATION -y I-EXPLORATION -lóbulo I-EXPLORATION -medio, I-EXPLORATION -atelectasias I-EXPLORATION -bibasales I-EXPLORATION -y I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -moderado I-EXPLORATION -izquierdo, I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas I-EXPLORATION -e I-EXPLORATION -hiliares I-EXPLORATION -bilaterales, I-EXPLORATION -hepatoesplenomagalia I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -focales I-EXPLORATION -hipovasculares, I-EXPLORATION -en I-EXPLORATION -hígado, I-EXPLORATION -bazo I-EXPLORATION -y I-EXPLORATION -riñón. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -realizados I-EXPLORATION -de I-EXPLORATION -catéteres I-EXPLORATION -resultados I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -toracocentesis I-TREATMENT -evacuadora I-TREATMENT -con I-TREATMENT -estudio I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -pleural I-TREATMENT -que I-TREATMENT -muestra I-TREATMENT -exudado I-TREATMENT -de I-TREATMENT -predominio I-TREATMENT -mononuclear. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -invalidante I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -y I-EVOLUTION -flanco I-EVOLUTION -izquierdos, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -realiza I-EVOLUTION -control I-EVOLUTION -radiológico I-EVOLUTION -que I-EVOLUTION -evidencia I-EVOLUTION -regresión I-EVOLUTION -de I-EVOLUTION -lesiones I-EVOLUTION -hepáticas I-EVOLUTION -y I-EVOLUTION -renales, I-EVOLUTION -pero I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -esplénicas I-EVOLUTION -que I-EVOLUTION -ahora I-EVOLUTION -son I-EVOLUTION -de I-EVOLUTION -aspecto I-EVOLUTION -hemorrágico. I-EVOLUTION -Analizado B-TREATMENT -el I-TREATMENT -caso I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -multidisciplinaria I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -esplenectomía I-TREATMENT -de I-TREATMENT -desfocamiento I-TREATMENT -y I-TREATMENT -VTC, I-TREATMENT -para I-TREATMENT -evacuación I-TREATMENT -y I-TREATMENT -aseo I-TREATMENT -pleural I-TREATMENT -y, I-TREATMENT -definir I-TREATMENT -diagnóstico I-TREATMENT -diferencial I-TREATMENT -(neoplásico, I-TREATMENT -tuberculoso I-TREATMENT -y I-TREATMENT -micosis I-TREATMENT -invasora). I-TREATMENT -Se I-TREATMENT -efectúa I-TREATMENT -VTC I-TREATMENT -con I-TREATMENT -evacuación I-TREATMENT -de I-TREATMENT -2.000 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -derrame I-TREATMENT -pleural, I-TREATMENT -aseo I-TREATMENT -con I-TREATMENT -solución I-TREATMENT -salina, I-TREATMENT -biopsia I-TREATMENT -pleural I-TREATMENT -y I-TREATMENT -drenaje, I-TREATMENT -observándose B-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -4 I-EXPLORATION -mm I-EXPLORATION -distribuidas I-EXPLORATION -difusamente I-EXPLORATION -en I-EXPLORATION -pleura I-EXPLORATION -parietal, I-EXPLORATION -visceral I-EXPLORATION -y I-EXPLORATION -diafragmática. I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -laparotomía I-EXPLORATION -observándose I-EXPLORATION -esplenomegalia I-EXPLORATION -hemorrágica I-EXPLORATION -más I-EXPLORATION -abscesos I-EXPLORATION -esplénicos, I-EXPLORATION -se B-TREATMENT -practica I-TREATMENT -esplenectomía I-TREATMENT -para I-TREATMENT -limpieza I-TREATMENT -del I-TREATMENT -foco. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -tomadas I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -VTC I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -laparotomía I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -hifas I-EXPLORATION -septadas. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -intraoperatorios I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -S. I-EXPLORATION -capitata I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -72 I-EXPLORATION -h. I-EXPLORATION -Posterior B-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -favorablemente I-EVOLUTION -y B-TREATMENT -se I-TREATMENT -completan I-TREATMENT -58 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -liposomal I-TREATMENT -(alcanzando I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -acumulada I-TREATMENT -de I-TREATMENT -2, I-TREATMENT -9 I-TREATMENT -g I-TREATMENT -sin I-TREATMENT -manifestar I-TREATMENT -efectos I-TREATMENT -adversos) I-TREATMENT -y I-TREATMENT -80 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -voriconazol I-TREATMENT -(dosis I-TREATMENT -acumulada I-TREATMENT -de I-TREATMENT -32 I-TREATMENT -g I-TREATMENT -sin I-TREATMENT -efectos I-TREATMENT -adversos). I-TREATMENT -Se B-EVOLUTION -da I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones, I-EVOLUTION -finalizando I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -oncológico I-EVOLUTION -manteniéndose I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -ciclos I-EVOLUTION -de I-EVOLUTION -quimioterapia I-EVOLUTION -con I-EVOLUTION -profilaxis I-EVOLUTION -con I-EVOLUTION -voriconazol. I-EVOLUTION -A I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -en B-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -personalidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ánimo, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -intentos I-PAST_MEDICAL_HISTORY -suicidas. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -febrero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2017 I-PRESENT_ILLNESS -ingirió I-PRESENT_ILLNESS -bupropión I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -g, I-PRESENT_ILLNESS -clorpromazina I-PRESENT_ILLNESS -1, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -g I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -copas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vino. I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -familiares I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -encontraron I-PRESENT_ILLNESS -alterada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -llevaron I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Salvador, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -comprometida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Glasgow I-PRESENT_ILLNESS -10, I-PRESENT_ILLNESS -presión I-PRESENT_ILLNESS -arterial I-PRESENT_ILLNESS -90/60, I-PRESENT_ILLNESS -taquicárdica I-PRESENT_ILLNESS -115 I-PRESENT_ILLNESS -lpm, I-PRESENT_ILLNESS -electrocardiograma I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -segmento I-PRESENT_ILLNESS -Q-t I-PRESENT_ILLNESS -alargado I-PRESENT_ILLNESS -(550 I-PRESENT_ILLNESS -ms) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ácido I-PRESENT_ILLNESS -láctico I-PRESENT_ILLNESS -elevado I-PRESENT_ILLNESS -(32, I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -mg/dl). I-PRESENT_ILLNESS -Dentro B-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -breves I-EVOLUTION -episodios I-EVOLUTION -convulsivos, I-EVOLUTION -de I-EVOLUTION -30 I-EVOLUTION -seg I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -menos I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -minuto. I-EVOLUTION -El B-EXPLORATION -electroencefalograma I-EXPLORATION -(EEG) I-EXPLORATION -mostró I-EXPLORATION -actividad I-EXPLORATION -delta-theta I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -voltaje, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -epilepsia. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -(TAC) I-EXPLORATION -sin I-EXPLORATION -contraste I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -tenía I-EXPLORATION -escaza I-EXPLORATION -reactividad I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -alterada I-EXPLORATION -de I-EXPLORATION -conciencia, I-EXPLORATION -con I-EXPLORATION -mioclonías I-EXPLORATION -generalizadas I-EXPLORATION -y I-EXPLORATION -movimientos I-EXPLORATION -involuntarios I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades; I-EXPLORATION -tono I-EXPLORATION -muscular I-EXPLORATION -aumentado, I-EXPLORATION -reflejos I-EXPLORATION -osteotendíneos I-EXPLORATION -(ROT) I-EXPLORATION -policinéticos I-EXPLORATION -y I-EXPLORATION -reflejos I-EXPLORATION -plantares I-EXPLORATION -flexores. I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -mañana I-EVOLUTION -del I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -sufrió I-EVOLUTION -paro I-EVOLUTION -cardiorrespiratorio I-EVOLUTION -por I-EVOLUTION -asistolia, I-EVOLUTION -recibió B-TREATMENT -reanimación I-TREATMENT -inmediata, I-TREATMENT -adrenalina, I-TREATMENT -intubación, I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -min I-TREATMENT -logró I-TREATMENT -actividad I-TREATMENT -cardiaca I-TREATMENT -espontánea. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -habían I-EVOLUTION -desaparecido I-EVOLUTION -las I-EVOLUTION -mioclonías, I-EVOLUTION -estaba I-EVOLUTION -inconsciente I-EVOLUTION -y I-EVOLUTION -mantenía I-EVOLUTION -una I-EVOLUTION -persistente I-EVOLUTION -apertura I-EVOLUTION -palpebral I-EVOLUTION -con I-EVOLUTION -escaso I-EVOLUTION -pestañeo I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -sobre-elevación I-EVOLUTION -anormal I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -ojos, I-EVOLUTION -como I-EVOLUTION -mirando I-EVOLUTION -hacia I-EVOLUTION -atrás. I-EVOLUTION -Las I-EVOLUTION -pupilas I-EVOLUTION -estaban I-EVOLUTION -iguales I-EVOLUTION -y I-EVOLUTION -reactivas I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -luz, I-EVOLUTION -con I-EVOLUTION -reflejos I-EVOLUTION -oculocefálicos I-EVOLUTION -conservados. I-EVOLUTION -Sus I-EVOLUTION -extremidades I-EVOLUTION -se I-EVOLUTION -mostraban I-EVOLUTION -hipotónicas I-EVOLUTION -y I-EVOLUTION -tenía I-EVOLUTION -los I-EVOLUTION -ROT I-EVOLUTION -exaltados I-EVOLUTION -con I-EVOLUTION -Babinski I-EVOLUTION -bilateral. I-EVOLUTION -Los B-EXPLORATION -estímulos I-EXPLORATION -nociceptivos I-EXPLORATION -desencadenaban I-EXPLORATION -respuestas I-EXPLORATION -extensoras I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cuatro I-EXPLORATION -extremidades I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -simultáneo I-EXPLORATION -cierre I-EXPLORATION -palpebral I-EXPLORATION -con I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -globos I-EXPLORATION -oculares, I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -reapertura I-EXPLORATION -palpebral I-EXPLORATION -volvían I-EXPLORATION -a I-EXPLORATION -elevarse I-EXPLORATION -simulando I-EXPLORATION -un I-EXPLORATION -rebote I-EXPLORATION -ocular. I-EXPLORATION -El I-EXPLORATION -fen��meno I-EXPLORATION -se I-EXPLORATION -repetía I-EXPLORATION -con I-EXPLORATION -cualquier I-EXPLORATION -estímulo. I-EXPLORATION -La I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -realizada I-EXPLORATION -al I-EXPLORATION -octavo I-EXPLORATION -día, I-EXPLORATION -mostró I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -difusión I-EXPLORATION -imágenes I-EXPLORATION -hiperintensas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sustancia I-EXPLORATION -blanca I-EXPLORATION -del I-EXPLORATION -centro I-EXPLORATION -oval I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -calloso I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -secuencia I-EXPLORATION -FLAIR I-EXPLORATION -áreas I-EXPLORATION -menores I-EXPLORATION -hiperintensas I-EXPLORATION -en I-EXPLORATION -ganglios I-EXPLORATION -basales I-EXPLORATION -y I-EXPLORATION -corteza, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -encefalopatía I-EXPLORATION -hipóxico-isquémica. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -supraversión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mirada I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -al I-EVOLUTION -menos I-EVOLUTION -diez I-EVOLUTION -días, I-EVOLUTION -luego I-EVOLUTION -la I-EVOLUTION -mirada I-EVOLUTION -se I-EVOLUTION -hizo I-EVOLUTION -central, I-EVOLUTION -mientras I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -seguía I-EVOLUTION -en I-EVOLUTION -coma I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -variaciones I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -mes. I-EVOLUTION -Las I-EVOLUTION -pupilas I-EVOLUTION -se I-EVOLUTION -mantenían I-EVOLUTION -iguales I-EVOLUTION -con I-EVOLUTION -respuesta I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -luz I-EVOLUTION -y I-EVOLUTION -reflejos I-EVOLUTION -oculocefálicos I-EVOLUTION -conservados, I-EVOLUTION -los I-EVOLUTION -ROT I-EVOLUTION -estaban I-EVOLUTION -vivos I-EVOLUTION -con I-EVOLUTION -reflejos I-EVOLUTION -plantares I-EVOLUTION -extensores. I-EVOLUTION -Los I-EVOLUTION -estímulos I-EVOLUTION -nociseptivos I-EVOLUTION -seguían I-EVOLUTION -generando I-EVOLUTION -respuestas I-EVOLUTION -extensoras. I-EVOLUTION -El I-EVOLUTION -EEG I-EVOLUTION -estaba I-EVOLUTION -prácticamente I-EVOLUTION -plano. I-EVOLUTION -La B-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -definida I-EXPLORATION -atrofia I-EXPLORATION -cerebral, I-EXPLORATION -con I-EXPLORATION -hiperintensidades I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -núcleos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -distintas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -corteza I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -cerebelosa. I-EXPLORATION -Había B-EVOLUTION -desaparecido I-EVOLUTION -la I-EVOLUTION -hiperintensidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -substancia I-EVOLUTION -blanca. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -47 I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION - -Ingresa B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Hematología I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -masculino I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -LLA I-PAST_MEDICAL_HISTORY -común, I-PAST_MEDICAL_HISTORY -(Philadelphia I-PAST_MEDICAL_HISTORY -negativo). I-PAST_MEDICAL_HISTORY -Inducción B-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -LLA I-TREATMENT -15-30 I-TREATMENT -según I-TREATMENT -protocolo, I-TREATMENT -con I-TREATMENT -rápida I-TREATMENT -respuesta I-TREATMENT -y I-TREATMENT -remisión I-TREATMENT -completa. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -etapa I-TREATMENT -de I-TREATMENT -consolidación I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -QI I-TREATMENT -triple I-TREATMENT -(Metrotrexato I-TREATMENT -15 I-TREATMENT -mg, I-TREATMENT -Citarabina I-TREATMENT -50 I-TREATMENT -mg, I-TREATMENT -Betametasona I-TREATMENT -4 I-TREATMENT -mg). I-TREATMENT -Durante B-EVOLUTION -esta I-EVOLUTION -etapa I-EVOLUTION -apareció I-EVOLUTION -neutropenia I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -mielograma I-EVOLUTION -mostró I-EVOLUTION -71% I-EVOLUTION -de I-EVOLUTION -linfoblastos I-EVOLUTION -y I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -blastos I-EVOLUTION -en I-EVOLUTION -LCR, I-EVOLUTION -sin I-EVOLUTION -síntomas I-EVOLUTION -neurológicos. I-EVOLUTION -Se I-EVOLUTION -definió I-EVOLUTION -como I-EVOLUTION -una I-EVOLUTION -recaída I-EVOLUTION -combinada I-EVOLUTION -precoz. I-EVOLUTION -En B-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -rescate, I-TREATMENT -recibió I-TREATMENT -seis I-TREATMENT -pulsos I-TREATMENT -de I-TREATMENT -QI, I-TREATMENT -lográndose I-TREATMENT -remisión I-TREATMENT -completa I-TREATMENT -y I-TREATMENT -desaparición I-TREATMENT -de I-TREATMENT -los I-TREATMENT -blastos I-TREATMENT -del I-TREATMENT -LCR. I-TREATMENT -Al I-TREATMENT -octavo I-TREATMENT -mes I-TREATMENT -se I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -block I-TREATMENT -R2. I-TREATMENT -Después B-EVOLUTION -del I-EVOLUTION -primer I-EVOLUTION -procedimiento I-EVOLUTION -intratecal I-EVOLUTION -inició I-EVOLUTION -inestabilidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -marcha. I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -vigil, I-EXPLORATION -orientado, I-EXPLORATION -sin I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -pares I-EXPLORATION -craneanos, I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -potencia I-EXPLORATION -muscular, I-EXPLORATION -ROT I-EXPLORATION -preservados, I-EXPLORATION -marcha I-EXPLORATION -insegura, I-EXPLORATION -Romberg I-EXPLORATION -positivo I-EXPLORATION -y I-EXPLORATION -alteración I-EXPLORATION -propioceptiva I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -EEII, I-EXPLORATION -prueba I-EXPLORATION -índice-nariz I-EXPLORATION -y I-EXPLORATION -talón-rodilla I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -quimioterapia, I-TREATMENT -iniciándose I-TREATMENT -Tiamina I-TREATMENT -90 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -Piridoxina I-TREATMENT -150 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -Leucovorina I-TREATMENT -50 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -Cianocobalamina I-TREATMENT -2 I-TREATMENT -ampollas I-TREATMENT -y I-TREATMENT -c/24 I-TREATMENT -h I-TREATMENT -Meteonina I-TREATMENT -S-adenosylmetionina. I-TREATMENT - I-TREATMENT -Dos B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -paciente I-EVOLUTION -vigil I-EVOLUTION -con I-EVOLUTION -funciones I-EVOLUTION -superiores I-EVOLUTION -preservadas, I-EVOLUTION -había I-EVOLUTION -progresado I-EVOLUTION -la I-EVOLUTION -inestabilidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -marcha, I-EVOLUTION -agregándose I-EVOLUTION -hipostesia I-EVOLUTION -táctil, I-EVOLUTION -dificultad I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -bipedestación I-EVOLUTION -por I-EVOLUTION -debilidad I-EVOLUTION -proximal I-EVOLUTION -de I-EVOLUTION -EEII, I-EVOLUTION -hiperreflexia, I-EVOLUTION -Babinski I-EVOLUTION -e I-EVOLUTION -incontinencia I-EVOLUTION -urinaria. I-EVOLUTION -RM B-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -en I-EXPLORATION -cordones I-EXPLORATION -posteriores I-EXPLORATION -desde I-EXPLORATION -cervical I-EXPLORATION -a I-EXPLORATION -T11. I-EXPLORATION - I-EXPLORATION -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -aumentó I-EVOLUTION -la I-EVOLUTION -debilidad I-EVOLUTION -en I-EVOLUTION -EEII I-EVOLUTION -y I-EVOLUTION -pared I-EVOLUTION -abdominal, I-EVOLUTION -ROT I-EVOLUTION -apagados, I-EVOLUTION -Babinski, I-EVOLUTION -las I-EVOLUTION -alteraciones I-EVOLUTION -propioceptivas I-EVOLUTION -persistían, I-EVOLUTION -tenía I-EVOLUTION -preservada I-EVOLUTION -la I-EVOLUTION -sensibilidad I-EVOLUTION -dolorosa, I-EVOLUTION -sin I-EVOLUTION -compromiso I-EVOLUTION -en I-EVOLUTION -EESS. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -decimosegundo I-EVOLUTION -tenía I-EVOLUTION -paraplejia I-EVOLUTION -fláccida, I-EVOLUTION -ROT I-EVOLUTION -abolidos, I-EVOLUTION -sin I-EVOLUTION -nivel I-EVOLUTION -sensitivo. I-EVOLUTION -Un I-EVOLUTION -hemograma I-EVOLUTION -con I-EVOLUTION -recaída I-EVOLUTION -leucémica I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -decimonono I-EVOLUTION -obligó I-EVOLUTION -a I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -cuidados I-EVOLUTION -paliativos I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -domicilio. I-EVOLUTION -El I-EVOLUTION -compromiso I-EVOLUTION -neurológico I-EVOLUTION -no I-EVOLUTION -progresó, I-EVOLUTION -falleciendo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -LLA. I-EVOLUTION - I-EVOLUTION - -Mujer, B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hijos. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -17 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -diagnosticó I-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -polidipsia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -poliuria, I-PAST_MEDICAL_HISTORY -asociada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -glicemia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ayunas I-PAST_MEDICAL_HISTORY -130 I-PAST_MEDICAL_HISTORY -mg/dl, I-PAST_MEDICAL_HISTORY -confirmada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -prueba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tolerancia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -glucosa I-PAST_MEDICAL_HISTORY -oral I-PAST_MEDICAL_HISTORY -(PTGO) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -75 I-PAST_MEDICAL_HISTORY -g: I-PAST_MEDICAL_HISTORY -116 I-PAST_MEDICAL_HISTORY -mg/dl I-PAST_MEDICAL_HISTORY -ayunas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -234 I-PAST_MEDICAL_HISTORY -mg/dl I-PAST_MEDICAL_HISTORY -post I-PAST_MEDICAL_HISTORY -carga. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -descartó I-EXPLORATION -DM1 I-EXPLORATION -por I-EXPLORATION -autoanticuerpos I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -péptido I-EXPLORATION -C I-EXPLORATION -normal, I-EXPLORATION -HbA1c I-EXPLORATION -6, I-EXPLORATION -8% I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -sin I-EXPLORATION -glucosuria. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -RI, I-EXPLORATION -talla I-EXPLORATION -1, I-EXPLORATION -56 I-EXPLORATION -m I-EXPLORATION -y I-EXPLORATION -peso I-EXPLORATION -44, I-EXPLORATION -5 I-EXPLORATION -kg, I-EXPLORATION -IMC I-EXPLORATION -18 I-EXPLORATION -kg/m2. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -no I-TREATMENT -farmacológico I-TREATMENT -y I-TREATMENT -metformina I-TREATMENT -850 I-TREATMENT -mg/2 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Evolucionó B-EVOLUTION -satisfactoriamente I-EVOLUTION -durante I-EVOLUTION -4 I-EVOLUTION -años, I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -complicaciones, I-EVOLUTION -mantuvo I-EVOLUTION -HbA1c I-EVOLUTION -entre I-EVOLUTION -6-7%. I-EVOLUTION -En B-TREATMENT -enero I-TREATMENT -de I-TREATMENT -2015 I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -metformina I-TREATMENT -por I-TREATMENT -intolerancia I-TREATMENT -gástrica I-TREATMENT -y I-TREATMENT -considerando I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -y B-FAMILY_HISTORY -los I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -DM, I-FAMILY_HISTORY -se B-TREATMENT -planteó I-TREATMENT -que I-TREATMENT -podría I-TREATMENT -presentar I-TREATMENT -MODY. I-TREATMENT - I-TREATMENT -Se B-FAMILY_HISTORY -estudió I-FAMILY_HISTORY -la I-FAMILY_HISTORY -DM I-FAMILY_HISTORY -en I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -con I-FAMILY_HISTORY -PTGO, I-FAMILY_HISTORY -pesquisándose I-FAMILY_HISTORY -DM I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -padre. I-FAMILY_HISTORY -Su I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -presentaba I-FAMILY_HISTORY -anormalidad I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -glicemia. I-FAMILY_HISTORY -La I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -no I-FAMILY_HISTORY -tenía I-FAMILY_HISTORY -DM. I-FAMILY_HISTORY - I-FAMILY_HISTORY -*Rango I-FAMILY_HISTORY -normal: I-FAMILY_HISTORY -1, I-FAMILY_HISTORY -1 I-FAMILY_HISTORY -– I-FAMILY_HISTORY -4, I-FAMILY_HISTORY -4 I-FAMILY_HISTORY -ng/ml. I-FAMILY_HISTORY - I-FAMILY_HISTORY -De I-FAMILY_HISTORY -la I-FAMILY_HISTORY -anamnesis I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -destaca I-FAMILY_HISTORY -una I-FAMILY_HISTORY -fuerte I-FAMILY_HISTORY -presencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -DM I-FAMILY_HISTORY -por I-FAMILY_HISTORY -la I-FAMILY_HISTORY -línea I-FAMILY_HISTORY -paterna, I-FAMILY_HISTORY -donde I-FAMILY_HISTORY -8 I-FAMILY_HISTORY -de I-FAMILY_HISTORY -9 I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -del I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -del I-FAMILY_HISTORY -caso I-FAMILY_HISTORY -índice, I-FAMILY_HISTORY -están I-FAMILY_HISTORY -diagnosticados I-FAMILY_HISTORY -con I-FAMILY_HISTORY -DM2, I-FAMILY_HISTORY -además I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ambos I-FAMILY_HISTORY -abuelos. I-FAMILY_HISTORY -Por I-FAMILY_HISTORY -la I-FAMILY_HISTORY -línea I-FAMILY_HISTORY -materna, I-FAMILY_HISTORY -solamente I-FAMILY_HISTORY -la I-FAMILY_HISTORY -abuela I-FAMILY_HISTORY -y I-FAMILY_HISTORY -una I-FAMILY_HISTORY -tía I-FAMILY_HISTORY -tienen I-FAMILY_HISTORY -DM2. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Se B-EXPLORATION -utilizó I-EXPLORATION -la I-EXPLORATION -aplicación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Exeter5, I-EXPLORATION -estimándose I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -MODY I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -probabilidad I-EXPLORATION -de I-EXPLORATION -75, I-EXPLORATION -5%. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -familiar, I-EXPLORATION -para I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -contaba I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -consentimiento I-EXPLORATION -informado I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -participantes I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -aprobación I-EXPLORATION -del I-EXPLORATION -Comité I-EXPLORATION -de I-EXPLORATION -Ética I-EXPLORATION -del I-EXPLORATION -Hospital I-EXPLORATION -San I-EXPLORATION -Juan I-EXPLORATION -de I-EXPLORATION -Dios. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -análisis I-EXPLORATION -genético-molecular I-EXPLORATION -(Laboratorio I-EXPLORATION -de I-EXPLORATION -Genética I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Red I-EXPLORATION -UC-Christus I-EXPLORATION -Santiago, I-EXPLORATION -Chile) I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exones I-EXPLORATION -1 I-EXPLORATION -a I-EXPLORATION -10 I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -GCK I-EXPLORATION -mediante I-EXPLORATION -secuenciación I-EXPLORATION -directa I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -codificantes I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -uniones I-EXPLORATION -intrón-exón. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -mutación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -posición I-EXPLORATION -1343 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -10 I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -GCK, I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -cambio I-EXPLORATION -de I-EXPLORATION -guanina I-EXPLORATION -por I-EXPLORATION -adenina I-EXPLORATION -(1343 I-EXPLORATION -G>A); I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -otro I-EXPLORATION -alelo I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -dicha I-EXPLORATION -mutación I-EXPLORATION -(paciente I-EXPLORATION -heterocigota). I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -padre I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -hermano I-EXPLORATION -presentan I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -mutación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -GCK I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -heterocigota. I-EXPLORATION -La I-EXPLORATION -madre I-EXPLORATION -mostró I-EXPLORATION -ambos I-EXPLORATION -alelos I-EXPLORATION -silvestres, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -MODY2 I-EXPLORATION -ni I-EXPLORATION -tiene I-EXPLORATION -DM. I-EXPLORATION -La I-EXPLORATION -variante I-EXPLORATION -encontrada I-EXPLORATION -probablemente I-EXPLORATION -es I-EXPLORATION -patogénica, I-EXPLORATION -pues I-EXPLORATION -genera I-EXPLORATION -un I-EXPLORATION -cambio I-EXPLORATION -no I-EXPLORATION -sinónimo I-EXPLORATION -o I-EXPLORATION -missense I-EXPLORATION -del I-EXPLORATION -aminoácido I-EXPLORATION -(aa) I-EXPLORATION -glicina I-EXPLORATION -por I-EXPLORATION -ácido I-EXPLORATION -aspártico I-EXPLORATION -(Gly448Asp) I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -enzima I-EXPLORATION -glucoquinasa I-EXPLORATION -(GCK). I-EXPLORATION -Estos I-EXPLORATION -resultados I-EXPLORATION -permiten I-EXPLORATION -establecer I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -MODY2 I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -familia I-EXPLORATION -chilena I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -mutación I-EXPLORATION -no I-EXPLORATION -descrita I-EXPLORATION -previamente. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA), I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -asociada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -subclínico. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -evaluó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -HTA I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diabetes I-PRESENT_ILLNESS -mellitus. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -facies I-EXPLORATION -cushingoide I-EXPLORATION -y I-EXPLORATION -relleno I-EXPLORATION -de I-EXPLORATION -huecos I-EXPLORATION -supraclaviculares. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -cortisol I-EXPLORATION -libre I-EXPLORATION -urinario I-EXPLORATION -(CLU): I-EXPLORATION -236 I-EXPLORATION -ug/24 I-EXPLORATION -h I-EXPLORATION -(VN I-EXPLORATION -hasta I-EXPLORATION -100 I-EXPLORATION -ug/24 I-EXPLORATION -h), I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Nugent I-EXPLORATION -o I-EXPLORATION -de I-EXPLORATION -supresión I-EXPLORATION -nocturna I-EXPLORATION -con I-EXPLORATION -dexametasona I-EXPLORATION -(Dx) I-EXPLORATION -1 I-EXPLORATION -mg: I-EXPLORATION -11, I-EXPLORATION -1 I-EXPLORATION -ug/dl I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -1, I-EXPLORATION -8 I-EXPLORATION -ug/dl), I-EXPLORATION -ACTH I-EXPLORATION -32, I-EXPLORATION -1pg/ml I-EXPLORATION -(VN I-EXPLORATION -hasta I-EXPLORATION -46 I-EXPLORATION -pg/ml). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -funcional: I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Dx/ I-EXPLORATION -desmopresina, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -respuesta I-EXPLORATION -de I-EXPLORATION -cortisol I-EXPLORATION -postestímulo, I-EXPLORATION -sugiriendo I-EXPLORATION -origen I-EXPLORATION -hipofisiario. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -silla I-EXPLORATION -turca I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -adenoma I-EXPLORATION -posterolateral I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mm, I-EXPLORATION -que I-EXPLORATION -determina I-EXPLORATION -leve I-EXPLORATION -remodelación I-EXPLORATION -del I-EXPLORATION -piso I-EXPLORATION -selar. I-EXPLORATION -Por B-TREATMENT -distintas I-TREATMENT -razones, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -cirugía. I-TREATMENT -En B-EXPLORATION -controles I-EXPLORATION -sucesivos I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -CLU I-EXPLORATION -sin I-EXPLORATION -mediar I-EXPLORATION -tratamiento. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -3 I-EXPLORATION -años I-EXPLORATION -tuvo I-EXPLORATION -un I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Nugent I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -ng/dl, I-EXPLORATION -ACTH: I-EXPLORATION -54, I-EXPLORATION -8 I-EXPLORATION -pg/ml I-EXPLORATION -y I-EXPLORATION -CLU: I-EXPLORATION -50, I-EXPLORATION -1 I-EXPLORATION -ug/24 I-EXPLORATION -h. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -silla I-EXPLORATION -turca I-EXPLORATION -mostró I-EXPLORATION -adenoma I-EXPLORATION -de I-EXPLORATION -similares I-EXPLORATION -características, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -intratumoral. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -7 I-EXPLORATION -años I-EXPLORATION -tiene I-EXPLORATION -CLU I-EXPLORATION -28, I-EXPLORATION -8 I-EXPLORATION -ug/24 I-EXPLORATION -h, I-EXPLORATION -la I-EXPLORATION -diabetes I-EXPLORATION -mellitus I-EXPLORATION -mantiene I-EXPLORATION -un I-EXPLORATION -control I-EXPLORATION -adecuado I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -edad I-EXPLORATION -(HbA1c: I-EXPLORATION -7, I-EXPLORATION -6%) I-EXPLORATION -y I-EXPLORATION -ha I-EXPLORATION -disminuido I-EXPLORATION -10 I-EXPLORATION -kilos I-EXPLORATION -de I-EXPLORATION -peso I-EXPLORATION -desde I-EXPLORATION -su I-EXPLORATION -evaluación I-EXPLORATION -inicial. I-EXPLORATION - I-EXPLORATION -Ambas B-EVOLUTION -pacientes I-EVOLUTION -aún I-EVOLUTION -sobreviven, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -82 I-EVOLUTION -y I-EVOLUTION -88 I-EVOLUTION -años, I-EVOLUTION -respectivamente I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -manifiestan I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -hiperfunción I-EVOLUTION -endocrina. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -zurdo, B-PAST_MEDICAL_HISTORY -hipertenso, I-PAST_MEDICAL_HISTORY -despertó I-PAST_MEDICAL_HISTORY -desorientado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -disártrico, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -déficit I-PAST_MEDICAL_HISTORY -sensitivo-motor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -extremidades I-PAST_MEDICAL_HISTORY -derechas. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -vigilia, I-PRESENT_ILLNESS -cumplía I-PRESENT_ILLNESS -órdenes I-PRESENT_ILLNESS -simples, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -mantenía I-PRESENT_ILLNESS -cerrados I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -ojos, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apertura I-PRESENT_ILLNESS -mecánica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -párpados I-PRESENT_ILLNESS -mostró I-PRESENT_ILLNESS -pupilas I-PRESENT_ILLNESS -iguales, I-PRESENT_ILLNESS -oculomotilidad I-PRESENT_ILLNESS -conservada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -preferencial I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -hemiplejia I-PRESENT_ILLNESS -faciobraquiocrural I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hemianopsia. I-PRESENT_ILLNESS -La B-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -mostró I-EXPLORATION -hematoma I-EXPLORATION -fronto-parietal I-EXPLORATION -izquierdo. I-EXPLORATION -Al B-TREATMENT -segundo I-TREATMENT -día, I-TREATMENT -debido I-TREATMENT -al I-TREATMENT -progresivo I-TREATMENT -deterioro I-TREATMENT -clínico, I-TREATMENT -fue I-TREATMENT -necesario I-TREATMENT -drenar I-TREATMENT -el I-TREATMENT -hematoma, I-TREATMENT -que B-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -Permaneció I-EVOLUTION -comprometido I-EVOLUTION -de I-EVOLUTION -conciencia I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -sexto I-EVOLUTION -día. I-EVOLUTION -Cuando I-EVOLUTION -recuperó I-EVOLUTION -la I-EVOLUTION -vigilancia I-EVOLUTION -podía I-EVOLUTION -apretar I-EVOLUTION -la I-EVOLUTION -mano I-EVOLUTION -izquierda, I-EVOLUTION -pero I-EVOLUTION -era I-EVOLUTION -incapaz I-EVOLUTION -de I-EVOLUTION -abrir I-EVOLUTION -voluntariamente I-EVOLUTION -los I-EVOLUTION -ojos, I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -comprobar I-EVOLUTION -que I-EVOLUTION -conservaba I-EVOLUTION -la I-EVOLUTION -oculomotilidad I-EVOLUTION -voluntaria I-EVOLUTION -y I-EVOLUTION -dirigía I-EVOLUTION -la I-EVOLUTION -mirada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -orden. I-EVOLUTION -Desde I-EVOLUTION -el I-EVOLUTION -octavo I-EVOLUTION -día I-EVOLUTION -inició I-EVOLUTION -apertura I-EVOLUTION -palpebral I-EVOLUTION -parcial I-EVOLUTION -y I-EVOLUTION -transitoria I-EVOLUTION -del I-EVOLUTION -ojo I-EVOLUTION -izquierdo. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -subsiguientes I-EVOLUTION -lograba I-EVOLUTION -la I-EVOLUTION -elevación I-EVOLUTION -transitoria I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -párpados, I-EVOLUTION -notándose I-EVOLUTION -al I-EVOLUTION -decimosegundo I-EVOLUTION -día I-EVOLUTION -mayor I-EVOLUTION -apertura I-EVOLUTION -del I-EVOLUTION -ojo I-EVOLUTION -derecho. I-EVOLUTION -Después I-EVOLUTION -del I-EVOLUTION -decimotercer I-EVOLUTION -día I-EVOLUTION -tenía I-EVOLUTION -elevación I-EVOLUTION -persistente I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -párpados. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EF, I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -miocardiopatía. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -inicia I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -quemante I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pies I-PAST_MEDICAL_HISTORY -desencadenadas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ejercicio, I-PAST_MEDICAL_HISTORY -exposición I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -sol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fiebre. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -disminución I-PAST_MEDICAL_HISTORY -progresiva I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -crisis. I-PAST_MEDICAL_HISTORY -Ocasionalmente I-PAST_MEDICAL_HISTORY -sensación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mareo I-PAST_MEDICAL_HISTORY -subjetivo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estitiquez-diarrea. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -42 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -parte I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -familiar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -medición I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -enzimáticos. I-PAST_MEDICAL_HISTORY -Inició I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -reemplazo I-PAST_MEDICAL_HISTORY -enzimático I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -45 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -diagnostica I-PRESENT_ILLNESS -miocardiopatía I-PRESENT_ILLNESS -hipertrófica I-PRESENT_ILLNESS -y B-TREATMENT -se I-TREATMENT -instala I-TREATMENT -marcapaso. I-TREATMENT -Escasos B-EXPLORATION -angioqueratomas. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -neurológico I-EXPLORATION -mostro I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -polineuropatía I-EXPLORATION -sensitiva I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -neurofisiológica I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -polineuropatía I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -sensitivo I-EXPLORATION -axonal I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -mielínicas I-EXPLORATION -gruesas I-EXPLORATION -y I-EXPLORATION -severo I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -mielínicas I-EXPLORATION -delgadas I-EXPLORATION -y I-EXPLORATION -amielínicas, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -radiculopatía I-EXPLORATION -L5-S1 I-EXPLORATION -izquierda. I-EXPLORATION -Ausencia I-EXPLORATION -generalizada I-EXPLORATION -de I-EXPLORATION -RSC. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -evaluación I-EXPLORATION -intervalo I-EXPLORATION -R-R, I-EXPLORATION -debido I-EXPLORATION -al I-EXPLORATION -uso I-EXPLORATION -de I-EXPLORATION -marcapasos. I-EXPLORATION - I-EXPLORATION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -inicia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -quemante I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -manos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pies, I-PRESENT_ILLNESS -desencadenados I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ejercicio, I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -calor I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -frío. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pies I-PRESENT_ILLNESS -congelados, I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -pone I-PRESENT_ILLNESS -pies I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -tibia I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -abriga. I-PRESENT_ILLNESS -Ocasionalmente I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pinchazos. I-PRESENT_ILLNESS -Distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -ocasional. I-PRESENT_ILLNESS -Escasos B-EXPLORATION -angioqueratomas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -reciente I-EXPLORATION -en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -estudio I-EXPLORATION -familiar, I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -enzimáticos. I-EXPLORATION -Inicio B-TREATMENT -reciente I-TREATMENT -de I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -remplazo I-TREATMENT -enzimática. I-TREATMENT -Evaluación B-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -neurofisiológica I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -neuropático I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -mielínicas I-EXPLORATION -delgadas I-EXPLORATION -y I-EXPLORATION -amielínicas. I-EXPLORATION -Ausencia I-EXPLORATION -generalizada I-EXPLORATION -de I-EXPLORATION -RSC I-EXPLORATION -y I-EXPLORATION -evaluación I-EXPLORATION -de I-EXPLORATION -intervalo I-EXPLORATION -R-R I-EXPLORATION -en I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -trasladado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -UCI I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disnea, I-PRESENT_ILLNESS -hipotensión I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desaturación, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39.5°C. I-PRESENT_ILLNESS -Se B-EXPLORATION -diagnostica I-EXPLORATION -de I-EXPLORATION -shock I-EXPLORATION -séptico I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -colitis I-EXPLORATION -infecciosa. I-EXPLORATION -A B-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -drogas I-TREATMENT -vasoactivas I-TREATMENT -(noradrenalina I-TREATMENT -a I-TREATMENT -0.1 I-TREATMENT -ugr/kg/min I-TREATMENT -y I-TREATMENT -dopamina I-TREATMENT -a I-TREATMENT -6 I-TREATMENT -ugr/kg/min) I-TREATMENT -y I-TREATMENT -cobertura I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -llegada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -UCI, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -realizar I-EVOLUTION -deposiciones I-EVOLUTION -con I-EVOLUTION -aspecto I-EVOLUTION -melénico I-EVOLUTION -en I-EVOLUTION -cantidad I-EVOLUTION -abundante. I-EVOLUTION -Para B-EXPLORATION -facilitar I-EXPLORATION -la I-EXPLORATION -valoración I-EXPLORATION -exacta I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -heces, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mismas I-EXPLORATION -se I-EXPLORATION -coloca I-EXPLORATION -un I-EXPLORATION -dispositivo I-EXPLORATION -de I-EXPLORATION -incontinencia I-EXPLORATION -fecal I-EXPLORATION -Flexi-Seal I-EXPLORATION -FMS. I-EXPLORATION -Dicho I-EXPLORATION -dispositivo I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -colocado I-EXPLORATION -durante I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION -sin I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -de I-EXPLORATION -ninguna I-EXPLORATION -complicación, I-EXPLORATION -procediéndose I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -retirada I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -heces, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -consistencia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mismas. I-EXPLORATION -En B-TREATMENT -su I-TREATMENT -8º I-TREATMENT -día I-TREATMENT -en I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -aporte I-TREATMENT -nutricional I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -enteral, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -mala I-TREATMENT -tolerancia I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT -realizando I-TREATMENT -varias I-TREATMENT -deposiciones I-TREATMENT -diarias I-TREATMENT -aunque I-TREATMENT -en I-TREATMENT -escasa I-TREATMENT -cantidad. I-TREATMENT -Además, I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -solucionado I-TREATMENT -el I-TREATMENT -episodio I-TREATMENT -de I-TREATMENT -sangrado I-TREATMENT -digestivo I-TREATMENT -se I-TREATMENT -inicio I-TREATMENT -profilaxis I-TREATMENT -antitrombótica I-TREATMENT -con I-TREATMENT -enoxaparina I-TREATMENT -40 I-TREATMENT -mg/día I-TREATMENT -subcutáneo. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -25º I-EVOLUTION -tras I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -retirada I-EVOLUTION -del I-EVOLUTION -dispositivo, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comienza I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -brusca I-EVOLUTION -con I-EVOLUTION -dos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -rectorragia I-EVOLUTION -importante, I-EVOLUTION -sin I-EVOLUTION -producirse I-EVOLUTION -inestabilización I-EVOLUTION -hemodinámica. I-EVOLUTION -Se B-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -urgente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -normal I-EXPLORATION -hasta I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -recto I-EXPLORATION -distal, I-EXPLORATION -lugar I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -ulceración I-EXPLORATION -que I-EXPLORATION -abarca I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -circunferencia, I-EXPLORATION -existiendo I-EXPLORATION -además I-EXPLORATION -depósitos I-EXPLORATION -de I-EXPLORATION -fibrina I-EXPLORATION -y I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -necrótico, I-EXPLORATION -que I-EXPLORATION -impresiona I-EXPLORATION -de I-EXPLORATION -ulceración I-EXPLORATION -por I-EXPLORATION -sonda. I-EXPLORATION - I-EXPLORATION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -procedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -municipio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Guzmán, I-PAST_MEDICAL_HISTORY -Putumayo, I-PAST_MEDICAL_HISTORY -llevada B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -supurante I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cuello I-PRESENT_ILLNESS -presente I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -nacimiento, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cedió I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antibióticos. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -que I-EXPLORATION -sugería I-EXPLORATION -una I-EXPLORATION -fístula, I-EXPLORATION -según I-EXPLORATION -lo I-EXPLORATION -referido I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -historia I-EXPLORATION -clínica. I-EXPLORATION -Con B-TREATMENT -este I-TREATMENT -diagnóstico I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -para I-TREATMENT -cirugía. I-TREATMENT -En B-EXPLORATION -exámenes I-EXPLORATION -prequirúrgicos I-EXPLORATION -se I-EXPLORATION -reportó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tripomastigotes I-EXPLORATION -de I-EXPLORATION -T. I-EXPLORATION -cruzi I-EXPLORATION -en I-EXPLORATION -extendido I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -periférica. I-EXPLORATION -Se B-TREATMENT -prescribió I-TREATMENT -tratamiento I-TREATMENT -etiológico I-TREATMENT -con I-TREATMENT -benzonidazol I-TREATMENT -por I-TREATMENT -60 I-TREATMENT -días. I-TREATMENT -El B-EXPLORATION -diagnóstico I-EXPLORATION -fue I-EXPLORATION -confirmado I-EXPLORATION -mediante I-EXPLORATION -aislamiento, I-EXPLORATION -cultivo, I-EXPLORATION -isoenzimas, I-EXPLORATION -inoculación I-EXPLORATION -en I-EXPLORATION -ratón I-EXPLORATION -y I-EXPLORATION -PCR. I-EXPLORATION - I-EXPLORATION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -municipio I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -Peñón, I-PAST_MEDICAL_HISTORY -Santander. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -eritema I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -secreción I-PRESENT_ILLNESS -ocular I-PRESENT_ILLNESS -purulenta. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -edema I-EXPLORATION -palpebral I-EXPLORATION -y I-EXPLORATION -conjuntiva I-EXPLORATION -izquierda I-EXPLORATION -hiperémica I-EXPLORATION -sin I-EXPLORATION -secreciones. I-EXPLORATION -Se B-TREATMENT -hizo I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -celulitis I-TREATMENT -periorbitaria I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -manejo I-TREATMENT -antibiótico I-TREATMENT -ambulatorio. I-TREATMENT -Un B-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -consistente I-EVOLUTION -en I-EVOLUTION -debilidad, I-EVOLUTION -fiebre I-EVOLUTION -subjetiva, I-EVOLUTION -disnea, I-EVOLUTION -cefalea, I-EVOLUTION -malestar I-EVOLUTION -general I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -faríngeo. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -ficha I-EXPLORATION -epide-miológica I-EXPLORATION -se I-EXPLORATION -consignó I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Romaña I-EXPLORATION -positivo I-EXPLORATION -(probablemente I-EXPLORATION -en I-EXPLORATION -retrospectiva). I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -pruebas I-EXPLORATION -serológicas, I-EXPLORATION -reportadas I-EXPLORATION -como I-EXPLORATION -Elisa I-EXPLORATION -positivo I-EXPLORATION -e I-EXPLORATION -IFI I-EXPLORATION -reactivo I-EXPLORATION -con I-EXPLORATION -título I-EXPLORATION -de I-EXPLORATION -1: I-EXPLORATION -32, I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -Laboratorio I-EXPLORATION -Departamental I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION -de I-EXPLORATION -Santander. I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -etiológico I-TREATMENT -con I-TREATMENT -benzonidazol I-TREATMENT -a I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -250 I-TREATMENT -mg/día I-TREATMENT -durante I-TREATMENT -60 I-TREATMENT -días. I-TREATMENT -El B-EXPLORATION -diagnóstico I-EXPLORATION -fue I-EXPLORATION -confirmado I-EXPLORATION -mediante I-EXPLORATION -serología I-EXPLORATION -por I-EXPLORATION -IFI I-EXPLORATION -reactiva I-EXPLORATION -1: I-EXPLORATION -64 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -INS. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -para I-EXPLORATION -cultivo. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -municipio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Carepa, I-PAST_MEDICAL_HISTORY -quien B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -llevada I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rinorrea I-PRESENT_ILLNESS -hialina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -diarreicas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -moco I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -sangre. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -epistaxis. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -hipoactiva, I-EXPLORATION -con I-EXPLORATION -palidez I-EXPLORATION -generalizada I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -epistaxis I-EXPLORATION -reciente I-EXPLORATION -en I-EXPLORATION -narina I-EXPLORATION -derecha, I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION -de I-EXPLORATION -37, I-EXPLORATION -5 I-EXPLORATION -°C, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -96 I-EXPLORATION -por I-EXPLORATION -minuto I-EXPLORATION -y I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -de I-EXPLORATION -32 I-EXPLORATION -por I-EXPLORATION -minuto. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -hepatoesplenomegalia. I-EXPLORATION -Con B-TREATMENT -esta I-TREATMENT -historia I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -una I-TREATMENT -impresión I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -dengue I-TREATMENT -con I-TREATMENT -manifestaciones I-TREATMENT -hemorrágicas I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -líquidos I-TREATMENT -y I-TREATMENT -antipiréticos. I-TREATMENT - I-TREATMENT -Los B-EXPLORATION -exámenes I-EXPLORATION -paraclínicos I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -reportaron I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -18, I-EXPLORATION -4%, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -8.600/ml, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -30.000/µl, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -2, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -directa I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dl. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -persistió I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -gota I-EXPLORATION -gruesa, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -P. I-EXPLORATION -vivax. I-EXPLORATION -Con B-TREATMENT -este I-TREATMENT -resultado I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cloroquina. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -cuadro I-EVOLUTION -febril. I-EVOLUTION -A B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -su I-TREATMENT -estado I-TREATMENT -hematológico, I-TREATMENT -no I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -ninguna I-TREATMENT -intervención. I-TREATMENT -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -se I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -largo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oído I-PRESENT_ILLNESS -tapado I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipoacusia I-PRESENT_ILLNESS -ligera, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -manejada I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -tapón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cerumen I-PRESENT_ILLNESS -repetidamente I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -medicina I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lavados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oído. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -incrementaron I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -profundizó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hipoacusia I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -llegar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sordera I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conducción I-PRESENT_ILLNESS -definida I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -otorrinolaringólogo. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -consulta I-EXPLORATION -con I-EXPLORATION -este I-EXPLORATION -especialista, I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -apariencia I-EXPLORATION -tumoral I-EXPLORATION -que I-EXPLORATION -protruía I-EXPLORATION -del I-EXPLORATION -oído I-EXPLORATION -medio I-EXPLORATION -con I-EXPLORATION -lesión I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -membrana I-EXPLORATION -timpánica. I-EXPLORATION -Fue B-TREATMENT -llevada I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -para I-TREATMENT -resección-biopsia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -y I-TREATMENT -se I-TREATMENT -obtuvieron, I-TREATMENT -mediante I-TREATMENT -miringotomía, I-TREATMENT -múltiples I-TREATMENT -fragmentos I-TREATMENT -de I-TREATMENT -tejido I-TREATMENT -de I-TREATMENT -consistencia I-TREATMENT -firme, I-TREATMENT -de I-TREATMENT -color I-TREATMENT -parduzco, I-TREATMENT -con I-TREATMENT -escaso I-TREATMENT -sangrado. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -mencionó I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -especialista I-TREATMENT -el I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cadena I-TREATMENT -de I-TREATMENT -huesecillos I-TREATMENT -ni I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -facial. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -histológico, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -recubierto I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -escamoso I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -epitelial I-EXPLORATION -benigno I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -expansivo, I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -estructuras I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -trabécula I-EXPLORATION -y I-EXPLORATION -tubulares I-EXPLORATION -revestidas I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -capa I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -rectangulares I-EXPLORATION -sin I-EXPLORATION -atipias I-EXPLORATION -ni I-EXPLORATION -mitosis, I-EXPLORATION -con I-EXPLORATION -secreción I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -luz, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -áreas I-EXPLORATION -sólidas I-EXPLORATION -compuestas I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -escaso I-EXPLORATION -citoplasma I-EXPLORATION -y I-EXPLORATION -núcleo I-EXPLORATION -pequeño I-EXPLORATION -hipercromático. I-EXPLORATION -El I-EXPLORATION -estroma I-EXPLORATION -estaba I-EXPLORATION -ricamente I-EXPLORATION -irrigado. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -histoquímica I-EXPLORATION -con I-EXPLORATION -coloraciones I-EXPLORATION -de I-EXPLORATION -ácido I-EXPLORATION -peryódico I-EXPLORATION -de I-EXPLORATION -Schiff I-EXPLORATION -(PAS), I-EXPLORATION -Ziehl-Nielsen I-EXPLORATION -(ZN) I-EXPLORATION -y I-EXPLORATION -azul I-EXPLORATION -alciano I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Patología I-EXPLORATION -Interfacultades I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Colombia, I-EXPLORATION -acorde I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -metodología I-EXPLORATION -adaptada I-EXPLORATION -del I-EXPLORATION -Armed I-EXPLORATION -Forces I-EXPLORATION -Institute I-EXPLORATION -of I-EXPLORATION -Pathology I-EXPLORATION -(AFIP) I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -Estados I-EXPLORATION -Unidos I-EXPLORATION -(10), I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -secreción I-EXPLORATION -de I-EXPLORATION -mucoproteínas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -y I-EXPLORATION -mínimo I-EXPLORATION -componente I-EXPLORATION -intracitoplasmático I-EXPLORATION -; I-EXPLORATION -igualmente, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -pigmento I-EXPLORATION -pardo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -citoplasma I-EXPLORATION -celular. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -las I-EXPLORATION -tinciones I-EXPLORATION -de I-EXPLORATION -inmunohistoquímica, I-EXPLORATION -se I-EXPLORATION -empleó I-EXPLORATION -la I-EXPLORATION -metodología I-EXPLORATION -propia I-EXPLORATION -del I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Patología I-EXPLORATION -Interfacultades I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Colombia, I-EXPLORATION -adaptada I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -insertos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -reactivos. I-EXPLORATION -Previa I-EXPLORATION -inhibición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -actividad I-EXPLORATION -peroxidasa I-EXPLORATION -endógena I-EXPLORATION -con I-EXPLORATION -H2O2 I-EXPLORATION -al I-EXPLORATION -3%, I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -la I-EXPLORATION -recuperación I-EXPLORATION -antigénica I-EXPLORATION -en I-EXPLORATION -Target I-EXPLORATION -10x I-EXPLORATION -(Dako®) I-EXPLORATION -y I-EXPLORATION -lavados I-EXPLORATION -seriados I-EXPLORATION -con I-EXPLORATION -TBS, I-EXPLORATION -se I-EXPLORATION -incubó I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -minutos I-EXPLORATION -con I-EXPLORATION -cromogranín I-EXPLORATION -A I-EXPLORATION -en I-EXPLORATION -dilución I-EXPLORATION -1: I-EXPLORATION -200 I-EXPLORATION -(Novocastra®) I-EXPLORATION -y I-EXPLORATION -RTU-S100p I-EXPLORATION -prediluida I-EXPLORATION -(Novocastra®), I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -valoró I-EXPLORATION -la I-EXPLORATION -reactividad I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -sistema I-EXPLORATION -de I-EXPLORATION -estreptavidina-HRP I-EXPLORATION -(Dako®), I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -usó I-EXPLORATION -como I-EXPLORATION -cromógeno I-EXPLORATION -diaminobencidina I-EXPLORATION -(DAB). I-EXPLORATION -Luego I-EXPLORATION -del I-EXPLORATION -montaje I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -láminas, I-EXPLORATION -se I-EXPLORATION -pudo I-EXPLORATION -demostrar I-EXPLORATION -la I-EXPLORATION -positividad, I-EXPLORATION -tanto I-EXPLORATION -de I-EXPLORATION -cromogranina I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -S100 I-EXPLORATION -con I-EXPLORATION -intensidad I-EXPLORATION -leve I-EXPLORATION -a I-EXPLORATION -moderada, I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -patrones I-EXPLORATION -observados I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -mioepiteliales I-EXPLORATION -con I-EXPLORATION -S100. I-EXPLORATION - I-EXPLORATION - -El B-PRESENT_ILLNESS -primer I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -licor I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -fin I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -embriaguez, I-PAST_MEDICAL_HISTORY -cuatro B-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -purulenta, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -moderados I-PRESENT_ILLNESS -esfuerzos, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5°C, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -pleurítico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hemitórax I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -automedicación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dexametasona I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -mg I-PRESENT_ILLNESS -intramuscular I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -admisión. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Ingresó B-EXPLORATION -febril, I-EXPLORATION -taquicárdico, I-EXPLORATION -taquipneico, I-EXPLORATION -hipo-xémico I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -y I-EXPLORATION -consolidación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -muestra I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -14.500 I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION -neutrofilia I-EXPLORATION -de I-EXPLORATION -96%, I-EXPLORATION -hiperglucemia I-EXPLORATION -de I-EXPLORATION -638 I-EXPLORATION -mg/dl, I-EXPLORATION -hiperazoemia I-EXPLORATION -(nitrógeno I-EXPLORATION -ureico I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -de I-EXPLORATION -27, I-EXPLORATION -45 I-EXPLORATION -mg/dl). I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -neumonía I-EVOLUTION -grave I-EVOLUTION -extrahospitalaria I-EVOLUTION -IIIA, I-EVOLUTION -según I-EVOLUTION -las I-EVOLUTION -guías I-EVOLUTION -nacionales I-EVOLUTION -de I-EVOLUTION -manejo I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -enfermedad I-EVOLUTION -(6). I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -progresó I-EVOLUTION -rápidamente I-EVOLUTION -a I-EVOLUTION -falla I-EVOLUTION -respiratoria I-EVOLUTION -hipoxémica, I-EVOLUTION -con I-EVOLUTION -choque I-EVOLUTION -séptico I-EVOLUTION -y, I-EVOLUTION -posteriormente, I-EVOLUTION -disfunción I-EVOLUTION -orgánica I-EVOLUTION -múltiple. I-EVOLUTION -Se B-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cuidados I-DERIVED_FROM/TO -intensivos, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se B-TREATMENT -inició I-TREATMENT -manejo I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -ceftriaxona, I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -endovenosos I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -y I-TREATMENT -claritromicina, I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -endovenosos I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computadorizada I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -consolidación I-EXPLORATION -multilobar I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -lóbulos I-EXPLORATION -inferiores I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -bilateral, I-EXPLORATION -no I-EXPLORATION -libre I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudió I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -indicó I-EXPLORATION -empiema I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -cocos I-EXPLORATION -Gram I-EXPLORATION -positivos. I-EXPLORATION -Requirió B-TREATMENT -toracostomía I-TREATMENT -de I-TREATMENT -drenaje I-TREATMENT -cerrado I-TREATMENT -y I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -posteriormente I-TREATMENT -toracotomía I-TREATMENT -más I-TREATMENT -decorticación. I-TREATMENT -Durante B-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -postoperatorio, I-EVOLUTION -persistieron I-EVOLUTION -los I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -respuesta I-EVOLUTION -inflamatoria I-EVOLUTION -sistémica. I-EVOLUTION -Ante B-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -requirió I-TREATMENT -soporte I-TREATMENT -dialítico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -antibiótico I-TREATMENT -a I-TREATMENT -linezolide. I-TREATMENT -Posterior B-EVOLUTION -al I-EVOLUTION -cambio I-EVOLUTION -de I-EVOLUTION -antimicrobiano I-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -adecuada, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -permitió I-EVOLUTION -retirarlo I-EVOLUTION -del I-EVOLUTION -respirador I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -soporte I-EVOLUTION -vasopresor. I-EVOLUTION -Se I-EVOLUTION -completaron I-EVOLUTION -21 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -respuesta I-EVOLUTION -satisfactoria I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -terapia I-EVOLUTION -antimicrobiana I-EVOLUTION -ambulatoria I-EVOLUTION -adicional. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -manejo I-PAST_MEDICAL_HISTORY -farmacológico, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alcoholismo, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -clínico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -súbito I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sensación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mareo; I-PAST_MEDICAL_HISTORY -cuatro B-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -disartria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hemiparesia I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Consultó B-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -urgencias I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -encontró I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -120/70 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -y I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -100 I-EXPLORATION -por I-EXPLORATION -minuto; I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Estaba I-EXPLORATION -alerta, I-EXPLORATION -orientado I-EXPLORATION -en I-EXPLORATION -persona, I-EXPLORATION -tiempo I-EXPLORATION -y I-EXPLORATION -espacio, I-EXPLORATION -con I-EXPLORATION -disartria, I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -esfera I-EXPLORATION -mental, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -meníngeos; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cráneo I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION -vertebral; I-EXPLORATION -había I-EXPLORATION -isocoria I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -pupila I-EXPLORATION -de I-EXPLORATION -Argyll I-EXPLORATION -Robertson, I-EXPLORATION -parálisis I-EXPLORATION -facial I-EXPLORATION -izquierda, I-EXPLORATION -con I-EXPLORATION -escasa I-EXPLORATION -elevación I-EXPLORATION -del I-EXPLORATION -velo I-EXPLORATION -del I-EXPLORATION -paladar I-EXPLORATION -y I-EXPLORATION -trastornos I-EXPLORATION -dinámicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -deglución, I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -nervios I-EXPLORATION -craneales. I-EXPLORATION - I-EXPLORATION -Presentaba I-EXPLORATION -hemiparesia I-EXPLORATION -izquierda, I-EXPLORATION -con I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fuerza I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -miembro I-EXPLORATION -superior I-EXPLORATION -(3/5) I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -inferior I-EXPLORATION -(4/5), I-EXPLORATION -con I-EXPLORATION -hiperreflexia I-EXPLORATION -generalizada I-EXPLORATION -simétrica, I-EXPLORATION -con I-EXPLORATION -respuesta I-EXPLORATION -plantar I-EXPLORATION -izquierda I-EXPLORATION -neutra I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -flexión I-EXPLORATION -contralateral; I-EXPLORATION -además, I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -temblor I-EXPLORATION -de I-EXPLORATION -acción I-EXPLORATION -y I-EXPLORATION -postural I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -derecha, I-EXPLORATION -sin I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computadorizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hipodensa, I-EXPLORATION -lacunar, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -interna. I-EXPLORATION -Ese I-EXPLORATION -mismo I-EXPLORATION -día I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -un I-EXPLORATION -infarto I-EXPLORATION -póntico I-EXPLORATION -extenso, I-EXPLORATION -con I-EXPLORATION -estenosis I-EXPLORATION -crítica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -basilar I-EXPLORATION -y I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -vertebral I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -circulación I-EXPLORATION -anterior. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -sometió I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -endovascular I-TREATMENT -en I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -estenosis I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -tercio I-TREATMENT -inferior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -basilar, I-TREATMENT -sin I-TREATMENT -flujo I-TREATMENT -distal, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -stent I-TREATMENT -sin I-TREATMENT -complicaciones, I-TREATMENT -quedando I-TREATMENT -con I-TREATMENT -una I-TREATMENT -estenosis I-TREATMENT -residual I-TREATMENT -de I-TREATMENT -24 I-TREATMENT -%. I-TREATMENT - I-TREATMENT -Durante B-EXPLORATION -la I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -hicieron I-EXPLORATION -estudios I-EXPLORATION -para I-EXPLORATION -accidente I-EXPLORATION -cerebrovascular I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -era I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -VIH, I-EXPLORATION -el I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -suero I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -(1:256) I-EXPLORATION -con I-EXPLORATION -FTA-ABS, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -compromiso I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -nervioso I-EXPLORATION -central. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -pleocitosis I-EXPLORATION -de I-EXPLORATION -65 I-EXPLORATION -leucocitos I-EXPLORATION -por I-EXPLORATION -mm3 I-EXPLORATION -con I-EXPLORATION -10 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -polimorfonucleares I-EXPLORATION -y I-EXPLORATION -90 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -mononucleares, I-EXPLORATION -glucosa I-EXPLORATION -de I-EXPLORATION -71 I-EXPLORATION -mg/dl, I-EXPLORATION -proteínas I-EXPLORATION -de I-EXPLORATION -33 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -VDRL I-EXPLORATION -reactivo I-EXPLORATION -(1:2). I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -se I-TREATMENT -confirmó I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -neurosífilis I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -24 I-TREATMENT -millones I-TREATMENT -de I-TREATMENT -unidades I-TREATMENT -de I-TREATMENT -penicilina I-TREATMENT -cristalina I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT -Durante I-TREATMENT -su I-TREATMENT -estadía I-TREATMENT -en I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intensivos, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -requirió I-TREATMENT -intubación I-TREATMENT -orotraqueal I-TREATMENT -por I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -aérea I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -su I-TREATMENT -infarto I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tallo I-TREATMENT -cerebral. I-TREATMENT -Presentó B-EVOLUTION -una I-EVOLUTION -neumonía I-EVOLUTION -tardía I-EVOLUTION -asociada I-EVOLUTION -al I-EVOLUTION -respirador I-EVOLUTION -por I-EVOLUTION -Serratia I-EVOLUTION -marcescens, I-EVOLUTION -para B-TREATMENT -la I-TREATMENT -cual I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -antibiótico, I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT -Durante B-EVOLUTION -su I-EVOLUTION -hospitalización, I-EVOLUTION -no I-EVOLUTION -recuperó I-EVOLUTION -la I-EVOLUTION -funcionalidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -nervios I-EVOLUTION -craneales I-EVOLUTION -bulbares, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -fue I-TREATMENT -necesario I-TREATMENT -practicar I-TREATMENT -traqueostomía I-TREATMENT -y I-TREATMENT -gastrostomía. I-TREATMENT -Antes B-EXPLORATION -de I-EXPLORATION -dar I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -al I-EXPLORATION -paciente, I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -importante I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pleocitosis I-EXPLORATION -y I-EXPLORATION -proteinorraquia; I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -el I-EXPLORATION -VDRL I-EXPLORATION -fue I-EXPLORATION -reactivo I-EXPLORATION -(1:8), I-EXPLORATION -probablemente I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION -posterior I-EXPLORATION -al I-EXPLORATION -tratamiento. I-EXPLORATION - I-EXPLORATION -Fue B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -disartria, I-EVOLUTION -parálisis I-EVOLUTION -supranuclear I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mirada, I-EVOLUTION -hemiparesia I-EVOLUTION -izquierda, I-EVOLUTION -traqueostomía, I-EVOLUTION -gastrostomía I-EVOLUTION -percutánea I-EVOLUTION -y B-TREATMENT -manejo I-TREATMENT -ambulatorio I-TREATMENT -dual I-TREATMENT -con I-TREATMENT -antiagregación I-TREATMENT -plaquetaria. I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -proveniente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Palmira I-PAST_MEDICAL_HISTORY -(población I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -suroccidente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Colombia I-PAST_MEDICAL_HISTORY -cerca I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Costa I-PAST_MEDICAL_HISTORY -Pacífica), I-PAST_MEDICAL_HISTORY -referida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Clínica I-DERIVED_FROM/TO -Sebastián I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Belalcázar I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cali, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -historia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -20 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -fiebre I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -tos I-DERIVED_FROM/TO -productiva, I-DERIVED_FROM/TO -asociada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -pérdida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -peso I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -seis I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -(4 I-DERIVED_FROM/TO -kg) I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -infección I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vías I-DERIVED_FROM/TO -aéreas I-DERIVED_FROM/TO -superiores I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -antibiótico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -tórpida. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -hepatoesplenomegalia I-EXPLORATION -y I-EXPLORATION -adenopatía I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -axila I-EXPLORATION -derecha; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -manifestaciones I-EXPLORATION -cutáneas. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -hemático I-EXPLORATION -inicialmente I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -anemia I-EXPLORATION -y I-EXPLORATION -leucopenia, I-EXPLORATION -seguidas I-EXPLORATION -por I-EXPLORATION -leucocitosis, I-EXPLORATION -linfocitosis I-EXPLORATION -(11.000/mm I-EXPLORATION -3 I-EXPLORATION -) I-EXPLORATION -y I-EXPLORATION -neutropenia I-EXPLORATION -absoluta. I-EXPLORATION -Se I-EXPLORATION -encontraron I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -deshigrogenasa I-EXPLORATION -láctica I-EXPLORATION -de I-EXPLORATION -300 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -calcio I-EXPLORATION -sérico I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -obtuvieron I-EXPLORATION -biopsias I-EXPLORATION -de I-EXPLORATION -ganglio I-EXPLORATION -linfático I-EXPLORATION -y I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -fin I-EXPLORATION -de I-EXPLORATION -descartar I-EXPLORATION -un I-EXPLORATION -linfoma. I-EXPLORATION -Estos I-EXPLORATION -dos I-EXPLORATION -tejidos I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -sangre I-EXPLORATION -estaban I-EXPLORATION -infiltrados I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -T I-EXPLORATION -con I-EXPLORATION -importante I-EXPLORATION -pleomorfismo I-EXPLORATION -nuclear. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -extendidos I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -"células I-EXPLORATION -flor" I-EXPLORATION -( I-EXPLORATION -flower I-EXPLORATION -cells I-EXPLORATION -) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -identificó I-EXPLORATION -un I-EXPLORATION -fenotipo I-EXPLORATION -CD3+, I-EXPLORATION -CD2+, I-EXPLORATION -CD4+, I-EXPLORATION -CD5+, I-EXPLORATION -CD7-, I-EXPLORATION -CD8-, I-EXPLORATION -CD56- I-EXPLORATION -y I-EXPLORATION -TdTen I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -ganglio I-EXPLORATION -linfático I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -citometría I-EXPLORATION -de I-EXPLORATION -flujo I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -periférica. I-EXPLORATION - I-EXPLORATION -Teniendo I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -anteriores, I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -una I-EXPLORATION -leucemia/linfoma I-EXPLORATION -de I-EXPLORATION -célula I-EXPLORATION -T I-EXPLORATION -del I-EXPLORATION -adulto; I-EXPLORATION -por I-EXPLORATION -consiguiente, I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -ELISA I-EXPLORATION -y I-EXPLORATION -Western I-EXPLORATION -Blot I-EXPLORATION -para I-EXPLORATION -HTLV I-EXPLORATION -1-2, I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -resultaron I-EXPLORATION -positivas, I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -del I-EXPLORATION -Western I-EXPLORATION -blot I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -HTLV-1 I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -bandas I-EXPLORATION -p19, I-EXPLORATION -GD21 I-EXPLORATION -y I-EXPLORATION -rgp46-I. I-EXPLORATION -La B-EVOLUTION -forma I-EVOLUTION -de I-EVOLUTION -leucemia I-EVOLUTION -identificada I-EVOLUTION -correspondió I-EVOLUTION -a I-EVOLUTION -leucemia I-EVOLUTION -aguda. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -antes I-EVOLUTION -de I-EVOLUTION -iniciar I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -posterior, I-PRESENT_ILLNESS -cuya I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -aumentó I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -dificultar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente, I-PRESENT_ILLNESS -además, I-PRESENT_ILLNESS -tuvo I-PRESENT_ILLNESS -picos I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificados, I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -retroocular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -entró I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estupor I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ingresar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -registró I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -sistólico I-EXPLORATION -mitral I-EXPLORATION -de I-EXPLORATION -grado I-EXPLORATION -II/IV, I-EXPLORATION -rigidez I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -nuca I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -puntaje I-EXPLORATION -de I-EXPLORATION -8/15 I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -coma I-EXPLORATION -de I-EXPLORATION -Glasgow. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -ordenaron I-EXPLORATION -tomografías I-EXPLORATION -computadorizadas I-EXPLORATION -(TC), I-EXPLORATION -una I-EXPLORATION -cerebral I-EXPLORATION -simple I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -contrastada, I-EXPLORATION -con I-EXPLORATION -resultados I-EXPLORATION -normales. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -meningitis I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -hizo I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -con I-EXPLORATION -análisis I-EXPLORATION -citoquímico I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -número I-EXPLORATION -de I-EXPLORATION -células, I-EXPLORATION -hipoglucorraquia I-EXPLORATION -e I-EXPLORATION -hiperproteinorraquia, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -cocos I-EXPLORATION -Gram I-EXPLORATION -positivos. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -(2 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas), I-TREATMENT -vancomicina I-TREATMENT -(1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas) I-TREATMENT -y I-TREATMENT -dexametasona I-TREATMENT -(8 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -4 I-TREATMENT -días). I-TREATMENT -En B-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo, I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -Streptococcus I-EXPLORATION -pneumoniae, I-EXPLORATION -serotipo I-EXPLORATION -18C, I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas, I-EXPLORATION -con I-EXPLORATION -concentración I-EXPLORATION -inhibitoria I-EXPLORATION -mínima I-EXPLORATION -(CIM) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -06 I-EXPLORATION -µg/ml I-EXPLORATION -para I-EXPLORATION -penicilina I-EXPLORATION -y I-EXPLORATION -eritromicina, I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -03 I-EXPLORATION -µg/ml I-EXPLORATION -para I-EXPLORATION -ceftriaxona I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION -µg/ml I-EXPLORATION -para I-EXPLORATION -trimetoprim- I-EXPLORATION -sulfametoxazol I-EXPLORATION -y I-EXPLORATION -vancomicina, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -microorganismo I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -varios I-EXPLORATION -antibióticos. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -base I-TREATMENT -en I-TREATMENT -estos I-TREATMENT -resultados, I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -de I-TREATMENT -tra I-TREATMENT -tamiento I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -suspender I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -continuó I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -dirigido I-TREATMENT -específicamente I-TREATMENT -al I-TREATMENT -microorganismo I-TREATMENT -aislado. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -siguió I-EVOLUTION -siendo I-EVOLUTION -irregular, I-EVOLUTION -con I-EVOLUTION -picos I-EVOLUTION -febriles I-EVOLUTION -durante I-EVOLUTION -su I-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -leucocitosis, I-EVOLUTION -neutrófilos I-EVOLUTION -en I-EVOLUTION -cayado I-EVOLUTION -y I-EVOLUTION -elevación I-EVOLUTION -constante I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -reactantes I-EVOLUTION -de I-EVOLUTION -fase I-EVOLUTION -aguda. I-EVOLUTION -Los B-EXPLORATION -hemocultivos I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -para I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -hongos I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -al I-EXPLORATION -octavo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -registró I-EXPLORATION -hipoventilación I-EXPLORATION -bilateral I-EXPLORATION -y I-EXPLORATION -estertores I-EXPLORATION -basales I-EXPLORATION -en I-EXPLORATION -pulmón I-EXPLORATION -derecho; I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -infiltrados I-EXPLORATION -alveolares I-EXPLORATION -basales I-EXPLORATION -en I-EXPLORATION -dicho I-EXPLORATION -pulmón I-EXPLORATION -y I-EXPLORATION -broncograma I-EXPLORATION -aéreo. I-EXPLORATION -Dado B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -neumonía I-TREATMENT -asociada I-TREATMENT -y I-TREATMENT -la I-TREATMENT -deficiente I-TREATMENT -progresión I-TREATMENT -clínica, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -comenzar I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -cefepime I-TREATMENT -(2 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas) I-TREATMENT -y I-TREATMENT -linezolid I-TREATMENT -(600 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas). I-TREATMENT - I-TREATMENT -Ante B-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -soplo I-EXPLORATION -cardiaco I-EXPLORATION -mitral, I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -evidenció I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -grave I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -ruptura I-EXPLORATION -del I-EXPLORATION -festón I-EXPLORATION -medial I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -subsiguiente I-EXPLORATION -prolapso, I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -cuatro I-EXPLORATION -vegetaciones I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -auricular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -valva I-EXPLORATION -posterior, I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -mm, I-EXPLORATION -11 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -mm, I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -mm I-EXPLORATION -y I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -mm. I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -de I-TREATMENT -endocarditis I-TREATMENT -sobre I-TREATMENT -válvula I-TREATMENT -mitral I-TREATMENT -nativa, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -continuar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -durante I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -más I-TREATMENT -y B-DERIVED_FROM/TO -remitir I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -institución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -IV I-DERIVED_FROM/TO -nivel I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -reemplazo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -válvula. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El B-EVOLUTION -paciente I-EVOLUTION -ingresó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -institución I-EVOLUTION -de I-EVOLUTION -nivel I-EVOLUTION -IV I-EVOLUTION -en I-EVOLUTION -malas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -estaba I-EVOLUTION -hipotenso I-EVOLUTION -y B-TREATMENT -hubo I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -administrarle I-TREATMENT -vasopresores I-TREATMENT -y I-TREATMENT -utilizar I-TREATMENT -catéter I-TREATMENT -de I-TREATMENT -Swan-Ganz I-TREATMENT -; I-TREATMENT -presentó B-EVOLUTION -tres I-EVOLUTION -paros I-EVOLUTION -cardiorrespiratorios I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -(ritmo I-EVOLUTION -de I-EVOLUTION -paro: I-EVOLUTION -actividad I-EVOLUTION -eléctrica I-EVOLUTION -sin I-EVOLUTION -pulso). I-EVOLUTION -Presentaba, B-TREATMENT -además, I-TREATMENT -signos I-TREATMENT -clínicos I-TREATMENT -y I-TREATMENT -paraclínicos I-TREATMENT -de I-TREATMENT -hipoperfusión, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -inotrópico, I-TREATMENT -y I-TREATMENT -nuevamente I-TREATMENT -se I-TREATMENT -intensificó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico, I-TREATMENT -administrando I-TREATMENT -vancomicina I-TREATMENT -(1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas) I-TREATMENT -y I-TREATMENT -meropenem I-TREATMENT -(1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas). I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -hizo, I-EXPLORATION -igualmente, I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -contrastada, I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -focos I-EXPLORATION -isquémicos I-EXPLORATION -en I-EXPLORATION -varios I-EXPLORATION -terri I-EXPLORATION -torios I-EXPLORATION -vasculares I-EXPLORATION -supratentoriales I-EXPLORATION -e I-EXPLORATION -infratentoriales, I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -se I-EXPLORATION -consideran I-EXPLORATION -indicativos I-EXPLORATION -de I-EXPLORATION -embolia. I-EXPLORATION - I-EXPLORATION -Gradualmente B-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -neurológica I-EVOLUTION -parcial, I-EVOLUTION -lo B-TREATMENT -que I-TREATMENT -posibilitó I-TREATMENT -retirarle I-TREATMENT -el I-TREATMENT -tubo I-TREATMENT -de I-TREATMENT -tórax I-TREATMENT -y I-TREATMENT -el I-TREATMENT -medicamento I-TREATMENT -vasoactivo, I-TREATMENT -pero I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -del I-TREATMENT -inotrópico I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -persis I-TREATMENT -tencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -disfunción I-TREATMENT -cardiaca I-TREATMENT -con I-TREATMENT -compromiso I-TREATMENT -grave I-TREATMENT -de I-TREATMENT -la I-TREATMENT -válvula I-TREATMENT -mitral. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Neurología I-EVOLUTION -se I-EVOLUTION -evaluó I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -cinco I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -que I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -de I-EVOLUTION -conciencia I-EVOLUTION -era I-EVOLUTION -adecuado, I-EVOLUTION -sin I-EVOLUTION -deficiencias I-EVOLUTION -neurológicas I-EVOLUTION -focalizadas; I-EVOLUTION -finalmente, B-TREATMENT -al I-TREATMENT -décimo I-TREATMENT -día I-TREATMENT -de I-TREATMENT -hospitalización, I-TREATMENT -se I-TREATMENT -reemplazó I-TREATMENT -la I-TREATMENT -válvula I-TREATMENT -mitral I-TREATMENT -por I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -mecánica I-TREATMENT -#27. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -inicial I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -fue I-EVOLUTION -estable I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -requirió I-EVOLUTION -de I-EVOLUTION -medicamento I-EVOLUTION -vasopresor I-EVOLUTION -o I-EVOLUTION -inotrópico; I-EVOLUTION -la I-EVOLUTION -única I-EVOLUTION -complicación I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -presentó I-EVOLUTION -fue I-EVOLUTION -una I-EVOLUTION -coagulopatía I-EVOLUTION -secundaria I-EVOLUTION -al I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -bomba I-EVOLUTION -extracorpórea, I-EVOLUTION -la B-TREATMENT -cual I-TREATMENT -se I-TREATMENT -corrigió I-TREATMENT -con I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -hemocomponentes. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -mitral I-EXPLORATION -nativa I-EXPLORATION -se I-EXPLORATION -reportó I-EXPLORATION -endocarditis I-EXPLORATION -aguda, I-EXPLORATION -en I-EXPLORATION -tanto I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -definitivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -siguió I-EVOLUTION -hospitalizado I-EVOLUTION -para I-EVOLUTION -optimizar I-EVOLUTION -la I-EVOLUTION -anticoagulación. I-EVOLUTION -Diez I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -presentó I-EVOLUTION -deterioro I-EVOLUTION -clínico, I-EVOLUTION -con I-EVOLUTION -inestabilidad I-EVOLUTION -hemodinámica I-EVOLUTION -y I-EVOLUTION -falla I-EVOLUTION -respiratoria. I-EVOLUTION -Se B-TREATMENT -documentó I-TREATMENT -bacteriemia I-TREATMENT -por I-TREATMENT -Klebsiella I-TREATMENT -pneumoniae I-TREATMENT -positiva I-TREATMENT -para I-TREATMENT -betalactamasa I-TREATMENT -de I-TREATMENT -espectro I-TREATMENT -extendido I-TREATMENT -(BLEE), I-TREATMENT -ante I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -meropenem I-TREATMENT -y I-TREATMENT -vancomicina. I-TREATMENT -En B-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -prótesis I-EXPLORATION -mecánica I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION -mitral I-EXPLORATION -funcio I-EXPLORATION -naba I-EXPLORATION -normalmente. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -hacer I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humoral I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -al I-EXPLORATION -haber I-EXPLORATION -presentado I-EXPLORATION -dos I-EXPLORATION -bacteriemias I-EXPLORATION -por I-EXPLORATION -bacterias I-EXPLORATION -encapsuladas, I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -rangos I-EXPLORATION -normales. I-EXPLORATION -Al B-TREATMENT -completarse I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -meropenem I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -ceftriaxona I-TREATMENT -con I-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -completar I-TREATMENT -otra I-TREATMENT -semana I-TREATMENT -más, I-TREATMENT -suspender I-TREATMENT -y I-TREATMENT -continuar I-TREATMENT -después I-TREATMENT -solo I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -las I-TREATMENT -seis I-TREATMENT -semanas I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -endocarditis. I-TREATMENT - I-TREATMENT -Finalmente, B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -secuelas I-EVOLUTION -neurológicas I-EVOLUTION -evidentes I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -fracción I-EVOLUTION -de I-EVOLUTION -eyección I-EVOLUTION -preservada I-EVOLUTION -(60-65 I-EVOLUTION -%), I-EVOLUTION -cavidades I-EVOLUTION -izquierda I-EVOLUTION -y I-EVOLUTION -derecha I-EVOLUTION -de I-EVOLUTION -tamaño I-EVOLUTION -y I-EVOLUTION -contractilidad I-EVOLUTION -normales, I-EVOLUTION -prótesis I-EVOLUTION -mecánica I-EVOLUTION -mitral I-EVOLUTION -con I-EVOLUTION -función I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -gradiente I-EVOLUTION -medio I-EVOLUTION -(6 I-EVOLUTION -mm I-EVOLUTION -Hg), I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -imágenes I-EVOLUTION -sugestivas I-EVOLUTION -de I-EVOLUTION -vegetaciones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -externa I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urología I-DERIVED_FROM/TO -ante I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -hallazgo I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -ecografía I-DERIVED_FROM/TO -abdominal, I-DERIVED_FROM/TO -realizada I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -síntomas I-DERIVED_FROM/TO -digestivos I-DERIVED_FROM/TO -inespecíficos, I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -suprarrenal I-DERIVED_FROM/TO -derecha I-DERIVED_FROM/TO -sólida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -6 I-DERIVED_FROM/TO -cm I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -diámetro. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -La B-EXPLORATION -anamnesis I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -no I-EXPLORATION -revelaron I-EXPLORATION -síntomas I-EXPLORATION -ni I-EXPLORATION -signos I-EXPLORATION -que I-EXPLORATION -orientaran I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -endocrinopatía, I-EXPLORATION -ni I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -primario. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -procedió, I-EXPLORATION -mediante I-EXPLORATION -estudio I-EXPLORATION -endocrinológico, I-EXPLORATION -a I-EXPLORATION -establecer I-EXPLORATION -el I-EXPLORATION -carácter I-EXPLORATION -funcionante I-EXPLORATION -o I-EXPLORATION -no I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -suprarrenal. I-EXPLORATION -Se I-EXPLORATION -determinaron: I-EXPLORATION -cortisol I-EXPLORATION -libre I-EXPLORATION -en I-EXPLORATION -orina; I-EXPLORATION -cortisol I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas; I-EXPLORATION -supresión I-EXPLORATION -con I-EXPLORATION -1 I-EXPLORATION -mgr I-EXPLORATION -de I-EXPLORATION -dexametasona; I-EXPLORATION -cortisol I-EXPLORATION -basal I-EXPLORATION -en I-EXPLORATION -sangre; I-EXPLORATION -ACTH; I-EXPLORATION -aldosterona I-EXPLORATION -en I-EXPLORATION -sangre; I-EXPLORATION -DHEA-sulfato; I-EXPLORATION -catecolaminas I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -(noradrenalina, I-EXPLORATION -adrenalina) I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -orina, I-EXPLORATION -y I-EXPLORATION -sus I-EXPLORATION -metabolitos I-EXPLORATION -(vanilmandélico, I-EXPLORATION -metanefrinas). I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -analíticos I-EXPLORATION -practicados I-EXPLORATION -fueron I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -sólida, I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -bien I-EXPLORATION -definidos I-EXPLORATION -y I-EXPLORATION -densidad I-EXPLORATION -heterogénea, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -hipodensas I-EXPLORATION -e I-EXPLORATION -imágenes I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -calcio I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -que I-EXPLORATION -mide I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -cm. I-EXPLORATION -La I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -ovalada I-EXPLORATION -y I-EXPLORATION -bien I-EXPLORATION -definida, I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -isointensa I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -bazo I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -T2, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -irregulares I-EXPLORATION -hiperintensas I-EXPLORATION -en I-EXPLORATION -T2. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -concluyó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -sólida, I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -funcionante. I-EXPLORATION -Con B-TREATMENT -este I-TREATMENT -diagnóstico, I-TREATMENT -y I-TREATMENT -apoyados I-TREATMENT -fundamentalmente I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -en I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -calcificaciones I-TREATMENT -irregulares I-TREATMENT -en I-TREATMENT -su I-TREATMENT -interior, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -quirúrgica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -que I-TREATMENT -se I-TREATMENT -tratara I-TREATMENT -de I-TREATMENT -un I-TREATMENT -carcinoma I-TREATMENT -suprarrenal. I-TREATMENT -Se I-TREATMENT -practicó I-TREATMENT -suprarrenalectomía I-TREATMENT -derecha I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -lumbotomía. I-TREATMENT - I-TREATMENT -Macroscópicamente, I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -de I-TREATMENT -suprarrenalectomía I-TREATMENT -midió I-TREATMENT -8 I-TREATMENT -x I-TREATMENT -6, I-TREATMENT -5 I-TREATMENT -x I-TREATMENT -3 I-TREATMENT -cm. I-TREATMENT -La B-EXPLORATION -tumoración I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -superficie I-EXPLORATION -multinodular, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -homogéneo, I-EXPLORATION -blanquecino-grisáceo I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -fasciculado. I-EXPLORATION -Microscópicamente, I-EXPLORATION -el I-EXPLORATION -tumor I-EXPLORATION -está I-EXPLORATION -constituido I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Schwann I-EXPLORATION -dispuestas I-EXPLORATION -en I-EXPLORATION -pequeños I-EXPLORATION -fascículos I-EXPLORATION -entrelazados I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -estroma I-EXPLORATION -mixoide I-EXPLORATION -y I-EXPLORATION -grupos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -ganglionares I-EXPLORATION -maduras. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -para I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -S-100, I-EXPLORATION -observándose I-EXPLORATION -intensa I-EXPLORATION -y I-EXPLORATION -generalizada I-EXPLORATION -inmunoreacción I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -neoplásicas. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -ganglioneuroma I-EXPLORATION -suprarrenal. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesión. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -prostático I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -IPSS I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -PSA: I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -91. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destaca I-EXPLORATION -un I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -encontrando I-EXPLORATION -un I-EXPLORATION -adenoma I-EXPLORATION -grado I-EXPLORATION -1, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -hemiescroto I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -lisa, I-EXPLORATION -dura, I-EXPLORATION -no I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -profundos, I-EXPLORATION -blanquecina I-EXPLORATION -e I-EXPLORATION -indolora I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración. I-EXPLORATION -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -demanda I-PRESENT_ILLNESS -cirugía I-PRESENT_ILLNESS -aduciendo I-PRESENT_ILLNESS -problemas I-PRESENT_ILLNESS -estéticos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-TREATMENT -realiza I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -Macroscópicamente B-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -presenta I-EXPLORATION -coloración I-EXPLORATION -blanquecina I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -firme I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -cm, I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -sólida, I-EXPLORATION -amarillenta I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -arremolinado. I-EXPLORATION - I-EXPLORATION -Microscópicamente I-EXPLORATION -se I-EXPLORATION -describe I-EXPLORATION -una I-EXPLORATION -neoformación I-EXPLORATION -mesenquimal I-EXPLORATION -relativamente I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -no I-EXPLORATION -encapsulada, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -haces I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -estirpe I-EXPLORATION -muscular I-EXPLORATION -lisa I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -marcada I-EXPLORATION -positividad I-EXPLORATION -citoplasmática I-EXPLORATION -con I-EXPLORATION -actina, I-EXPLORATION -desmina I-EXPLORATION -y I-EXPLORATION -focal I-EXPLORATION -con I-EXPLORATION -CD I-EXPLORATION -68. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -atipia I-EXPLORATION -citológica. I-EXPLORATION -La I-EXPLORATION -actividad I-EXPLORATION -mitótica I-EXPLORATION -es I-EXPLORATION -muy I-EXPLORATION -baja I-EXPLORATION -(0, I-EXPLORATION -5 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -50 I-EXPLORATION -HPF), I-EXPLORATION -no I-EXPLORATION -observándose I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -ni I-EXPLORATION -necrosis. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -diagnóstico I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -leiomioma I-EVOLUTION -escrotal. I-EVOLUTION -Tras I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -no I-EVOLUTION -hay I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -local. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -69 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que, B-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales, I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -próstata I-PAST_MEDICAL_HISTORY -bien I-PAST_MEDICAL_HISTORY -diferenciado I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -análogos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -LHRH I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mielolipoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -glándula I-PAST_MEDICAL_HISTORY -suprarrenal I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -casualmente I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -TAC I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -0º I-PRESENT_ILLNESS -C, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -coincidiendo, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuadro, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -accidental I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cama. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -aunque I-EXPLORATION -hemodinámica I-EXPLORATION -estable. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -globuloso I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -ligeramente I-EXPLORATION -distendido. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Murphy I-EXPLORATION -positivo. I-EXPLORATION -La I-EXPLORATION -auscultación I-EXPLORATION -cardio I-EXPLORATION -respiratoria I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -mostraba I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -13.800 I-EXPLORATION -*10e9/L I-EXPLORATION -y I-EXPLORATION -neutrofilia I-EXPLORATION -(83%), I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -110 I-EXPLORATION -g/l I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -indirecta I-EXPLORATION -(0, I-EXPLORATION -9 I-EXPLORATION -mg/dl). I-EXPLORATION - I-EXPLORATION -Fue I-EXPLORATION -realizada I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -urgencia I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -heterogénea I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -dependiente I-EXPLORATION -de I-EXPLORATION -glándula I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -compresión I-EXPLORATION -de I-EXPLORATION -vena I-EXPLORATION -cava, I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -discernir I-EXPLORATION -si I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -hematoma I-EXPLORATION -o I-EXPLORATION -absceso. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -confirmó I-EXPLORATION -tal I-EXPLORATION -hallazgo, I-EXPLORATION -informándolo I-EXPLORATION -como I-EXPLORATION -hematoma I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -activo, I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -que I-EXPLORATION -comprimía I-EXPLORATION -y I-EXPLORATION -desplazaba I-EXPLORATION -vena I-EXPLORATION -cava. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -laparotomía I-TREATMENT -urgente I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -suprarrenalectomía I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -exéresis I-TREATMENT -del I-TREATMENT -hematoma. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -décimo I-EVOLUTION -día. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -excepción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -palpitaciones I-PAST_MEDICAL_HISTORY -ocasionales. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -súbita I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -disnea, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -neumonía I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antibiótico. I-PRESENT_ILLNESS -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -se I-EVOLUTION -agravó I-EVOLUTION -el I-EVOLUTION -cuadro I-EVOLUTION -con I-EVOLUTION -fiebre, I-EVOLUTION -hipoxemia I-EVOLUTION -progresiva I-EVOLUTION -y I-EVOLUTION -oliguria, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -trasladada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos I-EVOLUTION -(UCI). I-EVOLUTION - I-EVOLUTION -Al B-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -UCI I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -40, I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -oxígeno I-EXPLORATION -del I-EXPLORATION -85% I-EXPLORATION -con I-EXPLORATION -reservorio, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -140 I-EXPLORATION -ppm, I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -120/40 I-EXPLORATION -mmHg, I-EXPLORATION -temp-35º I-EXPLORATION -C. I-EXPLORATION -La I-EXPLORATION -auscultación I-EXPLORATION -cardiopulmonar I-EXPLORATION -mostraba I-EXPLORATION -crepitantes I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hemitorax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -aunque I-EXPLORATION -sin I-EXPLORATION -edemas I-EXPLORATION -en I-EXPLORATION -extremidades. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -realizada I-EXPLORATION -destacaba I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -36400, I-EXPLORATION -Glucosa: I-EXPLORATION -266 I-EXPLORATION -mg/dL, I-EXPLORATION -Creatinina: I-EXPLORATION -3, I-EXPLORATION -3 I-EXPLORATION -mg/dL, I-EXPLORATION -AST: I-EXPLORATION -3127 I-EXPLORATION -U/L, I-EXPLORATION -ALT: I-EXPLORATION -3139 I-EXPLORATION -U/L, I-EXPLORATION -Gamma I-EXPLORATION -GT: I-EXPLORATION -86 I-EXPLORATION -U/L I-EXPLORATION -y I-EXPLORATION -tiempos I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -ligeramente I-EXPLORATION -elevados. I-EXPLORATION -Gasometría: I-EXPLORATION -PH: I-EXPLORATION -7, I-EXPLORATION -11. I-EXPLORATION -PCO2: I-EXPLORATION -41. I-EXPLORATION -PO2: I-EXPLORATION -44. I-EXPLORATION -Saturación I-EXPLORATION -O2: I-EXPLORATION -63. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -infiltrado I-EXPLORATION -alveolo-intersticial I-EXPLORATION -bilateral I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -derecho. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -intubación I-TREATMENT -inmediata I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -de I-TREATMENT -mayor I-TREATMENT -espectro. I-TREATMENT -La B-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -un I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -fracaso I-EXPLORATION -multiorgánico I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -analítica I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -creatinin-fosfoquinasa I-EXPLORATION -y I-EXPLORATION -troponina, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico, I-EXPLORATION -objetivándose I-EXPLORATION -masa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -cava I-EXPLORATION -superior I-EXPLORATION -que I-EXPLORATION -llegaba I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -derecha. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -bilateral I-EXPLORATION -sin I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar, I-EXPLORATION -dilatación I-EXPLORATION -y I-EXPLORATION -ocupación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior I-EXPLORATION -intrahépatica I-EXPLORATION -que I-EXPLORATION -proximalmente I-EXPLORATION -llega I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -distalmente I-EXPLORATION -hasta I-EXPLORATION -las I-EXPLORATION -venas I-EXPLORATION -renales. I-EXPLORATION -Hipodensidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -suprahepática I-EXPLORATION -derecha I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -trombosis I-EXPLORATION -secundaria I-EXPLORATION -y I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -hipercaptante, I-EXPLORATION -en I-EXPLORATION -íntimo I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior. I-EXPLORATION - I-EXPLORATION -Habiendo B-DERIVED_FROM/TO -estabilizado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -UCI I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -4 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -ingreso, I-DERIVED_FROM/TO -intubada I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -disfunción I-DERIVED_FROM/TO -multiorgánica, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -fin I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -planificar I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -quirúrgico. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Se B-EXPLORATION -repite I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -destaca I-EXPLORATION -leucocitosis, I-EXPLORATION -AST: I-EXPLORATION -165 I-EXPLORATION -UI/L, I-EXPLORATION -ALT: I-EXPLORATION -1050 I-EXPLORATION -UI/L I-EXPLORATION -con I-EXPLORATION -ionograma I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -normales. I-EXPLORATION -Tras B-TREATMENT -valorar I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -aportadas, I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -gravedad I-TREATMENT -del I-TREATMENT -cuadro, I-TREATMENT -y I-TREATMENT -puesto I-TREATMENT -que I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -de I-TREATMENT -imagen I-TREATMENT -realizadas I-TREATMENT -no I-TREATMENT -presentan I-TREATMENT -metástasis I-TREATMENT -a I-TREATMENT -distancia, I-TREATMENT -se I-TREATMENT -planteó I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -urgente. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -laparatomía I-TREATMENT -subcostal I-TREATMENT -bilateral I-TREATMENT -al I-TREATMENT -mismo I-TREATMENT -tiempo I-TREATMENT -que I-TREATMENT -una I-TREATMENT -esternotomía I-TREATMENT -longitudinal. I-TREATMENT -Se I-TREATMENT -aprecia I-TREATMENT -derrame I-TREATMENT -pleural I-TREATMENT -bilateral, I-TREATMENT -ligero I-TREATMENT -derrame I-TREATMENT -pericárdico I-TREATMENT -y I-TREATMENT -corazón I-TREATMENT -con I-TREATMENT -contracción I-TREATMENT -normal I-TREATMENT -en I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -torácica, I-TREATMENT -mientras I-TREATMENT -que I-TREATMENT -la I-TREATMENT -laparotomía I-TREATMENT -muestra I-TREATMENT -isquemia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -segmentos I-TREATMENT -6 I-TREATMENT -y I-TREATMENT -7 I-TREATMENT -del I-TREATMENT -hígado I-TREATMENT -y I-TREATMENT -masa I-TREATMENT -suprarrenal I-TREATMENT -derecha. I-TREATMENT - I-TREATMENT -El I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -General I-TREATMENT -realiza I-TREATMENT -hepatectomía I-TREATMENT -anterior I-TREATMENT -con I-TREATMENT -maniobra I-TREATMENT -de I-TREATMENT -Pringle I-TREATMENT -intermitente, I-TREATMENT -sin I-TREATMENT -voltear I-TREATMENT -el I-TREATMENT -hígado, I-TREATMENT -seccionando I-TREATMENT -el I-TREATMENT -hígado I-TREATMENT -hasta I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -cara I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Cava I-TREATMENT -retrohepática. I-TREATMENT -Posteriormente, I-TREATMENT -el I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -Urología I-TREATMENT -tras I-TREATMENT -descolgar I-TREATMENT -el I-TREATMENT -colon I-TREATMENT -derecho I-TREATMENT -realiza I-TREATMENT -disección I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -hasta I-TREATMENT -iliacas I-TREATMENT -primitivas, I-TREATMENT -ligadura I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -genital I-TREATMENT -derecha, I-TREATMENT -liberación I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -renal I-TREATMENT -y I-TREATMENT -cara I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -riñón I-TREATMENT -derecho. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -liberación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -glándula I-TREATMENT -suprarrenal I-TREATMENT -derecha, I-TREATMENT -a I-TREATMENT -excepción I-TREATMENT -de I-TREATMENT -su I-TREATMENT -borde I-TREATMENT -superior I-TREATMENT -y I-TREATMENT -medial I-TREATMENT -que I-TREATMENT -está I-TREATMENT -íntimamente I-TREATMENT -unido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -cava. I-TREATMENT -Queda I-TREATMENT -así I-TREATMENT -expuesto I-TREATMENT -el I-TREATMENT -campo I-TREATMENT -para I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -suprarrenal I-TREATMENT -e I-TREATMENT -hígado I-TREATMENT -derecho I-TREATMENT -a I-TREATMENT -falta I-TREATMENT -de I-TREATMENT -cavotomía.. I-TREATMENT - I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -realizado I-TREATMENT -esto, I-TREATMENT -el I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -Cardiaca I-TREATMENT -comienza I-TREATMENT -la I-TREATMENT -circulación I-TREATMENT -extracorpórea I-TREATMENT -bajando I-TREATMENT -progresivamente I-TREATMENT -la I-TREATMENT -temperatura I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -14ºC I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -esofágico I-TREATMENT -y I-TREATMENT -19ºC I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -rectal, I-TREATMENT -tras I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -exanguinar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -parar I-TREATMENT -la I-TREATMENT -circulación I-TREATMENT -extracorpórea I-TREATMENT -manteniendo I-TREATMENT -la I-TREATMENT -sangre I-TREATMENT -en I-TREATMENT -un I-TREATMENT -oxigenador. I-TREATMENT -Es I-TREATMENT -entonces I-TREATMENT -cuando I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -cavotomía I-TREATMENT -inferior I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -suprarrenal I-TREATMENT -hasta I-TREATMENT -2 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -diafragma, I-TREATMENT -aurículotomía I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -trombo I-TREATMENT -tumoral I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -incisión I-TREATMENT -realizada I-TREATMENT -en I-TREATMENT -la I-TREATMENT -cava I-TREATMENT -inferior. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -sección I-TREATMENT -de I-TREATMENT -pared I-TREATMENT -lateral I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -(desde I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -suprarrenal I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -suprahepática I-TREATMENT -derecha), I-TREATMENT -extrayendo I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT -hígado I-TREATMENT -derecho I-TREATMENT -con I-TREATMENT -venas I-TREATMENT -suprahepática I-TREATMENT -y I-TREATMENT -suprarrenal I-TREATMENT -derechas I-TREATMENT -incluidas I-TREATMENT -en I-TREATMENT -dicho I-TREATMENT -parche, I-TREATMENT -suprarrenal I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -trombo. I-TREATMENT -Se I-TREATMENT -produce I-TREATMENT -rotura I-TREATMENT -del I-TREATMENT -trombo I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -renal, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -en I-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -tiempo I-TREATMENT -se I-TREATMENT -extrae I-TREATMENT -por I-TREATMENT -tracción I-TREATMENT -el I-TREATMENT -trombo I-TREATMENT -desde I-TREATMENT -vena I-TREATMENT -renal I-TREATMENT -hasta I-TREATMENT -iliacas I-TREATMENT -primitivas. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -irrigación I-TREATMENT -de I-TREATMENT -cava I-TREATMENT -y I-TREATMENT -aurícula I-TREATMENT -derecha I-TREATMENT -y, I-TREATMENT -al I-TREATMENT -no I-TREATMENT -observarse I-TREATMENT -restos I-TREATMENT -de I-TREATMENT -trombo I-TREATMENT -ni I-TREATMENT -infiltración I-TREATMENT -de I-TREATMENT -las I-TREATMENT -paredes I-TREATMENT -de I-TREATMENT -cava I-TREATMENT -o I-TREATMENT -aurícula, I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -al I-TREATMENT -cierre I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -y I-TREATMENT -orejuela I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -separado I-TREATMENT -y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -vez I-TREATMENT -mediante I-TREATMENT -sutura I-TREATMENT -continua I-TREATMENT -con I-TREATMENT -monofilamento. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -realizado I-TREATMENT -dicho I-TREATMENT -cierre I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -reperfundir I-TREATMENT -progresivamente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -volviendo I-TREATMENT -a I-TREATMENT -entrar I-TREATMENT -en I-TREATMENT -circulación I-TREATMENT -extracorpórea, I-TREATMENT -recalentándola I-TREATMENT -y I-TREATMENT -procediendo I-TREATMENT -a I-TREATMENT -desclampar I-TREATMENT -la I-TREATMENT -aorta I-TREATMENT -y I-TREATMENT -perfundir I-TREATMENT -el I-TREATMENT -corazón I-TREATMENT -al I-TREATMENT -alcanzar I-TREATMENT -una I-TREATMENT -temperatura I-TREATMENT -esofágica I-TREATMENT -de I-TREATMENT -34ºC. I-TREATMENT -El I-TREATMENT -inicio I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -cardiaca I-TREATMENT -permite I-TREATMENT -la I-TREATMENT -salida I-TREATMENT -de I-TREATMENT -circulación I-TREATMENT -extracorpórea. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -colocan I-TREATMENT -drenajes I-TREATMENT -retroesternal, I-TREATMENT -mediastínico, I-TREATMENT -subhepático I-TREATMENT -y I-TREATMENT -retroperitoneal I-TREATMENT -en I-TREATMENT -fosa I-TREATMENT -renal I-TREATMENT -derecha. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -transfundieron I-TREATMENT -14 I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes, I-TREATMENT -1200 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -plasma I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -unidades I-TREATMENT -de I-TREATMENT -plaquetas. I-TREATMENT -Durante B-EVOLUTION -la I-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -UCI I-EVOLUTION -se I-EVOLUTION -realiza I-EVOLUTION -ecografía I-EVOLUTION -abdominal I-EVOLUTION -que I-EVOLUTION -muestras I-EVOLUTION -buena I-EVOLUTION -permeabilidad I-EVOLUTION -del I-EVOLUTION -sistema I-EVOLUTION -venoso I-EVOLUTION -hepático I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -vena I-EVOLUTION -cava. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -trasladada I-EVOLUTION -a I-EVOLUTION -planta, I-EVOLUTION -encontrándose I-EVOLUTION -consciente, I-EVOLUTION -orientada I-EVOLUTION -y I-EVOLUTION -colaboradora, I-EVOLUTION -aunque I-EVOLUTION -presentando I-EVOLUTION -debilidad I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -cuatro I-EVOLUTION -extremidades. I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -permanece I-TREATMENT -ingresada I-TREATMENT -en I-TREATMENT -planta I-TREATMENT -durante I-TREATMENT -20 I-TREATMENT -días I-TREATMENT -recibiendo I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -cinesiterapia I-TREATMENT -generalizada I-TREATMENT -pasiva I-TREATMENT -y I-TREATMENT -asistida. I-TREATMENT -Tras I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -en I-TREATMENT -la I-TREATMENT -movilidad I-TREATMENT -es I-TREATMENT -dada I-TREATMENT -de I-TREATMENT -alta, I-TREATMENT -no I-TREATMENT -precisando I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -excepción I-TREATMENT -de I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -feocromocitoma I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -cuyo I-EXPLORATION -diámetro I-EXPLORATION -mayor I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm. I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -no I-EXPLORATION -está I-EXPLORATION -encapsulado I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -fuera I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -suprarrenal, I-EXPLORATION -sin I-EXPLORATION -afectar I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -órganos I-EXPLORATION -adyacentes. I-EXPLORATION -Existe I-EXPLORATION -necrosis I-EXPLORATION -tumoral I-EXPLORATION -extensa. I-EXPLORATION -La I-EXPLORATION -glándula I-EXPLORATION -suprarrenal I-EXPLORATION -no I-EXPLORATION -neoplásica I-EXPLORATION -no I-EXPLORATION -muestra I-EXPLORATION -anomalías. I-EXPLORATION -Los I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -estudiados I-EXPLORATION -no I-EXPLORATION -presentan I-EXPLORATION -tumor. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -hepático I-EXPLORATION -hay I-EXPLORATION -extensas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -centrolobulillar, I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -de I-EXPLORATION -hepatocitos I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -fragmentos I-EXPLORATION -estudiados I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -hepático. I-EXPLORATION -Trombo I-EXPLORATION -infrarrenal I-EXPLORATION -hemático, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -tumorales. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -revisión I-EVOLUTION -realizada I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -asintomática, I-EVOLUTION -realizando I-EVOLUTION -vida I-EVOLUTION -activa I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -TC I-EVOLUTION -no I-EVOLUTION -mostró I-EVOLUTION -lesiones I-EVOLUTION -sugestivas I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -tumoral. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sala I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -traumatología I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnostico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lumbalgia I-PRESENT_ILLNESS -rebelde I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -domiciliario. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -abdominopélvico I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -retroperitoneal I-EXPLORATION -(paraaórtica) I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -continua I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -cadena I-EXPLORATION -iliaca I-EXPLORATION -primitiva I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -cadenas I-EXPLORATION -iliacas, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -la I-EXPLORATION -externa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -abdominopelviana I-EXPLORATION -(9¥28 I-EXPLORATION -cm). I-EXPLORATION -La I-EXPLORATION -tumoración I-EXPLORATION -es I-EXPLORATION -sólida I-EXPLORATION -con I-EXPLORATION -pequeñas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -cervicotorácico I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -punción I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -germinales I-EXPLORATION -tipo I-EXPLORATION -seminoma. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -testicular I-EXPLORATION -bilateral I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -testicular I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION -ecogénicas I-EXPLORATION -puntiformes I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -testículos I-EXPLORATION -(mas I-EXPLORATION -llamativas I-EXPLORATION -y I-EXPLORATION -extensas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -teste I-EXPLORATION -izquierdo), I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -masa I-EXPLORATION -clara. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -ecográficos, I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -testicular I-EXPLORATION -bilateral. I-EXPLORATION -En I-EXPLORATION -ambos I-EXPLORATION -testes I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -atrofia I-EXPLORATION -testicular I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -"solo I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Sertoli", I-EXPLORATION -hialinización I-EXPLORATION -tubular I-EXPLORATION -y I-EXPLORATION -microlitiasis. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -practicada I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -llamaba I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -una I-EXPLORATION -LDH I-EXPLORATION -de I-EXPLORATION -1903 I-EXPLORATION -y I-EXPLORATION -b-HCG I-EXPLORATION -de I-EXPLORATION -23, I-EXPLORATION -8, I-EXPLORATION -con I-EXPLORATION -α-fetoproteína I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT -CTEP I-TREATMENT -(Cisplatino I-TREATMENT -y I-TREATMENT -Etopósido). I-TREATMENT -Después B-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -ciclos I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -observándose I-EXPLORATION -la I-EXPLORATION -total I-EXPLORATION -desaparición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -retroperitoneal, I-EXPLORATION -quedando I-EXPLORATION -tan I-EXPLORATION -solo I-EXPLORATION -dos I-EXPLORATION -adenopatías I-EXPLORATION -paraaórticas I-EXPLORATION -izquierdas I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -iliaca I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -cada I-EXPLORATION -una, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -dos I-TREATMENT -ciclos I-TREATMENT -mas I-TREATMENT -de I-TREATMENT -CTEP, I-TREATMENT -sin B-EVOLUTION -conseguirse I-EVOLUTION -reducción I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -dichas I-EVOLUTION -adenopatías. I-EVOLUTION - I-EVOLUTION -Con B-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -extirpar I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -tumoral I-TREATMENT -restante I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -quimioterapia, I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -las I-TREATMENT -adenopatías I-TREATMENT -y I-TREATMENT -orquiectomía I-TREATMENT -bilateral. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -adenopatías I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -fibroso I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -linfoide I-EXPLORATION -disperso I-EXPLORATION -y I-EXPLORATION -necrosis I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -tumor. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -testículos I-EXPLORATION -informo I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -solo I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Sertoli, I-EXPLORATION -con I-EXPLORATION -importante I-EXPLORATION -atrofia I-EXPLORATION -tubular, I-EXPLORATION -hialinosis, I-EXPLORATION -calcificaciones I-EXPLORATION -y I-EXPLORATION -microlitiasis I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -tumor. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -doce I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -clínicamente I-EVOLUTION -asintomático I-EVOLUTION -con B-TREATMENT -tratamiento I-TREATMENT -hormonal I-TREATMENT -sustitutivo I-TREATMENT -y B-EVOLUTION -sin I-EVOLUTION -recidiva I-EVOLUTION -radiológica I-EVOLUTION -ni I-EVOLUTION -analítica. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipo I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -dispepsia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -plenitud I-PRESENT_ILLNESS -postprandrial. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -laparotomía I-PAST_MEDICAL_HISTORY -exploradora I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -14 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -abdominal, I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -desconocemos I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -haberse I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -centro. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -ocupación I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -hemiabdomen I-EXPLORATION -derecho I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -elástica, I-EXPLORATION -a I-EXPLORATION -tensión, I-EXPLORATION -indolora I-EXPLORATION -y I-EXPLORATION -mate I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -percusión I-EXPLORATION -que I-EXPLORATION -sobrepasaba I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -de I-EXPLORATION -rutina I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -un I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -13 I-EXPLORATION -x I-EXPLORATION -106 I-EXPLORATION -hematíes, I-EXPLORATION -20.5 I-EXPLORATION -g/dl I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -y I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -65.9%, I-EXPLORATION -con I-EXPLORATION -cifras I-EXPLORATION -similares I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -preoperatorio I-EXPLORATION -inmediato. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -hidronefrosis I-EXPLORATION -masiva I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -ectasia I-EXPLORATION -pielocalicial I-EXPLORATION -masiva I-EXPLORATION -con I-EXPLORATION -prácticamente I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -cortical, I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION -del I-EXPLORATION -hemiabdomen I-EXPLORATION -derecho, I-EXPLORATION -sobrepasando I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -hasta I-EXPLORATION -contactar I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo, I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -en I-EXPLORATION -herradura I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -practicó, I-TREATMENT -por I-TREATMENT -lumbotomía, I-TREATMENT -nefrectomía I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -un I-TREATMENT -gran I-TREATMENT -riñón I-TREATMENT -hidronefrótico I-TREATMENT -secundario I-TREATMENT -a I-TREATMENT -estenosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -unión I-TREATMENT -pieloureteral, I-TREATMENT -cursando I-TREATMENT -el I-TREATMENT -postoperatorio I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -hidronefrótico I-EXPLORATION -con I-EXPLORATION -atrofia I-EXPLORATION -cortical I-EXPLORATION -marcada. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -al I-EXPLORATION -segundo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cirugía I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -Hemoglobina I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -g/dl, I-EXPLORATION -4, I-EXPLORATION -6 I-EXPLORATION -millones I-EXPLORATION -de I-EXPLORATION -eritrocitos I-EXPLORATION -y I-EXPLORATION -43, I-EXPLORATION -7% I-EXPLORATION -de I-EXPLORATION -hematocrito. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -otro I-EXPLORATION -hemograma I-EXPLORATION -10 I-EXPLORATION -meses I-EXPLORATION -después I-EXPLORATION -evidenciándose I-EXPLORATION -una I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -recuento I-EXPLORATION -eritrocitario. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Pielonefritis I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -nefríticos I-PAST_MEDICAL_HISTORY -izquierdos I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -estudiados I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -juventud. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -puñopercusión I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -positiva I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -con I-EXPLORATION -hipertrofia I-EXPLORATION -prostática I-EXPLORATION -volumen I-EXPLORATION -III/IV, I-EXPLORATION -fibroadenomatosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -nódulos. I-EXPLORATION -Analítica I-EXPLORATION -sanguínea I-EXPLORATION -con I-EXPLORATION -bioquímica I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -PSA I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -4 I-EXPLORATION -ng/ml I-EXPLORATION -y I-EXPLORATION -formula I-EXPLORATION -sanguínea I-EXPLORATION -con I-EXPLORATION -leucocitosis I-EXPLORATION -y I-EXPLORATION -desviación I-EXPLORATION -izquierda. I-EXPLORATION -Analítica I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -con I-EXPLORATION -nitritos I-EXPLORATION -positivos I-EXPLORATION -y I-EXPLORATION -leucocituria. I-EXPLORATION -Urocultivos I-EXPLORATION -y I-EXPLORATION -Hemocultivos I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -E. I-EXPLORATION -Coli. I-EXPLORATION -Rx I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -aparato I-EXPLORATION -urinario I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -significativos. I-EXPLORATION -Ecografía I-EXPLORATION -con I-EXPLORATION -ectasia I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -grado I-EXPLORATION -II-III. I-EXPLORATION -La I-EXPLORATION -UIV I-EXPLORATION -realizada I-EXPLORATION -muestra I-EXPLORATION -vía I-EXPLORATION -urinaria I-EXPLORATION -alta I-EXPLORATION -derecha I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -y I-EXPLORATION -retraso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -captación I-EXPLORATION -y I-EXPLORATION -eliminación I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -persiste I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -horas. I-EXPLORATION -Se I-EXPLORATION -procede I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -nefrostomía I-EXPLORATION -derivativa I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -posterior I-EXPLORATION -pielografía I-EXPLORATION -anterógrada, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -demuestra I-EXPLORATION -defecto I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -en I-EXPLORATION -uréter I-EXPLORATION -iliaco I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -tumoración I-EXPLORATION -ureteral I-EXPLORATION -de I-EXPLORATION -3-4 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -uréter I-EXPLORATION -en I-EXPLORATION -anzuelo. I-EXPLORATION -Citología I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -nefrostomía I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION -objetivaba I-EXPLORATION -dicha I-EXPLORATION -lesión I-EXPLORATION -como I-EXPLORATION -confinada I-EXPLORATION -al I-EXPLORATION -órgano I-EXPLORATION -origen. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -Nefroureterectomía I-TREATMENT -izquierda I-TREATMENT -previa I-TREATMENT -desinserción I-TREATMENT -endoscópica, I-TREATMENT -siendo I-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -anatomopatológico I-TREATMENT -de I-TREATMENT -Papiloma I-TREATMENT -invertido I-TREATMENT -de I-TREATMENT -uréter I-TREATMENT -y I-TREATMENT -riñón I-TREATMENT -izquierdo I-TREATMENT -con I-TREATMENT -pielonefritis I-TREATMENT -crónica. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -sufre I-EVOLUTION -una I-EVOLUTION -RAO I-EVOLUTION -que I-EVOLUTION -aconseja I-EVOLUTION -la I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -Adenomectomía I-EVOLUTION -Retropúbica I-EVOLUTION -y I-EVOLUTION -posteriormente I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -y I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -presenta I-EVOLUTION -sendas I-EVOLUTION -recidivas I-EVOLUTION -vesicales I-EVOLUTION -de I-EVOLUTION -Carcinoma I-EVOLUTION -transicional I-EVOLUTION -de I-EVOLUTION -vejiga I-EVOLUTION -T1GII. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -vivo I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -urotelial I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -años I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -PI. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -nódulo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -paratesticular I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Tres B-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -hospital I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ACVA I-PAST_MEDICAL_HISTORY -parietal I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -presentando I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fuerza I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemicuerpo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dificultad I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -habla. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tomografía I-PAST_MEDICAL_HISTORY -axial I-PAST_MEDICAL_HISTORY -computerizada I-PAST_MEDICAL_HISTORY -(TAC) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cráneo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -apreció I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -hipodensa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -brazo I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cápsula I-PAST_MEDICAL_HISTORY -blanca I-PAST_MEDICAL_HISTORY -interna I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -sutiles I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -fronto-parietal I-PAST_MEDICAL_HISTORY -izquierda. I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -administración I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -contraste I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -apreciaron I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -compatibles I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -aneurisma, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tortuosidad I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -arteria I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -media I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -podría I-PAST_MEDICAL_HISTORY -corresponder I-PAST_MEDICAL_HISTORY -bien I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trombo I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -efecto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -volumen I-PAST_MEDICAL_HISTORY -parcial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -contexto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -vaso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -morfología I-PAST_MEDICAL_HISTORY -tortuosa. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -angio-resonancia I-PAST_MEDICAL_HISTORY -magnética I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -arterias I-PAST_MEDICAL_HISTORY -cerebrales I-PAST_MEDICAL_HISTORY -medias I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -asimétricas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cuanto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -señal, I-PAST_MEDICAL_HISTORY -presentando I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -disminución I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -señal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -todo I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -trayecto, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -estenosis. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -electrocardiograma I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -alteraciones. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -carotídea, I-PAST_MEDICAL_HISTORY -arteriografía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -troncos I-PAST_MEDICAL_HISTORY -cerebrales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -supraórticos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ecocardiograma I-PAST_MEDICAL_HISTORY -transesofágico I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -determinaciones I-PAST_MEDICAL_HISTORY -analíticas I-PAST_MEDICAL_HISTORY -sanguíneas, I-PAST_MEDICAL_HISTORY -todos I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -parámetros I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -normales, I-PAST_MEDICAL_HISTORY -incluidos I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -estudios I-PAST_MEDICAL_HISTORY -realizados I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -llegar I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -etiológico I-PAST_MEDICAL_HISTORY -como: I-PAST_MEDICAL_HISTORY -anticoagulante I-PAST_MEDICAL_HISTORY -lúpico, I-PAST_MEDICAL_HISTORY -homocisteína, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anticardiolipina, I-PAST_MEDICAL_HISTORY -(α2 I-PAST_MEDICAL_HISTORY -antiplasmina, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti-proteinasa-3, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti-mieloperoxidasa, I-PAST_MEDICAL_HISTORY -proteína I-PAST_MEDICAL_HISTORY -S, I-PAST_MEDICAL_HISTORY -actividad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -proteína I-PAST_MEDICAL_HISTORY -C, I-PAST_MEDICAL_HISTORY -RPR, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -antinucleares, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anticitoplasma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -neutrófilos I-PAST_MEDICAL_HISTORY -(ANCA), I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti I-PAST_MEDICAL_HISTORY -SSA I-PAST_MEDICAL_HISTORY -Ro I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anti I-PAST_MEDICAL_HISTORY -SSB I-PAST_MEDICAL_HISTORY -LA. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -definitiva, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -trata I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -joven I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ACVA I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -territorio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -media I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -etiología I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -filiada. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -pétrea I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -paratesticular I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -testicular I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -del I-EXPLORATION -cordón I-EXPLORATION -espermático I-EXPLORATION -izquierdo. I-EXPLORATION -Los I-EXPLORATION -testículos I-EXPLORATION -son I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -morfología I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Resonacia I-EXPLORATION -Magnética I-EXPLORATION -objetivándose I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cordón I-EXPLORATION -espermático I-EXPLORATION -izquierdo I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -comporta I-EXPLORATION -con I-EXPLORATION -alta I-EXPLORATION -señal I-EXPLORATION -en I-EXPLORATION -secuencias I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -T2. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -se I-EXPLORATION -produce I-EXPLORATION -un I-EXPLORATION -realce I-EXPLORATION -periférico I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -hipointensa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION -que I-EXPLORATION -representa I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -avascular I-EXPLORATION -de I-EXPLORATION -necrosis. I-EXPLORATION -Las I-EXPLORATION -posibilidades I-EXPLORATION -diagnósticas I-EXPLORATION -fueron I-EXPLORATION -dos: I-EXPLORATION -liposarcoma I-EXPLORATION -del I-EXPLORATION -cordón I-EXPLORATION -espermático I-EXPLORATION -o I-EXPLORATION -vasculitis. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -biopsia I-TREATMENT -de I-TREATMENT -cordón I-TREATMENT -espermático I-TREATMENT -y I-TREATMENT -testículo. I-TREATMENT -Macroscópicamente B-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -nodular, I-EXPLORATION -sólida I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -coloración I-EXPLORATION -blanquecina, I-EXPLORATION -con I-EXPLORATION -zona I-EXPLORATION -irregulares I-EXPLORATION -amarillentas I-EXPLORATION -que I-EXPLORATION -medía I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm. I-EXPLORATION -Histológicamente I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -vasculitis I-EXPLORATION -granulomatosa I-EXPLORATION -necrotizante I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -fundamentalmente I-EXPLORATION -a I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -mediano I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -centra I-EXPLORATION -irregular I-EXPLORATION -con I-EXPLORATION -necrosis. I-EXPLORATION -El I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -es I-EXPLORATION -transmural I-EXPLORATION -y I-EXPLORATION -ocasiona I-EXPLORATION -una I-EXPLORATION -obliteración I-EXPLORATION -prácticamente I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -vascular. I-EXPLORATION -Periféricamente I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -adyacentes I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -marcada I-EXPLORATION -fibrosis, I-EXPLORATION -necrosis I-EXPLORATION -grasa I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -agudo I-EXPLORATION -y I-EXPLORATION -crónico. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -bacilos I-EXPLORATION -alcohol I-EXPLORATION -resistentes. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -anatomo I-EXPLORATION -patológico I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -vasculitis I-EXPLORATION -granulomatosa I-EXPLORATION -necrotizante I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -paratesticular. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -testículo I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -identifican I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -complicaciones I-EVOLUTION -postoperatorias I-EVOLUTION -y B-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -Deflazacort I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -30 I-TREATMENT -mg/día. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -16 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -ninguna I-EVOLUTION -sintomatología I-EVOLUTION -y I-EVOLUTION -sigue I-EVOLUTION -con I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -mantenimiento I-EVOLUTION -(6 I-EVOLUTION -mg/día). I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -cesáreas, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -remitida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -una I-EXPLORATION -litiasis I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -intravenosa I-EXPLORATION -una I-EXPLORATION -acodadura I-EXPLORATION -del I-EXPLORATION -uréter I-EXPLORATION -derecho I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -tercio I-EXPLORATION -superior I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -Asintomática, B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION -A B-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -meses, I-EXPLORATION -nuevo I-EXPLORATION -ingreso I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -nueva I-EXPLORATION -batería I-EXPLORATION -de I-EXPLORATION -pruebas: I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -comprueba I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -litiasis I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -uréter I-EXPLORATION -distal I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -pequeñas I-EXPLORATION -calcificaciones I-EXPLORATION -en I-EXPLORATION -riñón I-EXPLORATION -derecho; I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -confirma I-EXPLORATION -lo I-EXPLORATION -hallado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -y I-EXPLORATION -además I-EXPLORATION -descarta I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -uropatía I-EXPLORATION -obstructiva. I-EXPLORATION -En I-EXPLORATION -todo I-EXPLORATION -momento I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -trata I-TREATMENT -la I-TREATMENT -litiasis I-TREATMENT -ureteral I-TREATMENT -mediante I-TREATMENT -ureteroscopia I-TREATMENT -y I-TREATMENT -lasertricia I-TREATMENT -persistiendo I-TREATMENT -la I-TREATMENT -clínica I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -la I-TREATMENT -eficacia I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -motiva I-TREATMENT -nuevo I-TREATMENT -ingreso I-TREATMENT -unos I-TREATMENT -meses I-TREATMENT -más I-TREATMENT -tarde. I-TREATMENT -Se B-EXPLORATION -realiza I-EXPLORATION -UIV I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -ectasia I-EXPLORATION -ureteropielocalicial I-EXPLORATION -derecha I-EXPLORATION -hasta I-EXPLORATION -cresta I-EXPLORATION -iliaca. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -los I-EXPLORATION -riñones I-EXPLORATION -son I-EXPLORATION -normales I-EXPLORATION -pero I-EXPLORATION -el I-EXPLORATION -uréter I-EXPLORATION -derecho I-EXPLORATION -está I-EXPLORATION -discretamente I-EXPLORATION -dilatado I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -distal I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -identifica I-EXPLORATION -un I-EXPLORATION -quiste I-EXPLORATION -ovárico I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -que I-EXPLORATION -pudiera I-EXPLORATION -estar I-EXPLORATION -comprimiendo I-EXPLORATION -parcialmente I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -distal I-EXPLORATION -del I-EXPLORATION -uréter I-EXPLORATION -(vista I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -ginecología I-EXPLORATION -no I-EXPLORATION -precisa I-EXPLORATION -tratamiento I-EXPLORATION -alguno, I-EXPLORATION -solamente I-EXPLORATION -revisiones I-EXPLORATION -periódicas). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -pielografía I-EXPLORATION -ascendente I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -se I-EXPLORATION -ve I-EXPLORATION -la I-EXPLORATION -ectasia I-EXPLORATION -ureteropielocalicial I-EXPLORATION -sin I-EXPLORATION -observar I-EXPLORATION -claramente I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -ureteral; I-EXPLORATION -se B-TREATMENT -coloca I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -doble I-TREATMENT -J I-TREATMENT -que I-TREATMENT -es I-TREATMENT -retirado I-TREATMENT -a I-TREATMENT -las I-TREATMENT -8 I-TREATMENT -semanas I-TREATMENT -sin I-TREATMENT -apreciar I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -mejoría I-TREATMENT -clínica. I-TREATMENT -Se B-EXPLORATION -decide I-EXPLORATION -hacer I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION -que I-EXPLORATION -nos I-EXPLORATION -pueda I-EXPLORATION -aportar I-EXPLORATION -algún I-EXPLORATION -dato I-EXPLORATION -nuevo I-EXPLORATION -que I-EXPLORATION -justifique I-EXPLORATION -los I-EXPLORATION -síntomas; I-EXPLORATION -dicha I-EXPLORATION -RMN I-EXPLORATION -nos I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -ectasia I-EXPLORATION -ureteral I-EXPLORATION -derecha I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -ovárica. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -programa I-TREATMENT -para I-TREATMENT -intervención I-TREATMENT -quirúrgica: I-TREATMENT -ligadura I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -ovárica I-TREATMENT -más I-TREATMENT -ureterolisis I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -laparoscópica I-TREATMENT -transabdominal. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -colocada I-TREATMENT -en I-TREATMENT -ligero I-TREATMENT -decúbito I-TREATMENT -lateral I-TREATMENT -izquierdo. I-TREATMENT -Insuflación I-TREATMENT -abdominal I-TREATMENT -con I-TREATMENT -CO2 I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT -de I-TREATMENT -Veress I-TREATMENT -y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -cuatro I-TREATMENT -trócares, I-TREATMENT -2 I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mm I-TREATMENT -- I-TREATMENT -(uno I-TREATMENT -subesternal I-TREATMENT -y I-TREATMENT -otro I-TREATMENT -en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -lumbar I-TREATMENT -entre I-TREATMENT -la I-TREATMENT -cresta I-TREATMENT -iliaca I-TREATMENT -y I-TREATMENT -la I-TREATMENT -12ª I-TREATMENT -costilla) I-TREATMENT -- I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mm I-TREATMENT -- I-TREATMENT -(uno I-TREATMENT -en I-TREATMENT -el I-TREATMENT -ombligo, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -coloca I-TREATMENT -la I-TREATMENT -óptica, I-TREATMENT -y I-TREATMENT -el I-TREATMENT -otro I-TREATMENT -suprapúbico) I-TREATMENT --. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -incisión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -de I-TREATMENT -Toldt I-TREATMENT -y I-TREATMENT -decolación I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -identificación I-TREATMENT -del I-TREATMENT -uréter I-TREATMENT -lumbar I-TREATMENT -y I-TREATMENT -seguimiento I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -hasta I-TREATMENT -observar I-TREATMENT -su I-TREATMENT -paso I-TREATMENT -entre I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -iliaca I-TREATMENT -y I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -ovárica, I-TREATMENT -ésta I-TREATMENT -última I-TREATMENT -cruza I-TREATMENT -por I-TREATMENT -encima I-TREATMENT -del I-TREATMENT -uréter I-TREATMENT -y I-TREATMENT -se I-TREATMENT -bifurca I-TREATMENT -en I-TREATMENT -2 I-TREATMENT -ramas I-TREATMENT -que I-TREATMENT -actúan I-TREATMENT -a I-TREATMENT -modo I-TREATMENT -de I-TREATMENT -pinza I-TREATMENT -comprimiendo I-TREATMENT -el I-TREATMENT -uréter. I-TREATMENT -Se I-TREATMENT -libera I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -ovárica I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -ligadura I-TREATMENT -y I-TREATMENT -sección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma. I-TREATMENT -Para I-TREATMENT -finalizar, I-TREATMENT -colocamos I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -tipo I-TREATMENT -Redon I-TREATMENT -sin I-TREATMENT -aspiración I-TREATMENT -a I-TREATMENT -través I-TREATMENT -del I-TREATMENT -trócar I-TREATMENT -lateral, I-TREATMENT -se I-TREATMENT -confirma I-TREATMENT -la I-TREATMENT -hemostasia, I-TREATMENT -se I-TREATMENT -evacúa I-TREATMENT -el I-TREATMENT -CO2 I-TREATMENT -y I-TREATMENT -se I-TREATMENT -suturan I-TREATMENT -los I-TREATMENT -puertos I-TREATMENT -de I-TREATMENT -entrada. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -cursa I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -revisiones I-EVOLUTION -posteriores, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -totalmente I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -UIV I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -ha I-EVOLUTION -desaparecido I-EVOLUTION -la I-EVOLUTION -ectasia I-EVOLUTION -y I-EVOLUTION -acodadura I-EVOLUTION -del I-EVOLUTION -uréter I-EVOLUTION -derecho. I-EVOLUTION - I-EVOLUTION - -Hermanos B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -casados B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hijos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infertilidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sinusitis I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -infecciones I-PAST_MEDICAL_HISTORY -respiratorias I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -muchos I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -niegan I-PAST_MEDICAL_HISTORY -haberlas I-PAST_MEDICAL_HISTORY -padecido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -Madre B-FAMILY_HISTORY -y I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -presentan I-FAMILY_HISTORY -broncopatía I-FAMILY_HISTORY -crónica I-FAMILY_HISTORY -no I-FAMILY_HISTORY -filiada. I-FAMILY_HISTORY -Padre I-FAMILY_HISTORY -sano I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -afectación I-FAMILY_HISTORY -pulmonar I-FAMILY_HISTORY -o I-FAMILY_HISTORY -sinusal. I-FAMILY_HISTORY -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -hermanos, I-EXPLORATION -hermana, I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -madre, I-EXPLORATION -sólo I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -roncus I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -pulmonar. I-EXPLORATION -No B-FAMILY_HISTORY -se I-FAMILY_HISTORY -pudieron I-FAMILY_HISTORY -obtener I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -clínicos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -ascendencia I-FAMILY_HISTORY -tanto I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -como I-FAMILY_HISTORY -materna. I-FAMILY_HISTORY -Bioquímica B-EXPLORATION -ordinaria I-EXPLORATION -normal, I-EXPLORATION -incluyendo I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -renal. I-EXPLORATION -Alfa-1-anti-tripsina I-EXPLORATION -normal. I-EXPLORATION -Proteinograma I-EXPLORATION -e I-EXPLORATION -inmunoglobulinas I-EXPLORATION -normales. I-EXPLORATION -Hormonas I-EXPLORATION -tiroideas I-EXPLORATION -normales. I-EXPLORATION -Marcadores I-EXPLORATION -del I-EXPLORATION -virus I-EXPLORATION -B I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hepatitis I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -negativos. I-EXPLORATION -Anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -pruebas I-EXPLORATION -reumáticas, I-EXPLORATION -fracción I-EXPLORATION -C3 I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -negativos. I-EXPLORATION -Gasometría I-EXPLORATION -arterial I-EXPLORATION -basal I-EXPLORATION -y I-EXPLORATION -bicarbonato I-EXPLORATION -normal. I-EXPLORATION -Espirometría I-EXPLORATION -normal. I-EXPLORATION -Saturación I-EXPLORATION -Hb I-EXPLORATION -normal. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -normal. I-EXPLORATION -Tanto I-EXPLORATION -los I-EXPLORATION -hermanos I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -hermana I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -madre I-EXPLORATION -rehusaron I-EXPLORATION -hacer I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -respiratoria I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -ultraestructural I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cilios. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -semen I-EXPLORATION -indica I-EXPLORATION -astenozoospermia I-EXPLORATION -total I-EXPLORATION -en I-EXPLORATION -3 I-EXPLORATION -seminogramas I-EXPLORATION -diferentes I-EXPLORATION -realizados I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -hermanos, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -concentración I-EXPLORATION -espermática I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -23 I-EXPLORATION -millones/ml, I-EXPLORATION -un I-EXPLORATION -porcentaje I-EXPLORATION -de I-EXPLORATION -formas I-EXPLORATION -normales I-EXPLORATION -por I-EXPLORATION -criterios I-EXPLORATION -de I-EXPLORATION -Kruger I-EXPLORATION -del I-EXPLORATION -6% I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -viabilidad I-EXPLORATION -del I-EXPLORATION -95%. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -ultraestructural I-EXPLORATION -del I-EXPLORATION -flagelo I-EXPLORATION -espermático I-EXPLORATION -por I-EXPLORATION -microscopía I-EXPLORATION -electrónica I-EXPLORATION -indica I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -hermanos I-EXPLORATION -tienen I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -anomalía. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -mayoría I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -secciones I-EXPLORATION -transversales I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -brazos I-EXPLORATION -de I-EXPLORATION -dineína. I-EXPLORATION -El I-EXPLORATION -filamento I-EXPLORATION -de I-EXPLORATION -nexina I-EXPLORATION -está I-EXPLORATION -presente, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -fibras I-EXPLORATION -radiales I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -par I-EXPLORATION -central. I-EXPLORATION -En I-EXPLORATION -espermatozoides I-EXPLORATION -aislados, I-EXPLORATION -coincidiendo I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -brazos I-EXPLORATION -de I-EXPLORATION -dineína, I-EXPLORATION -hay I-EXPLORATION -también I-EXPLORATION -pérdida I-EXPLORATION -del I-EXPLORATION -par I-EXPLORATION -central. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -anomalía I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vaina I-EXPLORATION -fibrosa, I-EXPLORATION -ni I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -densas. I-EXPLORATION -La I-EXPLORATION -pieza I-EXPLORATION -intermedia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION -aproximadamente I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -tenía I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -número I-EXPLORATION -de I-EXPLORATION -mitocondrias I-EXPLORATION -y I-EXPLORATION -mitocondrias I-EXPLORATION -extras I-EXPLORATION -no I-EXPLORATION -alineadas. I-EXPLORATION -Otros I-EXPLORATION -datos I-EXPLORATION -añadidos I-EXPLORATION -fueron I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -microtúbulos I-EXPLORATION -extra I-EXPLORATION -periféricos I-EXPLORATION -al I-EXPLORATION -axonema. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vejiga I-PAST_MEDICAL_HISTORY -hiperrefléxica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sección I-PAST_MEDICAL_HISTORY -medular I-PAST_MEDICAL_HISTORY -traumática I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -disparos I-PRESENT_ILLNESS -miccionales I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -incontinencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuadros I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pielonefritis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -repetición. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -cistografía I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -vejiga I-EXPLORATION -de I-EXPLORATION -escasa I-EXPLORATION -capacidad, I-EXPLORATION -sin I-EXPLORATION -reflujo I-EXPLORATION -vesicoureteral. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -urodinámico I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -disparo I-EXPLORATION -miccional I-EXPLORATION -desde I-EXPLORATION -los I-EXPLORATION -60cc I-EXPLORATION -de I-EXPLORATION -llenado I-EXPLORATION -con I-EXPLORATION -altas I-EXPLORATION -presiones I-EXPLORATION -vesicales I-EXPLORATION -que I-EXPLORATION -había I-EXPLORATION -resultado I-EXPLORATION -refractario I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -conservador. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -enterocistoplastia I-TREATMENT -de I-TREATMENT -ampliación I-TREATMENT -laparoscópica I-TREATMENT -con I-TREATMENT -un I-TREATMENT -segmento I-TREATMENT -ileal I-TREATMENT -de I-TREATMENT -25 I-TREATMENT -cm I-TREATMENT -plegado I-TREATMENT -en I-TREATMENT -U. I-TREATMENT -La I-TREATMENT -duración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -4, I-TREATMENT -5 I-TREATMENT -horas I-TREATMENT -con I-TREATMENT -un I-TREATMENT -sangrado I-TREATMENT -mínimo. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -constipación, I-EVOLUTION -que I-EVOLUTION -ya I-EVOLUTION -presentaba I-EVOLUTION -ocasionalmente I-EVOLUTION -antes I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION -Se I-EVOLUTION -procedió I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -al I-EVOLUTION -duodécimo I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -seguimiento I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -meses. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -programa I-EVOLUTION -de I-EVOLUTION -autocateterismos, I-EVOLUTION -continente I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -infección I-EVOLUTION -urinaria. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -destacando B-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -insulina, I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miopía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cataratas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -craurosis I-PRESENT_ILLNESS -prepucial I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -impide I-PRESENT_ILLNESS -retracción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prepucio. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -debajo I-EXPLORATION -de I-EXPLORATION -prepucio I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -glande I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -tres I-EXPLORATION -centímetros I-EXPLORATION -no I-EXPLORATION -doloroso I-EXPLORATION -y I-EXPLORATION -muy I-EXPLORATION -consistente. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -pene, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -con I-EXPLORATION -anestesia I-EXPLORATION -local I-EXPLORATION -incisión I-EXPLORATION -prepucial I-EXPLORATION -encontrándonos I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -cuatro I-EXPLORATION -centímetros I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -rojo I-EXPLORATION -amarillento, I-EXPLORATION -algo I-EXPLORATION -rugoso, I-EXPLORATION -consistente I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -y I-EXPLORATION -situado I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -glande. I-EXPLORATION -Se I-EXPLORATION -tomó I-EXPLORATION -una I-EXPLORATION -cuña I-EXPLORATION -profunda I-EXPLORATION -del I-EXPLORATION -nódulo I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -realizar I-TREATMENT -circuncisión I-TREATMENT -ni I-TREATMENT -exéresis I-TREATMENT -del I-TREATMENT -nódulo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -espera I-TREATMENT -del I-TREATMENT -resultado. I-TREATMENT -Aunque I-TREATMENT -con I-TREATMENT -la I-TREATMENT -incisión I-TREATMENT -prepucial I-TREATMENT -el I-TREATMENT -glande I-TREATMENT -pudo I-TREATMENT -ser I-TREATMENT -exteriorizado I-TREATMENT -y I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -higiene I-TREATMENT -adecuada. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -histológico I-EXPLORATION -es I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -amiloidosis I-EXPLORATION -nodular. I-EXPLORATION -Es B-EVOLUTION -curioso I-EVOLUTION -señalar I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tiempo I-EVOLUTION -transcurrido I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -espera I-EVOLUTION -del I-EVOLUTION -resultado I-EVOLUTION -histológico, I-EVOLUTION -al I-EVOLUTION -poder I-EVOLUTION -realizar I-EVOLUTION -una I-EVOLUTION -higiene I-EVOLUTION -adecuada, I-EVOLUTION -el I-EVOLUTION -aspecto I-EVOLUTION -del I-EVOLUTION -nódulo I-EVOLUTION -mejoró. I-EVOLUTION - I-EVOLUTION -De B-TREATMENT -forma I-TREATMENT -reglada I-TREATMENT -realizamos I-TREATMENT -circuncisión I-TREATMENT -y I-TREATMENT -exéresis I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -nódulo, I-TREATMENT -confirmando B-EXPLORATION -este I-EXPLORATION -segundo I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -nódulo I-EXPLORATION -amiloidótico. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -permanganato I-EXPLORATION -potásico I-EXPLORATION -que I-EXPLORATION -permitió I-EXPLORATION -diferenciar I-EXPLORATION -el I-EXPLORATION -amiloide I-EXPLORATION -tipo I-EXPLORATION -AA I-EXPLORATION -del I-EXPLORATION -AL, I-EXPLORATION -éste I-EXPLORATION -último I-EXPLORATION -característico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -forma I-EXPLORATION -primaria I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -sensible I-EXPLORATION -al I-EXPLORATION -permanganato. I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -tisular I-EXPLORATION -se I-EXPLORATION -tiñó I-EXPLORATION -con I-EXPLORATION -Rojo I-EXPLORATION -Congo I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -examinó I-EXPLORATION -con I-EXPLORATION -luz I-EXPLORATION -polarizada I-EXPLORATION -observándose I-EXPLORATION -la I-EXPLORATION -típica I-EXPLORATION -birrefrigencia I-EXPLORATION -verde. I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -haber I-EXPLORATION -identificado I-EXPLORATION -el I-EXPLORATION -amiloide, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -proteínas I-EXPLORATION -e I-EXPLORATION -inmunohistoquímica. I-EXPLORATION -El I-EXPLORATION -componente I-EXPLORATION -amiloide I-EXPLORATION -lo I-EXPLORATION -constituía I-EXPLORATION -el I-EXPLORATION -tipo I-EXPLORATION -AL, I-EXPLORATION -característico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -amiloidosis I-EXPLORATION -primaria I-EXPLORATION -y I-EXPLORATION -amiloidosis I-EXPLORATION -local. I-EXPLORATION -Este I-EXPLORATION -componente I-EXPLORATION -fibrilar I-EXPLORATION -se I-EXPLORATION -caracteriza I-EXPLORATION -por I-EXPLORATION -tener I-EXPLORATION -un I-EXPLORATION -depósito I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -Kappa I-EXPLORATION -o I-EXPLORATION -lambda. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -complementario I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -amiloidosis I-EXPLORATION -generalizada I-EXPLORATION -consistente I-EXPLORATION -en I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica, I-EXPLORATION -proteinograma, I-EXPLORATION -PSA, I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -rectal. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -síndrome I-EXPLORATION -nefrótico I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -creímos I-EXPLORATION -oportuno I-EXPLORATION -realizar I-EXPLORATION -biopsia I-EXPLORATION -renal. I-EXPLORATION -Tampoco I-EXPLORATION -presentaba I-EXPLORATION -artritis, I-EXPLORATION -insuficiencia I-EXPLORATION -cardíaca, I-EXPLORATION -hipotensión I-EXPLORATION -ni I-EXPLORATION -neuropatía. I-EXPLORATION -Todas I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -presentaron I-EXPLORATION -unos I-EXPLORATION -resultados I-EXPLORATION -normales I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -amiloidosis I-EXPLORATION -generalizada. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -años I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -recidivado I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -desarrollado I-EVOLUTION -amiloidosis I-EVOLUTION -generalizada. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -edemas I-PRESENT_ILLNESS -progresivos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores, I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -genital I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inguinal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -acompañante. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -constaban I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -nefríticos I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -complicados. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -llamaba I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -dura I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -púbica, I-EXPLORATION -incluyendo I-EXPLORATION -pene, I-EXPLORATION -escroto I-EXPLORATION -y I-EXPLORATION -región I-EXPLORATION -inguinal, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -por I-EXPLORATION -ambas I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -siendo I-EXPLORATION -más I-EXPLORATION -evidente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -fovea. I-EXPLORATION -No I-EXPLORATION -existían I-EXPLORATION -lesiones I-EXPLORATION -cutáneas, I-EXPLORATION -ni I-EXPLORATION -adenopatías I-EXPLORATION -laterocervicales I-EXPLORATION -o I-EXPLORATION -axilares. I-EXPLORATION -Palpación I-EXPLORATION -de I-EXPLORATION -probables I-EXPLORATION -adenopatías I-EXPLORATION -inguinales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -próstata I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -tamaño, I-EXPLORATION -dura I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -dolorosa. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -incluyendo I-EXPLORATION -bioquímica, I-EXPLORATION -hemograma, I-EXPLORATION -proteinograma, I-EXPLORATION -coagulación I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -con I-EXPLORATION -proteinuria I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -estrictamente I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -solicitaron I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -destacando I-EXPLORATION -un I-EXPLORATION -PSA I-EXPLORATION -de I-EXPLORATION -100 I-EXPLORATION -microgramos/l. I-EXPLORATION - I-EXPLORATION -Tanto I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -objetivaron I-EXPLORATION -múltiples I-EXPLORATION -adenopatías I-EXPLORATION -retroperitoneales I-EXPLORATION -paraaórticas I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -cadenas I-EXPLORATION -ilíacas I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -próstata I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -tamaño. I-EXPLORATION -Se I-EXPLORATION -consultó I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Urología I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -llevó I-EXPLORATION -a I-EXPLORATION -cabo I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -prostática I-EXPLORATION -concluyente I-EXPLORATION -para I-EXPLORATION -adenocarcinoma I-EXPLORATION -de I-EXPLORATION -próstata I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -adenopatía I-EXPLORATION -inguinal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -invasión I-EXPLORATION -por I-EXPLORATION -adenocarcinoma I-EXPLORATION -prostático. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -intensa I-EXPLORATION -positividad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -población I-EXPLORATION -neoplásica I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -prostática, I-EXPLORATION -el I-EXPLORATION -antígeno I-EXPLORATION -prostático I-EXPLORATION -específico I-EXPLORATION -(PSA) I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -los I-EXPLORATION -receptores I-EXPLORATION -de I-EXPLORATION -andrógenos. I-EXPLORATION -La I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -captación I-EXPLORATION -retroauricular I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -apófisis I-EXPLORATION -espinosa I-EXPLORATION -y I-EXPLORATION -carilla I-EXPLORATION -auricular I-EXPLORATION -de I-EXPLORATION -C3. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -hormonal I-TREATMENT -con I-TREATMENT -antiandrógenos I-TREATMENT -y I-TREATMENT -análogos I-TREATMENT -de I-TREATMENT -LHRH. I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -metástasis I-TREATMENT -óseas, I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -ácido I-TREATMENT -zoledrónico. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -nueve I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -hallaba I-EVOLUTION -estable I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -cambios I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -exploración I-EVOLUTION -física. I-EVOLUTION -El I-EVOLUTION -PSA I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -4, I-EVOLUTION -6 I-EVOLUTION -microgramos/l. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -es B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -completar I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -acudir I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -especialidades I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -indolora I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -testículo I-DERIVED_FROM/TO -izquierdo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -mes I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -otra I-DERIVED_FROM/TO -sintomatología. I-DERIVED_FROM/TO -Se B-EXPLORATION -le I-EXPLORATION -detecta I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION -de I-EXPLORATION -especialidades I-EXPLORATION -un I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -hipogénico I-EXPLORATION -y I-EXPLORATION -disminuido I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -que I-EXPLORATION -dificulta I-EXPLORATION -su I-EXPLORATION -valoración, I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -testículo I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -parénquima I-EXPLORATION -heterogéneo I-EXPLORATION -sospechoso I-EXPLORATION -de I-EXPLORATION -neoplasia. I-EXPLORATION - I-EXPLORATION -No B-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tampoco I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -un I-EXPLORATION -teste I-EXPLORATION -izquierdo I-EXPLORATION -hipotrófico. I-EXPLORATION -El I-EXPLORATION -teste I-EXPLORATION -derecho I-EXPLORATION -se I-EXPLORATION -presenta I-EXPLORATION -algo I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño. I-EXPLORATION -Ambos I-EXPLORATION -no I-EXPLORATION -dolorosos, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -regulares. I-EXPLORATION -Epidídimos I-EXPLORATION -y I-EXPLORATION -cordones I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -solicitan I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -que I-EXPLORATION -resultan I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -alfa-feto I-EXPLORATION -proteína I-EXPLORATION -de I-EXPLORATION -2.7 I-EXPLORATION -ng/ml I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -beta-hCG I-EXPLORATION -de I-EXPLORATION -4.2 I-EXPLORATION -mUI/ml. I-EXPLORATION - I-EXPLORATION -Durante I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -nuevas I-EXPLORATION -exploraciones I-EXPLORATION -complementarias, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -con I-EXPLORATION -flujo I-EXPLORATION -Doppler I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -teste I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -49mm I-EXPLORATION -x I-EXPLORATION -36mm I-EXPLORATION -x I-EXPLORATION -26mm I-EXPLORATION -con I-EXPLORATION -lesión I-EXPLORATION -hipoecoica, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -lobulados, I-EXPLORATION -heterogénea, I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -prácticamente I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -testículo, I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -flujo I-EXPLORATION -Doppler. I-EXPLORATION -Y I-EXPLORATION -un I-EXPLORATION -teste I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -32 I-EXPLORATION -mm I-EXPLORATION -x I-EXPLORATION -22 I-EXPLORATION -mm I-EXPLORATION -x I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION -hetrogéneo I-EXPLORATION -con I-EXPLORATION -lesión I-EXPLORATION -focal I-EXPLORATION -ligeramente I-EXPLORATION -hipoecoica I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -9 I-EXPLORATION -mm I-EXPLORATION -con I-EXPLORATION -sutil I-EXPLORATION -flujo I-EXPLORATION -Doppler. I-EXPLORATION -Además, I-EXPLORATION -microlitiasis I-EXPLORATION -testiculares I-EXPLORATION -bilaterales. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -TAC I-EXPLORATION -toraco-abdomino-pélvico I-EXPLORATION -con I-EXPLORATION -contraste, I-EXPLORATION -donde I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -metástasis I-EXPLORATION -en I-EXPLORATION -ninguno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -territorios I-EXPLORATION -visualizados. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -testicular I-TREATMENT -bilateral, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -orquiectomía I-TREATMENT -bilateral I-TREATMENT -vía I-TREATMENT -inguinal. I-TREATMENT -Al I-TREATMENT -mismo I-TREATMENT -tiempo I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -hormonal I-TREATMENT -sustitutivo. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -Anatomía I-EXPLORATION -patológica I-EXPLORATION -informan I-EXPLORATION -de I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -atrófico I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -focos I-EXPLORATION -microscópicos I-EXPLORATION -de I-EXPLORATION -Seminoma I-EXPLORATION -clásico I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -amplias I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -Neoplasia I-EXPLORATION -Intratubular I-EXPLORATION -de I-EXPLORATION -Células I-EXPLORATION -Germinales I-EXPLORATION -(NICG) I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -tumoral I-EXPLORATION -en I-EXPLORATION -albugínea, I-EXPLORATION -rete I-EXPLORATION -testis, I-EXPLORATION -epidídimo I-EXPLORATION -o I-EXPLORATION -infiltración I-EXPLORATION -vascular. I-EXPLORATION -El I-EXPLORATION -testículo I-EXPLORATION -derecho I-EXPLORATION -presenta I-EXPLORATION -tumoración I-EXPLORATION -con I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -Seminoma I-EXPLORATION -clásico I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -prácticamente I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -parénquima, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -Neoplasia I-EXPLORATION -Intratubular I-EXPLORATION -de I-EXPLORATION -Células I-EXPLORATION -Germinales I-EXPLORATION -(NICG) I-EXPLORATION -y I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -atrofia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -testículo I-EXPLORATION -restante. I-EXPLORATION -Túnica I-EXPLORATION -albugínea, I-EXPLORATION -rete I-EXPLORATION -testis, I-EXPLORATION -epidídimo I-EXPLORATION -y I-EXPLORATION -borde I-EXPLORATION -quirúrgico I-EXPLORATION -libres I-EXPLORATION -de I-EXPLORATION -tumor. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -completó I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -carboplatino. I-TREATMENT - I-TREATMENT -Actualmente B-EVOLUTION -lleva I-EVOLUTION -aproximadamente I-EVOLUTION -3 I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumadora B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cigarrillos/día, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -poliquistosis I-PAST_MEDICAL_HISTORY -hepatorrenal I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -aclaramiento I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -ml/min I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -proteinuria). I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -patológico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -requiere I-PRESENT_ILLNESS -ingreso. I-PRESENT_ILLNESS -Inicialmente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -orienta I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -quística. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -reno-vesical I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -poliquistosis I-EXPLORATION -hepatorrenal, I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -desestructuración I-EXPLORATION -parenquimatosa I-EXPLORATION -renal I-EXPLORATION -por I-EXPLORATION -quistes, I-EXPLORATION -preferentemente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -contralateral, I-EXPLORATION -Existe I-EXPLORATION -una I-EXPLORATION -ecogenicidad I-EXPLORATION -heterogénea I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -preservado I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -turgencia I-EXPLORATION -parenquimatosa I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -desdibujamiento I-EXPLORATION -sinusal I-EXPLORATION -izquierdo I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -ecogénico I-EXPLORATION -que I-EXPLORATION -ejerce I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -proyecta I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -pelvis I-EXPLORATION -renal. I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION -poca I-EXPLORATION -especificidad I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -ecográficos I-EXPLORATION -se I-EXPLORATION -completa I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -mediante I-EXPLORATION -TC I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -nuevamente I-EXPLORATION -desestructuración I-EXPLORATION -renal I-EXPLORATION -bilateral I-EXPLORATION -por I-EXPLORATION -poliquistosis, I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -quistes I-EXPLORATION -hiperdensos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -basal I-EXPLORATION -realizado I-EXPLORATION -sin I-EXPLORATION -contraste I-EXPLORATION -endovenoso. I-EXPLORATION -La I-EXPLORATION -afectación I-EXPLORATION -es I-EXPLORATION -asimétrica, I-EXPLORATION -más I-EXPLORATION -intensa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo, I-EXPLORATION -siendo I-EXPLORATION -dicho I-EXPLORATION -riñón I-EXPLORATION -de I-EXPLORATION -mayor I-EXPLORATION -tamaño. I-EXPLORATION -La I-EXPLORATION -región I-EXPLORATION -piélica I-EXPLORATION -izquierda I-EXPLORATION -está I-EXPLORATION -ocupada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -realce I-EXPLORATION -moderado I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -endovenosa I-EXPLORATION -de I-EXPLORATION -contraste, I-EXPLORATION -sin I-EXPLORATION -definición I-EXPLORATION -clara I-EXPLORATION -de I-EXPLORATION -sus I-EXPLORATION -límites. I-EXPLORATION -Funcionalmente I-EXPLORATION -existe I-EXPLORATION -un I-EXPLORATION -evidente I-EXPLORATION -retraso I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -eliminación I-EXPLORATION -del I-EXPLORATION -contraste I-EXPLORATION -endovenoso I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -secciones I-EXPLORATION -realizadas I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -retardada. I-EXPLORATION -El I-EXPLORATION -conjunto I-EXPLORATION -de I-EXPLORATION -hallazgos I-EXPLORATION -sugiere I-EXPLORATION -ocupación I-EXPLORATION -tumoral I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pelvis I-EXPLORATION -renal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -poliquistosis I-EXPLORATION -con I-EXPLORATION -alteración I-EXPLORATION -funcional I-EXPLORATION -secundaria. I-EXPLORATION -Se I-EXPLORATION -observan I-EXPLORATION -ganglios I-EXPLORATION -retroperitoneales I-EXPLORATION -no I-EXPLORATION -aumentados I-EXPLORATION -significativamente I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -situación I-EXPLORATION -interaortocava I-EXPLORATION -y I-EXPLORATION -retroaórtica. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -clínico I-TREATMENT -de I-TREATMENT -masa I-TREATMENT -renal I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -proceso I-TREATMENT -neoformativo, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -nefrectomía I-TREATMENT -radical I-TREATMENT -izquierda, I-TREATMENT -con I-TREATMENT -suprarrenalectomía I-TREATMENT -izquierda I-TREATMENT -más I-TREATMENT -linfadenectomía I-TREATMENT -aortocava, I-TREATMENT -sin I-TREATMENT -incidencias I-TREATMENT -ni I-TREATMENT -complicaciones I-TREATMENT -inmediatas. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -no I-EVOLUTION -surgen I-EVOLUTION -complicaciones, I-EVOLUTION -con I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -estable. I-EVOLUTION -Un I-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -nefrectomía, I-EVOLUTION -el I-EVOLUTION -aclaramiento I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -52 I-EVOLUTION -ml/min I-EVOLUTION -y I-EVOLUTION -aparece I-EVOLUTION -proteinuria I-EVOLUTION -de I-EVOLUTION -0, I-EVOLUTION -16 I-EVOLUTION -g/24 I-EVOLUTION -h. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -anátomo-patológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza, I-EXPLORATION -macroscópicamente I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -renal I-EXPLORATION -blanquecina, I-EXPLORATION -firme, I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -cm., I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -mal I-EXPLORATION -definidos, I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -central I-EXPLORATION -de I-EXPLORATION -necrosis. I-EXPLORATION -Está I-EXPLORATION -situada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -central I-EXPLORATION -renal, I-EXPLORATION -afectando I-EXPLORATION -la I-EXPLORATION -práctica I-EXPLORATION -totalidad I-EXPLORATION -del I-EXPLORATION -parénquima, I-EXPLORATION -alcanzando I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -perirrenal I-EXPLORATION -y I-EXPLORATION -rodeando I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -suprarrenal. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hilio I-EXPLORATION -renal I-EXPLORATION -se I-EXPLORATION -identifican I-EXPLORATION -cuatro I-EXPLORATION -ganglios I-EXPLORATION -linfáticos. I-EXPLORATION -El I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION -no I-EXPLORATION -tumoral I-EXPLORATION -está I-EXPLORATION -totalmente I-EXPLORATION -desestructurado I-EXPLORATION -y I-EXPLORATION -sustituido I-EXPLORATION -por I-EXPLORATION -múltiples I-EXPLORATION -quistes I-EXPLORATION -de I-EXPLORATION -hasta I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -afectan I-EXPLORATION -tanto I-EXPLORATION -corteza I-EXPLORATION -como I-EXPLORATION -médula I-EXPLORATION -renal. I-EXPLORATION -Histológicamente, I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -está I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -citoplasma I-EXPLORATION -amplio I-EXPLORATION -y I-EXPLORATION -eosinófilo, I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -redondeados I-EXPLORATION -con I-EXPLORATION -marcada I-EXPLORATION -atipia, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -organizan I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -sólido I-EXPLORATION -cohesivo, I-EXPLORATION -característico I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -escamoso I-EXPLORATION -pobremente I-EXPLORATION -diferenciado. I-EXPLORATION -Son I-EXPLORATION -extensas I-EXPLORATION -las I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -tumoral. I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -afecta I-EXPLORATION -uréter I-EXPLORATION -proximal, I-EXPLORATION -pelvis I-EXPLORATION -renal, I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -tanto I-EXPLORATION -perirrenal I-EXPLORATION -como I-EXPLORATION -perihiliar. I-EXPLORATION -Se I-EXPLORATION -objetiva I-EXPLORATION -infiltración I-EXPLORATION -tumoral I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -extensa I-EXPLORATION -infiltración I-EXPLORATION -tumoral I-EXPLORATION -perineural I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -ganglios I-EXPLORATION -simpáticos I-EXPLORATION -del I-EXPLORATION -hilio I-EXPLORATION -renal. I-EXPLORATION -La I-EXPLORATION -masa I-EXPLORATION -tumoral I-EXPLORATION -está I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -carcinoma I-EXPLORATION -escamoso, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -seno I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cual, I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -urotelial I-EXPLORATION -papilar I-EXPLORATION -intraureteral. I-EXPLORATION -Se I-EXPLORATION -identifica I-EXPLORATION -metástasis I-EXPLORATION -del I-EXPLORATION -carcinoma I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuatro I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -hiliares I-EXPLORATION -identificados I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pieza. I-EXPLORATION -Los I-EXPLORATION -márgenes I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -quirúrgica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza, I-EXPLORATION -son I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -linfadenectomía I-EXPLORATION -paraórtica I-EXPLORATION -se I-EXPLORATION -identifican I-EXPLORATION -6 I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -libres I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -neoplásica. I-EXPLORATION -En I-EXPLORATION -resumen, I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -anátomo-patológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -escamoso I-EXPLORATION -pobremente I-EXPLORATION -diferenciado I-EXPLORATION -originado I-EXPLORATION -en I-EXPLORATION -pelvis I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -uréter, I-EXPLORATION -categoría I-EXPLORATION -pT4pN2, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -renal I-EXPLORATION -poliquística I-EXPLORATION -autosómico-dominante I-EXPLORATION -(riñón I-EXPLORATION -poliquístico I-EXPLORATION -del I-EXPLORATION -adulto). I-EXPLORATION - B-TREATMENT -En I-TREATMENT -la I-TREATMENT -actualidad, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -sigue I-TREATMENT -tratamiento I-TREATMENT -oncológico. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -reseñables, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -macrohematuria I-PRESENT_ILLNESS -asintomática I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -la I-EXPLORATION -citología I-EXPLORATION -urinaria I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cistoscopia I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -intravenosa I-EXPLORATION -se I-EXPLORATION -evidenciaba I-EXPLORATION -un I-EXPLORATION -efecto I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -desplazamiento I-EXPLORATION -craneal I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -colector. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -heterogénea I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm, I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -inferior, I-EXPLORATION -con I-EXPLORATION -realce I-EXPLORATION -periférico, I-EXPLORATION -áreas I-EXPLORATION -hipodensas I-EXPLORATION -centrales I-EXPLORATION -y I-EXPLORATION -calcificaciones. I-EXPLORATION -Se I-EXPLORATION -observaban I-EXPLORATION -asimismo I-EXPLORATION -adenopatías I-EXPLORATION -látero-cava, I-EXPLORATION -retrocava I-EXPLORATION -e I-EXPLORATION -interaorto-cava, I-EXPLORATION -siendo I-EXPLORATION -la I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -cm. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -practicó I-TREATMENT -nefrectomía I-TREATMENT -radical I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -linfadenectomía I-TREATMENT -retroperitoneal, I-TREATMENT -mediante I-TREATMENT -abordaje I-TREATMENT -abdominal I-TREATMENT -anterior. I-TREATMENT -El I-TREATMENT -estudio I-TREATMENT -anatomopatológico I-TREATMENT -reveló I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -un I-TREATMENT -adenocarcinoma I-TREATMENT -renal I-TREATMENT -de I-TREATMENT -células I-TREATMENT -claras I-TREATMENT -de I-TREATMENT -10, I-TREATMENT -5 I-TREATMENT -x I-TREATMENT -9 I-TREATMENT -cm I-TREATMENT -y I-TREATMENT -afectación I-TREATMENT -metastásica I-TREATMENT -de I-TREATMENT -9 I-TREATMENT -de I-TREATMENT -los I-TREATMENT -12 I-TREATMENT -ganglios I-TREATMENT -linfáticos I-TREATMENT -aislados, I-TREATMENT -cuyo I-TREATMENT -tamaño I-TREATMENT -oscilaba I-TREATMENT -entre I-TREATMENT -0, I-TREATMENT -3 I-TREATMENT -y I-TREATMENT -6 I-TREATMENT -cm. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -con I-EVOLUTION -normalidad I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -4º I-EVOLUTION -día, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -la I-EVOLUTION -salida I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -líquido I-EVOLUTION -lechoso I-EVOLUTION -y I-EVOLUTION -denso I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -de I-EVOLUTION -drenaje. I-EVOLUTION -El B-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -era I-EXPLORATION -estéril I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -análisis I-EXPLORATION -bioquímico I-EXPLORATION -y I-EXPLORATION -citológico I-EXPLORATION -era I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -quilo: I-EXPLORATION -pH: I-EXPLORATION -7, I-EXPLORATION -581, I-EXPLORATION -7600 I-EXPLORATION -células I-EXPLORATION -nucleadas/mm3 I-EXPLORATION -(82% I-EXPLORATION -mononucleares, I-EXPLORATION -18% I-EXPLORATION -polinucleares), I-EXPLORATION -colesterol: I-EXPLORATION -352 I-EXPLORATION -mg/dl, I-EXPLORATION -triglicéridos: I-EXPLORATION -3920 I-EXPLORATION -mg/dl. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -Sudan I-EXPLORATION -III I-EXPLORATION -se I-EXPLORATION -visualizaban I-EXPLORATION -abundantes I-EXPLORATION -gotas I-EXPLORATION -de I-EXPLORATION -grasa I-EXPLORATION -neutra. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -abdominal, I-EXPLORATION -observando I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -porción I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -mesenterio, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -linfocele. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -ascitis I-TREATMENT -quilosa I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -suspensión I-TREATMENT -de I-TREATMENT -dieta I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -total. I-TREATMENT -Ante I-TREATMENT -el I-TREATMENT -incremento I-TREATMENT -del I-TREATMENT -débito I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -quilosa I-TREATMENT -en I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -siguientes I-TREATMENT -al I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -tratamiento, I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -octreótide I-TREATMENT -(0, I-TREATMENT -1 I-TREATMENT -mg/8h, I-TREATMENT -subcutáneo), I-TREATMENT -observándose I-TREATMENT -un I-TREATMENT -descenso I-TREATMENT -manifiesto I-TREATMENT -del I-TREATMENT -drenaje I-TREATMENT -quiloso. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -linfografía I-EXPLORATION -isotópica I-EXPLORATION -(99mTc) I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -12 I-EXPLORATION -y I-EXPLORATION -24 I-EXPLORATION -días I-EXPLORATION -del I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fístula, I-EXPLORATION -observando I-EXPLORATION -un I-EXPLORATION -acúmulo I-EXPLORATION -de I-EXPLORATION -trazador I-EXPLORATION -medial I-EXPLORATION -a I-EXPLORATION -cadena I-EXPLORATION -ilíaca I-EXPLORATION -derecha, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -linfonodo, I-EXPLORATION -sin I-EXPLORATION -objetivarse I-EXPLORATION -fuga I-EXPLORATION -linfática I-EXPLORATION -alguna. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -tras I-EXPLORATION -9 I-EXPLORATION -días I-EXPLORATION -sin I-EXPLORATION -débito I-EXPLORATION -fistuloso, I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -quilocele I-EXPLORATION -retroperitoneal, I-EXPLORATION -procediendo B-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -drenaje I-TREATMENT -TAC-dirigido I-TREATMENT -del I-TREATMENT -mismo. I-TREATMENT -El I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colección I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -hasta I-TREATMENT -los I-TREATMENT -7 I-TREATMENT -días, I-TREATMENT -tras I-TREATMENT -4 I-TREATMENT -días I-TREATMENT -sin I-TREATMENT -débito. I-TREATMENT - I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -permaneció I-TREATMENT -en I-TREATMENT -dieta I-TREATMENT -absoluta I-TREATMENT -y I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -total I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -octreótide I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -22 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Cinco B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -radiológicamente I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -fuga I-EVOLUTION -quilosa. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -presentando B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -atraso I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -psico-motor, I-PAST_MEDICAL_HISTORY -trombocitopenia I-PAST_MEDICAL_HISTORY -auto-inmune, I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -linfocítica I-PAST_MEDICAL_HISTORY -granulomatosa I-PAST_MEDICAL_HISTORY -difusa, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -anti-fosfolipídeo, I-PAST_MEDICAL_HISTORY -esplenomegalia, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -central, I-PAST_MEDICAL_HISTORY -soriasis I-PAST_MEDICAL_HISTORY -inversa I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -psicosis. I-PAST_MEDICAL_HISTORY -Medicado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -alendronato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sodio, I-PAST_MEDICAL_HISTORY -haloperidol, I-PAST_MEDICAL_HISTORY -lorazepam, I-PAST_MEDICAL_HISTORY -trihexifenidilo, I-PAST_MEDICAL_HISTORY -omeprazol, I-PAST_MEDICAL_HISTORY -carbonato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hierro I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -Enviado B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -genitales I-PRESENT_ILLNESS -externos. I-PRESENT_ILLNESS -Refería I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -difusa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -escrotal, I-PRESENT_ILLNESS -condicionando I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -miccional, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -higiene I-PRESENT_ILLNESS -deficiente. I-PRESENT_ILLNESS -Negaba B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -genitales, I-PAST_MEDICAL_HISTORY -inguinales I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -pélvicos. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -inguinal I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -pélvica. I-PAST_MEDICAL_HISTORY -Negaba I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -países I-PAST_MEDICAL_HISTORY -asociados I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -filariosis I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -cuadros I-PAST_MEDICAL_HISTORY -compatibles I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -erisipela I-PAST_MEDICAL_HISTORY -inguinal/genital. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -objetivo I-EXPLORATION -presentaba I-EXPLORATION -marcado I-EXPLORATION -espesamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -túnicas I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -genitales I-EXPLORATION -externos, I-EXPLORATION -endurecido, I-EXPLORATION -indoloro, I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -mal I-EXPLORATION -definidos, I-EXPLORATION -envolviendo I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -circunferencia I-EXPLORATION -y I-EXPLORATION -hasta I-EXPLORATION -peniana, I-EXPLORATION -mimetizando I-EXPLORATION -edema I-EXPLORATION -penoescrotal I-EXPLORATION -masivo. I-EXPLORATION -Aparentemente I-EXPLORATION -las I-EXPLORATION -porciones I-EXPLORATION -dorsales I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -escrotal I-EXPLORATION -no I-EXPLORATION -estaban I-EXPLORATION -envueltas I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -proceso. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -las I-EXPLORATION -túnicas I-EXPLORATION -eran I-EXPLORATION -perfectamente I-EXPLORATION -móviles I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -planos I-EXPLORATION -profundos, I-EXPLORATION -tales I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -cuerpos I-EXPLORATION -cavernosos I-EXPLORATION -y I-EXPLORATION -glande, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -alteraciones. I-EXPLORATION -Adicionalmente I-EXPLORATION -presentaba I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -psoriásico I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -muslos I-EXPLORATION -y I-EXPLORATION -peri-umbilical, I-EXPLORATION -con I-EXPLORATION -aspectos I-EXPLORATION -de I-EXPLORATION -maceración I-EXPLORATION -y I-EXPLORATION -exudado I-EXPLORATION -importantes. I-EXPLORATION -La I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -inguinales I-EXPLORATION -no I-EXPLORATION -ponía I-EXPLORATION -en I-EXPLORATION -evidencia I-EXPLORATION -adenopatías I-EXPLORATION -sospechosas. I-EXPLORATION -Miembros I-EXPLORATION -inferiores I-EXPLORATION -sin I-EXPLORATION -edemas. I-EXPLORATION -Tacto I-EXPLORATION -rectal I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -anormales. I-EXPLORATION -Sin I-EXPLORATION -adenopatías I-EXPLORATION -periféricas. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -términos I-EXPLORATION -analíticos I-EXPLORATION -únicamente I-EXPLORATION -era I-EXPLORATION -notoria I-EXPLORATION -una I-EXPLORATION -trombocitopenia I-EXPLORATION -discreta I-EXPLORATION -(123.000/mL), I-EXPLORATION -no I-EXPLORATION -registrándose I-EXPLORATION -cualquier I-EXPLORATION -otra I-EXPLORATION -alteración I-EXPLORATION -como I-EXPLORATION -leucocitosis I-EXPLORATION -o I-EXPLORATION -eosinofília. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -descartar I-EXPLORATION -neoformaciones/adenopatías I-EXPLORATION -pélvicas I-EXPLORATION -o I-EXPLORATION -inguinales, I-EXPLORATION -fue I-EXPLORATION -pedido I-EXPLORATION -TAC I-EXPLORATION -pélvico I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -cualquier I-EXPLORATION -anomalía, I-EXPLORATION -excepto I-EXPLORATION -un I-EXPLORATION -marcadísimo I-EXPLORATION -espesamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -túnicas I-EXPLORATION -genitales. I-EXPLORATION - I-EXPLORATION -Sin I-EXPLORATION -antecedentes I-EXPLORATION -que I-EXPLORATION -permitieran I-EXPLORATION -orientar I-EXPLORATION -para I-EXPLORATION -otro I-EXPLORATION -tipo I-EXPLORATION -de I-EXPLORATION -diagnóstico, I-EXPLORATION -fue I-EXPLORATION -adelantado I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -linfedema I-EXPLORATION -idiopático I-EXPLORATION -genital, I-EXPLORATION -en I-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -linfedema I-EXPLORATION -praecox, I-EXPLORATION -dada I-EXPLORATION -la I-EXPLORATION -edad I-EXPLORATION -de I-EXPLORATION -presentación. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -mejorar I-TREATMENT -el I-TREATMENT -trofismo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -circundante I-TREATMENT -y I-TREATMENT -la I-TREATMENT -sintomatología I-TREATMENT -urinaria, I-TREATMENT -fue I-TREATMENT -colocada I-TREATMENT -cistostomía I-TREATMENT -percutánea I-TREATMENT -y I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -terapéutica I-TREATMENT -antibiótica I-TREATMENT -y I-TREATMENT -anti-fúngica I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -semanas. I-TREATMENT -Se B-EVOLUTION -verificó I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -acentuada I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas I-EVOLUTION -exudativas, I-EVOLUTION -sin I-EVOLUTION -modificación I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -áreas I-EVOLUTION -propiamente I-EVOLUTION -afectadas I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -situación. I-TREATMENT -Este I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -toda I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -macroscópicamente I-TREATMENT -afectada, I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -injertos I-TREATMENT -cutáneos I-TREATMENT -para I-TREATMENT -cobertura I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hasta I-TREATMENT -peniana I-TREATMENT -y I-TREATMENT -confección I-TREATMENT -de I-TREATMENT -neo-escroto I-TREATMENT -con I-TREATMENT -colgajos I-TREATMENT -cutáneos I-TREATMENT -de I-TREATMENT -piel I-TREATMENT -vecina. I-TREATMENT -En I-TREATMENT -primer I-TREATMENT -lugar I-TREATMENT -fue I-TREATMENT -realizada I-TREATMENT -una I-TREATMENT -circuncisión, I-TREATMENT -seguida I-TREATMENT -de I-TREATMENT -incisión I-TREATMENT -peniana I-TREATMENT -dorsal I-TREATMENT -longitudinal I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -y I-TREATMENT -túnicas I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -profundidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fáscia I-TREATMENT -de I-TREATMENT -Buck, I-TREATMENT -con I-TREATMENT -disección I-TREATMENT -circunferencial I-TREATMENT -de I-TREATMENT -la I-TREATMENT -totalidad I-TREATMENT -del I-TREATMENT -hasta I-TREATMENT -peniana I-TREATMENT -llegando I-TREATMENT -a I-TREATMENT -la I-TREATMENT -base I-TREATMENT -del I-TREATMENT -pene. I-TREATMENT -A I-TREATMENT -continuación I-TREATMENT -fue I-TREATMENT -realizada I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -arciforme I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -ambas I-TREATMENT -regiones I-TREATMENT -inguinales, I-TREATMENT -teniendo I-TREATMENT -como I-TREATMENT -centro I-TREATMENT -la I-TREATMENT -base I-TREATMENT -del I-TREATMENT -pene. I-TREATMENT -A I-TREATMENT -partir I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -fueron I-TREATMENT -aislados I-TREATMENT -los I-TREATMENT -cordones I-TREATMENT -inguinales, I-TREATMENT -exteriorizados I-TREATMENT -los I-TREATMENT -testículos I-TREATMENT -y I-TREATMENT -realizada I-TREATMENT -inversión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -túnica I-TREATMENT -vaginal. I-TREATMENT -Bajo I-TREATMENT -control I-TREATMENT -de I-TREATMENT -todas I-TREATMENT -las I-TREATMENT -estructuras I-TREATMENT -importantes, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -afectada. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -que I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -dorsal I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -escrotal I-TREATMENT -no I-TREATMENT -se I-TREATMENT -encontraba I-TREATMENT -aparentemente I-TREATMENT -afectada I-TREATMENT -(como I-TREATMENT -de I-TREATMENT -resto I-TREATMENT -es I-TREATMENT -típico I-TREATMENT -en I-TREATMENT -las I-TREATMENT -situaciones I-TREATMENT -de I-TREATMENT -linfedema), I-TREATMENT -esta I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -retirada, I-TREATMENT -permitiendo I-TREATMENT -tener I-TREATMENT -así I-TREATMENT -piel I-TREATMENT -suficiente I-TREATMENT -para I-TREATMENT -confeccionar I-TREATMENT -un I-TREATMENT -neo-escroto I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -rotación I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma. I-TREATMENT -Las I-TREATMENT -incisiones I-TREATMENT -inguinales I-TREATMENT -y I-TREATMENT -el I-TREATMENT -escroto I-TREATMENT -fueron I-TREATMENT -cerrados I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -drenos I-TREATMENT -aspirativos. I-TREATMENT -Para I-TREATMENT -cobertura I-TREATMENT -del I-TREATMENT -hasta I-TREATMENT -peniana I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -recogida I-TREATMENT -de I-TREATMENT -injertos I-TREATMENT -cutáneos I-TREATMENT -de I-TREATMENT -piel I-TREATMENT -parcial I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -del I-TREATMENT -muslo I-TREATMENT -que I-TREATMENT -fueron I-TREATMENT -colocados I-TREATMENT -directamente I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -fascia I-TREATMENT -de I-TREATMENT -Buck, I-TREATMENT -en I-TREATMENT -disposición I-TREATMENT -helicoidal. I-TREATMENT -Los I-TREATMENT -drenos I-TREATMENT -fueron I-TREATMENT -retirados I-TREATMENT -el I-TREATMENT -segundo I-TREATMENT -día I-TREATMENT -postoperatorio I-TREATMENT -y I-TREATMENT -el I-TREATMENT -apósito I-TREATMENT -compresivo I-TREATMENT -el I-TREATMENT -quinto I-TREATMENT -día I-TREATMENT -verificándose I-TREATMENT -viabilidad I-TREATMENT -total I-TREATMENT -del I-TREATMENT -material I-TREATMENT -injertado. I-TREATMENT - I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -era I-TREATMENT -notoria I-TREATMENT -la I-TREATMENT -consistencia I-TREATMENT -gelatinosa I-TREATMENT -acentuada I-TREATMENT -de I-TREATMENT -las I-TREATMENT -túnicas, I-TREATMENT -con I-TREATMENT -aparente I-TREATMENT -aspecto I-TREATMENT -translúcido I-TREATMENT -y I-TREATMENT -exudación I-TREATMENT -acentuada. I-TREATMENT -La I-TREATMENT -pieza I-TREATMENT -quirúrgica I-TREATMENT -comprendiendo I-TREATMENT -piel I-TREATMENT -peniana I-TREATMENT -y I-TREATMENT -escrotal I-TREATMENT -afectada I-TREATMENT -totalizaba I-TREATMENT -1, I-TREATMENT -05 I-TREATMENT -Kg. I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -anatomo-patológico I-EXPLORATION -puso I-EXPLORATION -en I-EXPLORATION -evidencia I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -mixoide I-EXPLORATION -hipocelular I-EXPLORATION -con I-EXPLORATION -abundante I-EXPLORATION -estroma I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -fusiformes, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -atipia I-EXPLORATION -celular I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -mitosis, I-EXPLORATION -infiltrante I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -componente I-EXPLORATION -prominente I-EXPLORATION -de I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -calibre I-EXPLORATION -variado I-EXPLORATION -y I-EXPLORATION -ectasiados. I-EXPLORATION -Inmunohistoquímica: I-EXPLORATION -vimentina I-EXPLORATION -+; I-EXPLORATION -CD I-EXPLORATION -34 I-EXPLORATION -+; I-EXPLORATION -desmina I-EXPLORATION -e I-EXPLORATION -actina I-EXPLORATION -negativos. I-EXPLORATION -Conclusión: I-EXPLORATION -aspectos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -angiomixoma I-EXPLORATION -agresivo. I-EXPLORATION - I-EXPLORATION -Después B-EVOLUTION -de I-EVOLUTION -13 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -bien, I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -y I-EVOLUTION -satisfecho I-EVOLUTION -del I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -estético. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -suprapúbico, I-PRESENT_ILLNESS -polaquiuria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -nicturia. I-PRESENT_ILLNESS -Sin B-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -laboratorio. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -cistoscopía I-EXPLORATION -se I-EXPLORATION -evidencian I-EXPLORATION -glomerulaciones I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -distención I-EXPLORATION -vesical. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -vesical I-EXPLORATION -randomizadas I-EXPLORATION -revela I-EXPLORATION -mucosa I-EXPLORATION -vesical I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -perivascular I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -eosinófilos. I-EXPLORATION -Se I-EXPLORATION -diagnóstica I-EXPLORATION -cistitis I-EXPLORATION -eosinofílica. I-EXPLORATION -Inicialmente B-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -instilaciones I-TREATMENT -vesicales I-TREATMENT -de I-TREATMENT -heparina I-TREATMENT -y I-TREATMENT -corticoides, I-TREATMENT -sin I-TREATMENT -embargo I-TREATMENT -persistió I-TREATMENT -con I-TREATMENT -frecuencia I-TREATMENT -miccional I-TREATMENT -de I-TREATMENT -20/6. I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -uso I-TREATMENT -amitriptilina, I-TREATMENT -oxibutinina I-TREATMENT -y I-TREATMENT -teltoridona I-TREATMENT -sin I-TREATMENT -respuesta. I-TREATMENT -Estudio B-EXPLORATION -urodinamico I-EXPLORATION -revela I-EXPLORATION -vejiga I-EXPLORATION -inestable I-EXPLORATION -sensitiva I-EXPLORATION -durante I-EXPLORATION -fase I-EXPLORATION -de I-EXPLORATION -continencia. I-EXPLORATION -Se I-EXPLORATION -repite I-EXPLORATION -cistoscopía I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -biopsia I-EXPLORATION -revela I-EXPLORATION -inflamación I-EXPLORATION -inespecífica. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Hidroxicina I-TREATMENT -20 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -más I-TREATMENT -Diclofenaco I-TREATMENT -sódico I-TREATMENT -50 I-TREATMENT -mg. I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h, I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT -El B-EVOLUTION -dolor I-EVOLUTION -cedió I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -frecuencia I-EVOLUTION -miccional I-EVOLUTION -disminuyó I-EVOLUTION -a I-EVOLUTION -6/0, I-EVOLUTION -con I-EVOLUTION -mayor I-EVOLUTION -volumen I-EVOLUTION -miccional. I-EVOLUTION -Por B-TREATMENT -somnolencia I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -antihistamínico I-TREATMENT -a I-TREATMENT -Cetirizina, I-TREATMENT -con I-TREATMENT -igual I-TREATMENT -respuesta. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -8-10 I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -macroscópica, I-PRESENT_ILLNESS -indolora I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -coágulos. I-PRESENT_ILLNESS -Asimismo I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -miccional, I-PRESENT_ILLNESS -escozor I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tenesmo I-PRESENT_ILLNESS -vesical, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -seguido I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ciprofloxacino I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Diclofenaco I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -evidenciar I-PRESENT_ILLNESS -mejoría. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -no I-EXPLORATION -evidencia I-EXPLORATION -ningún I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -interés I-EXPLORATION -(trayectos I-EXPLORATION -uretero-renales I-EXPLORATION -no I-EXPLORATION -dolorosos, I-EXPLORATION -puño I-EXPLORATION -percusión I-EXPLORATION -bilateral I-EXPLORATION -negativa). I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -intravesical I-EXPLORATION -de I-EXPLORATION -35, I-EXPLORATION -7 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo, I-EXPLORATION -con I-EXPLORATION -unos I-EXPLORATION -riñones I-EXPLORATION -ecográficamente I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -cistoscopia I-EXPLORATION -flexible, I-EXPLORATION -que I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -bilobulada I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -infiltrante I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -parcialmente I-EXPLORATION -necróticas I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -superficie. I-EXPLORATION - I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -Tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -tóraco-abdominal, I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -y I-EXPLORATION -Resección I-EXPLORATION -trans-uretral I-EXPLORATION -(RTU) I-EXPLORATION -biopsia I-EXPLORATION -para I-EXPLORATION -establecer I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -y I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -vesical I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -cm. I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo, I-EXPLORATION -bien I-EXPLORATION -definida I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -perivesical, I-EXPLORATION -ni I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -significativo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -se I-EXPLORATION -completó I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -RTU I-EXPLORATION -muestra I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -mesenquimal, I-EXPLORATION -fusocelular, I-EXPLORATION -con I-EXPLORATION -haces I-EXPLORATION -largos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -fusiformes I-EXPLORATION -y I-EXPLORATION -frecuentes I-EXPLORATION -mitosis. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -intensa I-EXPLORATION -inmunorreactividad I-EXPLORATION -con I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -actina I-EXPLORATION -muscular I-EXPLORATION -específica. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -leiomiosarcoma I-TREATMENT -vesical I-TREATMENT -clínicamente I-TREATMENT -localizado I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -exenteración I-TREATMENT -pélvica I-TREATMENT -anterior I-TREATMENT -(cistectomía I-TREATMENT -radical, I-TREATMENT -histerectomía I-TREATMENT -más I-TREATMENT -doble I-TREATMENT -anexectomía I-TREATMENT -y I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT -ileal). I-TREATMENT - I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vejiga I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -exofítico I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -4 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -pedículo I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION - I-EXPLORATION -Era I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -mesenquimal I-EXPLORATION -maligno I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -alargadas, I-EXPLORATION -de I-EXPLORATION -nucleolos I-EXPLORATION -longilíneos I-EXPLORATION -bordes I-EXPLORATION -romos I-EXPLORATION -y I-EXPLORATION -citoplasmas I-EXPLORATION -fibrilares. I-EXPLORATION -En I-EXPLORATION -algunas I-EXPLORATION -zonas I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -figuras I-EXPLORATION -de I-EXPLORATION -mitosis I-EXPLORATION -(20 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -10 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -aumento). I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -se I-EXPLORATION -alojaba I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -vesical, I-EXPLORATION -sin I-EXPLORATION -infiltrar I-EXPLORATION -el I-EXPLORATION -urotelio I-EXPLORATION -de I-EXPLORATION -superficie, I-EXPLORATION -ni I-EXPLORATION -la I-EXPLORATION -capa I-EXPLORATION -muscular I-EXPLORATION -propia I-EXPLORATION -vesical, I-EXPLORATION -presentando I-EXPLORATION -su I-EXPLORATION -origen I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -capa I-EXPLORATION -muscular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -submucosa I-EXPLORATION -(Muscularis I-EXPLORATION -Mucosae). I-EXPLORATION - I-EXPLORATION -Tanto I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -ganglios I-EXPLORATION -iliacos I-EXPLORATION -e I-EXPLORATION -ilio-obturatrices, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -perivesical I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -estructuras I-EXPLORATION -estudiadas, I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -ninguna I-EXPLORATION -alteración. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -un I-EVOLUTION -postoperatorio I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -relevantes, I-EVOLUTION -se B-TREATMENT -decidió I-TREATMENT -completar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT -adyuvante I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -con I-TREATMENT -Adriamicina I-TREATMENT -e I-TREATMENT -Ifosfamida I-TREATMENT -realizó I-TREATMENT -en I-TREATMENT -su I-TREATMENT -Centro I-TREATMENT -de I-TREATMENT -referencia, I-TREATMENT -recibiendo I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -(1 I-TREATMENT -mensual) I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -tolerancia. I-TREATMENT -Se I-TREATMENT -retrasó I-TREATMENT -el I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -ciclo I-TREATMENT -en I-TREATMENT -una I-TREATMENT -ocasión I-TREATMENT -por I-TREATMENT -fiebre. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -finalizar I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -complementario I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -recidiva I-EVOLUTION -locorregional I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -T.C. I-EVOLUTION -realizada I-EVOLUTION -durante I-EVOLUTION -una I-EVOLUTION -revisión. I-EVOLUTION -Por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -con I-TREATMENT -informe I-TREATMENT -anatomopatológico I-TREATMENT -de I-TREATMENT -leiomiosarcoma I-TREATMENT -de I-TREATMENT -6, I-TREATMENT -5 I-TREATMENT -cms. I-TREATMENT -de I-TREATMENT -diámetro I-TREATMENT -con I-TREATMENT -un I-TREATMENT -borde I-TREATMENT -afecto. I-TREATMENT -Se I-TREATMENT -decidió I-TREATMENT -completar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quicio-radioterapia I-TREATMENT -adyuvante, I-TREATMENT -con I-TREATMENT -régimen I-TREATMENT -quimioterápico I-TREATMENT -basado I-TREATMENT -en I-TREATMENT -Ifosfamida I-TREATMENT -a I-TREATMENT -altas I-TREATMENT -dosis I-TREATMENT -(3.520 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -5 I-TREATMENT -días), I-TREATMENT -de I-TREATMENT -los I-TREATMENT -cuales I-TREATMENT -se I-TREATMENT -ha I-TREATMENT -administrado I-TREATMENT -6 I-TREATMENT -ciclos, I-TREATMENT -uno I-TREATMENT -mensual. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -completados I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -primeros I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia, I-TREATMENT -recibió I-TREATMENT -radioterapia I-TREATMENT -externa, I-TREATMENT -a I-TREATMENT -razón I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -8 I-TREATMENT -Gy/día, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -de I-TREATMENT -45 I-TREATMENT -Gy I-TREATMENT -sobre I-TREATMENT -lecho I-TREATMENT -tumoral I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -una I-TREATMENT -sobreimpresión I-TREATMENT -pélvica I-TREATMENT -con I-TREATMENT -16 I-TREATMENT -Gy I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -pélvica I-TREATMENT -de I-TREATMENT -61 I-TREATMENT -Gy. I-TREATMENT -Posteriormente B-EVOLUTION -pasó I-EVOLUTION -a I-EVOLUTION -revisiones I-EVOLUTION -periódicas. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -ocho I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -finalizado I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -tratamiento I-EVOLUTION -adyuvante, I-EVOLUTION -32 I-EVOLUTION -meses I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -diagnóstico, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -una I-EVOLUTION -recidiva I-EVOLUTION -pélvica I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -x I-EVOLUTION -5, I-EVOLUTION -8 I-EVOLUTION -cm., I-EVOLUTION -con I-EVOLUTION -probable I-EVOLUTION -infiltración I-EVOLUTION -de I-EVOLUTION -recto-sigma I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vejiga I-EVOLUTION -ileal. I-EVOLUTION -Se B-TREATMENT -realiza I-TREATMENT -rectosigmoidoscopia I-TREATMENT -con I-TREATMENT -punción I-TREATMENT -aspiración I-TREATMENT -con I-TREATMENT -aguja I-TREATMENT -fina, I-TREATMENT -con I-TREATMENT -resultado I-TREATMENT -anatomopatológico I-TREATMENT -de I-TREATMENT -citología I-TREATMENT -maligna, I-TREATMENT -sarcoma I-TREATMENT -fusocelular I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -leiomiosarcoma. I-TREATMENT -Se B-EXPLORATION -ha I-EXPLORATION -realizado I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -con I-EXPLORATION -anticuerpos I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -Caldesmón I-EXPLORATION -y I-EXPLORATION -Miosina I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso, I-EXPLORATION -observándose I-EXPLORATION -inmunorreactividad I-EXPLORATION -intensa I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -anticuerpos. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -segunda I-TREATMENT -recidiva I-TREATMENT -se I-TREATMENT -recomendó I-TREATMENT -realizar I-TREATMENT -resección I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -consolidación I-TREATMENT -con I-TREATMENT -braquiterapia. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -desestimó I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -cirugía I-TREATMENT -con I-TREATMENT -braquiterapia I-TREATMENT -por I-TREATMENT -miedo I-TREATMENT -a I-TREATMENT -las I-TREATMENT -complicaciones I-TREATMENT -de I-TREATMENT -la I-TREATMENT -braquiterapia, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT -en I-TREATMENT -otro I-TREATMENT -centro, I-TREATMENT -realizando I-TREATMENT -exenteración I-TREATMENT -pélvica I-TREATMENT -posterior. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -control I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -recidiva, I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -incisión, I-EVOLUTION -realizándose B-TREATMENT -resección I-TREATMENT -del I-TREATMENT -mismo. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -y I-EVOLUTION -41 I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -inicial, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática, I-EVOLUTION -en I-EVOLUTION -controles I-EVOLUTION -periódicos I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -(IMC) I-EXPLORATION -de I-EXPLORATION -31, I-EXPLORATION -2, I-EXPLORATION -que B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cáncer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -próstata I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -estadio I-PRESENT_ILLNESS -T2a I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -examen I-PRESENT_ILLNESS -(antígeno I-PRESENT_ILLNESS -prostático I-PRESENT_ILLNESS -específico I-PRESENT_ILLNESS -[PSA], I-PRESENT_ILLNESS -3, I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -ng/ml). I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión, I-PAST_MEDICAL_HISTORY -diabetes, I-PAST_MEDICAL_HISTORY -hiperlipemia, I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cirrosis. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Antes B-TREATMENT -de I-TREATMENT -la I-TREATMENT -cirugía, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -tenía I-TREATMENT -vendaje I-TREATMENT -espiral I-TREATMENT -y I-TREATMENT -dispositivos I-TREATMENT -de I-TREATMENT -compresión I-TREATMENT -intermitente I-TREATMENT -en I-TREATMENT -ambas I-TREATMENT -extremidades I-TREATMENT -inferiores I-TREATMENT -para I-TREATMENT -prevenir I-TREATMENT -trombosis I-TREATMENT -venosa I-TREATMENT -profunda I-TREATMENT -(TVP). I-TREATMENT -Tras I-TREATMENT -administrar I-TREATMENT -anestesia I-TREATMENT -combinada I-TREATMENT -general-espinal, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -colocado I-TREATMENT -en I-TREATMENT -posición I-TREATMENT -de I-TREATMENT -Trendelenburg I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -PRL I-TREATMENT -extraperitoneal, I-TREATMENT -con I-TREATMENT -preservación I-TREATMENT -nerviosa I-TREATMENT -bilateral. I-TREATMENT -Su I-TREATMENT -presión I-TREATMENT -sanguínea I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -de I-TREATMENT -administrar I-TREATMENT -la I-TREATMENT -anestesia I-TREATMENT -era I-TREATMENT -de I-TREATMENT -150/80 I-TREATMENT -mmHg I-TREATMENT -y I-TREATMENT -permaneció I-TREATMENT -por I-TREATMENT -debajo I-TREATMENT -de I-TREATMENT -este I-TREATMENT -nivel I-TREATMENT -durante I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -procedimiento. I-TREATMENT -La I-TREATMENT -operación I-TREATMENT -duró I-TREATMENT -360 I-TREATMENT -min I-TREATMENT -y I-TREATMENT -la I-TREATMENT -pérdida I-TREATMENT -de I-TREATMENT -sangre I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -1.000 I-TREATMENT -ml. I-TREATMENT -El I-TREATMENT -sangrado I-TREATMENT -ocurrió I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -control I-TREATMENT -de I-TREATMENT -pedículos I-TREATMENT -vasculares I-TREATMENT -y I-TREATMENT -la I-TREATMENT -disección I-TREATMENT -del I-TREATMENT -paquete I-TREATMENT -neurovascular. I-TREATMENT -La B-EXPLORATION -patología I-EXPLORATION -quirúrgica I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -próstata I-EXPLORATION -de I-EXPLORATION -55 I-EXPLORATION -g, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -en I-EXPLORATION -estadio I-EXPLORATION -T2a I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -puntuación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -Gleason I-EXPLORATION -6 I-EXPLORATION -con I-EXPLORATION -márgenes I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -día I-EVOLUTION -posquirúrgico, I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -quejarse I-EVOLUTION -de I-EVOLUTION -entumecimiento I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -pierna I-EVOLUTION -derecha, I-EVOLUTION -que I-EVOLUTION -estaba I-EVOLUTION -inflamada I-EVOLUTION -y I-EVOLUTION -blanda I-EVOLUTION -al I-EVOLUTION -tacto. I-EVOLUTION -Los B-EXPLORATION -pulsos I-EXPLORATION -pedios I-EXPLORATION -estaban I-EXPLORATION -presentes I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -bilateral. I-EXPLORATION -Sospechamos I-EXPLORATION -una I-EXPLORATION -TVP I-EXPLORATION -y I-EXPLORATION -pedimos I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -Doppler, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -permeabilidad I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -venoso I-EXPLORATION -profundo. I-EXPLORATION -Su I-EXPLORATION -creatinina I-EXPLORATION -sérica I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -creatina I-EXPLORATION -fosfocinasa I-EXPLORATION -llegó I-EXPLORATION -hasta I-EXPLORATION -23.000 I-EXPLORATION -U/l. I-EXPLORATION -Aunque B-TREATMENT -el I-TREATMENT -Doppler I-TREATMENT -fue I-TREATMENT -normal, I-TREATMENT -se I-TREATMENT -diagnosticó I-TREATMENT -una I-TREATMENT -TVP I-TREATMENT -con I-TREATMENT -rabdomiólisis I-TREATMENT -secundaria I-TREATMENT -y I-TREATMENT -fallo I-TREATMENT -renal I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -base I-TREATMENT -de I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -clínicos, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -heparina. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -posquirúrgicos I-EVOLUTION -siguientes, I-EVOLUTION -aunque I-EVOLUTION -los I-EVOLUTION -pulsos I-EVOLUTION -pedios I-EVOLUTION -seguían I-EVOLUTION -siendo I-EVOLUTION -palpables I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -sérica I-EVOLUTION -y I-EVOLUTION -creatina I-EVOLUTION -fosfocinasa I-EVOLUTION -mejoraban, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -intermitente. I-EVOLUTION -Se B-EXPLORATION -repitieron I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -Doppler, I-EXPLORATION -que I-EXPLORATION -excluyeron I-EXPLORATION -TVP I-EXPLORATION -y I-EXPLORATION -mostraron I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -resistencia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -tibiales I-EXPLORATION -derechas. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -fasciotomía I-TREATMENT -de I-TREATMENT -cuatro I-TREATMENT -compartimentos I-TREATMENT -por I-TREATMENT -el I-TREATMENT -SC I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pierna. I-TREATMENT -Los I-TREATMENT -músculos I-TREATMENT -sobresalían I-TREATMENT -fácilmente I-TREATMENT -a I-TREATMENT -medida I-TREATMENT -que I-TREATMENT -se I-TREATMENT -seccionaba I-TREATMENT -la I-TREATMENT -fascia I-TREATMENT -suprayacente. I-TREATMENT -Había I-TREATMENT -áreas I-TREATMENT -de I-TREATMENT -necrosis I-TREATMENT -focal I-TREATMENT -que I-TREATMENT -fueron I-TREATMENT -eliminadas. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio, I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -fue I-EVOLUTION -remitiendo I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -capaz I-EVOLUTION -de I-EVOLUTION -caminar I-EVOLUTION -con I-EVOLUTION -ayuda. I-EVOLUTION -Las I-EVOLUTION -heridas I-EVOLUTION -se I-EVOLUTION -cerraron I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -14 I-EVOLUTION -días I-EVOLUTION -posteriores I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -fasciotomía. I-EVOLUTION - I-EVOLUTION -Seis I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -PRL, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -recuperó I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -capaz I-EVOLUTION -de I-EVOLUTION -caminar I-EVOLUTION -sin I-EVOLUTION -ayuda, I-EVOLUTION -pero I-EVOLUTION -aún I-EVOLUTION -presenta I-EVOLUTION -dolor I-EVOLUTION -neuropático I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -empeine I-EVOLUTION -del I-EVOLUTION -pie I-EVOLUTION -derecho. I-EVOLUTION -Su I-EVOLUTION -PSA I-EVOLUTION -estaba I-EVOLUTION -por I-EVOLUTION -debajo I-EVOLUTION -de I-EVOLUTION -0, I-EVOLUTION -04 I-EVOLUTION -ng/ml, I-EVOLUTION -usaba I-EVOLUTION -pañal I-EVOLUTION -diario I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -leve I-EVOLUTION -incontinencia I-EVOLUTION -por I-EVOLUTION -esfuerzo I-EVOLUTION -y I-EVOLUTION -aún I-EVOLUTION -no I-EVOLUTION -había I-EVOLUTION -recuperado I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -sexual. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -derivado B-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -plástica I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -reconstrucción I-DERIVED_FROM/TO -escrotal I-DERIVED_FROM/TO -después I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -inicial I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urología I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -desbridamiento I-DERIVED_FROM/TO -quirúrgico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -soporte I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -semanas. I-DERIVED_FROM/TO -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes: I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -mal I-PAST_MEDICAL_HISTORY -controlada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -necesidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -semana. I-PAST_MEDICAL_HISTORY -Había B-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -sometido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -amputación I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -isquemia. I-PRESENT_ILLNESS -El B-TREATMENT -colgajo I-TREATMENT -pediculado I-TREATMENT -fasciocutáneo I-TREATMENT -del I-TREATMENT -muslo I-TREATMENT -fue I-TREATMENT -usado I-TREATMENT -con I-TREATMENT -buenos I-TREATMENT -resultados I-TREATMENT -para I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -del I-TREATMENT -escroto. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -posoperatorio I-TREATMENT -(al I-TREATMENT -4.o I-TREATMENT -día), I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -desarrolló I-TREATMENT -un I-TREATMENT -edema I-TREATMENT -agudo I-TREATMENT -de I-TREATMENT -pulmón, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -resolvió I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -No B-EVOLUTION -hubo I-EVOLUTION -necrosis I-EVOLUTION -del I-EVOLUTION -colgajo I-EVOLUTION -ni I-EVOLUTION -se I-EVOLUTION -produjeron I-EVOLUTION -infecciones. I-EVOLUTION -Fue B-TREATMENT -necesario I-TREATMENT -proceder I-TREATMENT -a I-TREATMENT -la I-TREATMENT -remodelación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -inferomedial I-TREATMENT -del I-TREATMENT -colgajo I-TREATMENT -por I-TREATMENT -dehiscencia I-TREATMENT -parcial I-TREATMENT -de I-TREATMENT -la I-TREATMENT -sutura. I-TREATMENT -Se B-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -del I-EVOLUTION -servicio I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -internamiento. I-EVOLUTION - I-EVOLUTION - -Masculino B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sentado I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -cinturón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seguridad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS -trasera I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -automóvil, I-PRESENT_ILLNESS -participó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -automovilístico. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -mantuvo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -asiento I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -evento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -arribo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -paramédicos. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -ocurrió I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -rural I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -traslado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -DUP I-PRESENT_ILLNESS -duró I-PRESENT_ILLNESS -aprox. I-PRESENT_ILLNESS -90min. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -transportado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -collarín I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inmovilizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -decúbito I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tabla I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -protección. I-PRESENT_ILLNESS -Los B-EXPLORATION -signos I-EXPLORATION -vitales I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -llegada: I-EXPLORATION -temperatura, I-EXPLORATION -36, I-EXPLORATION -5oC; I-EXPLORATION -pulso, I-EXPLORATION -84/min; I-EXPLORATION -PA, I-EXPLORATION -110/63mm I-EXPLORATION -Hg I-EXPLORATION -y I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -14. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -(EF) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -DUP I-EXPLORATION -presentó I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -leve, I-EXPLORATION -escoriaciones I-EXPLORATION -en I-EXPLORATION -diferentes I-EXPLORATION -partes I-EXPLORATION -del I-EXPLORATION -cuerpo, I-EXPLORATION -sin I-EXPLORATION -embargo I-EXPLORATION -el I-EXPLORATION -ultrasonido I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -rayos I-EXPLORATION -X I-EXPLORATION -solo I-EXPLORATION -evidenciaron I-EXPLORATION -rectificación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION -cervical. I-EXPLORATION -Estudios I-EXPLORATION -de I-EXPLORATION -laboratorio: I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -normales; I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina: I-EXPLORATION -microhematuria. I-EXPLORATION -Después B-EVOLUTION -de I-EVOLUTION -algunas I-EVOLUTION -horas, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -hemotórax I-EVOLUTION -y I-EVOLUTION -continúo I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -abdominal. I-EVOLUTION -Se B-TREATMENT -le I-TREATMENT -colocó I-TREATMENT -sonda I-TREATMENT -en I-TREATMENT -tórax I-TREATMENT -en I-TREATMENT -el I-TREATMENT -hemitórax I-TREATMENT -izquierdo I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -contrastada. I-EXPLORATION -Al I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -TAC, I-EXPLORATION -el I-EXPLORATION -caso I-EXPLORATION -fue I-EXPLORATION -comentado I-EXPLORATION -con I-EXPLORATION -nuestro I-EXPLORATION -departamento. I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -momento I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -contaba I-EXPLORATION -con I-EXPLORATION -8hrs I-EXPLORATION -en I-EXPLORATION -observación. I-EXPLORATION -En I-EXPLORATION -nuestra I-EXPLORATION -evaluación, I-EXPLORATION -observamos I-EXPLORATION -equimosis I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -flanco I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -drenaje I-EXPLORATION -escaso I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -sonda I-EXPLORATION -en I-EXPLORATION -tórax. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -sin I-EXPLORATION -captación I-EXPLORATION -de I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -pequeño I-EXPLORATION -hematoma I-EXPLORATION -esplénico. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -manejar I-TREATMENT -conservadoramente. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -egresado I-EVOLUTION -6 I-EVOLUTION -días I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -controlado. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -patológico I-PAST_MEDICAL_HISTORY -relevante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -habia I-PAST_MEDICAL_HISTORY -advertido I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -masa I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -palpable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pulsátil I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -mes. I-PAST_MEDICAL_HISTORY -Diez B-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -intenso. I-PRESENT_ILLNESS -La B-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -abdominal I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -aneurisma I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -infrarrenal, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -que I-EXPLORATION -involucra I-EXPLORATION -y I-EXPLORATION -lo I-EXPLORATION -adhiere I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -tercera I-EXPLORATION -porción I-EXPLORATION -del I-EXPLORATION -duodeno. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -solicitó I-TREATMENT -el I-TREATMENT -alta I-TREATMENT -voluntaria I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -propuesta I-TREATMENT -quirúrgica. I-TREATMENT -Cinco B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -reingresó I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Terapia I-EVOLUTION -Intensiva I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -alta I-EVOLUTION -manifestada I-EVOLUTION -por I-EVOLUTION -hematemesis I-EVOLUTION -y I-EVOLUTION -melena I-EVOLUTION -de I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -shock I-EVOLUTION -hipovolémico, I-EVOLUTION -tensión I-EVOLUTION -arterial I-EVOLUTION -media I-EVOLUTION -(TAM) I-EVOLUTION -30 I-EVOLUTION -mmHg, I-EVOLUTION -frecuencia I-EVOLUTION -cardíaca I-EVOLUTION -(FC): I-EVOLUTION -140 I-EVOLUTION -lpm I-EVOLUTION -y I-EVOLUTION -hematocrito I-EVOLUTION -del I-EVOLUTION -18%. I-EVOLUTION -Una B-EXPLORATION -vez I-EXPLORATION -compensado I-EXPLORATION -el I-EXPLORATION -trastorno I-EXPLORATION -hemodinámico, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -fibroendoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta, I-EXPLORATION -constatándose I-EXPLORATION -sangrado I-EXPLORATION -activo I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tercera I-EXPLORATION -porción I-EXPLORATION -duodenal. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -entonces I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -por I-TREATMENT -resangrado I-TREATMENT -masivo, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -intraoperatorio I-TREATMENT -de I-TREATMENT -aneurisma I-TREATMENT -de I-TREATMENT -aorta I-TREATMENT -abdominal I-TREATMENT -infrarrenal I-TREATMENT -sacular I-TREATMENT -adherido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cara I-TREATMENT -posterior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tercera I-TREATMENT -porción I-TREATMENT -duodenal I-TREATMENT -con I-TREATMENT -comunicación I-TREATMENT -a I-TREATMENT -la I-TREATMENT -luz I-TREATMENT -de I-TREATMENT -dicho I-TREATMENT -órgano I-TREATMENT -por I-TREATMENT -un I-TREATMENT -orificio I-TREATMENT -de I-TREATMENT -unos I-TREATMENT -4 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -diámetro. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -by-pass I-TREATMENT -aorto-bifemoral. I-TREATMENT -Debido B-EVOLUTION -al I-EVOLUTION -grave I-EVOLUTION -compromiso I-EVOLUTION -hemodinámico I-EVOLUTION -presentó I-EVOLUTION -paro I-EVOLUTION -cardiorrespiratorio I-EVOLUTION -en I-EVOLUTION -quirófano, I-EVOLUTION -falleciendo I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Terapia I-EVOLUTION -Intensiva. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -disección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aorta I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clasificación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Stanford, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -colocación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -prótesis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -teflón, I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -consulta. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Una B-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -previa I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Terapia I-PRESENT_ILLNESS -Intensiva I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -melena I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lipotimia. I-PRESENT_ILLNESS -Ingresó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hematemesis I-PRESENT_ILLNESS -abundante I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -melena I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -shock I-PRESENT_ILLNESS -hipovolémico, I-PRESENT_ILLNESS -siendo B-TREATMENT -estabilizado I-TREATMENT -con I-TREATMENT -fluidos. I-TREATMENT -Un B-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -hematemesis I-EVOLUTION -masiva I-EVOLUTION -lo I-EVOLUTION -lleva I-EVOLUTION -al I-EVOLUTION -paro I-EVOLUTION -cardiorrespiratorio I-EVOLUTION -y B-TREATMENT -tras I-TREATMENT -una I-TREATMENT -adecuada I-TREATMENT -resucitación I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -FAE I-TREATMENT -al I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tercera I-TREATMENT -porción I-TREATMENT -duodenal, I-TREATMENT -y I-TREATMENT -un I-TREATMENT -orificio I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -x I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -diámetro. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -cierre I-TREATMENT -simple, I-TREATMENT -gastroyeyuno I-TREATMENT -anastomosis I-TREATMENT -y I-TREATMENT -anastomosis I-TREATMENT -coledocoduodenal. I-TREATMENT -Falleció B-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -sugerente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -viriasis, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -edemas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -superiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -oligoanuria I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -obnubilación, I-EXPLORATION -hipotensión, I-EXPLORATION -taquicardia I-EXPLORATION -y I-EXPLORATION -taquipnea, I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -lesiones I-EXPLORATION -petequiales I-EXPLORATION -en I-EXPLORATION -hombros, I-EXPLORATION -espalda I-EXPLORATION -y I-EXPLORATION -miembros I-EXPLORATION -superiores. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacan: I-EXPLORATION -plaquetopenia I-EXPLORATION -(13.000/mm3); I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -28 I-EXPLORATION -mg/dl; I-EXPLORATION -coagulopatía I-EXPLORATION -con I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activado: I-EXPLORATION -47 I-EXPLORATION -seg I-EXPLORATION -(control: I-EXPLORATION -30 I-EXPLORATION -seg), I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina: I-EXPLORATION -20 I-EXPLORATION -seg I-EXPLORATION -(control: I-EXPLORATION -11 I-EXPLORATION -seg), I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -Quick: I-EXPLORATION -60%, I-EXPLORATION -fibrinógeno: I-EXPLORATION -332 I-EXPLORATION -mg/dl; I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -antitrombina-III: I-EXPLORATION -38%, I-EXPLORATION -Na+: I-EXPLORATION -117mEq/l, I-EXPLORATION -K+: I-EXPLORATION -6, I-EXPLORATION -7 I-EXPLORATION -mEq/l, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dl; I-EXPLORATION -urea I-EXPLORATION -69 I-EXPLORATION -mg/dl, I-EXPLORATION -y I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -con I-EXPLORATION -30 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -de I-EXPLORATION -95 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -con I-TREATMENT -expansión, I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -noradrenalina I-TREATMENT -a I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -µg/kg/min, I-TREATMENT -y I-TREATMENT -cefotaxima. I-TREATMENT -Se I-TREATMENT -inicia I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -y I-TREATMENT -diálisis I-TREATMENT -peritoneal I-TREATMENT -por I-TREATMENT -insuficiencia I-TREATMENT -renal I-TREATMENT -y I-TREATMENT -alteraciones I-TREATMENT -iónicas. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -5 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -presenta I-EVOLUTION -parada I-EVOLUTION -cardiorrespiratoria I-EVOLUTION -por I-EVOLUTION -fibrilación I-EVOLUTION -ventricular I-EVOLUTION -refractaria I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -de I-EVOLUTION -reanimación. I-EVOLUTION - I-EVOLUTION -Los B-EXPLORATION -cultivos I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -salvo I-EXPLORATION -el I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -de I-EXPLORATION -petequia I-EXPLORATION -cutánea I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -S. I-EXPLORATION -pyogenes I-EXPLORATION -serotipo I-EXPLORATION -M1T1. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial I-PAST_MEDICAL_HISTORY -extrínseco I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -eco-transtorácico I-PAST_MEDICAL_HISTORY -(ETT) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -hipertrófica I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -obstructiva, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -mitral I-PAST_MEDICAL_HISTORY -leve-moderada. I-PAST_MEDICAL_HISTORY -Realizaba I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -activa I-PAST_MEDICAL_HISTORY -encontrándose I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -I. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -palpitaciones. I-PRESENT_ILLNESS -En B-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -taquicardia I-EXPLORATION -regular I-EXPLORATION -con I-EXPLORATION -QRS I-EXPLORATION -ancho I-EXPLORATION -a I-EXPLORATION -210 I-EXPLORATION -lpm, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -respondió I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -adenosina I-EXPLORATION -ni I-EXPLORATION -a I-EXPLORATION -maniobras I-EXPLORATION -vagales. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -cardioversión I-TREATMENT -eléctrica I-TREATMENT -con I-TREATMENT -100 I-TREATMENT -J I-TREATMENT -que I-TREATMENT -derivó I-TREATMENT -en I-TREATMENT -fibrilación I-TREATMENT -ventricular I-TREATMENT -(FV) I-TREATMENT -revertida I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -choques I-TREATMENT -de I-TREATMENT -360 I-TREATMENT -J. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona I-TREATMENT -intravenosa, I-TREATMENT -pero I-TREATMENT -fue I-TREATMENT -preciso I-TREATMENT -suspenderla I-TREATMENT -poco I-TREATMENT -después I-TREATMENT -por I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -disfunción I-TREATMENT -sinusal, I-TREATMENT -con I-TREATMENT -ritmo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -unión I-TREATMENT -a I-TREATMENT -40 I-TREATMENT -latidos/ I-TREATMENT -minuto. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -empírica I-TREATMENT -sulfato I-TREATMENT -de I-TREATMENT -magnesio I-TREATMENT -y I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -Coronaria. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -sistémica I-EXPLORATION -de I-EXPLORATION -130/70 I-EXPLORATION -mmHg. I-EXPLORATION -Se I-EXPLORATION -auscultaba I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -sistólico, I-EXPLORATION -en I-EXPLORATION -ápex I-EXPLORATION -y I-EXPLORATION -borde I-EXPLORATION -esternal I-EXPLORATION -izquierdo, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -ECG I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -disfunción I-EXPLORATION -sinusal, I-EXPLORATION -QRS I-EXPLORATION -ancho I-EXPLORATION -con I-EXPLORATION -morfología I-EXPLORATION -de I-EXPLORATION -bloqueo I-EXPLORATION -completo I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -izquierda I-EXPLORATION -e I-EXPLORATION -intervalo I-EXPLORATION -QT I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -30 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -síntomas I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -CPK I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -2.657 I-EXPLORATION -U/l I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -troponina I-EXPLORATION -I I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -21 I-EXPLORATION -ng/ml. I-EXPLORATION -Los I-EXPLORATION -iones I-EXPLORATION -séricos I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -realizado I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -equipo I-EXPLORATION -portátil I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -(VI) I-EXPLORATION -muy I-EXPLORATION -dilatado I-EXPLORATION -y I-EXPLORATION -globalmente I-EXPLORATION -hipoquinético, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -miocardio I-EXPLORATION -muy I-EXPLORATION -hipertrófico, I-EXPLORATION -con I-EXPLORATION -trabeculaciones. I-EXPLORATION - I-EXPLORATION -Como I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -protocolo I-EXPLORATION -de I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -taquicardias I-EXPLORATION -ventriculares I-EXPLORATION -(TV), I-EXPLORATION -con I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -miocardiopatía I-EXPLORATION -dilatada, I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -hemodinámico. I-EXPLORATION -La I-EXPLORATION -ventriculografía I-EXPLORATION -izquierda I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -ventrículo I-EXPLORATION -con I-EXPLORATION -fracción I-EXPLORATION -de I-EXPLORATION -eyección I-EXPLORATION -(FE) I-EXPLORATION -del I-EXPLORATION -20%, I-EXPLORATION -con I-EXPLORATION -defectos I-EXPLORATION -generalizados I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -contractilidad I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -importante I-EXPLORATION -trabeculación I-EXPLORATION -que I-EXPLORATION -sugirió I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -miocardiopatía I-EXPLORATION -no I-EXPLORATION -compactada I-EXPLORATION -(MNC) I-EXPLORATION -o I-EXPLORATION -miocardiopatía I-EXPLORATION -espongiforme I-EXPLORATION -(ME). I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -angiográficamente I-EXPLORATION -significativa. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -cateterismo I-EXPLORATION -derecho I-EXPLORATION -las I-EXPLORATION -presiones I-EXPLORATION -fueron: I-EXPLORATION -aurícula I-EXPLORATION -derecha I-EXPLORATION -(AD) I-EXPLORATION -10 I-EXPLORATION -mmHg, I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION -(VD) I-EXPLORATION -70/4 I-EXPLORATION -mmHg, I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -(AP) I-EXPLORATION -70/15 I-EXPLORATION -mmHg, I-EXPLORATION -enclavamiento I-EXPLORATION -capilar I-EXPLORATION -pulmonar I-EXPLORATION -(PECP) I-EXPLORATION -15 I-EXPLORATION -mmHg. I-EXPLORATION -Índice I-EXPLORATION -cardíaco I-EXPLORATION -2 I-EXPLORATION -litros/minuto/m2; I-EXPLORATION -presión I-EXPLORATION -telediastólica I-EXPLORATION -VI I-EXPLORATION -(PTDVI) I-EXPLORATION -30 I-EXPLORATION -mmHg; I-EXPLORATION -gradiente I-EXPLORATION -mitral I-EXPLORATION -invertido I-EXPLORATION -(PTDVI I-EXPLORATION -> I-EXPLORATION -PECP). I-EXPLORATION -La I-EXPLORATION -coronariografía I-EXPLORATION -mostró I-EXPLORATION -unas I-EXPLORATION -arterias I-EXPLORATION -epicárdicas I-EXPLORATION -angiográficamente I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -MNC I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -ecocardiografía I-EXPLORATION -por I-EXPLORATION -personal I-EXPLORATION -especializado. I-EXPLORATION -La I-EXPLORATION -ecocardiografía-2D I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -marcada I-EXPLORATION -trabeculación I-EXPLORATION -del I-EXPLORATION -VI, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -ápex I-EXPLORATION -y I-EXPLORATION -segmentos I-EXPLORATION -medios I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -e I-EXPLORATION -inferior, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -relación I-EXPLORATION -telesistólica I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -gruesa I-EXPLORATION -capa I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -miocardio I-EXPLORATION -no I-EXPLORATION -compactado I-EXPLORATION -(NC) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -fina I-EXPLORATION -capa I-EXPLORATION -externa I-EXPLORATION -de I-EXPLORATION -miocardio I-EXPLORATION -compactado I-EXPLORATION -(NC/C I-EXPLORATION -> I-EXPLORATION -2). I-EXPLORATION -Con I-EXPLORATION -doppler I-EXPLORATION -color I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -en I-EXPLORATION -comunicación I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -profundos I-EXPLORATION -recesos I-EXPLORATION -intertrabeculares I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -ventricular. I-EXPLORATION -El I-EXPLORATION -flujo I-EXPLORATION -diastólico I-EXPLORATION -mitral I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -restrictivo. I-EXPLORATION -El I-EXPLORATION -VI I-EXPLORATION -tenía I-EXPLORATION -morfología I-EXPLORATION -esferoidal I-EXPLORATION -y I-EXPLORATION -medía I-EXPLORATION -en I-EXPLORATION -telediástole I-EXPLORATION -70 I-EXPLORATION -mm, I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -izquierda I-EXPLORATION -47 I-EXPLORATION -mm I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -VD I-EXPLORATION -30 I-EXPLORATION -mm. I-EXPLORATION -Un I-EXPLORATION -flujo I-EXPLORATION -de I-EXPLORATION -regurgitación I-EXPLORATION -mitral I-EXPLORATION -fue I-EXPLORATION -valorado I-EXPLORATION -como I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -moderada, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -tricuspídea I-EXPLORATION -permitió I-EXPLORATION -calcular I-EXPLORATION -un I-EXPLORATION -gradiente I-EXPLORATION -AD-VD I-EXPLORATION -de I-EXPLORATION -55 I-EXPLORATION -mmHg, I-EXPLORATION -estimándose I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -de I-EXPLORATION -AP I-EXPLORATION -de I-EXPLORATION -65 I-EXPLORATION -mmHg. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectaron I-EXPLORATION -anomalías I-EXPLORATION -valvulares I-EXPLORATION -estructurales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -consideró I-EXPLORATION -necesario I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -ecocardiografía I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -dada I-EXPLORATION -la I-EXPLORATION -buena I-EXPLORATION -calidad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bidimensional1. I-EXPLORATION - I-EXPLORATION -Con B-EVOLUTION -estos I-EVOLUTION -hallazgos I-EVOLUTION -ecocardiográficos I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -MNC I-EVOLUTION -según I-EVOLUTION -los I-EVOLUTION -criterios I-EVOLUTION -de I-EVOLUTION -Jenni, I-EVOLUTION -por I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -compactación I-EVOLUTION -del I-EVOLUTION -miocardio I-EVOLUTION -ventricular I-EVOLUTION -izquierdo I-EVOLUTION -sin I-EVOLUTION -otras I-EVOLUTION -anomalías I-EVOLUTION -cardíacas I-EVOLUTION -asociadas2, I-EVOLUTION -3. I-EVOLUTION -Aunque I-EVOLUTION -hubiera I-EVOLUTION -sido I-EVOLUTION -interesante I-EVOLUTION -una I-EVOLUTION -cardiorresonancia, I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -realizar I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -disponer I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -técnica I-EVOLUTION -en I-EVOLUTION -nuestro I-EVOLUTION -hospital4, I-EVOLUTION -5. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -coche. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -valoración I-EXPLORATION -inicial I-EXPLORATION -estaba I-EXPLORATION -estable I-EXPLORATION -hemodinámicamente. I-EXPLORATION -La I-EXPLORATION -TACHT I-EXPLORATION -corporal I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -mostraba: I-EXPLORATION -seudoaneurisma I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -torácica I-EXPLORATION -distal I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -subclavia I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -sangrado I-EXPLORATION -periaórtico. I-EXPLORATION -Ingresó B-TREATMENT -en I-TREATMENT -la I-TREATMENT -UCI, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -36 I-TREATMENT -horas I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -reparación I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -endoprótesis I-TREATMENT -en I-TREATMENT -la I-TREATMENT -aorta I-TREATMENT -torácica I-TREATMENT -descendente I-TREATMENT -por I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -izquierda. I-TREATMENT -Hubo I-TREATMENT -una I-TREATMENT -oclusión I-TREATMENT -asintomática I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -subclavia I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -TACHT I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -correcta I-EXPLORATION -localización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -endoprótesis. I-EXPLORATION -Al B-EVOLUTION -décimo I-EVOLUTION -día I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -pericarditis I-EVOLUTION -aguda I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -decimosexto I-EVOLUTION -día, I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -prednisona I-PAST_MEDICAL_HISTORY -(30mg I-PAST_MEDICAL_HISTORY -diarios) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mesazalina, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -artralgias I-PRESENT_ILLNESS -generalizadas. I-PRESENT_ILLNESS -Ante B-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -hipotensión I-TREATMENT -con I-TREATMENT -una I-TREATMENT -presión I-TREATMENT -arterial I-TREATMENT -media I-TREATMENT -(PAM) I-TREATMENT -<55mmHg I-TREATMENT -e I-TREATMENT -hiponatremia I-TREATMENT -(129mEq/l) I-TREATMENT -se I-TREATMENT -sospecha I-TREATMENT -insuficiencia I-TREATMENT -suprarrenal I-TREATMENT -por I-TREATMENT -deprivación I-TREATMENT -(abandono I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prednisona I-TREATMENT -48h I-TREATMENT -antes) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -administran I-TREATMENT -60mg I-TREATMENT -de I-TREATMENT -metilprednisolona, I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -hemodinámica. I-TREATMENT -Las B-EXPLORATION -artralgias I-EXPLORATION -se I-EXPLORATION -atribuyen I-EXPLORATION -también I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -brote I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -enfermedad I-EXPLORATION -inflamatoria I-EXPLORATION -intestinal I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -cese I-EXPLORATION -brusco I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -medicación. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -las I-EVOLUTION -siguientes I-EVOLUTION -24h I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -disnea I-EVOLUTION -con I-EVOLUTION -desaturación I-EVOLUTION -progresiva I-EVOLUTION -(hasta I-EVOLUTION -el I-EVOLUTION -76%) I-EVOLUTION -sin I-EVOLUTION -oxigenoterapia. I-EVOLUTION -Se B-EXPLORATION -realiza I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -torácica, I-EXPLORATION -que I-EXPLORATION -observa I-EXPLORATION -patrón I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -deslustrado I-EXPLORATION -inespecífico I-EXPLORATION -bilateral. I-EXPLORATION -La B-TREATMENT -sospecha I-TREATMENT -diagnóstica I-TREATMENT -en I-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -corresponde I-TREATMENT -a I-TREATMENT -enfermedad I-TREATMENT -pulmonar I-TREATMENT -intersticial I-TREATMENT -versus I-TREATMENT -neumonía I-TREATMENT -adquirida I-TREATMENT -en I-TREATMENT -la I-TREATMENT -comunidad, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -oxigenoterapia, I-TREATMENT -levofloxacino I-TREATMENT -y I-TREATMENT -metilprednisolona. I-TREATMENT - I-TREATMENT -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -principal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -insuficiencia I-DERIVED_FROM/TO -respiratoria I-DERIVED_FROM/TO -hipoxémica I-DERIVED_FROM/TO -aguda. I-DERIVED_FROM/TO -Al B-TREATMENT -presentar I-TREATMENT -4 I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -gravedad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -British I-TREATMENT -Thoracic I-TREATMENT -Society4 I-TREATMENT -para I-TREATMENT -neumonía I-TREATMENT -adquirida I-TREATMENT -en I-TREATMENT -la I-TREATMENT -comunidad I-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT -nuestra I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Cuidados I-TREATMENT -Críticos: I-TREATMENT -taquipnea I-TREATMENT ->30 I-TREATMENT -respiraciones I-TREATMENT -por I-TREATMENT -minuto, I-TREATMENT -urea I-TREATMENT ->42mg/dl, I-TREATMENT -enfermedad I-TREATMENT -preexistente, I-TREATMENT -edad I-TREATMENT -superior I-TREATMENT -a I-TREATMENT -50 I-TREATMENT -años I-TREATMENT -y I-TREATMENT -afectación I-TREATMENT -pulmonar I-TREATMENT -bilateral I-TREATMENT -en I-TREATMENT -la I-TREATMENT -radiografía I-TREATMENT -de I-TREATMENT -tórax. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -presentó I-EXPLORATION -cuadro I-EXPLORATION -indicativo I-EXPLORATION -de I-EXPLORATION -neumonía I-EXPLORATION -intersticial I-EXPLORATION -bilateral I-EXPLORATION -difusa, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -acompañó I-EXPLORATION -de I-EXPLORATION -extensas I-EXPLORATION -manifestaciones I-EXPLORATION -de I-EXPLORATION -alveolitis I-EXPLORATION -exudativa I-EXPLORATION -con I-EXPLORATION -ensanchamiento I-EXPLORATION -mediastínico I-EXPLORATION -superior, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -cadenas I-EXPLORATION -paratraqueales I-EXPLORATION -derecha I-EXPLORATION -e I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -eosinofilia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -fórmula I-EXPLORATION -leucocitaria I-EXPLORATION -ni I-EXPLORATION -leucocitosis, I-EXPLORATION -esperable I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -parasitaria; I-EXPLORATION -además, I-EXPLORATION -el I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -tampoco I-EXPLORATION -fue I-EXPLORATION -llamativo. I-EXPLORATION -Se I-EXPLORATION -observó I-EXPLORATION -antígeno I-EXPLORATION -para I-EXPLORATION -neumococo I-EXPLORATION -positivo I-EXPLORATION -en I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -linezolid, I-TREATMENT -cefotaxima I-TREATMENT -y I-TREATMENT -fluconazol, I-TREATMENT -ventilación I-TREATMENT -no I-TREATMENT -invasiva I-TREATMENT -con I-TREATMENT -ventilación I-TREATMENT -con I-TREATMENT -presión I-TREATMENT -positiva I-TREATMENT -continua I-TREATMENT -de I-TREATMENT -+7 I-TREATMENT -cmH2O I-TREATMENT -y I-TREATMENT -asistencia I-TREATMENT -inspiratoria I-TREATMENT -de I-TREATMENT -+15cm I-TREATMENT -H2O I-TREATMENT -y I-TREATMENT -FiO2 I-TREATMENT -al I-TREATMENT -60%, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -alternó I-TREATMENT -con I-TREATMENT -períodos I-TREATMENT -de I-TREATMENT -oxigenoterapia I-TREATMENT -con I-TREATMENT -Ventimask. I-TREATMENT -Progresivamente, B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -deterioro I-EVOLUTION -general I-EVOLUTION -con I-EVOLUTION -sepsis I-EVOLUTION -grave I-EVOLUTION -y I-EVOLUTION -disfunción I-EVOLUTION -multiorgánica, I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -shock, I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -inotropos I-EVOLUTION -y I-EVOLUTION -vasopresores I-EVOLUTION -para I-EVOLUTION -conseguir I-EVOLUTION -una I-EVOLUTION -PAM I-EVOLUTION ->60mmHg, I-EVOLUTION -insuficiencia I-EVOLUTION -renal I-EVOLUTION -aguda I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -hemodiafiltración I-TREATMENT -venovenosa I-TREATMENT -continua I-TREATMENT -e I-TREATMENT -insuficiencia I-TREATMENT -respiratoria I-TREATMENT -con I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -intubación I-TREATMENT -orotraqueal I-TREATMENT -y I-TREATMENT -ventilación I-TREATMENT -mecánica. I-TREATMENT -Ante I-TREATMENT -este I-TREATMENT -deterioro, I-TREATMENT -se I-TREATMENT -sospechó I-TREATMENT -de I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -una I-TREATMENT -sobreinfección I-TREATMENT -bacteriana I-TREATMENT -o I-TREATMENT -por I-TREATMENT -hongos I-TREATMENT -concomitantes, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -llevó I-TREATMENT -al I-TREATMENT -cambio I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -(imipenem, I-TREATMENT -linezolid I-TREATMENT -y I-TREATMENT -anidulofungina) I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -nuevas I-TREATMENT -muestras I-TREATMENT -microbiológicas: I-TREATMENT -broncoaspirado I-TREATMENT -(BAS), I-TREATMENT -hemocultivo I-TREATMENT -y I-TREATMENT -urinocultivo. I-TREATMENT -Fue I-TREATMENT -en I-TREATMENT -este I-TREATMENT -último I-TREATMENT -BAS I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -observaron I-TREATMENT -larvas I-TREATMENT -de I-TREATMENT -Ss, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -ivermectina I-TREATMENT -(16,5mg/24h) I-TREATMENT -por I-TREATMENT -sonda I-TREATMENT -nasogástrica I-TREATMENT -(SNG). I-TREATMENT -Tras I-TREATMENT -repetir I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48h I-TREATMENT -los I-TREATMENT -cultivos I-TREATMENT -biológicos I-TREATMENT -y I-TREATMENT -mostrar I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -larvas I-TREATMENT -de I-TREATMENT -Ss I-TREATMENT -aún I-TREATMENT -activas I-TREATMENT -en I-TREATMENT -BAS, I-TREATMENT -jugo I-TREATMENT -gástrico I-TREATMENT -y I-TREATMENT -heces, I-TREATMENT -se I-TREATMENT -asoció I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -albendazol I-TREATMENT -(400mg/24h) I-TREATMENT -por I-TREATMENT -SNG. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -posterior I-EXPLORATION -control I-EXPLORATION -microbiológico I-EXPLORATION -tras I-EXPLORATION -48h I-EXPLORATION -del I-EXPLORATION -tratamiento I-EXPLORATION -combinado, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -en I-EXPLORATION -BAS I-EXPLORATION -Ss I-EXPLORATION -inactivos. I-EXPLORATION -Sin B-EVOLUTION -embargo, I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -distrés I-EVOLUTION -respiratorio I-EVOLUTION -agudo I-EVOLUTION -(SDRA) I-EVOLUTION -con I-EVOLUTION -hipoxemia I-EVOLUTION -grave I-EVOLUTION -y I-EVOLUTION -shock I-EVOLUTION -séptico I-EVOLUTION -refractario I-EVOLUTION -al I-EVOLUTION -soporte I-EVOLUTION -vasoconstrictor I-EVOLUTION -e I-EVOLUTION -inotropo. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -17 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION -nuestra I-EVOLUTION -unidad. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -describe I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Valme I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ideación I-PRESENT_ILLNESS -autolítica I-PRESENT_ILLNESS -persistente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alucinaciones I-PRESENT_ILLNESS -auditivas. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -psiquiátricos, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Unidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Agudos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Salud I-PAST_MEDICAL_HISTORY -Mental I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -diversas I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2007, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -orientación I-PAST_MEDICAL_HISTORY -diagnóstica, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -depresivo I-PAST_MEDICAL_HISTORY -moderado I-PAST_MEDICAL_HISTORY -(F32.1 I-PAST_MEDICAL_HISTORY -CIE-10). I-PAST_MEDICAL_HISTORY -Estaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -risperidona I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -mg/24h, I-PAST_MEDICAL_HISTORY -ac. I-PAST_MEDICAL_HISTORY -valproico I-PAST_MEDICAL_HISTORY -1500 I-PAST_MEDICAL_HISTORY -mg/24h, I-PAST_MEDICAL_HISTORY -citalopram I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg/24h I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -flunitrazepam I-PAST_MEDICAL_HISTORY -1mg/24h. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duelo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -fallecimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hija, I-PRESENT_ILLNESS -relataba I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ansiedad, I-PRESENT_ILLNESS -tristeza, I-PRESENT_ILLNESS -anhedonia, I-PRESENT_ILLNESS -apatía, I-PRESENT_ILLNESS -abandono I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -actividades, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alucinaciones I-PRESENT_ILLNESS -auditivas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -espacio I-PRESENT_ILLNESS -externo. I-PRESENT_ILLNESS -Eran I-PRESENT_ILLNESS -voces I-PRESENT_ILLNESS -imperativas I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -insultantes I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tenían I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -él I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -repercusión I-PRESENT_ILLNESS -conductual I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -afectiva: I-PRESENT_ILLNESS -"Empezó I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -rumor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ahora I-PRESENT_ILLNESS -son I-PRESENT_ILLNESS -claras, I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -si I-PRESENT_ILLNESS -alguien I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -hablara. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -hacen I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -fuertes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -puedo I-PRESENT_ILLNESS -controlarlas, I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -dicen I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -haga I-PRESENT_ILLNESS -daño, I-PRESENT_ILLNESS -también I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -insultan.". I-PRESENT_ILLNESS -Estaba B-EXPLORATION -consciente, I-EXPLORATION -orientado I-EXPLORATION -auto I-EXPLORATION -y I-EXPLORATION -alopsíquicamente, I-EXPLORATION -euproséxico. I-EXPLORATION -Su I-EXPLORATION -actitud I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -colaboración I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -alteraciones I-EXPLORATION -groseras I-EXPLORATION -en I-EXPLORATION -funciones I-EXPLORATION -superiores. I-EXPLORATION -El I-EXPLORATION -lenguaje I-EXPLORATION -era I-EXPLORATION -fluido, I-EXPLORATION -espontáneo I-EXPLORATION -y I-EXPLORATION -coherente. I-EXPLORATION -Refería I-EXPLORATION -sentimientos I-EXPLORATION -de I-EXPLORATION -culpa I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -reciente I-EXPLORATION -muerte I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -hija, I-EXPLORATION -desconfianza I-EXPLORATION -de I-EXPLORATION -todos I-EXPLORATION -aquellos I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -rodeaban, I-EXPLORATION -y I-EXPLORATION -desamparo I-EXPLORATION -y I-EXPLORATION -soledad I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -situación I-EXPLORATION -vital. I-EXPLORATION -Tenía I-EXPLORATION -ideas I-EXPLORATION -de I-EXPLORATION -muerte I-EXPLORATION -y I-EXPLORATION -autolisis. I-EXPLORATION -Se I-EXPLORATION -quejaba I-EXPLORATION -de I-EXPLORATION -insomnio I-EXPLORATION -con I-EXPLORATION -despertares I-EXPLORATION -intermitentes I-EXPLORATION -y I-EXPLORATION -frecuentes I-EXPLORATION -pesadillas. I-EXPLORATION -Disponía I-EXPLORATION -de I-EXPLORATION -nulo I-EXPLORATION -soporte I-EXPLORATION -familiar I-EXPLORATION -y I-EXPLORATION -social I-EXPLORATION -y I-EXPLORATION -había I-EXPLORATION -abandonado I-EXPLORATION -progresivamente I-EXPLORATION -su I-EXPLORATION -trabajo. I-EXPLORATION - I-EXPLORATION -Datos B-PAST_MEDICAL_HISTORY -biográficos I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Niñez I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -adolescencia I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Siendo I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -pequeño I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -emigraron I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -él, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -hermanos, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -quedó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -España, I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -cuidado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -abuelos I-PAST_MEDICAL_HISTORY -paternos. I-PAST_MEDICAL_HISTORY -Recuerda I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -feliz, I-PAST_MEDICAL_HISTORY -protegido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -arropado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ellos, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -llegó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -considerar I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres. I-PAST_MEDICAL_HISTORY -Definía I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -abuelo I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -persona, I-PAST_MEDICAL_HISTORY -responsable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -trabajador. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -abuela, I-PAST_MEDICAL_HISTORY -"Una I-PAST_MEDICAL_HISTORY -santa, I-PAST_MEDICAL_HISTORY -volcada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mi I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -todos.". I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -ellos I-PAST_MEDICAL_HISTORY -vivía I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -tía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ésta, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -compartió I-PAST_MEDICAL_HISTORY -juegos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -afecto. I-PAST_MEDICAL_HISTORY -Paso I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -adolescencia I-PAST_MEDICAL_HISTORY -separado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -estos I-PAST_MEDICAL_HISTORY -regresaron I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -país I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -emigraron, I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -consiguió I-PAST_MEDICAL_HISTORY -integrarse I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -nuclear. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -entender I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -qué, I-PAST_MEDICAL_HISTORY -comentaba I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sentido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -culpa I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ello. I-PAST_MEDICAL_HISTORY -Describía I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -distante I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -egoísta; I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -afectuoso, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -ambos, I-PAST_MEDICAL_HISTORY -"Incapaces I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hacer I-PAST_MEDICAL_HISTORY -nada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -mí". I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -crió I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -económico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -hermanos, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -despertó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -éstos I-PAST_MEDICAL_HISTORY -recelos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -críticas I-PAST_MEDICAL_HISTORY -constantes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -él, I-PAST_MEDICAL_HISTORY -clara I-PAST_MEDICAL_HISTORY -desconfianza I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -relación. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -colegio I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -instituto I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -ejemplar, I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -buenas I-PAST_MEDICAL_HISTORY -notas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -compañeros I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -profesores. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -aquella I-PAST_MEDICAL_HISTORY -época, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -describía I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sí I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -"Trabajador, I-PAST_MEDICAL_HISTORY -guasón, I-PAST_MEDICAL_HISTORY -amable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -entregado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -todos...". I-PAST_MEDICAL_HISTORY -Cursó I-PAST_MEDICAL_HISTORY -estudios I-PAST_MEDICAL_HISTORY -superiores, I-PAST_MEDICAL_HISTORY -ejerciendo I-PAST_MEDICAL_HISTORY -posteriormente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -profesión I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -éxito I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Vida I-PAST_MEDICAL_HISTORY -adulta I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -noviazgo I-PAST_MEDICAL_HISTORY -normalizado I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -casó I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -hijos: I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -niña I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -niño, I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -menor. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -matrimonio I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -bien, I-PAST_MEDICAL_HISTORY -sentía I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -esposa I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -aliada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -escasas I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -podía I-PAST_MEDICAL_HISTORY -imponer I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -criterio. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -hija, I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -él, I-PAST_MEDICAL_HISTORY -"La I-PAST_MEDICAL_HISTORY -única I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mundo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -me I-PAST_MEDICAL_HISTORY -defendía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -apoyaba I-PAST_MEDICAL_HISTORY -ante I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -críticas". I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -conflicto I-PAST_MEDICAL_HISTORY -relevante I-PAST_MEDICAL_HISTORY -surgió I-PAST_MEDICAL_HISTORY -quince I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -morir I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -abuelos. I-PAST_MEDICAL_HISTORY -Por I-PAST_MEDICAL_HISTORY -cuestiones I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -herencia, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -sintió I-PAST_MEDICAL_HISTORY -duramente I-PAST_MEDICAL_HISTORY -criticado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hermanos, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -llamaron I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -"Niño I-PAST_MEDICAL_HISTORY -rico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -aprovechado.". I-PAST_MEDICAL_HISTORY -Dos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -comentado, I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -importantes I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -laboral; I-PAST_MEDICAL_HISTORY -tema I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -generó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -él I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -profundo I-PAST_MEDICAL_HISTORY -malestar; I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sentirse I-PAST_MEDICAL_HISTORY -intensamente I-PAST_MEDICAL_HISTORY -inseguro I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desconfiado, I-PAST_MEDICAL_HISTORY -reduciendo I-PAST_MEDICAL_HISTORY -progresivamente I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -labor I-PAST_MEDICAL_HISTORY -profesional. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -hizo I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -patente I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -conflictiva I-PAST_MEDICAL_HISTORY -conyugal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -separación I-PAST_MEDICAL_HISTORY -matrimonial, I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -enfermó I-PAST_MEDICAL_HISTORY -gravemente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -falleció I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -después. I-PAST_MEDICAL_HISTORY -Ahora I-PAST_MEDICAL_HISTORY -vivía I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mantenía I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -vecinos I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -barrio I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -residía. I-PAST_MEDICAL_HISTORY -Disfrutaba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pequeñas I-PAST_MEDICAL_HISTORY -tertulias I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -bares I-PAST_MEDICAL_HISTORY -cercanos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -abandonando I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -irritabilidad I-PAST_MEDICAL_HISTORY -creciente, I-PAST_MEDICAL_HISTORY -facilitada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -abusivo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Psicoterapia B-TREATMENT -breve I-TREATMENT - I-TREATMENT -Se I-TREATMENT -propuso I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -psicoterapia I-TREATMENT -dinámica I-TREATMENT -breve I-TREATMENT -durante I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Agudos. I-TREATMENT -El I-TREATMENT -número I-TREATMENT -de I-TREATMENT -sesiones I-TREATMENT -no I-TREATMENT -se I-TREATMENT -concretó I-TREATMENT -al I-TREATMENT -inicio, I-TREATMENT -quedando I-TREATMENT -esto I-TREATMENT -a I-TREATMENT -expensas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -y I-TREATMENT -tiempo I-TREATMENT -del I-TREATMENT -ingreso. I-TREATMENT -Se I-TREATMENT -realizaron I-TREATMENT -doce I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -cuarenta I-TREATMENT -minutos I-TREATMENT -de I-TREATMENT -duración. I-TREATMENT -Como I-TREATMENT -criterios I-TREATMENT -de I-TREATMENT -inclusión I-TREATMENT -se I-TREATMENT -tuvieron I-TREATMENT -en I-TREATMENT -cuenta: I-TREATMENT -la I-TREATMENT -capacidad I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT -pensar I-TREATMENT -sobre I-TREATMENT -sus I-TREATMENT -sentimientos, I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -varias I-TREATMENT -relaciones I-TREATMENT -significativas I-TREATMENT -en I-TREATMENT -el I-TREATMENT -pasado I-TREATMENT -y I-TREATMENT -la I-TREATMENT -buena I-TREATMENT -capacidad I-TREATMENT -de I-TREATMENT -vinculación I-TREATMENT -con I-TREATMENT -el I-TREATMENT -terapeuta. I-TREATMENT - I-TREATMENT -Hipótesis B-EXPLORATION -Psicodinámica I-EXPLORATION -Inicial I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -mecanismos I-EXPLORATION -adaptativos I-EXPLORATION -del I-EXPLORATION -yo I-EXPLORATION -desplegados I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -infancia I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -constancia, I-EXPLORATION -capacidad I-EXPLORATION -de I-EXPLORATION -trabajo, I-EXPLORATION -responsabilidad, I-EXPLORATION -entrega I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -demás I-EXPLORATION -y I-EXPLORATION -calidez I-EXPLORATION -afectiva I-EXPLORATION -proporcionaron I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -una I-EXPLORATION -adecuada I-EXPLORATION -imagen I-EXPLORATION -del I-EXPLORATION -sí I-EXPLORATION -durante I-EXPLORATION -años. I-EXPLORATION -Ninguna I-EXPLORATION -de I-EXPLORATION -estas I-EXPLORATION -cualidades I-EXPLORATION -habían I-EXPLORATION -logrado I-EXPLORATION -mantenerse I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -duro I-EXPLORATION -golpe I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -muerte I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -hija I-EXPLORATION -(factor I-EXPLORATION -desencadenante). I-EXPLORATION -Debilitado I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -emocional I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -fracaso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -relación I-EXPLORATION -conyugal, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -profesional I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -conflicto I-EXPLORATION -laboral I-EXPLORATION -y I-EXPLORATION -aislado I-EXPLORATION -socialmente I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -consecuencias I-EXPLORATION -del I-EXPLORATION -consumo I-EXPLORATION -excesivo I-EXPLORATION -de I-EXPLORATION -alcohol, I-EXPLORATION -fue I-EXPLORATION -invadido I-EXPLORATION -por I-EXPLORATION -sentimientos I-EXPLORATION -reactivados I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -pasado, I-EXPLORATION -surgidos I-EXPLORATION -en I-EXPLORATION -etapas I-EXPLORATION -no I-EXPLORATION -resueltas I-EXPLORATION -del I-EXPLORATION -desarrollo I-EXPLORATION -infantil, I-EXPLORATION -cuando I-EXPLORATION -fue I-EXPLORATION -excluido I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -nuclear I-EXPLORATION -(conflicto I-EXPLORATION -nuclear). I-EXPLORATION -Sentimientos I-EXPLORATION -de I-EXPLORATION -culpa, I-EXPLORATION -desconfianza, I-EXPLORATION -desamparo I-EXPLORATION -y I-EXPLORATION -soledad, I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -presente I-EXPLORATION -provocaron I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -quiebra I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -sí, I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -del I-EXPLORATION -yo I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -sentido I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -realidad. I-EXPLORATION -Vencido I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -puesta I-EXPLORATION -en I-EXPLORATION -marcha I-EXPLORATION -de I-EXPLORATION -mecanismos I-EXPLORATION -defensivos I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -introyección, I-EXPLORATION -interiorizando I-EXPLORATION -el I-EXPLORATION -objeto I-EXPLORATION -persecutorio, I-EXPLORATION -las I-EXPLORATION -voces I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -objeto I-EXPLORATION -idealizado, I-EXPLORATION -las I-EXPLORATION -figuras I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -abuela I-EXPLORATION -e I-EXPLORATION -hija, I-EXPLORATION -deseando I-EXPLORATION -morir I-EXPLORATION -como I-EXPLORATION -ellas, I-EXPLORATION -se I-EXPLORATION -mostraba I-EXPLORATION -incapaz I-EXPLORATION -de I-EXPLORATION -enfrentar I-EXPLORATION -su I-EXPLORATION -propio I-EXPLORATION -sustento I-EXPLORATION -y I-EXPLORATION -destino. I-EXPLORATION - I-EXPLORATION -Trabajo B-TREATMENT -en I-TREATMENT -el I-TREATMENT -Foco I-TREATMENT - I-TREATMENT -Teniendo I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -la I-TREATMENT -hipótesis I-TREATMENT -psicodinámica I-TREATMENT -inicial, I-TREATMENT -se I-TREATMENT -seleccionaron I-TREATMENT -los I-TREATMENT -sentimientos I-TREATMENT -de I-TREATMENT -culpa, I-TREATMENT -desconfianza, I-TREATMENT -desamparo I-TREATMENT -y I-TREATMENT -soledad I-TREATMENT -como I-TREATMENT -foco I-TREATMENT -terapéutico. I-TREATMENT -Estos I-TREATMENT -sentimientos I-TREATMENT -se I-TREATMENT -abordaron I-TREATMENT -desde I-TREATMENT -una I-TREATMENT -perspectiva I-TREATMENT -cognitiva, I-TREATMENT -emocional I-TREATMENT -y I-TREATMENT -conductual, I-TREATMENT -intentando I-TREATMENT -facilitar I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -su I-TREATMENT -identificación, I-TREATMENT -expresión, I-TREATMENT -regulación I-TREATMENT -y I-TREATMENT -transformación: I-TREATMENT - I-TREATMENT -Sentimiento I-TREATMENT -de I-TREATMENT -culpa: I-TREATMENT -se I-TREATMENT -sentía I-TREATMENT -terriblemente I-TREATMENT -culpable I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -y I-TREATMENT -posterior I-TREATMENT -fallecimiento I-TREATMENT -de I-TREATMENT -su I-TREATMENT -hija. I-TREATMENT -Se I-TREATMENT -facilitó I-TREATMENT -la I-TREATMENT -expresión I-TREATMENT -de I-TREATMENT -este I-TREATMENT -sentimiento, I-TREATMENT -aumentando I-TREATMENT -la I-TREATMENT -conciencia I-TREATMENT -de I-TREATMENT -su I-TREATMENT -presencia I-TREATMENT -en I-TREATMENT -el I-TREATMENT -pasado. I-TREATMENT -Se I-TREATMENT -abordaron I-TREATMENT -las I-TREATMENT -fantasías I-TREATMENT -de I-TREATMENT -omnipotencia I-TREATMENT -y I-TREATMENT -creencias I-TREATMENT -mágicas, I-TREATMENT -la I-TREATMENT -aceptación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -límites I-TREATMENT -propios I-TREATMENT -y I-TREATMENT -el I-TREATMENT -reconocimiento I-TREATMENT -de I-TREATMENT -los I-TREATMENT -límites I-TREATMENT -de I-TREATMENT -la I-TREATMENT -naturaleza I-TREATMENT -humana. I-TREATMENT -Para I-TREATMENT -favorecer I-TREATMENT -la I-TREATMENT -reparación I-TREATMENT -del I-TREATMENT -daño I-TREATMENT -y I-TREATMENT -la I-TREATMENT -transformación I-TREATMENT -del I-TREATMENT -sentimiento, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -animó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -conducta I-TREATMENT -de I-TREATMENT -ayuda I-TREATMENT -y I-TREATMENT -entrega I-TREATMENT -a I-TREATMENT -los I-TREATMENT -demás I-TREATMENT -pacientes, I-TREATMENT -personas I-TREATMENT -necesitadas I-TREATMENT -como I-TREATMENT -él. I-TREATMENT - I-TREATMENT -Sentimiento I-TREATMENT -de I-TREATMENT -desconfianza: I-TREATMENT -sentimiento I-TREATMENT -que I-TREATMENT -emergió I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -conflictiva I-TREATMENT -familiar I-TREATMENT -y I-TREATMENT -laboral. I-TREATMENT -Con I-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -trabajar I-TREATMENT -la I-TREATMENT -confianza I-TREATMENT -en I-TREATMENT -sí I-TREATMENT -mismo, I-TREATMENT -base I-TREATMENT -de I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -confiar I-TREATMENT -en I-TREATMENT -los I-TREATMENT -demás, I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -un I-TREATMENT -intento I-TREATMENT -de I-TREATMENT -reestructurar I-TREATMENT -la I-TREATMENT -imagen I-TREATMENT -de I-TREATMENT -sí I-TREATMENT -y I-TREATMENT -la I-TREATMENT -autoestima I-TREATMENT -perdida, I-TREATMENT -ofreciéndole I-TREATMENT -una I-TREATMENT -experiencia I-TREATMENT -emocional I-TREATMENT -correctiva, I-TREATMENT -en I-TREATMENT -el I-TREATMENT -contexto I-TREATMENT -de I-TREATMENT -la I-TREATMENT -relación I-TREATMENT -terapéutica, I-TREATMENT -al I-TREATMENT -valorarle I-TREATMENT -y I-TREATMENT -reforzar I-TREATMENT -con I-TREATMENT -frecuencia I-TREATMENT -sus I-TREATMENT -cualidades, I-TREATMENT -entre I-TREATMENT -ellas, I-TREATMENT -su I-TREATMENT -generosidad, I-TREATMENT -entrega I-TREATMENT -y I-TREATMENT -capacidad I-TREATMENT -de I-TREATMENT -apego. I-TREATMENT -Además I-TREATMENT -se I-TREATMENT -le I-TREATMENT -instó I-TREATMENT -a I-TREATMENT -contactar I-TREATMENT -con I-TREATMENT -su I-TREATMENT -tía I-TREATMENT -y I-TREATMENT -primo I-TREATMENT -que I-TREATMENT -residían I-TREATMENT -ahora I-TREATMENT -en I-TREATMENT -otra I-TREATMENT -ciudad, I-TREATMENT -con I-TREATMENT -los I-TREATMENT -que I-TREATMENT -había I-TREATMENT -mantenido I-TREATMENT -una I-TREATMENT -relación I-TREATMENT -de I-TREATMENT -confianza I-TREATMENT -y I-TREATMENT -apego. I-TREATMENT - I-TREATMENT -Sentimiento I-TREATMENT -de I-TREATMENT -desamparo I-TREATMENT -y I-TREATMENT -soledad: I-TREATMENT -La I-TREATMENT -muerte I-TREATMENT -de I-TREATMENT -sus I-TREATMENT -abuelos I-TREATMENT -y I-TREATMENT -su I-TREATMENT -hija, I-TREATMENT -el I-TREATMENT -divorcio I-TREATMENT -y I-TREATMENT -el I-TREATMENT -aislamiento I-TREATMENT -social I-TREATMENT -favorecieron I-TREATMENT -ambos I-TREATMENT -sentimientos. I-TREATMENT -Se I-TREATMENT -trabajó I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -del I-TREATMENT -duelo, I-TREATMENT -facilitando I-TREATMENT -la I-TREATMENT -identificación I-TREATMENT -y I-TREATMENT -expresión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -rabia I-TREATMENT -por I-TREATMENT -la I-TREATMENT -muerte I-TREATMENT -de I-TREATMENT -sus I-TREATMENT -seres I-TREATMENT -más I-TREATMENT -queridos I-TREATMENT -y I-TREATMENT -señalando I-TREATMENT -la I-TREATMENT -permanencia I-TREATMENT -de I-TREATMENT -las I-TREATMENT -relaciones I-TREATMENT -de I-TREATMENT -objeto I-TREATMENT -en I-TREATMENT -el I-TREATMENT -interior. I-TREATMENT -Además, I-TREATMENT -se I-TREATMENT -destacó I-TREATMENT -la I-TREATMENT -importancia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ayuda I-TREATMENT -recibida I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -exterior, I-TREATMENT -de I-TREATMENT -la I-TREATMENT -institución I-TREATMENT -sanitaria. I-TREATMENT -Tomó I-TREATMENT -en I-TREATMENT -aquel I-TREATMENT -momento I-TREATMENT -conciencia I-TREATMENT -del I-TREATMENT -miedo I-TREATMENT -a I-TREATMENT -enfrentar I-TREATMENT -su I-TREATMENT -situación, I-TREATMENT -a I-TREATMENT -vivir I-TREATMENT -en I-TREATMENT -soledad I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -propuso I-TREATMENT -entonces I-TREATMENT -reiniciar I-TREATMENT -el I-TREATMENT -contacto I-TREATMENT -telefónico I-TREATMENT -con I-TREATMENT -amigos I-TREATMENT -y I-TREATMENT -compañeros. I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urgencias I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -psiquiatra I-DERIVED_FROM/TO -habitual I-DERIVED_FROM/TO -debido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -alteraciones I-DERIVED_FROM/TO -conductuales I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -entorno I-DERIVED_FROM/TO -familiar. I-DERIVED_FROM/TO -Ha B-PRESENT_ILLNESS -venido I-PRESENT_ILLNESS -desarrollando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -hábitos I-PRESENT_ILLNESS -alimentarios I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -han I-PRESENT_ILLNESS -puesto I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -peligro I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -salud, I-PRESENT_ILLNESS -rechazando I-PRESENT_ILLNESS -algunos I-PRESENT_ILLNESS -alimentos I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -considerar I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -estaban I-PRESENT_ILLNESS -"contaminados". I-PRESENT_ILLNESS -Cuando I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -tratado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -modificar I-PRESENT_ILLNESS -estas I-PRESENT_ILLNESS -conductas, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -mostrado I-PRESENT_ILLNESS -irritado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -agresividad I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hermano I-PRESENT_ILLNESS -menor. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -entrevista I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mostró I-PRESENT_ILLNESS -colaborador, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -descuidado I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -falta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -higiene. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -contacto I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -peculiar, I-PRESENT_ILLNESS -mostrando I-PRESENT_ILLNESS -sonrisas I-PRESENT_ILLNESS -inapropiadas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -latencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -discurso. I-PRESENT_ILLNESS -Negaba I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sensopercepción I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pensamiento. I-PRESENT_ILLNESS -Refirió B-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -epilépticas I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -acudió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -psiquiatría I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conducta; I-PAST_MEDICAL_HISTORY -allí I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Asperger. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -sintomatología I-PAST_MEDICAL_HISTORY -psicótica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -aquella I-PAST_MEDICAL_HISTORY -ocasión, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -pautó I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -neuroléptico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -abandonó I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -reacción I-PAST_MEDICAL_HISTORY -adversa. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -valoración I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -psiquiátrico. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mostraba I-PRESENT_ILLNESS -tranquilo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -colaborador. I-PRESENT_ILLNESS -En B-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -consulta, I-EVOLUTION -solicitó I-EVOLUTION -un I-EVOLUTION -tiempo I-EVOLUTION -previo I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -entrevista I-EVOLUTION -para I-EVOLUTION -poder I-EVOLUTION -realizar I-EVOLUTION -un I-EVOLUTION -paseo I-EVOLUTION -por I-EVOLUTION -los I-EVOLUTION -pasillos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -planta, I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -esto I-EVOLUTION -le I-EVOLUTION -ayudaba I-EVOLUTION -a I-EVOLUTION -calmarse. I-EVOLUTION -Cuando I-EVOLUTION -se I-EVOLUTION -exploró I-EVOLUTION -el I-EVOLUTION -motivo I-EVOLUTION -del I-EVOLUTION -ingreso, I-EVOLUTION -mostró I-EVOLUTION -escasa I-EVOLUTION -conciencia I-EVOLUTION -de I-EVOLUTION -enfermedad, I-EVOLUTION -refiriendo I-EVOLUTION -encontrarse I-EVOLUTION -en I-EVOLUTION -desacuerdo I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -necesidad I-EVOLUTION -del I-EVOLUTION -mismo. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -no I-EVOLUTION -mostraba I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -desconfianza, I-EVOLUTION -presentando I-EVOLUTION -buena I-EVOLUTION -disposición I-EVOLUTION -a I-EVOLUTION -recibir I-EVOLUTION -tratamiento. I-EVOLUTION -Su B-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -notado I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -algo I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -diferente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente, I-PAST_MEDICAL_HISTORY -si I-PAST_MEDICAL_HISTORY -bien I-PAST_MEDICAL_HISTORY -reconocía I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -información I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Asperger I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -comentaba I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -compañeros I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colegio I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -reían I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -él I-PAST_MEDICAL_HISTORY -porque I-PAST_MEDICAL_HISTORY -utilizaba I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -vocabulario I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -formal. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -rendimiento I-PAST_MEDICAL_HISTORY -académico I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -excelente I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -bachillerato, I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -suspender I-PAST_MEDICAL_HISTORY -asignaturas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -contar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -capacidad I-PAST_MEDICAL_HISTORY -intelectual I-PAST_MEDICAL_HISTORY -superior I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -media. I-PAST_MEDICAL_HISTORY -Hasta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -pasaba I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -parte I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -casa, I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -convivía I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -hermano I-PAST_MEDICAL_HISTORY -menor. I-PAST_MEDICAL_HISTORY -Comentaba I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -menudo I-PAST_MEDICAL_HISTORY -solía I-PAST_MEDICAL_HISTORY -dar I-PAST_MEDICAL_HISTORY -largos I-PAST_MEDICAL_HISTORY -paseos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -desplazaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -autobús, I-PAST_MEDICAL_HISTORY -actividades I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -realizaba I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -solitario. I-PAST_MEDICAL_HISTORY -Refería I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -fuerte I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -ciencias I-PAST_MEDICAL_HISTORY -naturales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EVOLUTION -avanzar I-EVOLUTION -el I-EVOLUTION -ingreso, I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -observaba I-EVOLUTION -más I-EVOLUTION -distendido, I-EVOLUTION -con I-EVOLUTION -menor I-EVOLUTION -rigidez I-EVOLUTION -postural I-EVOLUTION -y I-EVOLUTION -menor I-EVOLUTION -latencia I-EVOLUTION -de I-EVOLUTION -respuesta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -discurso. I-EVOLUTION -También I-EVOLUTION -se I-EVOLUTION -redujeron I-EVOLUTION -las I-EVOLUTION -sonrisas I-EVOLUTION -inmotivadas, I-EVOLUTION -las I-EVOLUTION -cuales I-EVOLUTION -reaparecían I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -contexto I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -interacción I-EVOLUTION -con I-EVOLUTION -personas I-EVOLUTION -desconocidas. I-EVOLUTION -El B-TREATMENT -tratamiento I-TREATMENT -antipsicótico I-TREATMENT -se I-TREATMENT -mostró I-TREATMENT -eficaz I-TREATMENT -en I-TREATMENT -la I-TREATMENT -reducción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -irritabilidad I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -La B-EVOLUTION -rigidez I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -ideas I-EVOLUTION -sobre I-EVOLUTION -la I-EVOLUTION -alimentación I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -hábitos I-EVOLUTION -de I-EVOLUTION -higiene I-EVOLUTION -y I-EVOLUTION -sueño I-EVOLUTION -continuaron I-EVOLUTION -al I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urgencias I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -alteraciones I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -conducta I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -vía I-DERIVED_FROM/TO -pública. I-DERIVED_FROM/TO -Sus B-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -referían I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -ido I-PRESENT_ILLNESS -disminuyendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sueño, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -verbalizado I-PRESENT_ILLNESS -ideas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -mesiánico. I-PRESENT_ILLNESS -Parecía I-PRESENT_ILLNESS -llevar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -desorganizada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -descuido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -tareas I-PRESENT_ILLNESS -básicas, I-PRESENT_ILLNESS -dedicación I-PRESENT_ILLNESS -excesiva I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -videojuegos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deficiente I-PRESENT_ILLNESS -alimentación. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -entrevista I-EXPLORATION -se I-EXPLORATION -mostró I-EXPLORATION -hostil, I-EXPLORATION -suspicaz, I-EXPLORATION -e I-EXPLORATION -interpretativo I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -entorno, I-EXPLORATION -especialmente I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -colores, I-EXPLORATION -llegando I-EXPLORATION -a I-EXPLORATION -referir I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -"sentía" I-EXPLORATION -azul. I-EXPLORATION -Negó I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -esfera I-EXPLORATION -sensoperceptiva. I-EXPLORATION -Desde B-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -psiquiatría I-PAST_MEDICAL_HISTORY -debido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -psicóticos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -afectivos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -psicofarmacológico, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -abandonado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ya B-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mostró I-EVOLUTION -tranquilo, I-EVOLUTION -pero I-EVOLUTION -muy I-EVOLUTION -desconfiado. I-EVOLUTION -Explicó I-EVOLUTION -lo I-EVOLUTION -sucedido I-EVOLUTION -como I-EVOLUTION -resultado I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -"pistas I-EVOLUTION -falsas" I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -llevaron I-EVOLUTION -a I-EVOLUTION -alertar I-EVOLUTION -a I-EVOLUTION -determinadas I-EVOLUTION -personas I-EVOLUTION -de I-EVOLUTION -que I-EVOLUTION -estaban I-EVOLUTION -en I-EVOLUTION -peligro. I-EVOLUTION -Su B-FAMILY_HISTORY -madre I-FAMILY_HISTORY -refirió I-FAMILY_HISTORY -llevar I-FAMILY_HISTORY -varios I-FAMILY_HISTORY -años I-FAMILY_HISTORY -en I-FAMILY_HISTORY -tratamiento I-FAMILY_HISTORY -psiquiátrico I-FAMILY_HISTORY -por I-FAMILY_HISTORY -distimia, I-FAMILY_HISTORY -mientras I-FAMILY_HISTORY -que I-FAMILY_HISTORY -el I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -había I-FAMILY_HISTORY -recibido I-FAMILY_HISTORY -un I-FAMILY_HISTORY -diagnóstico I-FAMILY_HISTORY -de I-FAMILY_HISTORY -trastorno I-FAMILY_HISTORY -obsesivo I-FAMILY_HISTORY -compulsivo I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -pasado. I-FAMILY_HISTORY -Los B-EXPLORATION -familiares I-EXPLORATION -no I-EXPLORATION -refirieron I-EXPLORATION -ninguna I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -desarrollo I-EXPLORATION -del I-EXPLORATION -paciente, I-EXPLORATION -si I-EXPLORATION -bien I-EXPLORATION -él I-EXPLORATION -mismo I-EXPLORATION -reconoció I-EXPLORATION -que I-EXPLORATION -siempre I-EXPLORATION -se I-EXPLORATION -había I-EXPLORATION -sentido I-EXPLORATION -un I-EXPLORATION -"bicho I-EXPLORATION -raro". I-EXPLORATION -Recordaba I-EXPLORATION -la I-EXPLORATION -etapa I-EXPLORATION -escolar I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -"infierno", I-EXPLORATION -presentando I-EXPLORATION -un I-EXPLORATION -mal I-EXPLORATION -manejo I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -relaciones I-EXPLORATION -interpersonales, I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -punto I-EXPLORATION -de I-EXPLORATION -reconocer I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -daba I-EXPLORATION -"fobia" I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -personas. I-EXPLORATION -Es I-EXPLORATION -por I-EXPLORATION -esta I-EXPLORATION -razón I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -adolescencia I-EXPLORATION -mantenía I-EXPLORATION -contacto I-EXPLORATION -interpersonal I-EXPLORATION -casi I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -exclusiva I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -juegos I-EXPLORATION -de I-EXPLORATION -ordenador I-EXPLORATION -en I-EXPLORATION -línea. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -medida I-EVOLUTION -que I-EVOLUTION -avanzó I-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -observaba I-EVOLUTION -más I-EVOLUTION -distendido, I-EVOLUTION -si I-EVOLUTION -bien I-EVOLUTION -refería I-EVOLUTION -sentirse I-EVOLUTION -incómodo I-EVOLUTION -rodeado I-EVOLUTION -de I-EVOLUTION -gente. I-EVOLUTION -También I-EVOLUTION -comentó I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -molestaba I-EVOLUTION -el I-EVOLUTION -sonido I-EVOLUTION -del I-EVOLUTION -tubo I-EVOLUTION -del I-EVOLUTION -televisor I-EVOLUTION -situado I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -salas I-EVOLUTION -comunes I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -unidad, I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -percibía I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -nítida. I-EVOLUTION -Como I-EVOLUTION -estrategia I-EVOLUTION -de I-EVOLUTION -afrontamiento I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -momentos I-EVOLUTION -de I-EVOLUTION -estrés, I-EVOLUTION -deambulaba I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -pasillo I-EVOLUTION -siguiendo I-EVOLUTION -una I-EVOLUTION -secuencia I-EVOLUTION -rutinaria I-EVOLUTION -que I-EVOLUTION -podía I-EVOLUTION -durar I-EVOLUTION -varias I-EVOLUTION -horas I-EVOLUTION -y I-EVOLUTION -que, I-EVOLUTION -según I-EVOLUTION -decía, I-EVOLUTION -le I-EVOLUTION -ayudaba I-EVOLUTION -a I-EVOLUTION -relajarse. I-EVOLUTION -Mencionó B-EXPLORATION -tener I-EXPLORATION -habitualmente I-EXPLORATION -"paranoias" I-EXPLORATION -que I-EXPLORATION -asociaba I-EXPLORATION -con I-EXPLORATION -su I-EXPLORATION -comportamiento I-EXPLORATION -anterior I-EXPLORATION -al I-EXPLORATION -ingreso. I-EXPLORATION -Relacionó I-EXPLORATION -el I-EXPLORATION -episodio I-EXPLORATION -conductual I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -sentimiento I-EXPLORATION -profundo I-EXPLORATION -de I-EXPLORATION -soledad I-EXPLORATION -y I-EXPLORATION -frustración I-EXPLORATION -por I-EXPLORATION -su I-EXPLORATION -incapacidad I-EXPLORATION -para I-EXPLORATION -mantener I-EXPLORATION -relaciones I-EXPLORATION -interpersonales I-EXPLORATION -estables. I-EXPLORATION -Al I-EXPLORATION -ser I-EXPLORATION -preguntado I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -relación I-EXPLORATION -entre I-EXPLORATION -percepción I-EXPLORATION -y I-EXPLORATION -color I-EXPLORATION -manifestada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -urgencias, I-EXPLORATION -respondió I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -letra I-EXPLORATION -traducida I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -canción I-EXPLORATION -(en I-EXPLORATION -inglés I-EXPLORATION -la I-EXPLORATION -palabra I-EXPLORATION -"blue" I-EXPLORATION -presenta I-EXPLORATION -dos I-EXPLORATION -significados: I-EXPLORATION -azul I-EXPLORATION -y I-EXPLORATION -triste. I-EXPLORATION -Al I-EXPLORATION -decir I-EXPLORATION -sentirse I-EXPLORATION -azul I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -realmente I-EXPLORATION -expresaba I-EXPLORATION -un I-EXPLORATION -sentimiento I-EXPLORATION -de I-EXPLORATION -tristeza). I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -presentó I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -antipsicótico, I-TREATMENT -si B-EVOLUTION -bien I-EVOLUTION -tanto I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -afectivos I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -rigidez I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -pensamiento I-EVOLUTION -nunca I-EVOLUTION -desaparecieron. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -tabla I-EXPLORATION -1 I-EXPLORATION -muestra I-EXPLORATION -la I-EXPLORATION -comparación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Escala I-EXPLORATION -de I-EXPLORATION -Inteligencia I-EXPLORATION -Wechsler I-EXPLORATION -para I-EXPLORATION -Adultos I-EXPLORATION -(WAIS) I-EXPLORATION -(30), I-EXPLORATION -la I-EXPLORATION -Escala I-EXPLORATION -de I-EXPLORATION -Síndromes I-EXPLORATION -Positivos I-EXPLORATION -y I-EXPLORATION -Negativos I-EXPLORATION -(PANSS) I-EXPLORATION -(32) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -Cociente I-EXPLORATION -de I-EXPLORATION -Espectro I-EXPLORATION -Autista I-EXPLORATION -(AQ) I-EXPLORATION -(31) I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -pacientes. I-EXPLORATION -La I-EXPLORATION -tabla I-EXPLORATION -2 I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -comparación I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION -de I-EXPLORATION -esquizofrenia I-EXPLORATION -y I-EXPLORATION -autismo I-EXPLORATION -compartidos I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -casos I-EXPLORATION -descritos. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA) I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -difícil I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mala I-PAST_MEDICAL_HISTORY -cumplimiento I-PAST_MEDICAL_HISTORY -terapéutico. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2008 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -probable I-PAST_MEDICAL_HISTORY -nefroangiosclerosis. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -implanta I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -peritoneal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -diciembre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2009, I-PAST_MEDICAL_HISTORY -iniciando I-PAST_MEDICAL_HISTORY -DP I-PAST_MEDICAL_HISTORY -continua I-PAST_MEDICAL_HISTORY -ambulatoria I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -tarde I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -incidencias I-PAST_MEDICAL_HISTORY -destacables. I-PAST_MEDICAL_HISTORY -Un B-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disfunción I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -catéter I-PRESENT_ILLNESS -peritoneal, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -drenaje. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -hipoventilación I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -campo I-EXPLORATION -medio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pulmón I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -refiere I-EXPLORATION -disnea, I-EXPLORATION -aunque I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -oxígeno, I-EXPLORATION -con I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -importante I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -hidrotórax I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -DP I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -toracocentesis I-EXPLORATION -diagnóstica, I-EXPLORATION -obteniendo I-EXPLORATION -un I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -datos: I-EXPLORATION -leucocitos I-EXPLORATION -200. I-EXPLORATION -Glucosa I-EXPLORATION -418. I-EXPLORATION -Proteínas I-EXPLORATION -<1, I-EXPLORATION -LDH I-EXPLORATION -42. I-EXPLORATION - I-EXPLORATION -Dado B-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -negaba I-TREATMENT -a I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -hemodiálisis, I-TREATMENT -tras I-TREATMENT -unos I-TREATMENT -días I-TREATMENT -de I-TREATMENT -reposo I-TREATMENT -peritoneal I-TREATMENT -con I-TREATMENT -los I-TREATMENT -que I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -la I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -radiografía I-TREATMENT -de I-TREATMENT -tórax, I-TREATMENT -se I-TREATMENT -intenta I-TREATMENT -realizar I-TREATMENT -DP I-TREATMENT -automática I-TREATMENT -con I-TREATMENT -bajo I-TREATMENT -volumen I-TREATMENT -y I-TREATMENT -cabecera I-TREATMENT -a I-TREATMENT -45o, I-TREATMENT -sin I-TREATMENT -conseguir I-TREATMENT -un I-TREATMENT -buen I-TREATMENT -funcionamiento I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -por I-TREATMENT -importante I-TREATMENT -dificultad I-TREATMENT -para I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -y I-TREATMENT -con I-TREATMENT -nueva I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -hidrotórax. I-TREATMENT -Finalmente, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -aceptó I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -HD I-TREATMENT -que I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -actual I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -sin I-TREATMENT -incidencias I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -FAV I-TREATMENT -radiocefálica I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Nefrología I-DERIVED_FROM/TO -por B-PRESENT_ILLNESS -creatinina I-PRESENT_ILLNESS -plasmática I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2, I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -mg/dl. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -diversas I-PAST_MEDICAL_HISTORY -intervenciones I-PAST_MEDICAL_HISTORY -quirúrgicas I-PAST_MEDICAL_HISTORY -(menisco I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1985; I-PAST_MEDICAL_HISTORY -timoma I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anatomía I-PAST_MEDICAL_HISTORY -patológica I-PAST_MEDICAL_HISTORY -benigna I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1999; I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -nasosinusales I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2008; I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2006; I-PAST_MEDICAL_HISTORY -cistocele I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2008; I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cadera I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2010); I-PAST_MEDICAL_HISTORY -colangitis I-PAST_MEDICAL_HISTORY -esclerosante I-PAST_MEDICAL_HISTORY -primaria I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2003, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -ursodesoxicólico. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -cateterismo I-PAST_MEDICAL_HISTORY -biliar I-PAST_MEDICAL_HISTORY -retrógado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esfinterectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zonas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estenosis. I-PAST_MEDICAL_HISTORY -También I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -inflamatoria I-PAST_MEDICAL_HISTORY -intestinal I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -misma I-PAST_MEDICAL_HISTORY -época; I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practicaron I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -colonoscopias I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -unas I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -normales I-PAST_MEDICAL_HISTORY -y, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otras, I-PAST_MEDICAL_HISTORY -mostraban I-PAST_MEDICAL_HISTORY -mínimas I-PAST_MEDICAL_HISTORY -ulceraciones I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -iliocecal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -colon. I-PAST_MEDICAL_HISTORY -Pericarditis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -etiología I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -filiada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -enero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2010. I-PAST_MEDICAL_HISTORY -Gonartrosis I-PAST_MEDICAL_HISTORY -bilateral. I-PAST_MEDICAL_HISTORY -Intolerancia I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -hierro I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -vista I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -externa I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -zolpidem, I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -ursodesoxicólico, I-PAST_MEDICAL_HISTORY -1250 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -pantoprazol, I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -mirtazapina, I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -dextropropoxífeno, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -paracetamol I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -ocasional. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -interrogatorio I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -cansancio, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -medianos I-PRESENT_ILLNESS -esfuerzos; I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -apetito; I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -ocasionales I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tos; I-PRESENT_ILLNESS -estreñimiento I-PRESENT_ILLNESS -habitual I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -unas I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -alternaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día, I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos; I-PRESENT_ILLNESS -nicturia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -meses; I-PRESENT_ILLNESS -micciones I-PRESENT_ILLNESS -diurnas I-PRESENT_ILLNESS -cada I-PRESENT_ILLNESS -3-4 I-PRESENT_ILLNESS -horas; I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -relataba I-PRESENT_ILLNESS -antecedentes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -renoureterales I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -tenido I-PRESENT_ILLNESS -hematuria. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-FAMILY_HISTORY -cuanto I-FAMILY_HISTORY -a I-FAMILY_HISTORY -sus I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares, I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -fallecidos I-FAMILY_HISTORY -en I-FAMILY_HISTORY -edad I-FAMILY_HISTORY -avanzada I-FAMILY_HISTORY -y I-FAMILY_HISTORY -tres I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -fallecidos I-FAMILY_HISTORY -por I-FAMILY_HISTORY -tumores. I-FAMILY_HISTORY - I-FAMILY_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física: I-EXPLORATION -talla: I-EXPLORATION -159 I-EXPLORATION -cm; I-EXPLORATION -peso: I-EXPLORATION -53 I-EXPLORATION -kg. I-EXPLORATION -Presión I-EXPLORATION -arterial: I-EXPLORATION -137/72 I-EXPLORATION -mmHg; I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca: I-EXPLORATION -95 I-EXPLORATION -lpm. I-EXPLORATION -Sin I-EXPLORATION -ingurgitación I-EXPLORATION -yugular; I-EXPLORATION -carótidas I-EXPLORATION -rítmicas I-EXPLORATION -y I-EXPLORATION -simétricas; I-EXPLORATION -auscultación I-EXPLORATION -cardiopulmonar I-EXPLORATION -normal; I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -de I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -traveses I-EXPLORATION -de I-EXPLORATION -dedo I-EXPLORATION -más I-EXPLORATION -evidente I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -derecho, I-EXPLORATION -no I-EXPLORATION -dolorosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -soplos I-EXPLORATION -abdominales. I-EXPLORATION -Extremidades: I-EXPLORATION -sin I-EXPLORATION -edemas I-EXPLORATION -y I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -presentes. I-EXPLORATION - I-EXPLORATION -Revisada I-EXPLORATION -la I-EXPLORATION -historia I-EXPLORATION -analítica, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -noviembre I-EXPLORATION -de I-EXPLORATION -2010 I-EXPLORATION -la I-EXPLORATION -creatinina I-EXPLORATION -plasmática I-EXPLORATION -osciló I-EXPLORATION -entre I-EXPLORATION -2, I-EXPLORATION -4-2, I-EXPLORATION -5 I-EXPLORATION -mg/dl; I-EXPLORATION -en I-EXPLORATION -diciembre I-EXPLORATION -de I-EXPLORATION -2010 I-EXPLORATION -la I-EXPLORATION -creatinina I-EXPLORATION -plasmática I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -9 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -enero I-EXPLORATION -de I-EXPLORATION -2011, I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -7 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -en I-EXPLORATION -enero I-EXPLORATION -y I-EXPLORATION -febrero I-EXPLORATION -de I-EXPLORATION -2011, I-EXPLORATION -cabe I-EXPLORATION -destacar: I-EXPLORATION -colesterol: I-EXPLORATION -204 I-EXPLORATION -mg/dl; I-EXPLORATION -GOT I-EXPLORATION -(glutamato-oxalacetato-transaminasa): I-EXPLORATION -37 I-EXPLORATION -U/l; I-EXPLORATION -GPT I-EXPLORATION -(glutamato-piruvato-transaminasa): I-EXPLORATION -23 I-EXPLORATION -U/l; I-EXPLORATION -GGT I-EXPLORATION -(gammaglutamil I-EXPLORATION -transferasa): I-EXPLORATION -431 I-EXPLORATION -U/l; I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina: I-EXPLORATION -483 I-EXPLORATION -U/l; I-EXPLORATION -LDH I-EXPLORATION -(lactatodeshidrogenasa): I-EXPLORATION -646 I-EXPLORATION -U/l; I-EXPLORATION -ferritina: I-EXPLORATION -399 I-EXPLORATION -ng/ml; I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -transferrina, I-EXPLORATION -11%. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -ordinaria I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma: I-EXPLORATION -hematocrito: I-EXPLORATION -35, I-EXPLORATION -1%; I-EXPLORATION -hemoglobina: I-EXPLORATION -11, I-EXPLORATION -3 I-EXPLORATION -g/dl; I-EXPLORATION -resto I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación: I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activado: I-EXPLORATION -45 I-EXPLORATION -segundos. I-EXPLORATION -Anticardiolipina I-EXPLORATION -IgM I-EXPLORATION -positiva: I-EXPLORATION -21, I-EXPLORATION -80 I-EXPLORATION -U I-EXPLORATION -MPL/ml I-EXPLORATION -(normal: I-EXPLORATION -0, I-EXPLORATION -5-11). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -recogida I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas: I-EXPLORATION -proteinuria: I-EXPLORATION -0, I-EXPLORATION -53 I-EXPLORATION -g/24 I-EXPLORATION -horas; I-EXPLORATION -aclaramiento I-EXPLORATION -de I-EXPLORATION -creatinina: I-EXPLORATION -17 I-EXPLORATION -ml/min. I-EXPLORATION -El I-EXPLORATION -sistemático I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunológico I-EXPLORATION -mostró I-EXPLORATION -positividad I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -anticitoplasma I-EXPLORATION -de I-EXPLORATION -neutrófilos I-EXPLORATION -(ANCA) I-EXPLORATION -(anti-MPO I-EXPLORATION -y I-EXPLORATION -Anti-PR3 I-EXPLORATION -negativos); I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(ANA), I-EXPLORATION -anti-DNA, I-EXPLORATION -anticuerpos I-EXPLORATION -antimúsculo I-EXPLORATION -liso, I-EXPLORATION -anticuerpos I-EXPLORATION -antimitocondriales I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas: I-EXPLORATION -IgG: I-EXPLORATION -253 I-EXPLORATION -mg/dl I-EXPLORATION -(normal: I-EXPLORATION -751-1560); I-EXPLORATION -IgM: I-EXPLORATION -10 I-EXPLORATION -mg/dl I-EXPLORATION -(normal: I-EXPLORATION -46-304); I-EXPLORATION -IgA I-EXPLORATION -81 I-EXPLORATION -mg/dl I-EXPLORATION -(normal: I-EXPLORATION -82-453). I-EXPLORATION -El I-EXPLORATION -complemento, I-EXPLORATION -factor I-EXPLORATION -reumatoide, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -y I-EXPLORATION -ceruloplasmina I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana, I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -hormonas I-EXPLORATION -tiroideas I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antitiroideos I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -paratohormona I-EXPLORATION -intacta I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -149 I-EXPLORATION -pg/ml. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -orina, I-EXPLORATION -proteinuria I-EXPLORATION -no I-EXPLORATION -selectiva. I-EXPLORATION -La I-EXPLORATION -proteinuria I-EXPLORATION -de I-EXPLORATION -Bence-Jones I-EXPLORATION -resultó I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -(ecografía I-EXPLORATION -renal): I-EXPLORATION -riñones I-EXPLORATION -de I-EXPLORATION -tamaño, I-EXPLORATION -morfología I-EXPLORATION -y I-EXPLORATION -ecogenicidad I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -litiasis I-EXPLORATION -ni I-EXPLORATION -dilatación. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -deterioro I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -de I-EXPLORATION -causa I-EXPLORATION -no I-EXPLORATION -clara I-EXPLORATION -(se I-EXPLORATION -desconocían I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -previa), I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION -percutánea I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -hallazgos: I-EXPLORATION -4 I-EXPLORATION -glomérulos, I-EXPLORATION -2 I-EXPLORATION -de I-EXPLORATION -ellos I-EXPLORATION -completamente I-EXPLORATION -esclerosados I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -otros I-EXPLORATION -2 I-EXPLORATION -en I-EXPLORATION -vías I-EXPLORATION -de I-EXPLORATION -esclerosis. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -inmunofluorescencia I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -IgG, I-EXPLORATION -IgA, I-EXPLORATION -IgM I-EXPLORATION -y I-EXPLORATION -C3. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -intersticio I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -un I-EXPLORATION -denso I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION -que I-EXPLORATION -expandía I-EXPLORATION -y I-EXPLORATION -ocupaba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -tejido, I-EXPLORATION -destruyendo I-EXPLORATION -la I-EXPLORATION -arquitectura I-EXPLORATION -habitual I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -renal. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -valoraba I-EXPLORATION -bien I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -debido I-EXPLORATION -al I-EXPLORATION -infiltrado I-EXPLORATION -existente. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -2 I-EXPLORATION -A I-EXPLORATION -se I-EXPLORATION -muestra I-EXPLORATION -la I-EXPLORATION -inmunohistoquímica I-EXPLORATION -con I-EXPLORATION -CD3 I-EXPLORATION -(anticuerpo I-EXPLORATION -monoclonal I-EXPLORATION -que I-EXPLORATION -marca I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -en I-EXPLORATION -general) I-EXPLORATION -y I-EXPLORATION -demuestra I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -mayoría I-EXPLORATION -del I-EXPLORATION -infiltrado I-EXPLORATION -es I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -T, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -2 I-EXPLORATION -B, I-EXPLORATION -la I-EXPLORATION -inmunohistoquímica I-EXPLORATION -con I-EXPLORATION -CD4. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -final I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -nefropatía I-EXPLORATION -tubulointersticial I-EXPLORATION -severa I-EXPLORATION -(infiltrado I-EXPLORATION -intersticial I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -linfocitario I-EXPLORATION -T I-EXPLORATION -CD4 I-EXPLORATION -positivos). I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -los I-TREATMENT -hallazgos I-TREATMENT -de I-TREATMENT -la I-TREATMENT -biopsia I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona, I-TREATMENT -50 I-TREATMENT -mg/día, I-TREATMENT -en I-TREATMENT -pauta I-TREATMENT -descendente. I-TREATMENT - I-TREATMENT -Ocho B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -mantiene I-EVOLUTION -una I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -estabilizada I-EVOLUTION -(creatinina I-EVOLUTION -plasmática I-EVOLUTION -de I-EVOLUTION -2, I-EVOLUTION -2 I-EVOLUTION -mg/dl, I-EVOLUTION -aclaramiento I-EVOLUTION -de I-EVOLUTION -20 I-EVOLUTION -ml/min I-EVOLUTION -y I-EVOLUTION -proteinuria I-EVOLUTION -de I-EVOLUTION -0, I-EVOLUTION -49 I-EVOLUTION -g/24 I-EVOLUTION -h). I-EVOLUTION -Respecto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -hepática: I-EVOLUTION -GOT: I-EVOLUTION -24 I-EVOLUTION -U/l; I-EVOLUTION -GPT: I-EVOLUTION -18 I-EVOLUTION -U/l; I-EVOLUTION -GGT: I-EVOLUTION -172 I-EVOLUTION -U/l; I-EVOLUTION -fosfatasa I-EVOLUTION -alcalina: I-EVOLUTION -342 I-EVOLUTION -U/l. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosas I-PRESENT_ILLNESS -lumbares, I-PRESENT_ILLNESS -fatiga I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diuresis I-PRESENT_ILLNESS -conservada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -intranasal I-PAST_MEDICAL_HISTORY -(1 I-PAST_MEDICAL_HISTORY -g) I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -admisión. I-PAST_MEDICAL_HISTORY -Negó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -antiinflamatorios I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -esteroideos I-PRESENT_ILLNESS -u I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -medicamentos. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -ligeramente I-EXPLORATION -elevada I-EXPLORATION -de I-EXPLORATION -147/97 I-EXPLORATION -mmHg, I-EXPLORATION -sin I-EXPLORATION -fiebre, I-EXPLORATION -erupción I-EXPLORATION -cutánea I-EXPLORATION -o I-EXPLORATION -artralgias. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -cardiovascular I-EXPLORATION -y I-EXPLORATION -respiratoria I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -blando, I-EXPLORATION -depresible I-EXPLORATION -e I-EXPLORATION -indoloro, I-EXPLORATION -el I-EXPLORATION -hígado I-EXPLORATION -era I-EXPLORATION -palpable I-EXPLORATION -a I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -por I-EXPLORATION -debajo I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -costal I-EXPLORATION -y I-EXPLORATION -presentaba I-EXPLORATION -discreto I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -lumbar I-EXPLORATION -bilateral. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -inicial I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -anodino I-EXPLORATION -(sin I-EXPLORATION -eosinofilia), I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -funci��n I-EXPLORATION -hepática I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -albúmina I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -rango I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad; I-EXPLORATION -creatinina I-EXPLORATION -sérica: I-EXPLORATION -160 I-EXPLORATION -μmol/l; I-EXPLORATION -urea: I-EXPLORATION -7, I-EXPLORATION -5 I-EXPLORATION -mmol/l; I-EXPLORATION -potasio: I-EXPLORATION -3, I-EXPLORATION -9 I-EXPLORATION -mmol/l; I-EXPLORATION -sodio: I-EXPLORATION -139 I-EXPLORATION -mmol/l; I-EXPLORATION -cloruro: I-EXPLORATION -101 I-EXPLORATION -mmol/l. I-EXPLORATION -La I-EXPLORATION -creatina I-EXPLORATION -cinasa I-EXPLORATION -total I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -(3, I-EXPLORATION -3 I-EXPLORATION -μkat/l), I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -fracción I-EXPLORATION -MB I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -mostró I-EXPLORATION -2 I-EXPLORATION -leucocitos I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -hematíes I-EXPLORATION -por I-EXPLORATION -campo I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -hematíes I-EXPLORATION -dismórficos I-EXPLORATION -ni I-EXPLORATION -eosinófilos. I-EXPLORATION -Bioquímica I-EXPLORATION -orina: I-EXPLORATION -sodio: I-EXPLORATION -46 I-EXPLORATION -mmol/l, I-EXPLORATION -potasio: I-EXPLORATION -33 I-EXPLORATION -mmol/l I-EXPLORATION -y I-EXPLORATION -cloruro: I-EXPLORATION -63 I-EXPLORATION -mmol/l, I-EXPLORATION -cociente I-EXPLORATION -proteína: I-EXPLORATION -creatinina I-EXPLORATION -en I-EXPLORATION -5 I-EXPLORATION -g/mol; I-EXPLORATION -urocultivo I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Proteinograma I-EXPLORATION -electroforético, I-EXPLORATION -inmunoglobulinas, I-EXPLORATION -complemento, I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -enzima I-EXPLORATION -convertidora I-EXPLORATION -de I-EXPLORATION -angiotensina I-EXPLORATION -y I-EXPLORATION -títulos I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -Epstein-Barr, I-EXPLORATION -citomegalovirus, I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -B, I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -y I-EXPLORATION -micoplasma I-EXPLORATION -no I-EXPLORATION -detectó I-EXPLORATION -infección I-EXPLORATION -activa. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -demostró I-EXPLORATION -unos I-EXPLORATION -riñones I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -normal, I-EXPLORATION -difusamente I-EXPLORATION -ecogénicos I-EXPLORATION -con I-EXPLORATION -flujo I-EXPLORATION -arterial I-EXPLORATION -y I-EXPLORATION -venoso I-EXPLORATION -apropiado. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -electrocardiograma I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -cardiotorácico I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -y I-EXPLORATION -unos I-EXPLORATION -campos I-EXPLORATION -pulmonares I-EXPLORATION -sin I-EXPLORATION -infiltrados. I-EXPLORATION - I-EXPLORATION -Después B-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -admisión, I-EVOLUTION -el I-EVOLUTION -débito I-EVOLUTION -urinario I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -en I-EVOLUTION -50 I-EVOLUTION -a I-EVOLUTION -75 I-EVOLUTION -ml/h I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -creatinina I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -sin I-EVOLUTION -cambios. I-EVOLUTION -El B-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -sometió I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -renal. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -histológicos I-EXPLORATION -son I-EXPLORATION -los I-EXPLORATION -siguientes: I-EXPLORATION -la I-EXPLORATION -microscopía I-EXPLORATION -óptica I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -13 I-EXPLORATION -glomérulos, I-EXPLORATION -todos I-EXPLORATION -ellos I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -esclerosis, I-EXPLORATION -proliferación I-EXPLORATION -o I-EXPLORATION -lesiones I-EXPLORATION -necróticas. I-EXPLORATION -Las I-EXPLORATION -membranas I-EXPLORATION -basales I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -mesangio I-EXPLORATION -glomerular I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -intersticio I-EXPLORATION -mostraba I-EXPLORATION -moderado I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -mononuclear I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -eosinófilos, I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tubulitis I-EXPLORATION -focal I-EXPLORATION -y I-EXPLORATION -atrofia. I-EXPLORATION -Las I-EXPLORATION -arteriolas I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -lesiones I-EXPLORATION -destacables I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -existían I-EXPLORATION -depósitos I-EXPLORATION -inmunes I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -inmunofluorescencia. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -patológico I-EXPLORATION -de I-EXPLORATION -nefritis I-EXPLORATION -tubulointersticial I-EXPLORATION -aguda I-EXPLORATION -(NIA). I-EXPLORATION - I-EXPLORATION -Este I-EXPLORATION -hecho, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -clínicas I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -consumo I-EXPLORATION -reciente I-EXPLORATION -de I-EXPLORATION -cocaína, I-EXPLORATION -nos I-EXPLORATION -llevó I-EXPLORATION -a I-EXPLORATION -definir I-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -como I-EXPLORATION -NIA I-EXPLORATION -inducida I-EXPLORATION -por I-EXPLORATION -cocaína. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -obviamente I-TREATMENT -interrumpió I-TREATMENT -el I-TREATMENT -consumo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -droga I-TREATMENT -y I-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -oral I-TREATMENT -(1 I-TREATMENT -mg/kg/día I-TREATMENT -dosis I-TREATMENT -inicial), I-TREATMENT -que I-TREATMENT -se I-TREATMENT -disminuyó I-TREATMENT -progresivamente I-TREATMENT -y I-TREATMENT -se I-TREATMENT -interrumpió I-TREATMENT -después I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -semanas. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -posterior I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -recuperación I-EVOLUTION -completa I-EVOLUTION -ya I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -(IMC I-PAST_MEDICAL_HISTORY -47 I-PAST_MEDICAL_HISTORY -kg/m2), I-PAST_MEDICAL_HISTORY -HTA, I-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -apnea I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -sueño I-PAST_MEDICAL_HISTORY -(SAOS), I-PAST_MEDICAL_HISTORY -hipercolesterolemia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -infarto I-PAST_MEDICAL_HISTORY -agudo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miocardio I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -stent I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -angioplastia I-PAST_MEDICAL_HISTORY -coronaria I-PAST_MEDICAL_HISTORY -transluminal I-PAST_MEDICAL_HISTORY -percutánea-stent. I-PAST_MEDICAL_HISTORY -Se B-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -realización I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -bariátrica, I-DERIVED_FROM/TO -técnica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -gastrectomía I-DERIVED_FROM/TO -tubular I-DERIVED_FROM/TO -laparoscópica. I-DERIVED_FROM/TO -Al B-TREATMENT -alta, I-TREATMENT -su I-TREATMENT -tratamiento I-TREATMENT -incluyó I-TREATMENT -ramipril I-TREATMENT -10 I-TREATMENT -mg/24 I-TREATMENT -horas, I-TREATMENT -bisoprolol/hidroclorotiazida I-TREATMENT -10/25 I-TREATMENT -mg/24 I-TREATMENT -horas, I-TREATMENT -atorvastatina I-TREATMENT -10 I-TREATMENT -mg/24 I-TREATMENT -horas, I-TREATMENT -barnidipino I-TREATMENT -20 I-TREATMENT -mg/24 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -metformina I-TREATMENT -1/8 I-TREATMENT -horas. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refirió I-EVOLUTION -escasa I-EVOLUTION -ingesta I-EVOLUTION -hidroalimentaria, I-EVOLUTION -episodios I-EVOLUTION -ocasionales I-EVOLUTION -de I-EVOLUTION -mareo I-EVOLUTION -y I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -20 I-EVOLUTION -kg I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -mes. I-EVOLUTION -Ante I-EVOLUTION -el I-EVOLUTION -empeoramiento I-EVOLUTION -clínico I-EVOLUTION -progresivo I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -asociación I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -diarreico, I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -Urgencias, I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -bradipsiquia, I-EVOLUTION -sequedad I-EVOLUTION -de I-EVOLUTION -piel I-EVOLUTION -y I-EVOLUTION -mucosas, I-EVOLUTION -y I-EVOLUTION -presión I-EVOLUTION -arterial I-EVOLUTION -(PA) I-EVOLUTION -92/65 I-EVOLUTION -mmHg. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -analítica: I-EXPLORATION -glucosa I-EXPLORATION -214 I-EXPLORATION -mg/dl, I-EXPLORATION -urea I-EXPLORATION -403 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -(Cr) I-EXPLORATION -9, I-EXPLORATION -2 I-EXPLORATION -mg/dl, I-EXPLORATION -Na I-EXPLORATION -151 I-EXPLORATION -mmol/l, I-EXPLORATION -Cl I-EXPLORATION -113 I-EXPLORATION -mmol/l, I-EXPLORATION -K I-EXPLORATION -4 I-EXPLORATION -mmol/l; I-EXPLORATION -hemograma: I-EXPLORATION -hemoglobina I-EXPLORATION -(Hb) I-EXPLORATION -15, I-EXPLORATION -4 I-EXPLORATION -g/dl, I-EXPLORATION -VH I-EXPLORATION -44, I-EXPLORATION -5%; I-EXPLORATION -leucocitos I-EXPLORATION -18800/uL; I-EXPLORATION -plaquetas I-EXPLORATION -287000/uL; I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -en I-EXPLORATION -orina: I-EXPLORATION -urea I-EXPLORATION -239 I-EXPLORATION -mg/dl, I-EXPLORATION -Cr I-EXPLORATION -339 I-EXPLORATION -mg/dl, I-EXPLORATION -Na I-EXPLORATION -52 I-EXPLORATION -mmol/l, I-EXPLORATION -K I-EXPLORATION -9, I-EXPLORATION -1 I-EXPLORATION -mmol/l, I-EXPLORATION -excreción I-EXPLORATION -fraccional I-EXPLORATION -de I-EXPLORATION -sodio I-EXPLORATION -(EF I-EXPLORATION -Na) I-EXPLORATION -0, I-EXPLORATION -9%; I-EXPLORATION -gasometría I-EXPLORATION -venosa: I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -33, I-EXPLORATION -bicarbonato I-EXPLORATION -11, I-EXPLORATION -1 I-EXPLORATION -mmol/l, I-EXPLORATION -pCO2 I-EXPLORATION -21 I-EXPLORATION -mmHg. I-EXPLORATION -Se B-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT -Nefrología I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -IRA I-TREATMENT -prerrenal, I-TREATMENT -hipernatremia I-TREATMENT -e I-TREATMENT -infección I-TREATMENT -urinaria, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -y I-TREATMENT -reposición I-TREATMENT -hidroelectrolítica I-TREATMENT -controlada I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta, I-TREATMENT -siendo I-TREATMENT -la I-TREATMENT -creatinina I-TREATMENT -al I-TREATMENT -alta I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -86 I-TREATMENT -mg/dl. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -IRC B-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nefropatía I-PAST_MEDICAL_HISTORY -diabética I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -sustitutivo I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hemodiálisis, I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -dilatada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -isquémico, I-PAST_MEDICAL_HISTORY -retinopatía I-PAST_MEDICAL_HISTORY -diabética, I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -años; I-PAST_MEDICAL_HISTORY -ingresa B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -medicina I-PRESENT_ILLNESS -interna I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cetoacidosis I-PRESENT_ILLNESS -diabética. I-PRESENT_ILLNESS -Durante B-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -detectan I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -maculopapulosas, I-EXPLORATION -eritematosas, I-EXPLORATION -con I-EXPLORATION -zona I-EXPLORATION -descamativa I-EXPLORATION -hiperqueratósica I-EXPLORATION -central, I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -universal. I-EXPLORATION -Se B-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -dermatología, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realiza I-DERIVED_FROM/TO -biopsia I-DERIVED_FROM/TO -cutánea I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -diagnostica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Kyrle. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -en B-PAST_MEDICAL_HISTORY -DP I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -octubre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2012 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nefropatía I-PAST_MEDICAL_HISTORY -diabética. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -líquido I-PRESENT_ILLNESS -peritoneal I-PRESENT_ILLNESS -turbio, I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -descenso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ultrafiltración. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -neoformación I-PAST_MEDICAL_HISTORY -nasal. I-PAST_MEDICAL_HISTORY -Los B-EXPLORATION -resultados I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -eran: I-EXPLORATION -aspecto I-EXPLORATION -turbio, I-EXPLORATION -700 I-EXPLORATION -leucocitos/μl I-EXPLORATION -(mononucleares I-EXPLORATION -80% I-EXPLORATION -y I-EXPLORATION -polimorfonucleares I-EXPLORATION -20%), I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -del I-EXPLORATION -predominio I-EXPLORATION -de I-EXPLORATION -mononucleares I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -terapia I-EXPLORATION -antibiótica I-EXPLORATION -empírica I-EXPLORATION -con I-EXPLORATION -vancomicina I-EXPLORATION -y I-EXPLORATION -ceftazidima I-EXPLORATION -intraperitoneal. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -ni I-EXPLORATION -masas; I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION -de I-EXPLORATION -salida I-EXPLORATION -del I-EXPLORATION -catéter I-EXPLORATION -peritoneal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -túnel I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -analíticos I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -destacaban: I-EXPLORATION -leucocitos I-EXPLORATION -37000/mm3, I-EXPLORATION -plaquetas I-EXPLORATION -640000/mm3, I-EXPLORATION -hemoglobina I-EXPLORATION -10, I-EXPLORATION -3g/dl, I-EXPLORATION -creatinina I-EXPLORATION -5, I-EXPLORATION -4mg/dl, I-EXPLORATION -urea I-EXPLORATION -180mg/dl, I-EXPLORATION -Na I-EXPLORATION -138mEq/l, I-EXPLORATION -K I-EXPLORATION -4mEq/l, I-EXPLORATION -calcio I-EXPLORATION -9, I-EXPLORATION -5mg/dl, I-EXPLORATION -fósforo I-EXPLORATION -4, I-EXPLORATION -8mg/dl, I-EXPLORATION -albúmina I-EXPLORATION -3, I-EXPLORATION -9mg/dl. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -cráneo, I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -para I-EXPLORATION -completar I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -nasal I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -días I-EXPLORATION -siguientes, I-EXPLORATION -siendo I-EXPLORATION -informado I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas I-EXPLORATION -y I-EXPLORATION -retroperitoneales I-EXPLORATION -diseminadas. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -nasal I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -linfoma I-EXPLORATION -no-Hodgkin I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -B I-EXPLORATION -grandes I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -citología I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -demostró I-EXPLORATION -linfocitos I-EXPLORATION -atípicos. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -su I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -y I-TREATMENT -permaneció I-TREATMENT -en I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -de I-TREATMENT -DP I-TREATMENT -sin I-TREATMENT -más I-TREATMENT -incidencias I-TREATMENT -dialíticas. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -turbio I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -DP I-EXPLORATION -generalmente I-EXPLORATION -se I-EXPLORATION -asocia I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -peritonitis. I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -peritonitis I-EXPLORATION -bacteriana I-EXPLORATION -se I-EXPLORATION -requieren I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION -dos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -condiciones: I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -solo I-EXPLORATION -o I-EXPLORATION -acompañado I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -síntomas I-EXPLORATION -abdominales, I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -con I-EXPLORATION -más I-EXPLORATION -de I-EXPLORATION -100 I-EXPLORATION -leucocitos/μl, I-EXPLORATION -siendo I-EXPLORATION -más I-EXPLORATION -del I-EXPLORATION -50% I-EXPLORATION -polimorfonucleares, I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -o I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -que I-EXPLORATION -demuestre I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -microorganismos1. I-EXPLORATION - I-EXPLORATION -Es I-EXPLORATION -difícil I-EXPLORATION -diferenciar I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -peritoneal I-EXPLORATION -con I-EXPLORATION -cultivo I-EXPLORATION -negativo I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -inflamación I-EXPLORATION -peritoneal I-EXPLORATION -no I-EXPLORATION -infecciosa I-EXPLORATION -(peritonitis I-EXPLORATION -estéril). I-EXPLORATION -Un I-EXPLORATION -cultivo I-EXPLORATION -peritoneal I-EXPLORATION -negativo I-EXPLORATION -generalmente I-EXPLORATION -se I-EXPLORATION -debe I-EXPLORATION -a I-EXPLORATION -fallos I-EXPLORATION -técnicos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -procesamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -manejo I-EXPLORATION -resulta I-EXPLORATION -complicado, I-EXPLORATION -dado I-EXPLORATION -que I-EXPLORATION -existen I-EXPLORATION -peritonitis I-EXPLORATION -infecciosas I-EXPLORATION -sin I-EXPLORATION -crecimiento I-EXPLORATION -bacteriano I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cultivo. I-EXPLORATION -Se I-EXPLORATION -aconseja I-EXPLORATION -revisar I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -cultivo I-EXPLORATION -cuando I-EXPLORATION -estos I-EXPLORATION -sean I-EXPLORATION -negativos I-EXPLORATION -en I-EXPLORATION -más I-EXPLORATION -del I-EXPLORATION -20% I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -ocasiones I-EXPLORATION -e I-EXPLORATION -interrogar I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -uso I-EXPLORATION -de I-EXPLORATION -antibióticos I-EXPLORATION -previos I-EXPLORATION -al I-EXPLORATION -paciente2. I-EXPLORATION -Para I-EXPLORATION -lograr I-EXPLORATION -una I-EXPLORATION -rapidez I-EXPLORATION -diagnóstica I-EXPLORATION -en I-EXPLORATION -casos I-EXPLORATION -de I-EXPLORATION -peritonitis I-EXPLORATION -estéril, I-EXPLORATION -las I-EXPLORATION -guías I-EXPLORATION -de I-EXPLORATION -DP I-EXPLORATION -españolas I-EXPLORATION -esquematizan I-EXPLORATION -teniendo I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -o I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tipo I-EXPLORATION -de I-EXPLORATION -células. I-EXPLORATION -Un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -polimorfornucleares I-EXPLORATION -puede I-EXPLORATION -ser I-EXPLORATION -por I-EXPLORATION -inflamación I-EXPLORATION -de I-EXPLORATION -víscera I-EXPLORATION -intraperitoneal I-EXPLORATION -o I-EXPLORATION -yuxtaperitoneal, I-EXPLORATION -medicamentos I-EXPLORATION -o I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -contaminado I-EXPLORATION -por I-EXPLORATION -endotoxinas. I-EXPLORATION -Si I-EXPLORATION -están I-EXPLORATION -aumentados I-EXPLORATION -los I-EXPLORATION -eosinófilos, I-EXPLORATION -se I-EXPLORATION -sospechará I-EXPLORATION -reacción I-EXPLORATION -alérgica I-EXPLORATION -al I-EXPLORATION -material I-EXPLORATION -de I-EXPLORATION -diálisis, I-EXPLORATION -medicamentos, I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -por I-EXPLORATION -sangre I-EXPLORATION -retrógrada I-EXPLORATION -o I-EXPLORATION -tras I-EXPLORATION -peritonitis I-EXPLORATION -por I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -parásitos. I-EXPLORATION -El I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -mononucleares I-EXPLORATION -puede I-EXPLORATION -asociarse I-EXPLORATION -a I-EXPLORATION -icodextrina, I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -micobacterias, I-EXPLORATION -hongos. I-EXPLORATION -Si I-EXPLORATION -además I-EXPLORATION -hay I-EXPLORATION -hematíes, I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -de I-EXPLORATION -considerar: I-EXPLORATION -ovulación, I-EXPLORATION -menstruación I-EXPLORATION -retrógrada, I-EXPLORATION -rotura I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -ovárico, I-EXPLORATION -líquido I-EXPLORATION -hipertónico, I-EXPLORATION -adherencias I-EXPLORATION -peritoneales, I-EXPLORATION -ejercicio I-EXPLORATION -físico I-EXPLORATION -y I-EXPLORATION -trauma I-EXPLORATION -por I-EXPLORATION -catéter. I-EXPLORATION -Con I-EXPLORATION -elevados I-EXPLORATION -mononucleares I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -malignas, I-EXPLORATION -hay I-EXPLORATION -que I-EXPLORATION -pensar I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -o I-EXPLORATION -metástasis I-EXPLORATION -peritoneales. I-EXPLORATION -Por I-EXPLORATION -otra I-EXPLORATION -parte, I-EXPLORATION -en I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -puede I-EXPLORATION -ser I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION -de I-EXPLORATION -fibrina I-EXPLORATION -o I-EXPLORATION -de I-EXPLORATION -triglicéridos3, I-EXPLORATION -4. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -literatura I-EXPLORATION -se I-EXPLORATION -describen I-EXPLORATION -algunos I-EXPLORATION -casos I-EXPLORATION -de I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -peritonitis I-EXPLORATION -en I-EXPLORATION -DP I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -procesos I-EXPLORATION -tumorales, I-EXPLORATION -entre I-EXPLORATION -ellos, I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -renales I-EXPLORATION -recurrente I-EXPLORATION -diagnosticado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -citología I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -peritoneal5. I-EXPLORATION -Otro I-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -peritonitis I-EXPLORATION -estéril I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -antecedente I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -diagnosticado I-EXPLORATION -diez I-EXPLORATION -años I-EXPLORATION -antes. I-EXPLORATION -La I-EXPLORATION -citología I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -permitió I-EXPLORATION -observar I-EXPLORATION -los I-EXPLORATION -linfocitos I-EXPLORATION -atípicos I-EXPLORATION -y, I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -caso, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -invasión I-EXPLORATION -peritoneal, I-EXPLORATION -continuó I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -DP6. I-EXPLORATION - I-EXPLORATION -Como I-EXPLORATION -conclusión I-EXPLORATION -del I-EXPLORATION -caso, I-EXPLORATION -debemos I-EXPLORATION -señalar I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -peritonitis I-EXPLORATION -estériles I-EXPLORATION -no I-EXPLORATION -debemos I-EXPLORATION -olvidar I-EXPLORATION -la I-EXPLORATION -posible I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -neoplásico. I-EXPLORATION - I-EXPLORATION - -Paciente B-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -48 I-DERIVED_FROM/TO -años I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -detectarse I-DERIVED_FROM/TO -ambulatoriamente I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -creatinina I-DERIVED_FROM/TO -sérica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -7, I-DERIVED_FROM/TO -56mg/dl. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destacaba: I-EXPLORATION -tensión I-EXPLORATION -arterial: I-EXPLORATION -163/111mmHg, I-EXPLORATION -peso: I-EXPLORATION -105kg, I-EXPLORATION -talla: I-EXPLORATION -190cm, I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal: I-EXPLORATION -29kg/m2. I-EXPLORATION -Leve I-EXPLORATION -déficit I-EXPLORATION -cognitivo. I-EXPLORATION -Fenotipo I-EXPLORATION -corporal I-EXPLORATION -corpulento. I-EXPLORATION -Facies I-EXPLORATION -con I-EXPLORATION -prognatismo I-EXPLORATION -y I-EXPLORATION -macroglosia. I-EXPLORATION -Labios I-EXPLORATION -gruesos, I-EXPLORATION -arcos I-EXPLORATION -superciliares I-EXPLORATION -prominentes, I-EXPLORATION -voz I-EXPLORATION -grave. I-EXPLORATION -Auscultación I-EXPLORATION -normal. I-EXPLORATION -Fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refería I-EXPLORATION -cambios I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -morfología I-EXPLORATION -corporal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -mostraba I-EXPLORATION -riñones I-EXPLORATION -de I-EXPLORATION -dimensiones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -límite I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -con I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION -bilateral I-EXPLORATION -marcadamente I-EXPLORATION -adelgazado, I-EXPLORATION -prácticamente I-EXPLORATION -inexistente. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -presentaba I-EXPLORATION -parámetros I-EXPLORATION -bioquímicos I-EXPLORATION -propios I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -uremia I-EXPLORATION -con I-EXPLORATION -serologías I-EXPLORATION -víricas I-EXPLORATION -negativas I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -inmunológicas I-EXPLORATION -normales. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -practicaron I-EXPLORATION -determinaciones I-EXPLORATION -hormonales: I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Cortisol: I-EXPLORATION -23mcg/dl I-EXPLORATION -(6-28), I-EXPLORATION -TSH: I-EXPLORATION -1, I-EXPLORATION -01mcUI/ml I-EXPLORATION -(0,27-4,2). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Renina: I-EXPLORATION -29, I-EXPLORATION -7microUI/ml I-EXPLORATION -(2,8-39,9). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Aldosterona: I-EXPLORATION -152, I-EXPLORATION -8pg/ml I-EXPLORATION -(10-160). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -FSH: I-EXPLORATION -12, I-EXPLORATION -4mUI/ml I-EXPLORATION -(1,5-12,4), I-EXPLORATION -LH: I-EXPLORATION -8, I-EXPLORATION -4mUI/ml I-EXPLORATION -(1,7-8,6). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Prolactina: I-EXPLORATION -553mUI/l I-EXPLORATION -(86-324), I-EXPLORATION -testosterona I-EXPLORATION -total: I-EXPLORATION -1, I-EXPLORATION -99ng/ml I-EXPLORATION -(2,5-8,4). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -GH: I-EXPLORATION -4, I-EXPLORATION -24ng/ml I-EXPLORATION -(0-1). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Somatomedina I-EXPLORATION -C I-EXPLORATION -(IGF1): I-EXPLORATION -670ng/ml I-EXPLORATION -(100-358). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -IGF1-BP3: I-EXPLORATION -7, I-EXPLORATION -59micro/ml I-EXPLORATION -(3,3-6,7). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -ACTH: I-EXPLORATION -39pg/ml I-EXPLORATION -(8-46). I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -hipertensión I-TREATMENT -se I-TREATMENT -controló I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -Ante I-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -cuya I-TREATMENT -etiología I-TREATMENT -no I-TREATMENT -se I-TREATMENT -pudo I-TREATMENT -filiar, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -mediante I-TREATMENT -hemodiálisis I-TREATMENT -crónica. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -practicó I-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -sobrecarga I-EXPLORATION -oral I-EXPLORATION -a I-EXPLORATION -glucosa I-EXPLORATION -(TSOG). I-EXPLORATION - I-EXPLORATION -Llegados I-EXPLORATION -a I-EXPLORATION -este I-EXPLORATION -punto, I-EXPLORATION -los I-EXPLORATION -clínicos I-EXPLORATION -sospechábamos, I-EXPLORATION -en I-EXPLORATION -función I-EXPLORATION -del I-EXPLORATION -fenotipo I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -perfil I-EXPLORATION -hormonal I-EXPLORATION -(aumento I-EXPLORATION -de I-EXPLORATION -GH, I-EXPLORATION -IGF-1 I-EXPLORATION -y I-EXPLORATION -IGF1-BP3; I-EXPLORATION -TSOG I-EXPLORATION -sin I-EXPLORATION -supresión I-EXPLORATION -clara I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -GH), I-EXPLORATION -una I-EXPLORATION -acromegalia. I-EXPLORATION -No B-TREATMENT -pudo I-TREATMENT -practicarse I-TREATMENT -una I-TREATMENT -resonancia I-TREATMENT -magnética I-TREATMENT -nuclear I-TREATMENT -(RMN) I-TREATMENT -hipofisaria I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -negativa I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -su I-TREATMENT -familia. I-TREATMENT - I-TREATMENT -Cuatro I-TREATMENT -meses I-TREATMENT -después I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -finalmente I-TREATMENT -la I-TREATMENT -RMN I-TREATMENT -sin I-TREATMENT -contraste I-TREATMENT -paramagnético. I-TREATMENT -La B-EXPLORATION -hipófisis I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tallo I-EXPLORATION -hipofisario I-EXPLORATION -centrado. I-EXPLORATION -Se B-TREATMENT -practicó I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -TSOG, I-TREATMENT -mostrando I-TREATMENT -una I-TREATMENT -GH I-TREATMENT -basal I-TREATMENT -normal, I-TREATMENT -con I-TREATMENT -aumento I-TREATMENT -paradójico I-TREATMENT -a I-TREATMENT -los I-TREATMENT -30 I-TREATMENT -minutos, I-TREATMENT -pero I-TREATMENT -con I-TREATMENT -adecuada I-TREATMENT -supresión I-TREATMENT -a I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -horas. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -esa I-EXPLORATION -fecha I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -IGF-1 I-EXPLORATION -(340 I-EXPLORATION -ng/ml) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -IGF1-BP3 I-EXPLORATION -(6, I-EXPLORATION -3 I-EXPLORATION -µg/ml) I-EXPLORATION -se I-EXPLORATION -habían I-EXPLORATION -normalizado I-EXPLORATION -también. I-EXPLORATION -La I-EXPLORATION -prolactina I-EXPLORATION -continuaba I-EXPLORATION -elevada I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -testosterona I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Actualmente B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -controles I-EVOLUTION -periódicos I-EVOLUTION -en I-EVOLUTION -endocrinología I-EVOLUTION -y I-EVOLUTION -continúa I-EVOLUTION -en I-EVOLUTION -hemodiálisis. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hialinosis I-PRESENT_ILLNESS -segmentaria I-PRESENT_ILLNESS -focal I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -esteroides, I-PRESENT_ILLNESS -ciclofosfamida I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vincristina. I-PRESENT_ILLNESS -Comenzó I-PRESENT_ILLNESS -DP I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -1990. I-PRESENT_ILLNESS -Durante B-TREATMENT -los I-TREATMENT -siguientes I-TREATMENT -11 I-TREATMENT -años I-TREATMENT -recibió I-TREATMENT -3 I-TREATMENT -trasplantes I-TREATMENT -renales, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -tiempo I-TREATMENT -total I-TREATMENT -fuera I-TREATMENT -de I-TREATMENT -diálisis I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -años. I-TREATMENT -Fue I-TREATMENT -paratiroidectomizado I-TREATMENT -por I-TREATMENT -hiperparatiroidismo I-TREATMENT -grave. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -transporte I-EVOLUTION -peritoneal I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -como I-EVOLUTION -medio-alto I-EVOLUTION -con I-EVOLUTION -tendencia I-EVOLUTION -al I-EVOLUTION -alza. I-EVOLUTION -Con B-TREATMENT -el I-TREATMENT -tiempo I-TREATMENT -se I-TREATMENT -redujo I-TREATMENT -la I-TREATMENT -ultrafiltración I-TREATMENT -y I-TREATMENT -aumentaron I-TREATMENT -las I-TREATMENT -necesidades I-TREATMENT -osmóticas I-TREATMENT -de I-TREATMENT -las I-TREATMENT -soluciones. I-TREATMENT -Medimos B-EXPLORATION -CA-125 I-EXPLORATION -en I-EXPLORATION -efluente I-EXPLORATION -en I-EXPLORATION -diferentes I-EXPLORATION -momentos, I-EXPLORATION -encontrándose I-EXPLORATION -un I-EXPLORATION -progresivo I-EXPLORATION -descenso. I-EXPLORATION -Sufrió B-EVOLUTION -12 I-EVOLUTION -peritonitis, I-EVOLUTION -todas I-EVOLUTION -por I-EVOLUTION -gérmenes I-EVOLUTION -Gram I-EVOLUTION -positivos. I-EVOLUTION -Se I-EVOLUTION -insistió I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -ser I-EVOLUTION -transferido I-EVOLUTION -a I-EVOLUTION -HD, I-EVOLUTION -circunstancia I-EVOLUTION -que I-EVOLUTION -trataba I-EVOLUTION -de I-EVOLUTION -evitar; I-EVOLUTION -finalmente I-EVOLUTION -inició I-EVOLUTION -HD I-EVOLUTION -en I-EVOLUTION -2011. I-EVOLUTION - I-EVOLUTION -Seis I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -ingresó I-EVOLUTION -por I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -distensión I-EVOLUTION -abdominal. I-EVOLUTION -Una B-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -evidenció I-EXPLORATION -dilatación I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -duodenal I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -loculado, I-EXPLORATION -y I-EXPLORATION -asas I-EXPLORATION -edematosas. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -del I-EXPLORATION -peritoneo: I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -pequeños I-EXPLORATION -vasos, I-EXPLORATION -celularidad I-EXPLORATION -inflamatoria I-EXPLORATION -y I-EXPLORATION -fibrosis. I-EXPLORATION -Se B-TREATMENT -diagnosticó I-TREATMENT -de I-TREATMENT -EPE, I-TREATMENT -comenzando I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -y I-TREATMENT -tamoxifeno. I-TREATMENT -Tras B-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -la I-EVOLUTION -colección I-EVOLUTION -había I-EVOLUTION -disminuido I-EVOLUTION -de I-EVOLUTION -tamaño, I-EVOLUTION -no I-EVOLUTION -observándose I-EVOLUTION -dilatación I-EVOLUTION -de I-EVOLUTION -asas. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -sufrió I-EVOLUTION -más I-EVOLUTION -complicaciones. I-EVOLUTION -Se B-TREATMENT -encuentra I-TREATMENT -en I-TREATMENT -HD I-TREATMENT -y I-TREATMENT -continúa I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tamoxifeno. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -ansioso-depresivo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia, I-PAST_MEDICAL_HISTORY -remitida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -aumento I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -tamaño I-DERIVED_FROM/TO -tiroideo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -adenopatías I-DERIVED_FROM/TO -laterocervicales. I-DERIVED_FROM/TO -La B-EXPLORATION -punción- I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -fue I-EXPLORATION -sospechosa I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -papilar I-EXPLORATION -de I-EXPLORATION -tiroides I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -remitida I-EXPLORATION -al I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Cirugía I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -tratamiento. I-EXPLORATION -Fue B-TREATMENT -intervenida I-TREATMENT -realizándose I-TREATMENT -tiroidectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -vaciamiento I-TREATMENT -cervical I-TREATMENT -funcional I-TREATMENT -bilateral I-TREATMENT -(niveles I-TREATMENT -II, I-TREATMENT -III, I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -V) I-TREATMENT -y I-TREATMENT -del I-TREATMENT -compartimento I-TREATMENT -central I-TREATMENT -del I-TREATMENT -cuello. I-TREATMENT -Se I-TREATMENT -conservaron I-TREATMENT -ambos I-TREATMENT -nervios I-TREATMENT -recurrentes, I-TREATMENT -se I-TREATMENT -reimplantaron I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -paratiroides I-TREATMENT -inferiores I-TREATMENT -y I-TREATMENT -se I-TREATMENT -ligo I-TREATMENT -el I-TREATMENT -conducto I-TREATMENT -torácico. I-TREATMENT -Como B-EVOLUTION -complicación I-EVOLUTION -postquirúrgica I-EVOLUTION -inmediata I-EVOLUTION -presentó I-EVOLUTION -hipocalcemia I-EVOLUTION -transitoria. I-EVOLUTION -Fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - B-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -papilar I-EXPLORATION -multifocal I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -regiones I-EXPLORATION -cervicales I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -recurrencial. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -diez I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó, I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -brusca, I-EVOLUTION -tumefacción I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -cervical I-EVOLUTION -izquierda I-EVOLUTION -con I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -anterior I-EVOLUTION -y I-EVOLUTION -cervical I-EVOLUTION -derecha. I-EVOLUTION -No I-EVOLUTION -presentaba I-EVOLUTION -signos I-EVOLUTION -inflamatorios. I-EVOLUTION -Fue B-TREATMENT -valorada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -decidiéndose I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -aspirativo I-TREATMENT -de I-TREATMENT -baja I-TREATMENT -presión I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -fístula I-TREATMENT -de I-TREATMENT -conducto I-TREATMENT -torácico. I-TREATMENT -La B-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -lechoso I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -triglicéridos I-EXPLORATION -de I-EXPLORATION -1410 I-EXPLORATION -mg/dl I-EXPLORATION -confirmo I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION -siendo I-EXPLORATION -remitido I-EXPLORATION -a I-EXPLORATION -nuestras I-EXPLORATION -consultas I-EXPLORATION -para I-EXPLORATION -tratamiento I-EXPLORATION -dietético. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -consulta I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -valoración I-EXPLORATION -antropométrica I-EXPLORATION -básica I-EXPLORATION -y I-EXPLORATION -analítica, I-EXPLORATION -objetivándose I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -normonutrida I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -complicaciones I-EXPLORATION -metabólicas I-EXPLORATION -derivadas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fístula. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -prescripción I-TREATMENT -yeducación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -de I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -baja I-TREATMENT -en I-TREATMENT -LCT. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -dieron I-TREATMENT -instrucciones I-TREATMENT -dietéticas I-TREATMENT -escritas I-TREATMENT -(tabla I-TREATMENT -I) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -suplementó I-TREATMENT -con I-TREATMENT -aceite I-TREATMENT -MCT I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -40 I-TREATMENT -cc/día. I-TREATMENT - I-TREATMENT -Entre B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -y I-EXPLORATION -antropometría I-EXPLORATION -pretratamiento I-EXPLORATION -dietético I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -realizadas I-EXPLORATION -dos I-EXPLORATION -semanas I-EXPLORATION -después I-EXPLORATION -no I-EXPLORATION -hubo I-EXPLORATION -diferencias I-EXPLORATION -significativas I-EXPLORATION -sin I-EXPLORATION -objetivarse I-EXPLORATION -complicaciones I-EXPLORATION -metabólicas I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -patolología. I-EXPLORATION - I-EXPLORATION -Antes I-EXPLORATION -de I-EXPLORATION -iniciar I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -dietético I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -drenaje I-EXPLORATION -diario I-EXPLORATION -máximo I-EXPLORATION -de I-EXPLORATION -400 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -linfa. I-EXPLORATION -Al I-EXPLORATION -segundo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -obtenido I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -drenaje I-EXPLORATION -disminuyó I-EXPLORATION -a I-EXPLORATION -100-200 I-EXPLORATION -cc I-EXPLORATION -diario I-EXPLORATION -y I-EXPLORATION -fue I-EXPLORATION -variando I-EXPLORATION -sus I-EXPLORATION -características I-EXPLORATION -macroscópicas I-EXPLORATION -haciéndose I-EXPLORATION -más I-EXPLORATION -claro, I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -más I-EXPLORATION -serohemático I-EXPLORATION -y I-EXPLORATION -menos I-EXPLORATION -quiloso. I-EXPLORATION -Se B-TREATMENT -mantuvo I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -dietético I-TREATMENT -y I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -percutáneo I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -día I-TREATMENT -14 I-TREATMENT -tras I-TREATMENT -lo I-TREATMENT -cual, I-TREATMENT -al I-TREATMENT -observarse I-TREATMENT -mínima I-TREATMENT -salida I-TREATMENT -de I-TREATMENT -fluido I-TREATMENT -y I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -características I-TREATMENT -quilosas I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -el I-TREATMENT -acceso I-TREATMENT -percutáneo. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -dietético I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -4 I-TREATMENT -días I-TREATMENT -más I-TREATMENT -para I-TREATMENT -observar I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -drenaje I-TREATMENT -y B-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -signos I-EVOLUTION -que I-EVOLUTION -sugirieran I-EVOLUTION -recidiva I-EVOLUTION -se I-EVOLUTION -liberalizó I-EVOLUTION -la I-EVOLUTION -dieta, I-EVOLUTION -encontrándose I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -dieta I-EVOLUTION -libre. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -sangrado I-PRESENT_ILLNESS -postmenopáusico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -legrado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -adenocarcinoma I-PRESENT_ILLNESS -velloglandular I-PRESENT_ILLNESS -bien I-PRESENT_ILLNESS -diferenciado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -extensa I-PRESENT_ILLNESS -diferenciación I-PRESENT_ILLNESS -escamosa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -epidermoide. I-PRESENT_ILLNESS -Se B-TREATMENT -intervino I-TREATMENT -quirúrgicamente I-TREATMENT -realizando I-TREATMENT -histerectomía I-TREATMENT -y I-TREATMENT -doble I-TREATMENT -anexectomía, I-TREATMENT -linfadenectomía I-TREATMENT -pélvica I-TREATMENT -y I-TREATMENT -lavado I-TREATMENT -peritoneal. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -miometrial, I-EXPLORATION -la I-EXPLORATION -serosa I-EXPLORATION -uterina, I-EXPLORATION -el I-EXPLORATION -epitelio I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estroma I-EXPLORATION -cervical, I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Trompa I-EXPLORATION -de I-EXPLORATION -Falopio I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -linfáticos I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -uterino I-EXPLORATION -(estadio I-EXPLORATION -IIIa I-EXPLORATION -GIII). I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -tratar I-TREATMENT -con I-TREATMENT -radioquimioterapia I-TREATMENT -concurrente. I-TREATMENT -Se I-TREATMENT -administraron I-TREATMENT -46 I-TREATMENT -Gy I-TREATMENT -con I-TREATMENT -fraccionamiento I-TREATMENT -clásico I-TREATMENT -(5 I-TREATMENT -x I-TREATMENT -200 I-TREATMENT -cGy) I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -cinco I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -Cisplatino I-TREATMENT -(40 I-TREATMENT -mg/semanales). I-TREATMENT -Tras I-TREATMENT -finalizar I-TREATMENT -ambos I-TREATMENT -tratamiento I-TREATMENT -la I-TREATMENT -enferma I-TREATMENT -recibió I-TREATMENT -radioterapia I-TREATMENT -endocavitaria I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -molde I-TREATMENT -de I-TREATMENT -Chassagne I-TREATMENT -con I-TREATMENT -tres I-TREATMENT -fuentes I-TREATMENT -radioactivas I-TREATMENT -de I-TREATMENT -Cesio-137 I-TREATMENT -de I-TREATMENT -baja I-TREATMENT -tasa I-TREATMENT -de I-TREATMENT -dosis. I-TREATMENT -Recibió I-TREATMENT -además I-TREATMENT -tratamiento I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -Tegafur. I-TREATMENT - I-TREATMENT -Tres B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -terminado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -ingresó I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -suboclusión I-EVOLUTION -intestinal I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -manejó I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -conservadora. I-EVOLUTION -Presentó I-EVOLUTION -varios I-EVOLUTION -episodios I-EVOLUTION -similares I-EVOLUTION -con I-EVOLUTION -posterioridad I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -aproximadamente I-EVOLUTION -30 I-EVOLUTION -kg I-EVOLUTION -de I-EVOLUTION -peso. I-EVOLUTION -Fue B-TREATMENT -valorada I-TREATMENT -por I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Nutrición I-TREATMENT -Clínica I-TREATMENT -que I-TREATMENT -recomendó I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -pobre I-TREATMENT -en I-TREATMENT -grasas I-TREATMENT -y I-TREATMENT -residuos I-TREATMENT -y I-TREATMENT -suplementos I-TREATMENT -hipercalóricos I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -sin I-TREATMENT -respuesta. I-TREATMENT -Ingresó B-EVOLUTION -para I-EVOLUTION -rehabilitación I-EVOLUTION -intestinal I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -26 I-EVOLUTION -kg I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -talla I-EVOLUTION -de I-EVOLUTION -148 I-EVOLUTION -cm. I-EVOLUTION -IMC: I-EVOLUTION -11, I-EVOLUTION -9 I-EVOLUTION -kg/m2. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -realizado I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -permitió I-EXPLORATION -descartar I-EXPLORATION -recidiva I-EXPLORATION -tumoral I-EXPLORATION -encontrando I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tránsito I-EXPLORATION -digestivo I-EXPLORATION -superior I-EXPLORATION -una I-EXPLORATION -marcada I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -duodeno I-EXPLORATION -y I-EXPLORATION -porción I-EXPLORATION -proximal I-EXPLORATION -de I-EXPLORATION -yeyuno I-EXPLORATION -que I-EXPLORATION -llega I-EXPLORATION -a I-EXPLORATION -medir I-EXPLORATION -como I-EXPLORATION -diámetro I-EXPLORATION -máximo I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -yeyuno I-EXPLORATION -proximal. I-EXPLORATION -Tránsito I-EXPLORATION -intestinal I-EXPLORATION -muy I-EXPLORATION -prolongado I-EXPLORATION -que I-EXPLORATION -llega I-EXPLORATION -a I-EXPLORATION -demorarse I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -desde I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -administró I-EXPLORATION -el I-EXPLORATION -contraste I-EXPLORATION -hasta I-EXPLORATION -que I-EXPLORATION -alcanzó I-EXPLORATION -ciego I-EXPLORATION -y I-EXPLORATION -colon I-EXPLORATION -ascendente. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -dilatación I-EXPLORATION -masiva I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -que I-EXPLORATION -ocupan I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -abdomen. I-EXPLORATION -Discreto I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -asas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -hidrógeno I-EXPLORATION -espirado I-EXPLORATION -con I-EXPLORATION -lactosa I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -malabsorción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma. I-EXPLORATION -Una I-EXPLORATION -colonoscopia I-EXPLORATION -realizada I-EXPLORATION -en I-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -colitis I-EXPLORATION -distal I-EXPLORATION -que I-EXPLORATION -histológicamente I-EXPLORATION -correspondían I-EXPLORATION -a I-EXPLORATION -colitis I-EXPLORATION -crónica I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION -postradioterapia. I-EXPLORATION -Se B-TREATMENT -colocó I-TREATMENT -una I-TREATMENT -sonda I-TREATMENT -nasogástrica I-TREATMENT -para I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -continua I-TREATMENT -con I-TREATMENT -incapacidad I-TREATMENT -para I-TREATMENT -progresar I-TREATMENT -por I-TREATMENT -encima I-TREATMENT -de I-TREATMENT -30 I-TREATMENT -ml/hora I-TREATMENT -de I-TREATMENT -una I-TREATMENT -fórmula I-TREATMENT -polimérica I-TREATMENT -normocalórica, I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -la I-TREATMENT -adición I-TREATMENT -de I-TREATMENT -procinéticos. I-TREATMENT -Por I-TREATMENT -este I-TREATMENT -motivo I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -venoso I-TREATMENT -central I-TREATMENT -tunelizado I-TREATMENT -y I-TREATMENT -se I-TREATMENT -incluyó I-TREATMENT -en I-TREATMENT -el I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -NPD I-TREATMENT -de I-TREATMENT -nuestro I-TREATMENT -centro. I-TREATMENT -Su I-TREATMENT -NP I-TREATMENT -inicial I-TREATMENT -consistía I-TREATMENT -en I-TREATMENT -1.250 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -volumen I-TREATMENT -y I-TREATMENT -1.440 I-TREATMENT -kcal, I-TREATMENT -infundida I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -horas, I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -a I-TREATMENT -la I-TREATMENT -semana. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -inicial I-EVOLUTION -fue I-EVOLUTION -buena I-EVOLUTION -con I-EVOLUTION -progresiva I-EVOLUTION -recuperación I-EVOLUTION -del I-EVOLUTION -peso I-EVOLUTION -y I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -NPD. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -primer I-EVOLUTION -ingreso I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -bacteriemia I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -catéter. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -siguientes I-EVOLUTION -14 I-EVOLUTION -meses I-EVOLUTION -fue I-EVOLUTION -ingresada I-EVOLUTION -en I-EVOLUTION -2 I-EVOLUTION -ocasiones I-EVOLUTION -por I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -deshidratación I-EVOLUTION -con I-EVOLUTION -afectación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -(insuficiencia I-EVOLUTION -renal I-EVOLUTION -prerrenal) I-EVOLUTION -secundarias I-EVOLUTION -a I-EVOLUTION -pérdidas I-EVOLUTION -aumentadas I-EVOLUTION -por I-EVOLUTION -vómitos I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -9 I-EVOLUTION -por I-EVOLUTION -infecciones I-EVOLUTION -por I-EVOLUTION -diversos I-EVOLUTION -gérmenes I-EVOLUTION -Gram I-EVOLUTION -positivos, I-EVOLUTION -Gram I-EVOLUTION -negativos I-EVOLUTION -y I-EVOLUTION -hongos I-EVOLUTION -que I-EVOLUTION -obligaron I-EVOLUTION -a I-EVOLUTION -recambiar I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -ocasiones. I-EVOLUTION -En I-EVOLUTION -todos I-EVOLUTION -los I-EVOLUTION -ingresos I-EVOLUTION -se I-EVOLUTION -hizo I-EVOLUTION -revisión I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pautas I-EVOLUTION -de I-EVOLUTION -manejo I-EVOLUTION -del I-EVOLUTION -catéter I-EVOLUTION -venoso I-EVOLUTION -central I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -NPD I-EVOLUTION -sin I-EVOLUTION -poder I-EVOLUTION -constatar I-EVOLUTION -que I-EVOLUTION -hubiera I-EVOLUTION -quebrantamiento I-EVOLUTION -del I-EVOLUTION -protocolo. I-EVOLUTION -A B-TREATMENT -la I-TREATMENT -vista I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -evolución I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -remisión I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -tumoral I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -plantear I-TREATMENT -una I-TREATMENT -solución I-TREATMENT -quirúrgica I-TREATMENT -alternativa. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -tránsito I-EXPLORATION -digestivo I-EXPLORATION -con I-EXPLORATION -hallazgos I-EXPLORATION -similares I-EXPLORATION -al I-EXPLORATION -realizado I-EXPLORATION -dos I-EXPLORATION -años I-EXPLORATION -antes I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -calibre I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -más I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -sigma, I-EXPLORATION -aunque I-EXPLORATION -permite I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -de I-EXPLORATION -papilla I-EXPLORATION -sin I-EXPLORATION -ninguna I-EXPLORATION -dificultad: I-EXPLORATION -no I-EXPLORATION -hay I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -estenosis. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -laparotomía I-EXPLORATION -media I-EXPLORATION -supra I-EXPLORATION -e I-EXPLORATION -infraumbilical I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -duodeno I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -delgado I-EXPLORATION -hasta I-EXPLORATION -llegar I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -grupo I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -yeyunoileales I-EXPLORATION -adheridas I-EXPLORATION -entre I-EXPLORATION -sí I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -pelvis I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -colon I-EXPLORATION -de I-EXPLORATION -calibre I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -liberar I-TREATMENT -las I-TREATMENT -asas I-TREATMENT -afectadas I-TREATMENT -y I-TREATMENT -resecar I-TREATMENT -20 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -yeyunoíleon I-TREATMENT -incluyendo I-TREATMENT -el I-TREATMENT -segmento I-TREATMENT -patológico, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -anastomosis I-TREATMENT -laterolateral. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza: I-EXPLORATION -"intestino I-EXPLORATION -con I-EXPLORATION -atrofia I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -vellosidades I-EXPLORATION -y I-EXPLORATION -fibrosis I-EXPLORATION -subserosa I-EXPLORATION -con I-EXPLORATION -adherencias, I-EXPLORATION -propio I-EXPLORATION -de I-EXPLORATION -cambios I-EXPLORATION -postradioterapia". I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -tuvo I-EVOLUTION -una I-EVOLUTION -excelente I-EVOLUTION -recuperación, I-EVOLUTION -con I-EVOLUTION -tolerancia I-EVOLUTION -alimentaria I-EVOLUTION -y I-EVOLUTION -tránsito I-EVOLUTION -intestinal I-EVOLUTION -normal. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -lleva I-EVOLUTION -una I-EVOLUTION -vida I-EVOLUTION -normal, I-EVOLUTION -es I-EVOLUTION -capaz I-EVOLUTION -de I-EVOLUTION -tolerar I-EVOLUTION -una I-EVOLUTION -dieta I-EVOLUTION -variada I-EVOLUTION -con I-EVOLUTION -restricción I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lactosa I-EVOLUTION -y I-EVOLUTION -había I-EVOLUTION -recuperado I-EVOLUTION -el I-EVOLUTION -peso I-EVOLUTION -anterior I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -radioterapia. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -42 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -primer B-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -sanos I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consanguíneos, I-PAST_MEDICAL_HISTORY -diagnosticado B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -prenatal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ureterohidronefrosis I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dilatación I-PRESENT_ILLNESS -gástrica. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -período I-EXPLORATION -neonatal I-EXPLORATION -precoz I-EXPLORATION -únicamente I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención, I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -globuloso I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -deposición I-EXPLORATION -meconial I-EXPLORATION -al I-EXPLORATION -4º I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -vida, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -absoluta I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -deposiciones. I-EXPLORATION -Un I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -evidenció I-EXPLORATION -microcolon I-EXPLORATION -y I-EXPLORATION -malrotación I-EXPLORATION -intestinal, I-EXPLORATION -corrigiéndose I-EXPLORATION -éstaúltima I-EXPLORATION -quirúrgicamente. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -rectal I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -enolasa I-EXPLORATION -neuronal I-EXPLORATION -y I-EXPLORATION -descartó I-EXPLORATION -aganglionismo. I-EXPLORATION -Se B-TREATMENT -mantuvo I-TREATMENT -en I-TREATMENT -todo I-TREATMENT -momento I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -parenteral, I-TREATMENT -con I-TREATMENT -intentos I-TREATMENT -de I-TREATMENT -ingesta I-TREATMENT -oral I-TREATMENT -que I-TREATMENT -toleró I-TREATMENT -finalmente I-TREATMENT -a I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -con I-TREATMENT -un I-TREATMENT -volumen I-TREATMENT -máximo I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -ml/h. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -siempre I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -diuresis I-EVOLUTION -adecuada, I-EVOLUTION -aunque I-EVOLUTION -mantenía I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -en I-EVOLUTION -límites I-EVOLUTION -altos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad. I-EVOLUTION -Posteriormente B-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -pieloureterostomía I-TREATMENT -bilateral I-TREATMENT -mejorando I-TREATMENT -su I-TREATMENT -función I-TREATMENT -renal. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -sepsis I-EVOLUTION -nosocomial I-EVOLUTION -relacionada I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -por I-EVOLUTION -Staphylococcus I-EVOLUTION -epidermidis, I-EVOLUTION -tratada B-TREATMENT -con I-TREATMENT -teicoplanina I-TREATMENT -y I-TREATMENT -cefotaxima I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta9. I-EVOLUTION -Estos I-EVOLUTION -datos I-EVOLUTION -amplían I-EVOLUTION -lo I-EVOLUTION -ya I-EVOLUTION -publicado I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -año I-EVOLUTION -2004 I-EVOLUTION -por I-EVOLUTION -parte I-EVOLUTION -del I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Neonatología I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Cirugía I-EVOLUTION -Pediátrica I-EVOLUTION -del I-EVOLUTION -Hospital I-EVOLUTION -Universitario I-EVOLUTION -Central I-EVOLUTION -de I-EVOLUTION -Asturias10. I-EVOLUTION - I-EVOLUTION -Actualmente I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -ureterostomía I-EVOLUTION -cutánea I-EVOLUTION -bilateral, I-EVOLUTION -peristaltismo I-EVOLUTION -y I-EVOLUTION -hábito I-EVOLUTION -intestinal I-EVOLUTION -conservados, I-EVOLUTION -relativamente I-EVOLUTION -bien I-EVOLUTION -nutrido I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -aceptable I-EVOLUTION -y I-EVOLUTION -progresivo I-EVOLUTION -desarrollo I-EVOLUTION -ponderal: I-EVOLUTION -percentil I-EVOLUTION -10 I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -y I-EVOLUTION -talla, I-EVOLUTION -índice I-EVOLUTION -de I-EVOLUTION -Waterlow I-EVOLUTION -del I-EVOLUTION -96%. I-EVOLUTION -Recibe B-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -(NP) I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -tercer I-TREATMENT -día I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -y I-TREATMENT -actualmente I-TREATMENT -en I-TREATMENT -régimen I-TREATMENT -ambulatorio, I-TREATMENT -suplementada I-TREATMENT -con I-TREATMENT -aportes I-TREATMENT -orales I-TREATMENT -a I-TREATMENT -débito I-TREATMENT -continuo, I-TREATMENT -desde I-TREATMENT -que I-TREATMENT -inició I-TREATMENT -tolerancia I-TREATMENT -a I-TREATMENT -los I-TREATMENT -mismos. I-TREATMENT -La I-TREATMENT -composición I-TREATMENT -de I-TREATMENT -la I-TREATMENT -NP I-TREATMENT -por I-TREATMENT -kg I-TREATMENT -de I-TREATMENT -peso I-TREATMENT -y I-TREATMENT -día I-TREATMENT -es I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -8 I-TREATMENT -g I-TREATMENT -de I-TREATMENT -aminoácidos, I-TREATMENT -8, I-TREATMENT -6 I-TREATMENT -g I-TREATMENT -de I-TREATMENT -glucosa, I-TREATMENT -1, I-TREATMENT -4 I-TREATMENT -g I-TREATMENT -lípidos, I-TREATMENT -Na I-TREATMENT -3, I-TREATMENT -7 I-TREATMENT -mEq, I-TREATMENT -k I-TREATMENT -1, I-TREATMENT -4 I-TREATMENT -mEq, I-TREATMENT -Ca I-TREATMENT -0, I-TREATMENT -7 I-TREATMENT -mEq, I-TREATMENT -Cl I-TREATMENT -4, I-TREATMENT -4 I-TREATMENT -mEq, I-TREATMENT -P I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -mEq, I-TREATMENT -Mg I-TREATMENT -0, I-TREATMENT -3 I-TREATMENT -mEq, I-TREATMENT -contiene I-TREATMENT -55, I-TREATMENT -7 I-TREATMENT -kcal I-TREATMENT -totales I-TREATMENT -y I-TREATMENT -un I-TREATMENT -volumen I-TREATMENT -total I-TREATMENT -de I-TREATMENT -1.295 I-TREATMENT -ml. I-TREATMENT -La I-TREATMENT -NP I-TREATMENT -es I-TREATMENT -perfundida I-TREATMENT -durante I-TREATMENT -17 I-TREATMENT -horas, I-TREATMENT -en I-TREATMENT -pases I-TREATMENT -de I-TREATMENT -40 I-TREATMENT -ml/hora, I-TREATMENT -con I-TREATMENT -ascenso I-TREATMENT -y I-TREATMENT -descenso I-TREATMENT -en I-TREATMENT -una I-TREATMENT -hora, I-TREATMENT -siendo I-TREATMENT -el I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -reposo I-TREATMENT -sin I-TREATMENT -NPD I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -horas. I-TREATMENT -Recibe I-TREATMENT -tratamiento I-TREATMENT -profiláctico I-TREATMENT -frente I-TREATMENT -al I-TREATMENT -sobrecrecimiento I-TREATMENT -bacteriano I-TREATMENT -intestinal I-TREATMENT -con I-TREATMENT -metronidazol, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -trimetropim, I-TREATMENT -fenobarbital, I-TREATMENT -hierro, I-TREATMENT -ácido I-TREATMENT -ursodesoxicólico, I-TREATMENT -ranitidina, I-TREATMENT -eritromicina, I-TREATMENT -vitamina I-TREATMENT -E, I-TREATMENT -vitamina I-TREATMENT -D3 I-TREATMENT -y I-TREATMENT -darbepoetina. I-TREATMENT -Mensualmente, B-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -control I-EXPLORATION -clínico, I-EXPLORATION -analítico I-EXPLORATION -(bioquímica I-EXPLORATION -completa, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -reactantes I-EXPLORATION -de I-EXPLORATION -fase I-EXPLORATION -aguda) I-EXPLORATION -y I-EXPLORATION -control I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -ostomías I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -catéter I-EXPLORATION -Hickman. I-EXPLORATION -Ha B-EVOLUTION -presentado I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -obstrucción I-EVOLUTION -abdominal, I-EVOLUTION -uno B-TREATMENT -de I-TREATMENT -los I-TREATMENT -cuales, I-TREATMENT -secundario I-TREATMENT -a I-TREATMENT -bridas I-TREATMENT -intestinales, I-TREATMENT -requirió I-TREATMENT -intervención I-TREATMENT -quirúrgica. I-TREATMENT -Las B-EVOLUTION -complicaciones I-EVOLUTION -relacionadas I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -NP I-EVOLUTION -han I-EVOLUTION -sido I-EVOLUTION -dos: I-EVOLUTION -citolisis I-EVOLUTION -hepática I-EVOLUTION -transitoria, I-EVOLUTION -que B-TREATMENT -remitió I-TREATMENT -tras I-TREATMENT -normalizar I-TREATMENT -la I-TREATMENT -relación I-TREATMENT -de I-TREATMENT -calorías I-TREATMENT -procedentes I-TREATMENT -de I-TREATMENT -hidratos I-TREATMENT -de I-TREATMENT -carbono I-TREATMENT -frente I-TREATMENT -a I-TREATMENT -grasas I-TREATMENT -(60/40) I-TREATMENT -(durante I-TREATMENT -este I-TREATMENT -período I-TREATMENT -tenía I-TREATMENT -niveles I-TREATMENT -elevados I-TREATMENT -de I-TREATMENT -GOT, I-TREATMENT -GPT, I-TREATMENT -fosfatasa I-TREATMENT -alcalina I-TREATMENT -y I-TREATMENT -bilirrubina, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -normalizaron) I-TREATMENT -y B-EVOLUTION -una I-EVOLUTION -sepsis I-EVOLUTION -nosocomial I-EVOLUTION -relacionada I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -por I-EVOLUTION -Staphylococcus I-EVOLUTION -epidermidis, I-EVOLUTION -que B-TREATMENT -respondió I-TREATMENT -adecuadamente I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -antibiótico. I-TREATMENT - I-TREATMENT - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -86 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -enero I-PRESENT_ILLNESS -2008 I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hipoglucemia I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -antidiabéticos I-PRESENT_ILLNESS -orales, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -demencia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -ingesta, I-PRESENT_ILLNESS -se B-TREATMENT -decide I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -sonda I-TREATMENT -nasogástrica I-TREATMENT -(SNG) I-TREATMENT -para I-TREATMENT -alimentación I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -enteral, I-TREATMENT -tras I-TREATMENT -presentar I-TREATMENT -varios I-TREATMENT -episodios I-TREATMENT -de I-TREATMENT -arrancamiento I-TREATMENT -de I-TREATMENT -sonda, I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -gastrostomía I-TREATMENT -radiológica I-TREATMENT -percutánea I-TREATMENT -(GRP). I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -arrancamiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sonda I-EVOLUTION -de I-EVOLUTION -gastrostomía, I-EVOLUTION -ante B-TREATMENT -la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -sondas I-TREATMENT -de I-TREATMENT -recambio, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -sonda I-TREATMENT -Foley I-TREATMENT -de I-TREATMENT -14 I-TREATMENT -french, I-TREATMENT -desde B-EVOLUTION -entonces I-EVOLUTION -son I-EVOLUTION -múltiples I-EVOLUTION -las I-EVOLUTION -visitas I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -urgencias I-EVOLUTION -con I-EVOLUTION -problemas I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -sonda. I-EVOLUTION -Es I-EVOLUTION -ingresado I-EVOLUTION -por I-EVOLUTION -vómitos I-EVOLUTION -e I-EVOLUTION -intolerancia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -nutrición I-EVOLUTION -enteral. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -abundante I-EVOLUTION -residuo I-EVOLUTION -bilioso I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -sonda I-EVOLUTION -Foley. I-EVOLUTION -Se B-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -radiológico I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sonda, I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -mala I-EXPLORATION -tolerancia I-EXPLORATION -enteral I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -alteraciones I-EXPLORATION -radiológicas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -intestinal, I-EXPLORATION -observándose I-EXPLORATION -como I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -ver I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -1 I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -directo I-EXPLORATION -del I-EXPLORATION -contraste I-EXPLORATION -directamente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -intestinal. I-EXPLORATION -Se B-TREATMENT -extrajo I-TREATMENT -la I-TREATMENT -sonda I-TREATMENT -Foley I-TREATMENT -por I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -cirugía I-TREATMENT -sin I-TREATMENT -presentar I-TREATMENT -complicaciones I-TREATMENT -y I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -sonda I-TREATMENT -de I-TREATMENT -gastrostomía I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -radiología I-TREATMENT -intervencionista, I-TREATMENT -siendo B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -en I-TREATMENT -bolos. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -81 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Nutrición I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -Medicina I-DERIVED_FROM/TO -Interna I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hipoproteinemia. I-DERIVED_FROM/TO -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacan I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -arritmia I-PAST_MEDICAL_HISTORY -cardíaca I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -ventricular I-PAST_MEDICAL_HISTORY -adecuada. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -moderada, I-EXPLORATION -insuficiencia I-EXPLORATION -aórtica I-EXPLORATION -moderada I-EXPLORATION -por I-EXPLORATION -anuloectasia I-EXPLORATION -valvular I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -auricular I-EXPLORATION -sin I-EXPLORATION -hipertensión I-EXPLORATION -pulmonar. I-EXPLORATION -También B-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Paget I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -hueso, I-PAST_MEDICAL_HISTORY -actualmente I-PAST_MEDICAL_HISTORY -inactiva. I-PAST_MEDICAL_HISTORY -Monorreno I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hipoplasia I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -contralateral. I-PAST_MEDICAL_HISTORY -Intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -gástrico I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -realizándose I-PAST_MEDICAL_HISTORY -gastrectomía I-PAST_MEDICAL_HISTORY -subtotal I-PAST_MEDICAL_HISTORY -Billroth I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -I I-PAST_MEDICAL_HISTORY -(última I-PAST_MEDICAL_HISTORY -endoscopia I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -objetiva I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -gastritis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -atrófica I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -muñón I-PAST_MEDICAL_HISTORY -gástrico). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -revisión I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Nefrología I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -patología I-PAST_MEDICAL_HISTORY -renal, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -proteinuria I-PAST_MEDICAL_HISTORY -significativa. I-PAST_MEDICAL_HISTORY -Perfil I-PAST_MEDICAL_HISTORY -hepático I-PAST_MEDICAL_HISTORY -correcto. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -buen I-PRESENT_ILLNESS -apetito I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -adecuada I-PRESENT_ILLNESS -ingesta, I-PRESENT_ILLNESS -realizando I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -dieta I-PRESENT_ILLNESS -equilibrada. I-PRESENT_ILLNESS -Hábito I-PRESENT_ILLNESS -deposicional I-PRESENT_ILLNESS -conservado. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -edemas I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -e I-EXPLORATION -IMC I-EXPLORATION -contaminado I-EXPLORATION -de I-EXPLORATION -21, I-EXPLORATION -7 I-EXPLORATION -kg/m2. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica, I-EXPLORATION -hipoalbuminemia I-EXPLORATION -de I-EXPLORATION -2.002 I-EXPLORATION -mg/dl. I-EXPLORATION -Se I-EXPLORATION -inicia I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -nutrición I-EXPLORATION -enteral I-EXPLORATION -domiciliaria I-EXPLORATION -hiperproteica. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -control, I-EXPLORATION -la I-EXPLORATION -albúmina I-EXPLORATION -ha I-EXPLORATION -disminuido I-EXPLORATION -a I-EXPLORATION -1.930 I-EXPLORATION -mg/dl I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -piensa I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -malabsortiva I-EXPLORATION -pese I-EXPLORATION -a I-EXPLORATION -no I-EXPLORATION -referir I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -diarrea. I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -D-xilosa I-EXPLORATION -y I-EXPLORATION -Van I-EXPLORATION -de I-EXPLORATION -Kammer, I-EXPLORATION -siendo I-EXPLORATION -ambos I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -descarta I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -celiaquía I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -gastroduodenal I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -grasa I-EXPLORATION -subcutánea I-EXPLORATION -no I-EXPLORATION -refleja I-EXPLORATION -amiloidosis. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -pierde I-EXPLORATION -proteínas, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -aclaramiento I-EXPLORATION -de I-EXPLORATION -A1AT I-EXPLORATION -en I-EXPLORATION -heces I-EXPLORATION -con I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -218 I-EXPLORATION -ml/día I-EXPLORATION -(> I-EXPLORATION -24ml/día) I-EXPLORATION -[A1AT I-EXPLORATION -en I-EXPLORATION -sangre: I-EXPLORATION -156 I-EXPLORATION -mg/dL; I-EXPLORATION -A1AT I-EXPLORATION -en I-EXPLORATION -heces: I-EXPLORATION -1, I-EXPLORATION -53 I-EXPLORATION -mg/g; I-EXPLORATION -peso I-EXPLORATION -heces I-EXPLORATION -en I-EXPLORATION -24 I-EXPLORATION -h: I-EXPLORATION -222, I-EXPLORATION -57 I-EXPLORATION -g] I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -patología. I-EXPLORATION -Pese I-EXPLORATION -a I-EXPLORATION -no I-EXPLORATION -observar I-EXPLORATION -otra I-EXPLORATION -causa I-EXPLORATION -subyacente, I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -posible I-EXPLORATION -asegurar I-EXPLORATION -que I-EXPLORATION -su I-EXPLORATION -alteración I-EXPLORATION -cardiológica I-EXPLORATION -sea I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -PLE. I-EXPLORATION -En B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -domiciliaria, I-TREATMENT -mantiene B-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -albúmina I-EVOLUTION -estables. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -mayo I-EXPLORATION -de I-EXPLORATION -2012 I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -27 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -probable I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -primera I-EXPLORATION -costilla. I-EXPLORATION -Fue I-EXPLORATION -diagnosticada I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -Pancoast I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -estadiaje I-EXPLORATION -inicial I-EXPLORATION -T4N0M0. I-EXPLORATION -En B-TREATMENT -julio I-TREATMENT -de I-TREATMENT -2012 I-TREATMENT -recibió I-TREATMENT -quimioterapia I-TREATMENT -y I-TREATMENT -radioterapia I-TREATMENT -concomitante. I-TREATMENT -Presentó B-EVOLUTION -una I-EVOLUTION -respuesta I-EVOLUTION -completa I-EVOLUTION -y, B-TREATMENT -en I-TREATMENT -octubre I-TREATMENT -de I-TREATMENT -2012, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -lobectomía I-TREATMENT -superior I-TREATMENT -derecha I-TREATMENT -videotoracoscópica I-TREATMENT -y I-TREATMENT -linfadenectomía. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -fue I-EVOLUTION -tórpido, I-EVOLUTION -con I-EVOLUTION -shock I-EVOLUTION -séptico I-EVOLUTION -de I-EVOLUTION -origen I-EVOLUTION -respiratorio, I-EVOLUTION -insuficiencia I-EVOLUTION -cardiaca, I-EVOLUTION -fracaso I-EVOLUTION -renal I-EVOLUTION -agudo I-EVOLUTION -y B-TREATMENT -requirió I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -UVI I-TREATMENT -por I-TREATMENT -insuficiencia I-TREATMENT -respiratoria, I-TREATMENT -precisando I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -total I-TREATMENT -(NPT). I-TREATMENT -Allí B-EVOLUTION -permaneció I-EVOLUTION -ingresada I-EVOLUTION -2 I-EVOLUTION -meses, I-EVOLUTION -hasta I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -trasladada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -planta, I-EVOLUTION -donde I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -abdomen I-EVOLUTION -agudo, I-EVOLUTION -practicándose I-EVOLUTION -una I-EVOLUTION -laparotomía I-EVOLUTION -exploradora. I-EVOLUTION -Tras B-TREATMENT -observarse I-TREATMENT -una I-TREATMENT -ileítis I-TREATMENT -con I-TREATMENT -componente I-TREATMENT -infeccioso I-TREATMENT -y I-TREATMENT -necrótico I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -asas I-TREATMENT -isquémicas I-TREATMENT -y I-TREATMENT -abundante I-TREATMENT -líquido I-TREATMENT -libre I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -hemático I-TREATMENT -antiguo I-TREATMENT -y I-TREATMENT -fecaloideo, I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -60 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -íleon I-TREATMENT -terminal I-TREATMENT -hasta I-TREATMENT -válvula I-TREATMENT -cecal I-TREATMENT -y I-TREATMENT -se I-TREATMENT -dejó I-TREATMENT -ileostomía I-TREATMENT -terminal I-TREATMENT -en I-TREATMENT -fosa I-TREATMENT -ilíaca I-TREATMENT -derecha. I-TREATMENT -Los B-EXPLORATION -cultivos I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -estafilococos I-EXPLORATION -y I-EXPLORATION -bacilos I-EXPLORATION -gram I-EXPLORATION -positivos, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -intravenoso I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -piperacilina-tazobactam I-TREATMENT -4 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -14 I-TREATMENT -días. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -dieta I-TREATMENT -oral, I-TREATMENT -suplementos I-TREATMENT -hiperproteicos I-TREATMENT -de I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -y I-TREATMENT -complejo I-TREATMENT -polivitamínico I-TREATMENT -con I-TREATMENT -minerales. I-TREATMENT - I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -acudir I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION -por I-EVOLUTION -disnea, I-EVOLUTION -fiebre, I-EVOLUTION -náuseas, I-EVOLUTION -vómitos I-EVOLUTION -alimentarios, I-EVOLUTION -febrícula, I-EVOLUTION -astenia, I-EVOLUTION -hiporexia I-EVOLUTION -y I-EVOLUTION -decaimiento I-EVOLUTION -importantes, I-EVOLUTION -acompañados I-EVOLUTION -de I-EVOLUTION -débito I-EVOLUTION -elevado I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -ileostomia I-EVOLUTION -(1.500-2.000 I-EVOLUTION -mL/día). I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TC, I-EXPLORATION -observándose I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -postquirúrgica I-EXPLORATION -abundante I-EXPLORATION -en I-EXPLORATION -hemitórax I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -probable I-EXPLORATION -fístula I-EXPLORATION -broncopleural, I-EXPLORATION -ingresando I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Cirugía I-EXPLORATION -Torácica. I-EXPLORATION -Se B-TREATMENT -sospechó I-TREATMENT -empiema I-TREATMENT -y I-TREATMENT -se I-TREATMENT -colocaron I-TREATMENT -dos I-TREATMENT -drenajes I-TREATMENT -"pigtail". I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -antibioterapia I-TREATMENT -con I-TREATMENT -piperacilina-tazobactam I-TREATMENT -4 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -catéter I-TREATMENT -central I-TREATMENT -de I-TREATMENT -inserción I-TREATMENT -periférica I-TREATMENT -(PICC) I-TREATMENT -en I-TREATMENT -miembro I-TREATMENT -superior I-TREATMENT -izquierdo. I-TREATMENT -No I-TREATMENT -era I-TREATMENT -posible I-TREATMENT -otro I-TREATMENT -acceso I-TREATMENT -central, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -trombosis I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -yugular I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -su I-TREATMENT -larga I-TREATMENT -estancia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -UVI. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -general I-EXPLORATION -destacaba I-EXPLORATION -hipocalcemia I-EXPLORATION -(pese I-EXPLORATION -a I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -Natecal® I-EXPLORATION -2 I-EXPLORATION -comprimidos I-EXPLORATION -al I-EXPLORATION -día), I-EXPLORATION -hipopotasemia I-EXPLORATION -e I-EXPLORATION -hipomagnesemia I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -previamente. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -intravenoso I-TREATMENT -con I-TREATMENT -gluconato I-TREATMENT -cálcico I-TREATMENT -1 I-TREATMENT -ampolla I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mL I-TREATMENT -al I-TREATMENT -10% I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas, I-TREATMENT -sulfato I-TREATMENT -de I-TREATMENT -magnesio I-TREATMENT -2 I-TREATMENT -gramos I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -suplementos I-TREATMENT -orales I-TREATMENT -de I-TREATMENT -potasio I-TREATMENT -(1 I-TREATMENT -Boi-K® I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas), I-TREATMENT -calcio I-TREATMENT -(Natecal® I-TREATMENT -2 I-TREATMENT -comprimidos I-TREATMENT -al I-TREATMENT -día) I-TREATMENT -y I-TREATMENT -magnesio I-TREATMENT -(2 I-TREATMENT -comprimidos I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas), I-TREATMENT -solicitándose I-TREATMENT -consulta I-TREATMENT -al I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Nutrición. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -continuaba I-EVOLUTION -con I-EVOLUTION -diarrea I-EVOLUTION -líquida I-EVOLUTION -abundante I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -ileostomía I-EVOLUTION -(más I-EVOLUTION -de I-EVOLUTION -1500 I-EVOLUTION -mL/día), I-EVOLUTION -refería I-EVOLUTION -anorexia, I-EVOLUTION -astenia, I-EVOLUTION -decaimiento I-EVOLUTION -y I-EVOLUTION -calambres. I-EVOLUTION -Pese I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -suplementacion I-EVOLUTION -oral, I-EVOLUTION -continuaba I-EVOLUTION -con I-EVOLUTION -niveles I-EVOLUTION -indectables I-EVOLUTION -de I-EVOLUTION -magnesio I-EVOLUTION -(< I-EVOLUTION -0, I-EVOLUTION -6 I-EVOLUTION -mg/dL). I-EVOLUTION -Dada B-TREATMENT -la I-TREATMENT -baja I-TREATMENT -ingesta I-TREATMENT -y I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -tolerancia I-TREATMENT -oral I-TREATMENT -a I-TREATMENT -los I-TREATMENT -suplementos I-TREATMENT -de I-TREATMENT -magnesio, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -central I-TREATMENT -por I-TREATMENT -el I-TREATMENT -PICC. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -normalización I-TREATMENT -hidroelectrolítica I-TREATMENT -y I-TREATMENT -un I-TREATMENT -correcto I-TREATMENT -aporte I-TREATMENT -nutricional, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT -para I-TREATMENT -el I-TREATMENT -cierre I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -broncopleural. I-TREATMENT -Una B-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -tomaba I-EVOLUTION -suplementos I-EVOLUTION -nutricionales I-EVOLUTION -y I-EVOLUTION -dieta I-EVOLUTION -por I-EVOLUTION -vía I-EVOLUTION -oral, I-EVOLUTION -mejorando I-EVOLUTION -los I-EVOLUTION -calambres I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -anímico, I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antidepresivo. I-EVOLUTION -La I-EVOLUTION -hipomagnesemia I-EVOLUTION -aislada I-EVOLUTION -tardó I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -recuperarse, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -suplementos I-TREATMENT -nutricionales I-TREATMENT -orales I-TREATMENT -y I-TREATMENT -magnesio I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -comprimido I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas. I-TREATMENT -Al I-TREATMENT -no I-TREATMENT -normalizarse I-TREATMENT -completamente I-TREATMENT -las I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -magnesio I-TREATMENT -y I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -buena I-TREATMENT -tolerancia, I-TREATMENT -se I-TREATMENT -aumentó I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -a I-TREATMENT -2 I-TREATMENT -comprimidos I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas, I-TREATMENT -consiguiendo B-EVOLUTION -remontar I-EVOLUTION -los I-EVOLUTION -niveles I-EVOLUTION -hasta I-EVOLUTION -límites I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad. I-EVOLUTION -Quedaron I-EVOLUTION -descartadas I-EVOLUTION -las I-EVOLUTION -pérdidas I-EVOLUTION -urinarias, I-EVOLUTION -con I-EVOLUTION -unos I-EVOLUTION -niveles I-EVOLUTION -magnesio I-EVOLUTION -en I-EVOLUTION -orina I-EVOLUTION -indetectables I-EVOLUTION -(< I-EVOLUTION -1, I-EVOLUTION -81 I-EVOLUTION -mg/dL), I-EVOLUTION -confirmando I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -malabsorción I-EVOLUTION -intestinal. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Enfermedad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Huntington, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -deterioro I-PRESENT_ILLNESS -cognitivo I-PRESENT_ILLNESS -severo, I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -neurogénica, I-PRESENT_ILLNESS -broncoaspiraciones I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desnutrición, I-PRESENT_ILLNESS -motivo B-TREATMENT -por I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -GEP I-TREATMENT -para I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -domiciliaria. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -procedimiento, I-TREATMENT -por I-TREATMENT -imposibilidad I-TREATMENT -de I-TREATMENT -obtener I-TREATMENT -un I-TREATMENT -punto I-TREATMENT -de I-TREATMENT -contacto I-TREATMENT -entre I-TREATMENT -estómago I-TREATMENT -y I-TREATMENT -pared I-TREATMENT -abdominal I-TREATMENT -por I-TREATMENT -transiluminación I-TREATMENT -y I-TREATMENT -digitopresión, I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -la I-TREATMENT -asistencia I-TREATMENT -de I-TREATMENT -laparoscópia I-TREATMENT -para I-TREATMENT -concluir I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -de I-TREATMENT -inserción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -sonda I-TREATMENT -de I-TREATMENT -gastrostomía. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -tabáquico, I-PAST_MEDICAL_HISTORY -hipercolesterolemia I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dieta I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipocolesterolemiantes, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -infarto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miocardio I-PAST_MEDICAL_HISTORY -diafragmático I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1985). I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -angiográfico I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -angor, I-PRESENT_ILLNESS -tanto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -reposo, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pesar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -B-bloqueantes, I-PRESENT_ILLNESS -nitratos, I-PRESENT_ILLNESS -antiagregantes I-PRESENT_ILLNESS -plaquetarios, I-PRESENT_ILLNESS -calcioantagonistas, I-PRESENT_ILLNESS -etc. I-PRESENT_ILLNESS -Tras B-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -del I-EXPLORATION -cateterismo I-EXPLORATION -arterial I-EXPLORATION -y I-EXPLORATION -coronariografía I-EXPLORATION -sin I-EXPLORATION -incidencias I-EXPLORATION -(se I-EXPLORATION -constató I-EXPLORATION -Enfermedad I-EXPLORATION -de I-EXPLORATION -Tres I-EXPLORATION -Vasos) I-EXPLORATION -fue B-EVOLUTION -remitido I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -domicilio I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -y I-EVOLUTION -12 I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -inicia I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -disestesias I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -ambas I-EVOLUTION -pantorrillas I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -incrementando I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -siguientes I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -acudió I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -urgencias I-EVOLUTION -del I-EVOLUTION -hospital I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -remitido I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -domicilio I-EVOLUTION -con B-TREATMENT -medicación I-TREATMENT -analgésica. I-TREATMENT -Acude B-EVOLUTION -nuevamente I-EVOLUTION -a I-EVOLUTION -dicho I-EVOLUTION -servicio I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -por I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -múltiples I-EVOLUTION -lesiones I-EVOLUTION -eritematosas I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -piel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mitad I-EVOLUTION -inferior I-EVOLUTION -del I-EVOLUTION -abdomen I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -extremidades I-EVOLUTION -inferiores. I-EVOLUTION -Ingresa I-EVOLUTION -para I-EVOLUTION -estudio. I-EVOLUTION -Exploración B-EXPLORATION -física: I-EXPLORATION -Varón, I-EXPLORATION -44 I-EXPLORATION -años, I-EXPLORATION -normolineo; I-EXPLORATION -afebril; I-EXPLORATION -buena I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas; I-EXPLORATION -xantelasma I-EXPLORATION -bilateral. I-EXPLORATION -PA: I-EXPLORATION -105/65. I-EXPLORATION -ACP: I-EXPLORATION -Frecuencia I-EXPLORATION -central I-EXPLORATION -rítmica I-EXPLORATION -a I-EXPLORATION -62 I-EXPLORATION -ppm. I-EXPLORATION -Abdomen: I-EXPLORATION -Blando, I-EXPLORATION -indoloro I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -sin I-EXPLORATION -visceromegalias I-EXPLORATION -ni I-EXPLORATION -masas. I-EXPLORATION -Extremidades I-EXPLORATION -sin I-EXPLORATION -edemas, I-EXPLORATION -con I-EXPLORATION -masas I-EXPLORATION -gemelares I-EXPLORATION -dolorosas I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -Pulsos I-EXPLORATION -femoral, I-EXPLORATION -tibial I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -pedio I-EXPLORATION -palpables I-EXPLORATION -y I-EXPLORATION -siméticos. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -cutáneo I-EXPLORATION -(en I-EXPLORATION -mitad I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -extremidades I-EXPLORATION -inferiores) I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -lesiones I-EXPLORATION -eritematosas I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -livedo I-EXPLORATION -reticularis I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -dedos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pies I-EXPLORATION -coloración I-EXPLORATION -púrpura I-EXPLORATION -con I-EXPLORATION -temperatura I-EXPLORATION -local I-EXPLORATION -normal. I-EXPLORATION -Pruebas I-EXPLORATION -complementarias. I-EXPLORATION -Hemograma: I-EXPLORATION -Leucocitos I-EXPLORATION -10800 I-EXPLORATION -(Seg I-EXPLORATION -43%, I-EXPLORATION -L I-EXPLORATION -36%, I-EXPLORATION -M I-EXPLORATION -6, I-EXPLORATION -1%, I-EXPLORATION -Eosinófilos I-EXPLORATION -13%) I-EXPLORATION -Hgb: I-EXPLORATION -13, I-EXPLORATION -9 I-EXPLORATION -g/dl, I-EXPLORATION -Hct: I-EXPLORATION -42, I-EXPLORATION -7%, I-EXPLORATION -Plaquetas I-EXPLORATION -203.000. I-EXPLORATION -VSG: I-EXPLORATION -16. I-EXPLORATION -Bioquímica: I-EXPLORATION -Glu I-EXPLORATION -129 I-EXPLORATION -mg/dl, I-EXPLORATION -Urea I-EXPLORATION -30 I-EXPLORATION -mg/dl, I-EXPLORATION -Cre I-EXPLORATION -1, I-EXPLORATION -1 I-EXPLORATION -mg/dl, I-EXPLORATION -Na I-EXPLORATION -138 I-EXPLORATION -mEq/l, I-EXPLORATION -K I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -mEq/l, I-EXPLORATION -GOT I-EXPLORATION -25, I-EXPLORATION -GPT I-EXPLORATION -31, I-EXPLORATION -CK I-EXPLORATION -50, I-EXPLORATION -LDH I-EXPLORATION -337, I-EXPLORATION -Aldolasa I-EXPLORATION -<8 I-EXPLORATION -U/l, I-EXPLORATION -Colesterol I-EXPLORATION -total I-EXPLORATION -232, I-EXPLORATION -HDL I-EXPLORATION -28, I-EXPLORATION -LDL I-EXPLORATION -168, I-EXPLORATION -TG I-EXPLORATION -179, I-EXPLORATION -APO I-EXPLORATION -B/ I-EXPLORATION -APO I-EXPLORATION -A1: I-EXPLORATION ->1.51. I-EXPLORATION -Hemostasia: I-EXPLORATION -Quick I-EXPLORATION -100%, I-EXPLORATION -Fibrinógeno I-EXPLORATION -335. I-EXPLORATION -Orina: I-EXPLORATION -25 I-EXPLORATION -leucos/ I-EXPLORATION -campo. I-EXPLORATION -PTG: I-EXPLORATION -Prot I-EXPLORATION -total I-EXPLORATION -6, I-EXPLORATION -3 I-EXPLORATION -g/l, I-EXPLORATION -Alb I-EXPLORATION -64%, I-EXPLORATION -Alfa I-EXPLORATION -1-G I-EXPLORATION -3, I-EXPLORATION -5%, I-EXPLORATION -Alfa I-EXPLORATION -2-G I-EXPLORATION -9, I-EXPLORATION -8%, I-EXPLORATION -Beta-G I-EXPLORATION -11, I-EXPLORATION -2%, I-EXPLORATION -Gamma-G I-EXPLORATION -12, I-EXPLORATION -8%. I-EXPLORATION -Complemento: I-EXPLORATION -C3 I-EXPLORATION -111 I-EXPLORATION -(83-177 I-EXPLORATION -mg/dl), I-EXPLORATION -C4 I-EXPLORATION -27 I-EXPLORATION -(15-45). I-EXPLORATION -Detección I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -antitejido: I-EXPLORATION -Negativa. I-EXPLORATION -Complejos I-EXPLORATION -inmunocirculantes: I-EXPLORATION -Positivos I-EXPLORATION -para I-EXPLORATION -Ig I-EXPLORATION -M. I-EXPLORATION -Radiografía I-EXPLORATION -tórax/abdomen: I-EXPLORATION -Sin I-EXPLORATION -hallazgos. I-EXPLORATION -Eco-Doppler I-EXPLORATION -MMII: I-EXPLORATION -Venas I-EXPLORATION -ilíacas, I-EXPLORATION -femorales I-EXPLORATION -y I-EXPLORATION -poplíteas I-EXPLORATION -permeables, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -flujo I-EXPLORATION -normal. I-EXPLORATION -ECG: I-EXPLORATION -RS I-EXPLORATION -a I-EXPLORATION -62 I-EXPLORATION -ppm, I-EXPLORATION -BCRDHH, I-EXPLORATION -necrosis I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -inferior I-EXPLORATION -residual. I-EXPLORATION -Examen I-EXPLORATION -oftalmológico: I-EXPLORATION -Normal. I-EXPLORATION -EMG I-EXPLORATION -(realizado I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -21 I-EXPLORATION -días): I-EXPLORATION -Se I-EXPLORATION -apreció I-EXPLORATION -lesión I-EXPLORATION -radicular I-EXPLORATION -irritativa I-EXPLORATION -en I-EXPLORATION -evolución I-EXPLORATION -S1 I-EXPLORATION -derecha I-EXPLORATION -leve. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -cutánea I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -pie I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -pequeñas I-EXPLORATION -arteriolas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -dermis I-EXPLORATION -media I-EXPLORATION -y I-EXPLORATION -profunda I-EXPLORATION -de I-EXPLORATION -cristales I-EXPLORATION -de I-EXPLORATION -colesterol I-EXPLORATION -enclavado I-EXPLORATION -intraluminalmente I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -ocasionales I-EXPLORATION -células I-EXPLORATION -gigantes I-EXPLORATION -fagocitando I-EXPLORATION -en I-EXPLORATION -parte I-EXPLORATION -estos I-EXPLORATION -cristales. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -enfermo I-EVOLUTION -fue I-EVOLUTION -satisfactoria, I-EVOLUTION -sin I-EVOLUTION -afectación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -livedo I-EVOLUTION -reticularis I-EVOLUTION -y I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -coloración I-EVOLUTION -violácea I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -dedos. I-EVOLUTION -Se B-TREATMENT -siguió I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -sintomático I-TREATMENT -(con I-TREATMENT -analgesia I-TREATMENT -y I-TREATMENT -su I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cardiopatía I-TREATMENT -isquémica) I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -siguiéndose I-TREATMENT -su I-TREATMENT -evolución I-TREATMENT -en I-TREATMENT -consultas I-TREATMENT -externas. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -64 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -unos I-DERIVED_FROM/TO -45 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nódulos I-DERIVED_FROM/TO -cutáneos I-DERIVED_FROM/TO -recidivantes, I-DERIVED_FROM/TO -indoloros I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -indurados I-DERIVED_FROM/TO -localizados I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -miembros I-DERIVED_FROM/TO -inferiores. I-DERIVED_FROM/TO -No B-EXPLORATION -impresionaba I-EXPLORATION -de I-EXPLORATION -enfermedad, I-EXPLORATION -ni I-EXPLORATION -refería I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -fiebre, I-EXPLORATION -ni I-EXPLORATION -síndrome I-EXPLORATION -constitucional. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaban I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -placas I-EXPLORATION -nodulares I-EXPLORATION -subcutáneas I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -a I-EXPLORATION -3 I-EXPLORATION -cm. I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -eritemato-violáceas, I-EXPLORATION -simétricas, I-EXPLORATION -duras I-EXPLORATION -e I-EXPLORATION -indoloras, I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -caras I-EXPLORATION -internas I-EXPLORATION -de I-EXPLORATION -muslos, I-EXPLORATION -pantorrilla, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -hombro I-EXPLORATION -izquierdo. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -visceromegalias I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -tromboflebitis I-EXPLORATION -superficial I-EXPLORATION -en I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -derecho. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -se I-EXPLORATION -objetivó: I-EXPLORATION -leucocitos I-EXPLORATION -12, I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -109/L I-EXPLORATION -(neutrófilos I-EXPLORATION -6, I-EXPLORATION -8, I-EXPLORATION -linfocitos I-EXPLORATION -1, I-EXPLORATION -1, I-EXPLORATION -monocitos I-EXPLORATION -4.3, I-EXPLORATION -eosinófilos I-EXPLORATION -0, I-EXPLORATION -1), I-EXPLORATION -Hb I-EXPLORATION -120 I-EXPLORATION -g/L, I-EXPLORATION -VCM I-EXPLORATION -109, I-EXPLORATION -8 I-EXPLORATION -fL; I-EXPLORATION -Hto. I-EXPLORATION -32%; I-EXPLORATION -plaquetas I-EXPLORATION -133 I-EXPLORATION -x I-EXPLORATION -109/L. I-EXPLORATION -Se I-EXPLORATION -observaban I-EXPLORATION -algunos I-EXPLORATION -granulocitos I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -pelgueroide I-EXPLORATION -(núcleo I-EXPLORATION -no I-EXPLORATION -segmentado I-EXPLORATION -o I-EXPLORATION -hiposegmentado) I-EXPLORATION -y I-EXPLORATION -anisocitosis I-EXPLORATION -discreta. I-EXPLORATION -Reticulocitos: I-EXPLORATION -2, I-EXPLORATION -4% I-EXPLORATION -(totales I-EXPLORATION -86, I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -109/L), I-EXPLORATION -VSG I-EXPLORATION -60 I-EXPLORATION -mm/h; I-EXPLORATION -inmunoglobulinas, I-EXPLORATION -proteinograma, I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -hemostasia, I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -sedimento, I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -hierro, I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -y I-EXPLORATION -ácido I-EXPLORATION -fólico, I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -Eco-doppler I-EXPLORATION -de I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -demostrándose I-EXPLORATION -una I-EXPLORATION -tromboflebitis I-EXPLORATION -superficial I-EXPLORATION -de I-EXPLORATION -safena I-EXPLORATION -interna I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -dicha I-EXPLORATION -vena I-EXPLORATION -e I-EXPLORATION -importante I-EXPLORATION -componente I-EXPLORATION -edematoso I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -graso I-EXPLORATION -circundante, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -profunda. I-EXPLORATION -En I-EXPLORATION -varios I-EXPLORATION -hemogramas I-EXPLORATION -posteriores I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -significativamente I-EXPLORATION -elevada I-EXPLORATION -la I-EXPLORATION -cifra I-EXPLORATION -de I-EXPLORATION -monocitos I-EXPLORATION -en I-EXPLORATION -sangre. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -cutánea I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -en I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -paniculitis I-EXPLORATION -granulomatosa I-EXPLORATION -panlobular I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -lobulillar I-EXPLORATION -tipo I-EXPLORATION -eritema I-EXPLORATION -indurado I-EXPLORATION -de I-EXPLORATION -Bazin I-EXPLORATION -o I-EXPLORATION -vasculitis I-EXPLORATION -nodular, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -organizada. I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -batería I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -diagnósticas I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -causas I-EXPLORATION -Infecciosas I-EXPLORATION -(BK, I-EXPLORATION -cultivo I-EXPLORATION -y I-EXPLORATION -análisis I-EXPLORATION -por I-EXPLORATION -PCR I-EXPLORATION -para I-EXPLORATION -Mycobacterium I-EXPLORATION -tuberculosis: I-EXPLORATION -negativos; I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -infección I-EXPLORATION -reciente I-EXPLORATION -por I-EXPLORATION -Toxoplasma, I-EXPLORATION -Legionela, I-EXPLORATION -Mycoplasma I-EXPLORATION -pneumoniae I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -fiebre I-EXPLORATION -Q: I-EXPLORATION -negativas; I-EXPLORATION -ASLO, I-EXPLORATION -negativo; I-EXPLORATION -Singer I-EXPLORATION -Plotz I-EXPLORATION -y I-EXPLORATION -VDRL, I-EXPLORATION -negativos), I-EXPLORATION -causas I-EXPLORATION -neoplásicas I-EXPLORATION -(alfa-feto-proteína, I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario, I-EXPLORATION -b2-microglobulina, I-EXPLORATION -Ca-19.9, I-EXPLORATION -PSA: I-EXPLORATION -normales; I-EXPLORATION -TAC I-EXPLORATION -abdominopélvico: I-EXPLORATION -moderado I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -del I-EXPLORATION -mesenterio I-EXPLORATION -en I-EXPLORATION -flanco I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -impronta I-EXPLORATION -asas I-EXPLORATION -intestinales, I-EXPLORATION -en I-EXPLORATION -probable I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -paniculitis) I-EXPLORATION -y I-EXPLORATION -enfermedades I-EXPLORATION -sistémicas I-EXPLORATION -(factor I-EXPLORATION -reumatoideo I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antinúcleo I-EXPLORATION -negativos; I-EXPLORATION -niveles I-EXPLORATION -normales I-EXPLORATION -de I-EXPLORATION -C3 I-EXPLORATION -y I-EXPLORATION -C4, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva, I-EXPLORATION -enzima I-EXPLORATION -convertidor I-EXPLORATION -de I-EXPLORATION -angiotensina I-EXPLORATION -y I-EXPLORATION -alfa-1 I-EXPLORATION -antitripsina). I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -biopsia I-EXPLORATION -cutánea I-EXPLORATION -(pues I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -microscópica I-EXPLORATION -observada I-EXPLORATION -debe I-EXPLORATION -establecerse I-EXPLORATION -principalmente I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -cutánea I-EXPLORATION -por I-EXPLORATION -micobacterias) I-EXPLORATION -fue I-EXPLORATION -así I-EXPLORATION -mismo I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -La B-DERIVED_FROM/TO -presencia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -sangre I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -formas I-DERIVED_FROM/TO -granulocíticas I-DERIVED_FROM/TO -displásicas I-DERIVED_FROM/TO -motivó I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fuera I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Servicio, I-DERIVED_FROM/TO -en B-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -aspirado I-EXPLORATION -medular, I-EXPLORATION -observándose I-EXPLORATION -una I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -hipercelular I-EXPLORATION -con I-EXPLORATION -megacariocitos I-EXPLORATION -conservados I-EXPLORATION -y I-EXPLORATION -algún I-EXPLORATION -micromegacariocito I-EXPLORATION -ocasionalmente, I-EXPLORATION -destacando I-EXPLORATION -una I-EXPLORATION -hiperplasia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -serie I-EXPLORATION -monocítica I-EXPLORATION -(21% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -celularidad I-EXPLORATION -medular I-EXPLORATION -global, I-EXPLORATION -entre I-EXPLORATION -promonocitos I-EXPLORATION -y I-EXPLORATION -monocitos) I-EXPLORATION -e I-EXPLORATION -hipoplasia I-EXPLORATION -moderada I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -serie I-EXPLORATION -roja I-EXPLORATION -(13%) I-EXPLORATION -con I-EXPLORATION -displasia I-EXPLORATION -leve I-EXPLORATION -(puentes I-EXPLORATION -intercitoplasmáticos I-EXPLORATION -y I-EXPLORATION -algunas I-EXPLORATION -formas I-EXPLORATION -gigantes), I-EXPLORATION -y I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -una I-EXPLORATION -disgranulopoyesis I-EXPLORATION -significativa I-EXPLORATION -(citoplasmas I-EXPLORATION -francamente I-EXPLORATION -agranulares, I-EXPLORATION -frecuentes I-EXPLORATION -elementos I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -pelgueroide, I-EXPLORATION -asincronismo I-EXPLORATION -madurativo I-EXPLORATION -núcleo-citoplasmático I-EXPLORATION -y I-EXPLORATION -predominio I-EXPLORATION -de I-EXPLORATION -formas I-EXPLORATION -madurativas I-EXPLORATION -intermedias); I-EXPLORATION -la I-EXPLORATION -blastosis I-EXPLORATION -constituía I-EXPLORATION -sólo I-EXPLORATION -un I-EXPLORATION -3%. I-EXPLORATION -El I-EXPLORATION -cariotipo I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -46XY. I-EXPLORATION -Con I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION -el I-EXPLORATION -enfermo I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -de I-EXPLORATION -LMMC I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -cutánea I-EXPLORATION -inespecífica I-EXPLORATION -tipo I-EXPLORATION -paniculitis I-EXPLORATION -lobulillar. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -orales I-TREATMENT -(prednisona I-TREATMENT -30 I-TREATMENT -mg/día, I-TREATMENT -con I-TREATMENT -pauta I-TREATMENT -de I-TREATMENT -descenso I-TREATMENT -semanal), I-TREATMENT -resolviéndose I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -cutáneas I-TREATMENT -pocos I-TREATMENT -días I-TREATMENT -después I-TREATMENT -de I-TREATMENT -comenzar I-TREATMENT -este I-TREATMENT -tratamiento. I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -tratamiento I-EVOLUTION -desde I-EVOLUTION -entonces, I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático, I-EVOLUTION -con I-EVOLUTION -anemia I-EVOLUTION -leve, I-EVOLUTION -VCM I-EVOLUTION -110.9 I-EVOLUTION -fL, I-EVOLUTION -plaquetas I-EVOLUTION -143 I-EVOLUTION -x I-EVOLUTION -109/L, I-EVOLUTION -y I-EVOLUTION -monocitosis I-EVOLUTION -de I-EVOLUTION -2, I-EVOLUTION -3 I-EVOLUTION -x I-EVOLUTION -109/L I-EVOLUTION -en I-EVOLUTION -sangre, I-EVOLUTION -haciéndose I-EVOLUTION -controles I-EVOLUTION -trimestrales; I-EVOLUTION -en I-EVOLUTION -médula I-EVOLUTION -ósea I-EVOLUTION -persiste I-EVOLUTION -la I-EVOLUTION -displasia I-EVOLUTION -trilineal I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -blastosis I-EVOLUTION -del I-EVOLUTION -6% I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -componente I-EVOLUTION -monocítico I-EVOLUTION -del I-EVOLUTION -25%. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colecistectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -artrosis I-PAST_MEDICAL_HISTORY -poliarticular I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ibuprofeno. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -acuosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -tiempo. I-PRESENT_ILLNESS -Exploración B-EXPLORATION -física: I-EXPLORATION -anodina. I-EXPLORATION -Pruebas I-EXPLORATION -complementarias: I-EXPLORATION -hematimetría, I-EXPLORATION -coagulación, I-EXPLORATION -bioquímica I-EXPLORATION -completa I-EXPLORATION -con I-EXPLORATION -ionograma, I-EXPLORATION -transaminasas I-EXPLORATION -hepáticas, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -total: I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -TSH I-EXPLORATION -y I-EXPLORATION -hormonas I-EXPLORATION -tiroideas: I-EXPLORATION -valores I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -Niveles I-EXPLORATION -plasmáticos I-EXPLORATION -de I-EXPLORATION -péptido I-EXPLORATION -intestinal I-EXPLORATION -vasoactivo I-EXPLORATION -(VIP): I-EXPLORATION -5 I-EXPLORATION -pg/ml I-EXPLORATION -(valores I-EXPLORATION -normales: I-EXPLORATION -0-70 I-EXPLORATION -pg/ml). I-EXPLORATION -Niveles I-EXPLORATION -de I-EXPLORATION -ácido I-EXPLORATION -5-hidroxindol-acético I-EXPLORATION -(5HIAA) I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas: I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -mg/24 I-EXPLORATION -horas I-EXPLORATION -(las I-EXPLORATION -cifras I-EXPLORATION -normales I-EXPLORATION -son I-EXPLORATION -inferiores I-EXPLORATION -a I-EXPLORATION -10 I-EXPLORATION -mg/24 I-EXPLORATION -horas). I-EXPLORATION -PCR: I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -(cifras I-EXPLORATION -normales I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -laboratorio I-EXPLORATION -hasta I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -mg/dl), I-EXPLORATION -VSG: I-EXPLORATION -46 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -1ª I-EXPLORATION -hora. I-EXPLORATION -Anticuerpos I-EXPLORATION -antiendomisio I-EXPLORATION -y I-EXPLORATION -antigliadina I-EXPLORATION -negativos I-EXPLORATION -Leucocitos I-EXPLORATION -en I-EXPLORATION -heces: I-EXPLORATION -negativos. I-EXPLORATION -Coprocultivos, I-EXPLORATION -e I-EXPLORATION -investigación I-EXPLORATION -de I-EXPLORATION -Cl I-EXPLORATION -difficile, I-EXPLORATION -de I-EXPLORATION -parásitos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -huevos I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -en I-EXPLORATION -heces: I-EXPLORATION -negativos. I-EXPLORATION -Tránsito I-EXPLORATION -esófago-gastro-duodenal I-EXPLORATION -(TEGD): I-EXPLORATION -normal. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal: I-EXPLORATION -normal I-EXPLORATION -salvo I-EXPLORATION -aerobilia I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -vesícula I-EXPLORATION -biliar. I-EXPLORATION -Colonoscopia I-EXPLORATION -e I-EXPLORATION -ileoscopia: I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -macroscópicas. I-EXPLORATION -Se I-EXPLORATION -toman I-EXPLORATION -6 I-EXPLORATION -biopsias I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -(incluido I-EXPLORATION -sigma I-EXPLORATION -y I-EXPLORATION -recto), I-EXPLORATION -observándose I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -ellas I-EXPLORATION -un I-EXPLORATION -importante I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -con I-EXPLORATION -gran I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -intraepiteliales. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -kg I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -artralgias I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hombros I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -rodillas. I-PAST_MEDICAL_HISTORY -Había B-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -brotes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -episódica I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -febrícula. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -advirtió I-EXPLORATION -una I-EXPLORATION -hiperpigmentación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -desnutrición I-EXPLORATION -importante. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -básica I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -microcítica, I-EXPLORATION -eosinofilia I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG) I-EXPLORATION -57 I-EXPLORATION -seg, I-EXPLORATION -albúmina I-EXPLORATION -2, I-EXPLORATION -46 I-EXPLORATION -g/dl, I-EXPLORATION -colesterol I-EXPLORATION -82mg/dl, I-EXPLORATION -sideremia I-EXPLORATION -12 I-EXPLORATION -mcg/dl, I-EXPLORATION -ferritina I-EXPLORATION -12 I-EXPLORATION -ng/ml, I-EXPLORATION -Van I-EXPLORATION -de I-EXPLORATION -Kamer I-EXPLORATION -9, I-EXPLORATION -2 I-EXPLORATION -g I-EXPLORATION -de I-EXPLORATION -grasa/día. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION -mostró I-EXPLORATION -gran I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -retroperitoneales I-EXPLORATION -y I-EXPLORATION -mesentéricas I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -significativo. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -punteado I-EXPLORATION -blanquecino I-EXPLORATION -en I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -duodenal. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -duodenal I-EXPLORATION -demostró I-EXPLORATION -macrófagos I-EXPLORATION -positivos I-EXPLORATION -al I-EXPLORATION -ácido I-EXPLORATION -peryódico I-EXPLORATION -de I-EXPLORATION -Schiff I-EXPLORATION -(PAS) I-EXPLORATION -y I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Ziehl I-EXPLORATION -negativa, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Whipple. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -empezó I-TREATMENT -a I-TREATMENT -tratar I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -y I-TREATMENT -estreptomicina I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -trimetroprim-sulfametoxazol I-TREATMENT -(TM-SF) I-TREATMENT -pero I-TREATMENT -presentó I-TREATMENT -una I-TREATMENT -reacción I-TREATMENT -urticarial, I-TREATMENT -por I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -hubo I-TREATMENT -que I-TREATMENT -suspender I-TREATMENT -este I-TREATMENT -último, I-TREATMENT -pasando I-TREATMENT -a I-TREATMENT -doxiciclina. I-TREATMENT -Tuvo B-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -aumentó I-EVOLUTION -de I-EVOLUTION -peso, I-EVOLUTION -pero I-EVOLUTION -al I-EVOLUTION -persistir I-EVOLUTION -los I-EVOLUTION -macrófagos I-EVOLUTION -PAS I-EVOLUTION -positivos I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -biopsia, I-EVOLUTION -se I-EVOLUTION -repiten I-EVOLUTION -hasta I-EVOLUTION -dos I-EVOLUTION -ciclos I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -penicilina I-EVOLUTION -y I-EVOLUTION -estreptomicina. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -tuvo I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -inestabilidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -marcha I-EVOLUTION -y I-EVOLUTION -sensación I-EVOLUTION -de I-EVOLUTION -mareo I-EVOLUTION -secundarios I-EVOLUTION -a I-EVOLUTION -toxicidad I-EVOLUTION -laberíntica I-EVOLUTION -por I-EVOLUTION -estreptomicina, I-EVOLUTION -que I-EVOLUTION -inicialmente I-EVOLUTION -planteó I-EVOLUTION -diagnóstico I-EVOLUTION -diferencial I-EVOLUTION -con I-EVOLUTION -afectación I-EVOLUTION -neurológica I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION -Se B-TREATMENT -retiró I-TREATMENT -entonces I-TREATMENT -la I-TREATMENT -doxiciclina, I-TREATMENT -por I-TREATMENT -asociarse I-TREATMENT -a I-TREATMENT -mayor I-TREATMENT -número I-TREATMENT -de I-TREATMENT -recidivas, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -cefixima. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -cumplió I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico I-EVOLUTION -estando I-EVOLUTION -asintomático I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -torácico. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -recurrentes I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ocasión I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -diagnosticó I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -probable I-PAST_MEDICAL_HISTORY -abdomen I-PAST_MEDICAL_HISTORY -agudo, I-PAST_MEDICAL_HISTORY -habiendo I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -punto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -laparotomizado. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -ºC, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -pleurítico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemitórax I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -doloroso, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacaba I-EXPLORATION -PCR I-EXPLORATION -25 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -leucocitos I-EXPLORATION -18.109/ml I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -datos I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -apendicitis I-EXPLORATION -aguda. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -analgésico I-TREATMENT -con I-TREATMENT -remisión I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -en I-TREATMENT -24 I-TREATMENT -horas, I-TREATMENT -siendo I-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta. I-TREATMENT -Posteriormente B-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -ambulatorio I-EXPLORATION -con I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -fibrocolonoscopia I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -remisión I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -clínica, I-EXPLORATION -los I-EXPLORATION -antecedentes I-EXPLORATION -de I-EXPLORATION -episodios I-EXPLORATION -recurrentes I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -negatividad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -practicadas I-EXPLORATION -se I-EXPLORATION -orientó I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -FMF, I-EXPLORATION -procediéndose I-EXPLORATION -a I-EXPLORATION -estudio I-EXPLORATION -genético. I-EXPLORATION -Este I-EXPLORATION -mostró I-EXPLORATION -dos I-EXPLORATION -mutaciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -MEFV: I-EXPLORATION -una I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -2, I-EXPLORATION -detectándose I-EXPLORATION -la I-EXPLORATION -sustitución I-EXPLORATION -del I-EXPLORATION -nucleótido I-EXPLORATION -guanina I-EXPLORATION -por I-EXPLORATION -citosina I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -posición I-EXPLORATION -del I-EXPLORATION -triplete I-EXPLORATION -148, I-EXPLORATION -dando I-EXPLORATION -lugar I-EXPLORATION -al I-EXPLORATION -cambio I-EXPLORATION -de I-EXPLORATION -aminoácido I-EXPLORATION -glutámico I-EXPLORATION -por I-EXPLORATION -glutamina. I-EXPLORATION -Dicha I-EXPLORATION -mutuación I-EXPLORATION -recibe I-EXPLORATION -el I-EXPLORATION -nombre I-EXPLORATION -de I-EXPLORATION -E148Q, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -solo I-EXPLORATION -alelo, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -heterozigoto I-EXPLORATION -para I-EXPLORATION -esta I-EXPLORATION -mutuación. I-EXPLORATION -Se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -mutuación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -10, I-EXPLORATION -que I-EXPLORATION -consistía I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -sustitución I-EXPLORATION -del I-EXPLORATION -nucleótido I-EXPLORATION -guanina I-EXPLORATION -por I-EXPLORATION -adenina I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tercera I-EXPLORATION -posición I-EXPLORATION -del I-EXPLORATION -triplete I-EXPLORATION -694, I-EXPLORATION -dando I-EXPLORATION -lugar I-EXPLORATION -al I-EXPLORATION -cambio I-EXPLORATION -de I-EXPLORATION -aminoácido I-EXPLORATION -metionina I-EXPLORATION -por I-EXPLORATION -isoleucina. I-EXPLORATION -Dicha I-EXPLORATION -mutuación I-EXPLORATION -recibe I-EXPLORATION -el I-EXPLORATION -nombre I-EXPLORATION -de I-EXPLORATION -M694I I-EXPLORATION -y I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -solo I-EXPLORATION -alelo, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -también I-EXPLORATION -heterozigoto I-EXPLORATION -para I-EXPLORATION -esta I-EXPLORATION -mutuación. I-EXPLORATION -Ambas I-EXPLORATION -mutaciones I-EXPLORATION -están I-EXPLORATION -descritas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -FMF. I-EXPLORATION -Asimismo I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -exón I-EXPLORATION -3 I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -proteina I-EXPLORATION -sérica I-EXPLORATION -del I-EXPLORATION -amiloide I-EXPLORATION -SAA-1, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -genotipo I-EXPLORATION -alfa/beta, I-EXPLORATION -considerado I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -riesgo I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -amiloidosis. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -colchicina I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -mg/día I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -y I-EVOLUTION -desaparición I-EVOLUTION -paulatina I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -crisis. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -mestiza, B-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -ingresó I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -vez I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -febrero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1999 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -hospital. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -diez I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -comenzado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -rodillas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tobillos, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -aparentes I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -inflamatorios, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -aliviaban I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Indometacina I-PAST_MEDICAL_HISTORY -y, I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -acompañaba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -astenia. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -llegara I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -etiológico. I-PAST_MEDICAL_HISTORY -Este B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -articular I-PRESENT_ILLNESS -evolucionaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -episodios, I-PRESENT_ILLNESS -acompañándose I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -anemia I-PRESENT_ILLNESS -comprobada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -sólo I-EXPLORATION -mostró I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mucosas, I-EXPLORATION -ligero I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -tobillos, I-EXPLORATION -adenopatía I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm, I-EXPLORATION -movible I-EXPLORATION -y I-EXPLORATION -elástica I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -inguinal I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -ingreso I-EXPLORATION -fueron I-EXPLORATION -los I-EXPLORATION -siguientes: I-EXPLORATION -hemoglobina I-EXPLORATION -98 I-EXPLORATION -g/l, I-EXPLORATION -hematocrito I-EXPLORATION -30 I-EXPLORATION -vol%, I-EXPLORATION -leucograma I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -normales, I-EXPLORATION -reticolocitos, I-EXPLORATION -glucemias, I-EXPLORATION -creatinina, I-EXPLORATION -TGO I-EXPLORATION -y I-EXPLORATION -TGP, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -TP I-EXPLORATION -y I-EXPLORATION -TPT, I-EXPLORATION -todos I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION -de I-EXPLORATION -proteínas I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -hipergammaglobulinemia I-EXPLORATION -32, I-EXPLORATION -85 I-EXPLORATION -g/l, I-EXPLORATION -eritrosedimentación I-EXPLORATION -115 I-EXPLORATION -mm/h I-EXPLORATION -y I-EXPLORATION -106 I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -segunda I-EXPLORATION -oportunidad. I-EXPLORATION -El I-EXPLORATION -ultrasonido I-EXPLORATION -de I-EXPLORATION -hemiabdomen I-EXPLORATION -superior I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -ninguna I-EXPLORATION -alteración. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -diagnóstico I-EVOLUTION -preciso. I-EVOLUTION -Reingresa I-EVOLUTION -en I-EVOLUTION -enero I-EVOLUTION -del I-EVOLUTION -2004 I-EVOLUTION -por I-EVOLUTION -astenia I-EVOLUTION -y I-EVOLUTION -fiebre I-EVOLUTION -de I-EVOLUTION -38 I-EVOLUTION -a I-EVOLUTION -39 I-EVOLUTION -ºC I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -periódica I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -duración I-EVOLUTION -con I-EVOLUTION -intervalos I-EVOLUTION -de I-EVOLUTION -remisiones I-EVOLUTION -espontáneas I-EVOLUTION -cada I-EVOLUTION -dos I-EVOLUTION -o I-EVOLUTION -tres I-EVOLUTION -meses. I-EVOLUTION -Mantenía I-EVOLUTION -dolores I-EVOLUTION -articulares I-EVOLUTION -en I-EVOLUTION -rodillas I-EVOLUTION -y I-EVOLUTION -tobillos I-EVOLUTION -que I-EVOLUTION -mejoraban I-EVOLUTION -con I-EVOLUTION -medicamentos I-EVOLUTION -antinflamatorios I-EVOLUTION -no I-EVOLUTION -esteroideos. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -supraclavicular I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -y I-EXPLORATION -fija I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -profundos. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio: I-EXPLORATION -hemoglobina I-EXPLORATION -110 I-EXPLORATION -g/l, I-EXPLORATION -eritrosedimentación I-EXPLORATION -130 I-EXPLORATION -mm/h, I-EXPLORATION -hipergammaglobulinemia I-EXPLORATION -policlonal I-EXPLORATION -de I-EXPLORATION -36 I-EXPLORATION -g/l; I-EXPLORATION -medulograma: I-EXPLORATION -médula I-EXPLORATION -reactiva I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -plasmocitos. I-EXPLORATION -Ultrasonido I-EXPLORATION -de I-EXPLORATION -abdomen: I-EXPLORATION -ligera I-EXPLORATION -hepatomegalia I-EXPLORATION -difusa I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ecorrefringencia; I-EXPLORATION -placa I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -ensanchamiento I-EXPLORATION -del I-EXPLORATION -contorno I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -del I-EXPLORATION -mediastino; I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -mediastino: I-EXPLORATION -adenomegalia I-EXPLORATION -en I-EXPLORATION -mediastino I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -campos I-EXPLORATION -pulmonares. I-EXPLORATION - I-EXPLORATION -Biopsia I-EXPLORATION -de I-EXPLORATION -ganglio I-EXPLORATION -linfático I-EXPLORATION -cervical: I-EXPLORATION -pérdida I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arquitectura I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -linfoide I-EXPLORATION -focal I-EXPLORATION -marcada I-EXPLORATION -y I-EXPLORATION -expansión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -interfolicular, I-EXPLORATION -ocupada I-EXPLORATION -por I-EXPLORATION -abundantes I-EXPLORATION -plasmocitos I-EXPLORATION -y I-EXPLORATION -cuerpos I-EXPLORATION -de I-EXPLORATION -Russel. I-EXPLORATION - I-EXPLORATION -Inmunohistoquímica: I-EXPLORATION -CD20 I-EXPLORATION -positivo I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -T, I-EXPLORATION -kappa I-EXPLORATION -y I-EXPLORATION -lambda I-EXPLORATION -positivo I-EXPLORATION -en I-EXPLORATION -plasmocitos. I-EXPLORATION - I-EXPLORATION -Conclusiones: I-EXPLORATION -EC I-EXPLORATION -plasmocelular. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -un I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -poliquimioterapia I-TREATMENT -con I-TREATMENT -adriamicina, I-TREATMENT -vincristina, I-TREATMENT -bleomicina I-TREATMENT -y I-TREATMENT -prednisona I-TREATMENT -y B-EVOLUTION -fue I-EVOLUTION -egresada I-EVOLUTION -para I-EVOLUTION -seguimiento I-EVOLUTION -ambulatorio. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -usuaria B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -parenteral, I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -VHC I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antirretroviral I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -resolución. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -(hacía I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mes), I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -droga I-PAST_MEDICAL_HISTORY -(heroína), I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -foliculitis I-PAST_MEDICAL_HISTORY -candidiásica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -costocondritis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2º I-PAST_MEDICAL_HISTORY -arco I-PAST_MEDICAL_HISTORY -costal I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -respectivamente. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fluconazol I-PAST_MEDICAL_HISTORY -400 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -precisando, I-PAST_MEDICAL_HISTORY -además, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cartílago I-PAST_MEDICAL_HISTORY -costal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -trayecto I-PAST_MEDICAL_HISTORY -fistuloso. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -explicaba I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -productiva I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -purulenta, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -pleuríticas, I-PRESENT_ILLNESS -adelgazamiento I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -característica I-PRESENT_ILLNESS -mecánicas. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -no I-EXPLORATION -impresionaba I-EXPLORATION -de I-EXPLORATION -afectada, I-EXPLORATION -destacando I-EXPLORATION -semiología I-EXPLORATION -de I-EXPLORATION -neumonía I-EXPLORATION -en I-EXPLORATION -1/3 I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -hemotórax I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -apófisis I-EXPLORATION -espinosas I-EXPLORATION -de I-EXPLORATION -última I-EXPLORATION -vértebra I-EXPLORATION -dorsal I-EXPLORATION -y I-EXPLORATION -primeras I-EXPLORATION -lumbares. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -complementarios: I-EXPLORATION -leucocitos I-EXPLORATION -11.800 I-EXPLORATION -(67%N), I-EXPLORATION -hemoglobina I-EXPLORATION -10, I-EXPLORATION -6, I-EXPLORATION -hematocrito I-EXPLORATION -34, I-EXPLORATION -VCM I-EXPLORATION -123 I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -normales. I-EXPLORATION -VSG I-EXPLORATION -de I-EXPLORATION -117 I-EXPLORATION -mm I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -hora. I-EXPLORATION -Los I-EXPLORATION -parámetros I-EXPLORATION -bioquímicos I-EXPLORATION -de I-EXPLORATION -rutina, I-EXPLORATION -coagulación I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -elemental I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION -Las I-EXPLORATION -determinaciones I-EXPLORATION -de I-EXPLORATION -subpoblaciones I-EXPLORATION -linfocitarias I-EXPLORATION -CD4 I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -944/mm3 I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -de I-EXPLORATION -VIH I-EXPLORATION -indetectable. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -microbiológicos, I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -brucella I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -constataron I-EXPLORATION -vegetaciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -ecocardiográfica. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -radioopacidad I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -inferior I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -asociado. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -microbiológicos I-EXPLORATION -de I-EXPLORATION -esputo I-EXPLORATION -resultaron I-EXPLORATION -estériles I-EXPLORATION -con I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -BAAR I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -(exudado I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -mononuclear) I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -candida I-EXPLORATION -albicans. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -Tac I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -dorso-lumbar I-EXPLORATION -se I-EXPLORATION -hallaron I-EXPLORATION -signos I-EXPLORATION -radiológicos I-EXPLORATION -de I-EXPLORATION -espondilodiscitis I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -tanto I-EXPLORATION -de I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -D-11, I-EXPLORATION -D-12 I-EXPLORATION -y I-EXPLORATION -L-1, I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -espacios I-EXPLORATION -intervertebrales I-EXPLORATION -D10-D11, I-EXPLORATION -D11-D12 I-EXPLORATION -y I-EXPLORATION -D12-L1, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos I-EXPLORATION -paravertebral I-EXPLORATION -y I-EXPLORATION -afectación I-EXPLORATION -intrarraquídea I-EXPLORATION -de I-EXPLORATION -localización I-EXPLORATION -epidural I-EXPLORATION -anterior. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -punción I-EXPLORATION -directa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -paravertebral. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -material I-EXPLORATION -purulento I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -la I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -BAAR I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Candida I-EXPLORATION -albicans. I-EXPLORATION -Se B-TREATMENT -establecieron I-TREATMENT -medidas I-TREATMENT -ortésicas I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -secuencial I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -liposomal I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -150 I-TREATMENT -mg/día I-TREATMENT -durante I-TREATMENT -20 I-TREATMENT -días, I-TREATMENT -seguido I-TREATMENT -de I-TREATMENT -fluconazol I-TREATMENT -400 I-TREATMENT -mg/día I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -meses, I-TREATMENT -evolucionando B-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -radiológica I-EVOLUTION -(tanto I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -neumonía I-EVOLUTION -como I-EVOLUTION -del I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -de I-EVOLUTION -espondilodiscitis I-EVOLUTION -con I-EVOLUTION -afectación I-EVOLUTION -de I-EVOLUTION -cuerpos I-EVOLUTION -vertebrales). I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -Tabla I-EVOLUTION -I I-EVOLUTION -se I-EVOLUTION -exponen I-EVOLUTION -diversas I-EVOLUTION -características I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -casos. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumadora B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -paquetes/año, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anticonceptivos I-PAST_MEDICAL_HISTORY -orales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -intermitente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -octubre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1997 I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -orinas I-PRESENT_ILLNESS -colúricas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -heces I-PRESENT_ILLNESS -acólicas. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -eritema I-EXPLORATION -palmar I-EXPLORATION -bilateral, I-EXPLORATION -ictericia I-EXPLORATION -y I-EXPLORATION -hepatomegalia. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -(ecografía I-EXPLORATION -y I-EXPLORATION -TAC I-EXPLORATION -abdominal) I-EXPLORATION -se I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -homogénea. I-EXPLORATION -Los I-EXPLORATION -análisis I-EXPLORATION -practicados I-EXPLORATION -demostraron: I-EXPLORATION -GOT I-EXPLORATION -384 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -496 I-EXPLORATION -UI/L, I-EXPLORATION -GGT I-EXPLORATION -78 I-EXPLORATION -UI/L, I-EXPLORATION -FA I-EXPLORATION -553 I-EXPLORATION -UI/L I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -11, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -(directa I-EXPLORATION -4, I-EXPLORATION -8 I-EXPLORATION -mg/dl), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -hipergammaglobulinemia I-EXPLORATION -policlonal, I-EXPLORATION -con I-EXPLORATION -3030 I-EXPLORATION -mg/dl I-EXPLORATION -de I-EXPLORATION -IgG. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -a I-EXPLORATION -VHA, I-EXPLORATION -VHB I-EXPLORATION -y I-EXPLORATION -VHC I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION -Los I-EXPLORATION -ANA I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Los I-EXPLORATION -AMA I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION -(1/1280), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -ASMA I-EXPLORATION -(1/320), I-EXPLORATION -Anti-LKM1 I-EXPLORATION -(1/640) I-EXPLORATION -y I-EXPLORATION -ANCA I-EXPLORATION -(1/40). I-EXPLORATION -Se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -leve I-EXPLORATION -distorsión I-EXPLORATION -focal I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -bandas I-EXPLORATION -fibrosas I-EXPLORATION -porto-portales I-EXPLORATION -ocasionales, I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -linfocitario I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -espacios I-EXPLORATION -porta I-EXPLORATION -formando I-EXPLORATION -folículos I-EXPLORATION -linfoides, I-EXPLORATION -en I-EXPLORATION -ocasiones I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -ductos I-EXPLORATION -biliares. I-EXPLORATION -Dicho I-EXPLORATION -infiltrado I-EXPLORATION -traspasaba I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -porta, I-EXPLORATION -observándose I-EXPLORATION -necrosis I-EXPLORATION -"piecemeal" I-EXPLORATION -moderada/severa. I-EXPLORATION -Se I-EXPLORATION -apreciaron I-EXPLORATION -hepatocitos I-EXPLORATION -alrededor I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -porta I-EXPLORATION -con I-EXPLORATION -acúmulo I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -transportadora I-EXPLORATION -de I-EXPLORATION -cobre, I-EXPLORATION -e I-EXPLORATION -incremento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -celularidad I-EXPLORATION -inflamatoria I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lobulillo, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -sinusoides I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima, I-EXPLORATION -con I-EXPLORATION -citolisis I-EXPLORATION -e I-EXPLORATION -incremento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -trama I-EXPLORATION -fibrosa I-EXPLORATION -intersticial. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -30 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -prednisona I-TREATMENT -con I-TREATMENT -posterior I-TREATMENT -reducción I-TREATMENT -de I-TREATMENT -su I-TREATMENT -dosis, I-TREATMENT -50 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -azatioprina I-TREATMENT -y I-TREATMENT -ácido I-TREATMENT -ursodesoxicólico. I-TREATMENT -Se B-EVOLUTION -produjo I-EVOLUTION -la I-EVOLUTION -resolución I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -clínico I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -análisis, I-EVOLUTION -persistiendo I-EVOLUTION -discretamente I-EVOLUTION -elevadas, I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -seis I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -la I-EVOLUTION -FA I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -GGT. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -cuando I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -detectó I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -bloqueo I-DERIVED_FROM/TO -auriculoventricular I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tercer I-DERIVED_FROM/TO -grado I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -examen I-DERIVED_FROM/TO -rutinario. I-DERIVED_FROM/TO -La B-TREATMENT -paciente I-TREATMENT -quedó I-TREATMENT -ingresada I-TREATMENT -y I-TREATMENT -se I-TREATMENT -implantó I-TREATMENT -un I-TREATMENT -marcapasos I-TREATMENT -temporal I-TREATMENT -endovenoso I-TREATMENT -7F I-TREATMENT -(electrodos I-TREATMENT -de I-TREATMENT -platino) I-TREATMENT -en I-TREATMENT -el I-TREATMENT -ventrículo I-TREATMENT -derecho I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -yugular I-TREATMENT -interna I-TREATMENT -derecha. I-TREATMENT -Fue I-TREATMENT -necesario I-TREATMENT -recolocarlo I-TREATMENT -en I-TREATMENT -cinco I-TREATMENT -ocasiones I-TREATMENT -durante I-TREATMENT -las I-TREATMENT -primeras I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -un I-TREATMENT -insuficiente I-TREATMENT -sensado I-TREATMENT -auricular. I-TREATMENT -El I-TREATMENT -tercer I-TREATMENT -día I-TREATMENT -de I-TREATMENT -ingreso I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -marcapasos I-TREATMENT -permanente I-TREATMENT -VDD I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -subclavia I-TREATMENT -izquierda I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -tuvo I-EVOLUTION -febrícula I-EVOLUTION -y B-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -ambulatoriamente I-TREATMENT -con I-TREATMENT -cloxacilina. I-TREATMENT -Los B-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Diez B-EVOLUTION -días I-EVOLUTION -mas I-EVOLUTION -tarde, I-EVOLUTION -ingresó I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hospital I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -febrícula I-EVOLUTION -intermitente, I-EVOLUTION -disnea, I-EVOLUTION -tos I-EVOLUTION -no I-EVOLUTION -productiva I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -pleurítico I-EVOLUTION -en I-EVOLUTION -hemitórax I-EVOLUTION -derecho. I-EVOLUTION -La B-EXPLORATION -herida I-EXPLORATION -quirúrgica I-EXPLORATION -estaba I-EXPLORATION -limpia I-EXPLORATION -e I-EXPLORATION -indolora. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -reveló I-EXPLORATION -cardiomegalia I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -ECG I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -bloqueo I-EXPLORATION -auriculoventricular I-EXPLORATION -de I-EXPLORATION -tercer I-EXPLORATION -grado I-EXPLORATION -con I-EXPLORATION -ritmo I-EXPLORATION -de I-EXPLORATION -escape I-EXPLORATION -de I-EXPLORATION -marcapasos. I-EXPLORATION -No B-TREATMENT -había I-TREATMENT -sensado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -onda I-TREATMENT -P, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -aumentó I-TREATMENT -la I-TREATMENT -sensibilidad I-TREATMENT -del I-TREATMENT -electrodo I-TREATMENT -auricular I-TREATMENT -y I-TREATMENT -el I-TREATMENT -dispositivo I-TREATMENT -funcionó I-TREATMENT -adecuadamente. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -tenía I-EVOLUTION -mayor I-EVOLUTION -disnea, I-EVOLUTION -ingurgitación I-EVOLUTION -yugular I-EVOLUTION -y I-EVOLUTION -edemas I-EVOLUTION -en I-EVOLUTION -miembros I-EVOLUTION -inferiores. I-EVOLUTION -Se B-EXPLORATION -auscultó I-EXPLORATION -por I-EXPLORATION -primera I-EXPLORATION -vez I-EXPLORATION -un I-EXPLORATION -fuerte I-EXPLORATION -roce I-EXPLORATION -pericárdico I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -precordial. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -se I-EXPLORATION -vio I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -sin I-EXPLORATION -colapso I-EXPLORATION -ventricular I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -cable I-EXPLORATION -del I-EXPLORATION -electrodo I-EXPLORATION -estaba I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -tracto I-EXPLORATION -de I-EXPLORATION -salida I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -proteína I-EXPLORATION -C-reactiva I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -153 I-EXPLORATION -mg/dl, I-EXPLORATION -el I-EXPLORATION -fibrinógeno I-EXPLORATION -de I-EXPLORATION -659 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -VSG I-EXPLORATION -de I-EXPLORATION -57 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -hora. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -anticuerpos I-EXPLORATION -antimúsculo I-EXPLORATION -cardiaco, I-EXPLORATION -complemento I-EXPLORATION -y I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -frente I-EXPLORATION -Coxsackie I-EXPLORATION -B1 I-EXPLORATION -a I-EXPLORATION -B6 I-EXPLORATION -y I-EXPLORATION -Echovirus I-EXPLORATION -fueron I-EXPLORATION -también I-EXPLORATION -negativos. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -diuréticos I-TREATMENT -y I-TREATMENT -prednisona I-TREATMENT -(30 I-TREATMENT -mg/día). I-TREATMENT -Su B-EVOLUTION -estado I-EVOLUTION -mejoró I-EVOLUTION -rápidamente. I-EVOLUTION -Dos I-EVOLUTION -semanas I-EVOLUTION -después, I-EVOLUTION -el I-EVOLUTION -roce I-EVOLUTION -pericárdico I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -habían I-EVOLUTION -desaparecido I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -marcadores I-EVOLUTION -inflamatorios I-EVOLUTION -se I-EVOLUTION -habían I-EVOLUTION -normalizado. I-EVOLUTION -La B-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -prednisona I-TREATMENT -fue I-TREATMENT -reduciéndose I-TREATMENT -gradualmente I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -hasta I-TREATMENT -suspender, I-TREATMENT -con I-TREATMENT -recurrencia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -(dolor I-TREATMENT -torácico I-TREATMENT -pleurítico I-TREATMENT -y I-TREATMENT -elevación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -marcadores I-TREATMENT -de I-TREATMENT -inflamación) I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -después. I-TREATMENT -Se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -curso I-TREATMENT -de I-TREATMENT -prednisona I-TREATMENT -sin I-TREATMENT -recurrencias I-TREATMENT -posteriores. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -esencial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -valsartan I-PAST_MEDICAL_HISTORY -(80 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -temblor I-PAST_MEDICAL_HISTORY -esencial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -propanolol I-PAST_MEDICAL_HISTORY -(80 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -venosa I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -miembros I-PAST_MEDICAL_HISTORY -inferiores I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -medidas I-PAST_MEDICAL_HISTORY -higiénico-posturales, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -externa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Medicina I-PRESENT_ILLNESS -Interna I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -valoración I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -seguimiento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -venosa I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -referir I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -estaba I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -salvo I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -soplo I-EXPLORATION -sistólico I-EXPLORATION -grado I-EXPLORATION -II/VI I-EXPLORATION -en I-EXPLORATION -borde I-EXPLORATION -esternal I-EXPLORATION -izquierdo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -cardiaca I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -venosa I-EXPLORATION -crónica I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -inferiores. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -exploraciones I-EXPLORATION -complementarias I-EXPLORATION -destacaba I-EXPLORATION -hemograma, I-EXPLORATION -VSG, I-EXPLORATION -coagulación, I-EXPLORATION -bioquímica I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -normales. I-EXPLORATION -ECG: I-EXPLORATION -normal. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -imagen I-EXPLORATION -vascular I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -mediastino I-EXPLORATION -superior I-EXPLORATION -izquierdo. I-EXPLORATION -Ecocardiografía I-EXPLORATION -doppler: I-EXPLORATION -normal. I-EXPLORATION -TAC I-EXPLORATION -torácica I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -intravenoso: I-EXPLORATION -dilatación I-EXPLORATION -aneurismática I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -47x75 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos. I-EXPLORATION -Cateterismo I-EXPLORATION -cardiaco I-EXPLORATION -con I-EXPLORATION -angiografía I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -coronaria: I-EXPLORATION -coronarias I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -aneurismática I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -izquierda. I-EXPLORATION -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Cardiovascular I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -referencia, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -sometida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -intervención I-DERIVED_FROM/TO -quirúrgica, I-DERIVED_FROM/TO -objetivándose B-TREATMENT -en I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -una I-TREATMENT -arteria I-TREATMENT -pulmonar I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -calibre I-TREATMENT -normal I-TREATMENT -y I-TREATMENT -realizándose I-TREATMENT -resección I-TREATMENT -parcial I-TREATMENT -y I-TREATMENT -plicatura I-TREATMENT -de I-TREATMENT -las I-TREATMENT -arterias I-TREATMENT -pulmonares I-TREATMENT -común I-TREATMENT -e I-TREATMENT -izquierda I-TREATMENT -hasta I-TREATMENT -reducir I-TREATMENT -a I-TREATMENT -un I-TREATMENT -diámetro I-TREATMENT -de I-TREATMENT -2-3 I-TREATMENT -centímetros, I-TREATMENT -cursando B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -permaneciendo I-EVOLUTION -asintomática I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION - -Dos B-PRESENT_ILLNESS -pacientes I-PRESENT_ILLNESS -varones I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -B, I-PRESENT_ILLNESS -diagnosticados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -inflamatoria I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentaron I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mesalazina. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -A, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -toma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mesalazina I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -así B-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -reacciones I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -urticaria I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -angioedema I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -toma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -AAS I-PAST_MEDICAL_HISTORY -(ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico). I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -B, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mesalazina, I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -rash I-PRESENT_ILLNESS -maculopapuloso I-PRESENT_ILLNESS -generalizado, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -retira. I-PRESENT_ILLNESS -Seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -tarde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -reinicia I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mesalazina, I-PRESENT_ILLNESS -aunque I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -introducido I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -budesonida I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -oral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rectal. I-PRESENT_ILLNESS -Tras I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -retirada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -corticoides, I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -generalizada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Test B-EXPLORATION -cutáneos I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -pruebas I-EXPLORATION -cutáneas I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -recomendaciones I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Academia I-EXPLORATION -Europea I-EXPLORATION -de I-EXPLORATION -Alergología I-EXPLORATION -e I-EXPLORATION -Inmunología I-EXPLORATION -Clínica I-EXPLORATION -(EAACI) I-EXPLORATION -(5). I-EXPLORATION -Prick I-EXPLORATION -a I-EXPLORATION -1/10 I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -1/1 I-EXPLORATION -con I-EXPLORATION -mesalazina I-EXPLORATION -(10 I-EXPLORATION -mg/ml I-EXPLORATION -de I-EXPLORATION -Claversal®) I-EXPLORATION -y I-EXPLORATION -sulfasalazina I-EXPLORATION -(10 I-EXPLORATION -mg/ml I-EXPLORATION -de I-EXPLORATION -Salazopyrina®). I-EXPLORATION -Se I-EXPLORATION -usó I-EXPLORATION -histamina I-EXPLORATION -a I-EXPLORATION -1/10 I-EXPLORATION -y I-EXPLORATION -1/1 I-EXPLORATION -como I-EXPLORATION -control I-EXPLORATION -positivo. I-EXPLORATION -El I-EXPLORATION -suero I-EXPLORATION -salino I-EXPLORATION -en I-EXPLORATION -prick I-EXPLORATION -se I-EXPLORATION -utilizó I-EXPLORATION -como I-EXPLORATION -control I-EXPLORATION -negativo. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -se I-EXPLORATION -consideran I-EXPLORATION -negativos I-EXPLORATION -cuando I-EXPLORATION -la I-EXPLORATION -pápula I-EXPLORATION -obtenida I-EXPLORATION -es I-EXPLORATION -< I-EXPLORATION -o I-EXPLORATION -igual I-EXPLORATION -a I-EXPLORATION -3 I-EXPLORATION -mm I-EXPLORATION -o I-EXPLORATION -menor I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -histamina. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -prick I-EXPLORATION -en I-EXPLORATION -10 I-EXPLORATION -pacientes I-EXPLORATION -sanos I-EXPLORATION -no I-EXPLORATION -expuestos I-EXPLORATION -a I-EXPLORATION -5-ASA I-EXPLORATION -previamente. I-EXPLORATION - I-EXPLORATION -Provocación I-EXPLORATION -oral I-EXPLORATION -controlada I-EXPLORATION -con I-EXPLORATION -placebo I-EXPLORATION -a I-EXPLORATION -simple I-EXPLORATION -ciego I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -la I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -un I-TREATMENT -placebo, I-TREATMENT -se I-TREATMENT -administran I-TREATMENT -dosis I-TREATMENT -crecientes I-TREATMENT -del I-TREATMENT -fármaco I-TREATMENT -implicado I-TREATMENT -en I-TREATMENT -una I-TREATMENT -reacción I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -tiempo I-TREATMENT -determinado, I-TREATMENT -a I-TREATMENT -partir I-TREATMENT -del I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -llega I-TREATMENT -a I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -deseada I-TREATMENT -para I-TREATMENT -el I-TREATMENT -tratamiento, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -mantiene I-TREATMENT -desde I-TREATMENT -entonces. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -deben I-TREATMENT -descartar I-TREATMENT -enfermedades I-TREATMENT -o I-TREATMENT -tratamientos I-TREATMENT -que I-TREATMENT -contraindiquen I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -adrenalina, I-TREATMENT -o I-TREATMENT -enfermedades I-TREATMENT -mal I-TREATMENT -controladas I-TREATMENT -(hipertensión I-TREATMENT -arterial, I-TREATMENT -diabetes). I-TREATMENT - I-TREATMENT -Se I-TREATMENT -deben I-TREATMENT -suspender I-TREATMENT -medicaciones I-TREATMENT -que I-TREATMENT -puedan I-TREATMENT -interferir I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -de I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -(corticoides, I-TREATMENT -antihistamínicos, I-TREATMENT -etc.). I-TREATMENT - I-TREATMENT -Si I-TREATMENT -aparecen I-TREATMENT -reacciones I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -administración, I-TREATMENT -como I-TREATMENT -urticaria, I-TREATMENT -angioedema, I-TREATMENT -etc., I-TREATMENT -se I-TREATMENT -le I-TREATMENT -administra I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -preciso I-TREATMENT -para I-TREATMENT -revertirlas I-TREATMENT -en I-TREATMENT -cada I-TREATMENT -caso I-TREATMENT -y I-TREATMENT -se I-TREATMENT -suspende I-TREATMENT -la I-TREATMENT -provocación. I-TREATMENT - I-TREATMENT -"Desensibilización" I-TREATMENT -a I-TREATMENT -mesalazina I-TREATMENT - I-TREATMENT -Se I-TREATMENT -pide I-TREATMENT -consentimiento I-TREATMENT -informado I-TREATMENT -firmado I-TREATMENT -por I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -pruebas I-TREATMENT -cutáneas I-TREATMENT -y I-TREATMENT -de I-TREATMENT -provocación I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -ambulatoria I-TREATMENT -el I-TREATMENT -protocolo I-TREATMENT -de I-TREATMENT -desensibilización, I-TREATMENT -elaborado I-TREATMENT -en I-TREATMENT -nuestro I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Alergia I-TREATMENT -como I-TREATMENT -se I-TREATMENT -puede I-TREATMENT -observar I-TREATMENT -en I-TREATMENT -la I-TREATMENT -Tabla I-TREATMENT -I. I-TREATMENT - I-TREATMENT -En I-TREATMENT -el I-TREATMENT -caso I-TREATMENT -B, I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -budesonida I-TREATMENT -en I-TREATMENT -enemas I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -iniciar I-TREATMENT -la I-TREATMENT -desensibilización. I-TREATMENT - I-TREATMENT -Con I-TREATMENT -este I-TREATMENT -protocolo I-TREATMENT -se I-TREATMENT -administran I-TREATMENT -en I-TREATMENT -17 I-TREATMENT -días I-TREATMENT -dosis I-TREATMENT -(mg) I-TREATMENT -crecientes I-TREATMENT -de I-TREATMENT -mesalazina, I-TREATMENT -con I-TREATMENT -varias I-TREATMENT -dosis I-TREATMENT -diarias, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -intervalo I-TREATMENT -de I-TREATMENT -tiempo I-TREATMENT -que I-TREATMENT -va I-TREATMENT -aumentando I-TREATMENT -cada I-TREATMENT -día I-TREATMENT -(45 I-TREATMENT -minutos, I-TREATMENT -1 I-TREATMENT -hora I-TREATMENT -y I-TREATMENT -8 I-TREATMENT -horas). I-TREATMENT -Se I-TREATMENT -administran I-TREATMENT -dosis I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -la I-TREATMENT -tolerancia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -terapéutica I-TREATMENT -requerida I-TREATMENT -por I-TREATMENT -el I-TREATMENT -paciente. I-TREATMENT -Se I-TREATMENT -señala I-TREATMENT -en I-TREATMENT -la I-TREATMENT -tabla I-TREATMENT -I I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -diaria I-TREATMENT -tolerada I-TREATMENT -y I-TREATMENT -la I-TREATMENT -acumulada I-TREATMENT -(la I-TREATMENT -suma I-TREATMENT -de I-TREATMENT -los I-TREATMENT -miligramos I-TREATMENT -tolerados I-TREATMENT -por I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -hasta I-TREATMENT -ese I-TREATMENT -momento). I-TREATMENT - I-TREATMENT -El I-TREATMENT -día I-TREATMENT -17 I-TREATMENT -se I-TREATMENT -administran I-TREATMENT -finalmente I-TREATMENT -1.000 I-TREATMENT -mg/1.000 I-TREATMENT -mg/1.000 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -mesalazina I-TREATMENT -(3.000 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día). I-TREATMENT - I-TREATMENT -Prick B-EXPLORATION -a I-EXPLORATION -1/10 I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -1/1 I-EXPLORATION -con I-EXPLORATION -mesalazina I-EXPLORATION -y I-EXPLORATION -sulfasalazina I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -pacientes I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -controles. I-EXPLORATION -Provocación I-EXPLORATION -oral I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -A I-EXPLORATION -con I-EXPLORATION -ácido I-EXPLORATION -acetilsalicílico I-EXPLORATION -hasta I-EXPLORATION -500 I-EXPLORATION -mg, I-EXPLORATION -con I-EXPLORATION -urticaria I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -cara. I-EXPLORATION -"Desensibilización" B-TREATMENT -a I-TREATMENT -mesalazina I-TREATMENT -desarrollado I-TREATMENT -en I-TREATMENT -17 I-TREATMENT -días, I-TREATMENT -con I-TREATMENT -tolerancia I-TREATMENT -de I-TREATMENT -1.000 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -mesalazina I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -(3.000 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día) I-TREATMENT -en I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -A I-TREATMENT -y I-TREATMENT -B. I-TREATMENT -Desde B-EVOLUTION -entonces, I-EVOLUTION -y I-EVOLUTION -durante I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -existe I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -mesalazina I-EVOLUTION -y I-EVOLUTION -mantienen I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -dosis I-EVOLUTION -tolerada I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -continuada, I-EVOLUTION -para I-EVOLUTION -evitar I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -reacciones. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -fumador B-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -cesó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -hábito, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -habitual. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -pleurítico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -habituales. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -38 I-EXPLORATION -ºC I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -difusa I-EXPLORATION -del I-EXPLORATION -murmullo I-EXPLORATION -vesicular I-EXPLORATION -con I-EXPLORATION -crepitantes I-EXPLORATION -y I-EXPLORATION -sibilancias I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -pulmonar I-EXPLORATION -izda. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -general I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -destacaron I-EXPLORATION -18.600 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -92% I-EXPLORATION -neutrófilos, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -gasometría I-EXPLORATION -con I-EXPLORATION -pCO2 I-EXPLORATION -de I-EXPLORATION -27 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -pO2 I-EXPLORATION -56, I-EXPLORATION -8, I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -48 I-EXPLORATION -y I-EXPLORATION -HCO3 I-EXPLORATION -23, I-EXPLORATION -6 I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -O2 I-EXPLORATION -del I-EXPLORATION -92%. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -torácica I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -alveolar I-EXPLORATION -en I-EXPLORATION -LII, I-EXPLORATION -LSI I-EXPLORATION -y I-EXPLORATION -língula I-EXPLORATION -y I-EXPLORATION -cardiomegalia. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -al I-TREATMENT -ingreso I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -iniciando I-TREATMENT -oxigenoterapia, I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -broncodilatadores I-TREATMENT -inhalados, I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -profiláctica I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -levofloxacino I-TREATMENT -intravenoso I-TREATMENT -(500 I-TREATMENT -mg/24 I-TREATMENT -horas). I-TREATMENT -El B-EVOLUTION -cuadro I-EVOLUTION -evolucionó I-EVOLUTION -lentamente, I-EVOLUTION -manteniéndose I-EVOLUTION -la I-EVOLUTION -febrícula I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria I-EVOLUTION -y B-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -esputo I-EXPLORATION -para I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -no I-EXPLORATION -fueron I-EXPLORATION -valorables, I-EXPLORATION -resultando I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -negativos. I-EXPLORATION -Por I-EXPLORATION -todo I-EXPLORATION -ello, I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -fibrobroncoscopia. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -del I-EXPLORATION -aspirado I-EXPLORATION -bronquial I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -abundantes I-EXPLORATION -polimorfonucleares I-EXPLORATION -(> I-EXPLORATION -25 I-EXPLORATION -PMN/c I-EXPLORATION -x100) I-EXPLORATION -y I-EXPLORATION -bacilos I-EXPLORATION -gram I-EXPLORATION -positivos I-EXPLORATION -difterimorfos I-EXPLORATION -extra I-EXPLORATION -e I-EXPLORATION -intracelulares, I-EXPLORATION -creciendo I-EXPLORATION -posteriormente I-EXPLORATION -en I-EXPLORATION -cultivo I-EXPLORATION -puro I-EXPLORATION -C. I-EXPLORATION -pseudodiphteriticum I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -clindamicina, I-EXPLORATION -eritromicina I-EXPLORATION -y I-EXPLORATION -ciprofloxacina I-EXPLORATION -y I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -penilina, I-EXPLORATION -amoxicilina-clavulánico, I-EXPLORATION -cefalosporinas I-EXPLORATION -de I-EXPLORATION -2ª I-EXPLORATION -y I-EXPLORATION -3ª I-EXPLORATION -generación I-EXPLORATION -y I-EXPLORATION -glicopéptidos. I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -frotis I-EXPLORATION -del I-EXPLORATION -exudado I-EXPLORATION -bronquial I-EXPLORATION -como I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -agudo I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -otras I-EXPLORATION -lesiones. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -neumonía I-TREATMENT -por I-TREATMENT -C. I-TREATMENT -pseudodiphteriticum I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -amoxicilina-clavulánico I-TREATMENT -2 I-TREATMENT -g/ I-TREATMENT -8 I-TREATMENT -h I-TREATMENT -i.v., I-TREATMENT -evolucionando B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -laterocervicales I-PRESENT_ILLNESS -izquierdas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -odinofagia. I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -asoció I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -salvo I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -fiebre I-EXPLORATION -(38 I-EXPLORATION -ºC), I-EXPLORATION -conglomerado I-EXPLORATION -adenopático I-EXPLORATION -látero-cervical I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -mínimas I-EXPLORATION -adenopatías I-EXPLORATION -latero-cervicales I-EXPLORATION -derechas. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -cervical I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -adenopatías I-EXPLORATION -cervicales, I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -con I-EXPLORATION -leucopenia I-EXPLORATION -y I-EXPLORATION -trombopenia I-EXPLORATION -y I-EXPLORATION -biopsia I-EXPLORATION -ganglionar I-EXPLORATION -informada I-EXPLORATION -de I-EXPLORATION -linfadenitis I-EXPLORATION -aguda. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacaba: I-EXPLORATION -leucocitos I-EXPLORATION -2.500 I-EXPLORATION -con I-EXPLORATION -26% I-EXPLORATION -linfocitos, I-EXPLORATION -plaquetas I-EXPLORATION -57.000 I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -816 I-EXPLORATION -U/L. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -PPD I-EXPLORATION -5U I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -hemocultivos, I-EXPLORATION -coprocultivo I-EXPLORATION -RPR I-EXPLORATION -y I-EXPLORATION -serologías I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -CMV, I-EXPLORATION -VEB, I-EXPLORATION -Brucella, I-EXPLORATION -Leptospira, I-EXPLORATION -Francisella I-EXPLORATION -tularensis I-EXPLORATION -y I-EXPLORATION -Bartonella I-EXPLORATION -fueron I-EXPLORATION -así I-EXPLORATION -mismo I-EXPLORATION -negativas. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fiebre I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -nueva I-EXPLORATION -biopsia I-EXPLORATION -cervical I-EXPLORATION -observándose I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cortical-paracortical I-EXPLORATION -una I-EXPLORATION -linfadenitis I-EXPLORATION -necrotizante I-EXPLORATION -parcheada, I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -restos I-EXPLORATION -celulares I-EXPLORATION -y I-EXPLORATION -rodeada I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -CD4+, I-EXPLORATION -histiocitos I-EXPLORATION -CD68, I-EXPLORATION -escasos I-EXPLORATION -polimorfonucleares I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -plasmáticas.; I-EXPLORATION -características I-EXPLORATION -histopatológicas I-EXPLORATION -que I-EXPLORATION -definen I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Kikuchi. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -antiinflamatorios I-TREATMENT -no I-TREATMENT -esteroides I-TREATMENT -con B-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fiebre. I-EVOLUTION -Año I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -después I-EVOLUTION -sigue I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -pediatra I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -adenopatía I-DERIVED_FROM/TO -cervical I-DERIVED_FROM/TO -dolorosa I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -semana I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución, I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -respuesta I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -amoxicilina-clavulánico. I-DERIVED_FROM/TO -No B-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -adenopatías I-EXPLORATION -laterocervicales I-EXPLORATION -izquierdas I-EXPLORATION -menores I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -adenopatía I-EXPLORATION -laterocervical I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -dura, I-EXPLORATION -no I-EXPLORATION -adherida, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios I-EXPLORATION -asociados. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -destacaba I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -normales, I-EXPLORATION -VSG I-EXPLORATION -30 I-EXPLORATION -mm, I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -y I-EXPLORATION -factor I-EXPLORATION -reumatoideo I-EXPLORATION -negativos. I-EXPLORATION -PPD I-EXPLORATION -5U I-EXPLORATION -negativo. I-EXPLORATION -Serología I-EXPLORATION -Herpesvirus I-EXPLORATION -6 I-EXPLORATION -IgM I-EXPLORATION -positiva. I-EXPLORATION -Serologías I-EXPLORATION -CMV, I-EXPLORATION -VEB, I-EXPLORATION -VHS I-EXPLORATION -I I-EXPLORATION -- I-EXPLORATION -II, I-EXPLORATION -Hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -VIH, I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii, I-EXPLORATION -Bartonella I-EXPLORATION -henselae, I-EXPLORATION -Parvovirus I-EXPLORATION -B19 I-EXPLORATION -y I-EXPLORATION -Salmonella I-EXPLORATION -typhi I-EXPLORATION -negativas. I-EXPLORATION -La I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -se I-EXPLORATION -confirmaron I-EXPLORATION -las I-EXPLORATION -adenopatías. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -adenopatías I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -abierta I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -evolución. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -mostró I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -paracortical, I-EXPLORATION -rodeados I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -CD4 I-EXPLORATION -y I-EXPLORATION -CD8 I-EXPLORATION -+ I-EXPLORATION -y I-EXPLORATION -abundantes I-EXPLORATION -histiocitos I-EXPLORATION -CD68+, I-EXPLORATION -entremezclados I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION -plasmocitoides I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -significativa I-EXPLORATION -de I-EXPLORATION -neutrófilos. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Auramina, I-EXPLORATION -cultivo I-EXPLORATION -para I-EXPLORATION -micobacterias, I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -Enterovirus, I-EXPLORATION -HSV, I-EXPLORATION -VVZ, I-EXPLORATION -CMV, I-EXPLORATION -VEB I-EXPLORATION -y I-EXPLORATION -Herpesvirus I-EXPLORATION -tipos I-EXPLORATION -6, I-EXPLORATION -7 I-EXPLORATION -y I-EXPLORATION -8 I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -ganglionar I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El B-EVOLUTION -curso I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION -autolimitado. I-EVOLUTION -Dos I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -73 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antidiabéticos I-PAST_MEDICAL_HISTORY -orales, I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -paroxística I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amiodarona, I-PAST_MEDICAL_HISTORY -calcioantagonistas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antiagregantes I-PAST_MEDICAL_HISTORY -plaquetarios. I-PAST_MEDICAL_HISTORY -Refería B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -En B-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -destacaban I-EXPLORATION -anemia I-EXPLORATION -normocítica, I-EXPLORATION -hipoxemia, I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -reactantes I-EXPLORATION -de I-EXPLORATION -fase I-EXPLORATION -aguda I-EXPLORATION -e I-EXPLORATION -infiltrados I-EXPLORATION -"parcheados" I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hemitórax I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -múltiples I-EXPLORATION -estudios I-EXPLORATION -microbiológicos, I-EXPLORATION -serológicos, I-EXPLORATION -citológicos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -o I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -estableció I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -presunción I-TREATMENT -bronquiolitis I-TREATMENT -obliterante I-TREATMENT -con I-TREATMENT -neumonía I-TREATMENT -organizada I-TREATMENT -(BONO) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -60 I-TREATMENT -mg/día I-TREATMENT -con I-TREATMENT -desaparición I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fiebre I-TREATMENT -y I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -respiratorios, I-TREATMENT -de I-TREATMENT -la I-TREATMENT -anemia I-TREATMENT -y I-TREATMENT -de I-TREATMENT -los I-TREATMENT -reactantes I-TREATMENT -de I-TREATMENT -fase I-TREATMENT -aguda. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -ingresada I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -por I-EVOLUTION -disnea I-EVOLUTION -de I-EVOLUTION -reposo, I-EVOLUTION -edemas I-EVOLUTION -y I-EVOLUTION -oliguria. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destacaban I-EXPLORATION -taquipnea, I-EXPLORATION -taquicardia I-EXPLORATION -rítmica I-EXPLORATION -sin I-EXPLORATION -soplos, I-EXPLORATION -disminución I-EXPLORATION -global I-EXPLORATION -del I-EXPLORATION -murmullo I-EXPLORATION -vesicular I-EXPLORATION -con I-EXPLORATION -crepitantes I-EXPLORATION -en I-EXPLORATION -bases I-EXPLORATION -y I-EXPLORATION -edemas I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -inferiores. I-EXPLORATION -Entre I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaban I-EXPLORATION -20.600 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -con I-EXPLORATION -85% I-EXPLORATION -polimorfonucleares, I-EXPLORATION -LDH I-EXPLORATION -537 I-EXPLORATION -U/L, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -249 I-EXPLORATION -U/L, I-EXPLORATION -albúmina I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -g/dL, I-EXPLORATION -pO2 I-EXPLORATION -58 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -CA I-EXPLORATION -19.9 I-EXPLORATION -214 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -0-27 I-EXPLORATION -U/L). I-EXPLORATION -Eran I-EXPLORATION -normales I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -hemoglobina, I-EXPLORATION -plaquetas, I-EXPLORATION -glucemia, I-EXPLORATION -bilirrubina, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -calcio, I-EXPLORATION -electrolitos, I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario, I-EXPLORATION -CA I-EXPLORATION -125 I-EXPLORATION -y I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -hormonas I-EXPLORATION -tiroideas. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -torácica I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -bilateral I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION -bilateral I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -pulmonar, I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -perihiliar. I-EXPLORATION -El I-EXPLORATION -mediastino I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -embolismo I-EXPLORATION -pulmonar I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -angio-TC. I-EXPLORATION -Un I-EXPLORATION -ecocardiograma I-EXPLORATION -transtorácico I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -toracocentesis I-EXPLORATION -bilateral I-EXPLORATION -obteniendo I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -casos I-EXPLORATION -un I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -lechoso, I-EXPLORATION -con I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -exudado, I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -triglicéridos I-EXPLORATION -de I-EXPLORATION -433 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -163 I-EXPLORATION -mg/dL I-EXPLORATION -respectivamente, I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -quilomicrones. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -citológicos I-EXPLORATION -y I-EXPLORATION -microbiológicos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -líquidos I-EXPLORATION -pleurales I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -broncoscopia I-EXPLORATION -con I-EXPLORATION -biopsia I-EXPLORATION -transbronquial I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -bronquial I-EXPLORATION -infiltrada I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -neoplásica I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -adenocarcinoma. I-EXPLORATION -Las I-EXPLORATION -citologías I-EXPLORATION -y I-EXPLORATION -estudios I-EXPLORATION -microbiológicos I-EXPLORATION -del I-EXPLORATION -broncoaspirado I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -lavado I-EXPLORATION -broncoalveolar I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se B-TREATMENT -incrementó I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -esteroides I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tubo I-TREATMENT -de I-TREATMENT -drenaje I-TREATMENT -torácico I-TREATMENT -bilateral I-TREATMENT -y I-TREATMENT -nutrición I-TREATMENT -parenteral. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -se I-EVOLUTION -caracterizó I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria I-EVOLUTION -progresiva I-EVOLUTION -que I-EVOLUTION -condujo I-EVOLUTION -al I-EVOLUTION -fallecimiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -necropsia I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -linfangitis I-EXPLORATION -carcinomatosa I-EXPLORATION -diseminada I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -pulmones, I-EXPLORATION -hígado, I-EXPLORATION -pericardio, I-EXPLORATION -páncreas I-EXPLORATION -y I-EXPLORATION -suprarrenales, I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -adenocarcinoma I-EXPLORATION -de I-EXPLORATION -primario I-EXPLORATION -desconocido. I-EXPLORATION - I-EXPLORATION - -Paciente, B-PRESENT_ILLNESS -mujer, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -prolapso I-PAST_MEDICAL_HISTORY -genital I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -III. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución., I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -discreta I-PRESENT_ILLNESS -rigidez I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -musculatura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cintura I-PRESENT_ILLNESS -escapular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pelviana. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -aquejaba I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -visuales I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -claudicación I-PRESENT_ILLNESS -mandibular. I-PRESENT_ILLNESS -Un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -visita I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -intervenida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -histerectomía I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -colpoperineoplastia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -prolapso I-PRESENT_ILLNESS -uterino I-PRESENT_ILLNESS -grado I-PRESENT_ILLNESS -III. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -descripción I-PRESENT_ILLNESS -microscópica I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -uterino I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -aprecian I-PRESENT_ILLNESS -vasos I-PRESENT_ILLNESS -arteriales I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -esclerosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pared I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -granulomatosa I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -células I-PRESENT_ILLNESS -gigantes, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -necrosis, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -capas I-PRESENT_ILLNESS -media I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -perivascular I-PRESENT_ILLNESS -aconsejándose I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -clínico. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas I-EXPLORATION -normal. I-EXPLORATION -Auscultación I-EXPLORATION -cardíaca I-EXPLORATION -y I-EXPLORATION -pulmonar I-EXPLORATION -anodina. I-EXPLORATION -Abdomen I-EXPLORATION -blando, I-EXPLORATION -depresible, I-EXPLORATION -no I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -cicatriz I-EXPLORATION -de I-EXPLORATION -histerectomía I-EXPLORATION -con I-EXPLORATION -buen I-EXPLORATION -aspecto. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpan I-EXPLORATION -masas. I-EXPLORATION -No I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -edemas I-EXPLORATION -maleolares. I-EXPLORATION -Los I-EXPLORATION -pulsos I-EXPLORATION -periféricos I-EXPLORATION -estaban I-EXPLORATION -conservados. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma, I-EXPLORATION -el I-EXPLORATION -hematocrito I-EXPLORATION -era I-EXPLORATION -del I-EXPLORATION -37, I-EXPLORATION -5% I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -11'9 I-EXPLORATION -g/dl, I-EXPLORATION -serie I-EXPLORATION -blanca I-EXPLORATION -y I-EXPLORATION -hemostasia I-EXPLORATION -normales. I-EXPLORATION -VSG I-EXPLORATION -52 I-EXPLORATION -mm/1ª I-EXPLORATION -hora I-EXPLORATION -y I-EXPLORATION -PCR I-EXPLORATION -66, I-EXPLORATION -3 I-EXPLORATION -g/dl. I-EXPLORATION -La I-EXPLORATION -bioquímica I-EXPLORATION -y I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -FR, I-EXPLORATION -ANA I-EXPLORATION -y I-EXPLORATION -ANCA I-EXPLORATION -negativos. I-EXPLORATION -HLA I-EXPLORATION -B27 I-EXPLORATION -positivo. I-EXPLORATION -Proteinograma I-EXPLORATION -normal. I-EXPLORATION -Mantoux I-EXPLORATION -negativo. I-EXPLORATION -Rx I-EXPLORATION -tórax: I-EXPLORATION -no I-EXPLORATION -cardiomegalia, I-EXPLORATION -campos I-EXPLORATION -pulmonares I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -arteria I-EXPLORATION -temporal I-EXPLORATION -izquierda I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -ACG I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Prednisona I-TREATMENT -1 I-TREATMENT -mg/kg/día. I-TREATMENT -Dos B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permanecía I-EVOLUTION -asintomática I-EVOLUTION -con B-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -mg/día. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -consultado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -familia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -38º I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nauseas, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kilogramos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -exfumador, I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatopatía I-PAST_MEDICAL_HISTORY -criptogenética, I-PAST_MEDICAL_HISTORY -taquicardia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -aberrante I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -ablación I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás, I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -angor I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -coronariografía I-PAST_MEDICAL_HISTORY -normal, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -ansioso-depresivo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -duodenal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -apendicitis. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -recientemente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -prácticas I-PAST_MEDICAL_HISTORY -sexuales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -objetivaba I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -de I-EXPLORATION -39, I-EXPLORATION -7 I-EXPLORATION -ºC, I-EXPLORATION -se I-EXPLORATION -palpaba I-EXPLORATION -hepatomegalia I-EXPLORATION -a I-EXPLORATION -unos I-EXPLORATION -3-4 I-EXPLORATION -centímetros I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -costal, I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -destacaban I-EXPLORATION -15.900/mm3 I-EXPLORATION -leucocitos I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda, I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -10.5 I-EXPLORATION -g/dl I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -VSG I-EXPLORATION -de I-EXPLORATION -101 I-EXPLORATION -mm. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -existía I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -hepáticos: I-EXPLORATION -GOT I-EXPLORATION -101 I-EXPLORATION -U/l, I-EXPLORATION -GPT I-EXPLORATION -128 I-EXPLORATION -U/l, I-EXPLORATION -FA I-EXPLORATION -208 I-EXPLORATION -U/l, I-EXPLORATION -GGT I-EXPLORATION -172 I-EXPLORATION -U/l, I-EXPLORATION -LDH I-EXPLORATION -1366 I-EXPLORATION -UI/l. I-EXPLORATION -La I-EXPLORATION -PCR I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -asimismo I-EXPLORATION -elevada. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -sistemático I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -Mantoux I-EXPLORATION -negativo. I-EXPLORATION -Serologías I-EXPLORATION -de I-EXPLORATION -Brucella, I-EXPLORATION -Leishmania, I-EXPLORATION -C. I-EXPLORATION -Burnetti, I-EXPLORATION -lúes, I-EXPLORATION -Salmonella, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -y I-EXPLORATION -VIH I-EXPLORATION -negativos. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -serologías I-EXPLORATION -de I-EXPLORATION -citomegalovirus, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -Epstein-Barr I-EXPLORATION -y I-EXPLORATION -toxoplasma I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -IgG I-EXPLORATION -+ I-EXPLORATION -y I-EXPLORATION -IgM I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Hemocultivos I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -ambulatorio I-EXPLORATION -y I-EXPLORATION -hospitalizado I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -hígado, I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION -vesícula, I-EXPLORATION -porción I-EXPLORATION -visible I-EXPLORATION -de I-EXPLORATION -retroperitoneo I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -porta I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -ecográficos I-EXPLORATION -significativos. I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -efectúo I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -extenso I-EXPLORATION -engrosamiento I-EXPLORATION -mamelonado I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud, I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -neoplasia I-EXPLORATION -de I-EXPLORATION -colon; I-EXPLORATION -gran I-EXPLORATION -lesión I-EXPLORATION -sólida I-EXPLORATION -con I-EXPLORATION -captación I-EXPLORATION -heterogénea I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo I-EXPLORATION -segmento I-EXPLORATION -IV, I-EXPLORATION -sugestiva I-EXPLORATION -de I-EXPLORATION -metástasis. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -en I-EXPLORATION -"corazón I-EXPLORATION -de I-EXPLORATION -manzana" I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -con I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -tramo I-EXPLORATION -aproximadamente I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -centímetros. I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -circunferencial I-EXPLORATION -a I-EXPLORATION -110 I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -ano I-EXPLORATION -que I-EXPLORATION -impedía I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio, I-EXPLORATION -tomándose I-EXPLORATION -biopsias. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -granulación I-EXPLORATION -y I-EXPLORATION -tejido I-EXPLORATION -conectivo I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -densos I-EXPLORATION -infiltrados I-EXPLORATION -linfocitarios I-EXPLORATION -con I-EXPLORATION -predominio I-EXPLORATION -CD20+ I-EXPLORATION -que I-EXPLORATION -con I-EXPLORATION -frecuencia I-EXPLORATION -expresaban I-EXPLORATION -tinción I-EXPLORATION -nuclear I-EXPLORATION -bcl-6. I-EXPLORATION -Los I-EXPLORATION -cambios I-EXPLORATION -morfológicos I-EXPLORATION -sugerían I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -tipo I-EXPLORATION -B I-EXPLORATION -aunque I-EXPLORATION -no I-EXPLORATION -era I-EXPLORATION -concluyente I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -PAAF I-EXPLORATION -hepática I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -linfoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -difuso I-EXPLORATION -tipo I-EXPLORATION -B. I-EXPLORATION - I-EXPLORATION -Posteriormente B-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -hematología, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -inició I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -quimioterapia I-DERIVED_FROM/TO -siguiendo I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -esquema I-DERIVED_FROM/TO -CHOP I-DERIVED_FROM/TO -(ciclofosfamida, I-DERIVED_FROM/TO -doxorrubicina, I-DERIVED_FROM/TO -vincristina I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -prednisona) I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -momento I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -tenemos I-DERIVED_FROM/TO -datos I-DERIVED_FROM/TO -sobre I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -eventual I-DERIVED_FROM/TO -respuesta I-DERIVED_FROM/TO -tumoral. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cefaleas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo. I-PAST_MEDICAL_HISTORY -Desde B-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -borrosa, I-PRESENT_ILLNESS -notando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -alguna I-PRESENT_ILLNESS -ocasión I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -visual I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemicampo I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -acompañándose I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefaleas I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedían I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -analgésico. I-PRESENT_ILLNESS -Hace I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -ictal I-PRESENT_ILLNESS -transitorio I-PRESENT_ILLNESS -hemisférico I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -desapareció I-PRESENT_ILLNESS -pasados I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -minutos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mañana I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -presente I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -notó I-PRESENT_ILLNESS -torpeza I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -desviación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -comisura I-PRESENT_ILLNESS -bucal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -articulación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -palabra. I-PRESENT_ILLNESS -Por I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -valorada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -neurólogo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -objetivó I-PRESENT_ILLNESS -paresia I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -supranuclear I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -disartria, I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -torpeza I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS -finos I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipoestesia I-PRESENT_ILLNESS -táctil I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -algésica I-PRESENT_ILLNESS -facio-braquial I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -En B-EXPLORATION -urgencias I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ECG, I-EXPLORATION -en I-EXPLORATION -ritmo I-EXPLORATION -sinusal, I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION -que I-EXPLORATION -inicialmente I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -infarto I-EXPLORATION -y I-EXPLORATION -Doppler I-EXPLORATION -de I-EXPLORATION -troncos I-EXPLORATION -supraaórticos I-EXPLORATION -y I-EXPLORATION -transcraneal I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -planta, I-EXPLORATION -solicitándose I-EXPLORATION -perfiles I-EXPLORATION -analíticos I-EXPLORATION -completos I-EXPLORATION -incluyendo I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -hipercoagulabilidad, I-EXPLORATION -ANAS, I-EXPLORATION -c-ANCA, I-EXPLORATION -p-ANCA, I-EXPLORATION -DNA I-EXPLORATION -nativo I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antimitocondriales. I-EXPLORATION -También I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen: I-EXPLORATION -RNM I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -ecocardiografía. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -RNM I-EXPLORATION -mostró I-EXPLORATION -infarto I-EXPLORATION -isquémico I-EXPLORATION -agudo I-EXPLORATION -en I-EXPLORATION -territorio I-EXPLORATION -silviano I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -cerebral I-EXPLORATION -media I-EXPLORATION -izquierda. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antineutrófilos, I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -anticentrómero I-EXPLORATION -y I-EXPLORATION -antimitocondrias I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -trombofilia I-EXPLORATION -tan I-EXPLORATION -sólo I-EXPLORATION -detectó I-EXPLORATION -ligera I-EXPLORATION -hiperfibrinogenemia. I-EXPLORATION - I-EXPLORATION -Finalmente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -ecocardiografía, I-EXPLORATION -prueba I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -crucial I-EXPLORATION -al I-EXPLORATION -proporcionar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo, I-EXPLORATION -observándose I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -pedunculada I-EXPLORATION -en I-EXPLORATION -AI I-EXPLORATION -que I-EXPLORATION -prolapsaba I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -mitral I-EXPLORATION -en I-EXPLORATION -diástole, I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -mixoma I-EXPLORATION -(35 I-EXPLORATION -x I-EXPLORATION -26 I-EXPLORATION -mm), I-EXPLORATION -con I-EXPLORATION -pedículo I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -oval. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -programó I-TREATMENT -para I-TREATMENT -cirugía I-TREATMENT -realizándose I-TREATMENT -previamente I-TREATMENT -RNM I-TREATMENT -cardiaca I-TREATMENT -para I-TREATMENT -determinar I-TREATMENT -con I-TREATMENT -mayor I-TREATMENT -precisión I-TREATMENT -las I-TREATMENT -características I-TREATMENT -morfológicas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -auricular. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -atriotomía I-TREATMENT -izquierda, I-TREATMENT -extrayéndose I-TREATMENT -el I-TREATMENT -tumor I-TREATMENT -en I-TREATMENT -su I-TREATMENT -totalidad, I-TREATMENT -siendo I-TREATMENT -éste I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -morulado. I-TREATMENT -Se I-TREATMENT -abrió I-TREATMENT -también I-TREATMENT -aurícula I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -se I-TREATMENT -resecó I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -de I-TREATMENT -implantación, I-TREATMENT -cerrándose I-TREATMENT -posteriormente I-TREATMENT -la I-TREATMENT -comunicación I-TREATMENT -interauricular I-TREATMENT -creada. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -posquirúrgica I-EVOLUTION -resultó I-EVOLUTION -muy I-EVOLUTION -satisfactoria, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -déficit I-EVOLUTION -neurológico. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -moderado, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -perímetro I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -acompañante. I-PRESENT_ILLNESS -En B-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -solicitadas I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION -Glucosa, I-EXPLORATION -urea, I-EXPLORATION -ácido I-EXPLORATION -úrico, I-EXPLORATION -creatinina, I-EXPLORATION -calcio I-EXPLORATION -total, I-EXPLORATION -fósforo, I-EXPLORATION -triglicéridos, I-EXPLORATION -colesterol I-EXPLORATION -LDL, I-EXPLORATION -bilirrubina I-EXPLORATION -total, I-EXPLORATION -GOT, I-EXPLORATION -GPT, I-EXPLORATION -GGT, I-EXPLORATION -LDH, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -amilasa, I-EXPLORATION -proteínas I-EXPLORATION -totales, I-EXPLORATION -albúmina, I-EXPLORATION -sodio, I-EXPLORATION -potasio, I-EXPLORATION -cloro, I-EXPLORATION -ferritina, I-EXPLORATION -transferrina, I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -y I-EXPLORATION -folato I-EXPLORATION -normales. I-EXPLORATION -Colesterol I-EXPLORATION -total I-EXPLORATION -243 I-EXPLORATION -mg/dl I-EXPLORATION -(110-200), I-EXPLORATION -colesterol I-EXPLORATION -HDL I-EXPLORATION -120 I-EXPLORATION -mg/dl I-EXPLORATION -(42-68), I-EXPLORATION -hierro I-EXPLORATION -44 I-EXPLORATION -microg/dl I-EXPLORATION -(65-165); I-EXPLORATION -Ca I-EXPLORATION -19, I-EXPLORATION -9, I-EXPLORATION -82, I-EXPLORATION -03 I-EXPLORATION -U/l I-EXPLORATION -(< I-EXPLORATION -40). I-EXPLORATION -CEA, I-EXPLORATION -PSA I-EXPLORATION -y I-EXPLORATION -alfa-fetoproteína I-EXPLORATION -normales. I-EXPLORATION -Velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -41 I-EXPLORATION -mm I-EXPLORATION -(< I-EXPLORATION -14). I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -Ca I-EXPLORATION -19, I-EXPLORATION -9, I-EXPLORATION -91, I-EXPLORATION -23 I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -normales. I-EXPLORATION -Resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -abdomino-pelvica: I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -multilobulada I-EXPLORATION -abdomino I-EXPLORATION -pelvica, I-EXPLORATION -cuya I-EXPLORATION -señal I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tabiques I-EXPLORATION -es I-EXPLORATION -preferentemente I-EXPLORATION -grasa. I-EXPLORATION -Las I-EXPLORATION -dimensiones I-EXPLORATION -máximas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -son I-EXPLORATION -de I-EXPLORATION -26 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -cráneo I-EXPLORATION -caudal, I-EXPLORATION -24, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -transverso I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -21 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -anteroposterior. I-EXPLORATION -Cruza I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -y I-EXPLORATION -produce I-EXPLORATION -importante I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -izquierdo, I-EXPLORATION -al I-EXPLORATION -que I-EXPLORATION -rota I-EXPLORATION -y I-EXPLORATION -desplaza I-EXPLORATION -cranealmente, I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -uropatía I-EXPLORATION -obstructiva. I-EXPLORATION -También I-EXPLORATION -ejerce I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -izquierdo, I-EXPLORATION -desplazándolo I-EXPLORATION -contra I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -son I-EXPLORATION -muy I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -liposarcoma. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -suprainfraumbilical I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -una I-TREATMENT -gran I-TREATMENT -masa I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -lipomatoso I-TREATMENT -desde I-TREATMENT -la I-TREATMENT -celda I-TREATMENT -renal I-TREATMENT -izquierda I-TREATMENT -hasta I-TREATMENT -espacio I-TREATMENT -retrovesical. I-TREATMENT -Se I-TREATMENT -intentó I-TREATMENT -extirpación I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -fibras I-TREATMENT -del I-TREATMENT -psoas I-TREATMENT -izquierdo I-TREATMENT -infiltrado. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -extraída I-EXPLORATION -fue I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -descripción I-EXPLORATION -macroscópica: I-EXPLORATION -Pieza I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -x I-EXPLORATION -40 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -cm. I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -peso I-EXPLORATION -de I-EXPLORATION -6.300 I-EXPLORATION -gr. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -coloración I-EXPLORATION -amarillenta, I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -sección I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -que I-EXPLORATION -mantiene I-EXPLORATION -esta I-EXPLORATION -coloración I-EXPLORATION -con I-EXPLORATION -finos I-EXPLORATION -tractos I-EXPLORATION -conectivos, I-EXPLORATION -sin I-EXPLORATION -apreciarse I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -clara I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -y I-EXPLORATION -sí I-EXPLORATION -una I-EXPLORATION -distribución I-EXPLORATION -en I-EXPLORATION -lóbulos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -descripción I-EXPLORATION -microscópica I-EXPLORATION -las I-EXPLORATION -secciones I-EXPLORATION -histológicas I-EXPLORATION -muestran I-EXPLORATION -todas I-EXPLORATION -ellas I-EXPLORATION -un I-EXPLORATION -mismo I-EXPLORATION -aspecto: I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -mayor I-EXPLORATION -parte I-EXPLORATION -están I-EXPLORATION -constituidas I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION -adiposas I-EXPLORATION -con I-EXPLORATION -tamaño I-EXPLORATION -grande I-EXPLORATION -de I-EXPLORATION -vacuola I-EXPLORATION -grande I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -maduro. I-EXPLORATION -Se I-EXPLORATION -observa I-EXPLORATION -también I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -núcleos I-EXPLORATION -atípicos I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -focal, I-EXPLORATION -con I-EXPLORATION -citoplasma I-EXPLORATION -vacuolado. I-EXPLORATION -Estas I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -maduro I-EXPLORATION -están I-EXPLORATION -distribuidas I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -difusa I-EXPLORATION -por I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -neoplasia, I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -focos I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -atípicos, I-EXPLORATION -en I-EXPLORATION -ocasiones I-EXPLORATION -hipercromáticos I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -aislada. I-EXPLORATION -Diagnóstico: I-EXPLORATION -Liposarcoma I-EXPLORATION -bien I-EXPLORATION -diferenciado. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -Ca I-EXPLORATION -19, I-EXPLORATION -9, I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -quirúrgica I-EXPLORATION -presenta I-EXPLORATION -normalización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -(24, I-EXPLORATION -17 I-EXPLORATION -U/l), I-EXPLORATION -manteniéndose I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -normales. I-EXPLORATION -Posteriormente B-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -radioterapia I-TREATMENT -complementaria, I-TREATMENT -presentando I-TREATMENT -una I-TREATMENT -evolución I-TREATMENT -favorable I-TREATMENT -y I-TREATMENT -permaneciendo I-TREATMENT -asintomático. I-TREATMENT -La B-EXPLORATION -RM I-EXPLORATION -abdominopélvica I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -realizada I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -cinco I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -quirurgica I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -estado I-EXPLORATION -postoperatorio I-EXPLORATION -del I-EXPLORATION -liposarcoma I-EXPLORATION -retroperitoneal, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -macroscópica I-EXPLORATION -de I-EXPLORATION -lesión. I-EXPLORATION -Así B-EVOLUTION -este I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable, I-EVOLUTION -permaneciendo I-EVOLUTION -asintomático I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -transcurriendo I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -artritis. I-PRESENT_ILLNESS -Tres B-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -comienza I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fiebre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -39º I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carácter I-PAST_MEDICAL_HISTORY -intermitente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -artralgias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tumefacción I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -tobillos, I-PAST_MEDICAL_HISTORY -rodillas, I-PAST_MEDICAL_HISTORY -codos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -muñecas. I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destaca I-EXPLORATION -palidez I-EXPLORATION -y I-EXPLORATION -discreto I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -difuso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -profunda. I-EXPLORATION -Datos I-EXPLORATION -analíticos: I-EXPLORATION -Hb I-EXPLORATION -9, I-EXPLORATION -6 I-EXPLORATION -mg/dL; I-EXPLORATION -HTO I-EXPLORATION -31%, I-EXPLORATION -VCM I-EXPLORATION -65 I-EXPLORATION -mm, I-EXPLORATION -660.000 I-EXPLORATION -plaquetas/mL, I-EXPLORATION -ferritina I-EXPLORATION -65 I-EXPLORATION -ng/mL, I-EXPLORATION -Fe I-EXPLORATION -15 I-EXPLORATION -microg/dL, I-EXPLORATION -fibrinógeno I-EXPLORATION -644 I-EXPLORATION -mg/dL, I-EXPLORATION -PCR I-EXPLORATION -55 I-EXPLORATION -mg/dL. I-EXPLORATION -Resto I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -bioquímicos, I-EXPLORATION -serológicos I-EXPLORATION -e I-EXPLORATION -inmunológicos I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -sigmoide I-EXPLORATION -hasta I-EXPLORATION -ciego, I-EXPLORATION -observándose I-EXPLORATION -úlceras I-EXPLORATION -transversales I-EXPLORATION -y I-EXPLORATION -longitudinales I-EXPLORATION -del I-EXPLORATION -colon. I-EXPLORATION -La I-EXPLORATION -colonoscopia I-EXPLORATION -demuestra I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -descendente I-EXPLORATION -y I-EXPLORATION -sigmoide, I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -eritematosa I-EXPLORATION -y I-EXPLORATION -edematosa, I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -ulceraciones I-EXPLORATION -y I-EXPLORATION -pseudopólipos I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -anatomopatológicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -son I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn. I-EXPLORATION - I-EXPLORATION -Curso B-EVOLUTION -evolutivo: I-EVOLUTION -la I-EVOLUTION -enferma I-EVOLUTION -cursó I-EVOLUTION -posteriormente I-EVOLUTION -con I-EVOLUTION -diarrea I-EVOLUTION -con I-EVOLUTION -2-3 I-EVOLUTION -deposiciones I-EVOLUTION -líquidas I-EVOLUTION -diarias I-EVOLUTION -sin I-EVOLUTION -productos I-EVOLUTION -patológicos I-EVOLUTION -y I-EVOLUTION -lesiones I-EVOLUTION -cutáneas I-EVOLUTION -de I-EVOLUTION -eritema I-EVOLUTION -nodoso. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Cowden I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -formaciones I-PAST_MEDICAL_HISTORY -papilomatosas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dorso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -lengua I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tamaño I-PAST_MEDICAL_HISTORY -variable, I-PAST_MEDICAL_HISTORY -macroglosia I-PAST_MEDICAL_HISTORY -saburral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pápulas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -color I-PAST_MEDICAL_HISTORY -piel I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mucosa I-PAST_MEDICAL_HISTORY -lingual I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -modo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -empedrado. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -resultado I-PAST_MEDICAL_HISTORY -anatomopatoógico I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -fibroepiteliales I-PAST_MEDICAL_HISTORY -(12). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -dermatológico I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -extensión: I-PAST_MEDICAL_HISTORY -a) I-PAST_MEDICAL_HISTORY -tránsito I-PAST_MEDICAL_HISTORY -EGD I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enema I-PAST_MEDICAL_HISTORY -opaco I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -evidencian I-PAST_MEDICAL_HISTORY -numerosos I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antro I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ampolla I-PAST_MEDICAL_HISTORY -rectal; I-PAST_MEDICAL_HISTORY -b) I-PAST_MEDICAL_HISTORY -endoscopias I-PAST_MEDICAL_HISTORY -digestivas I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -baja: I-PAST_MEDICAL_HISTORY -parcheado I-PAST_MEDICAL_HISTORY -difuso I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -esófago I-PAST_MEDICAL_HISTORY -cervical I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -cardias I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -histológicamente I-PAST_MEDICAL_HISTORY -coincide I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -acantosis I-PAST_MEDICAL_HISTORY -glucogénica; I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -sésiles I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alguno I-PAST_MEDICAL_HISTORY -pediculado I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -estómago I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -ampolla I-PAST_MEDICAL_HISTORY -rectal I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -corresponden I-PAST_MEDICAL_HISTORY -histológicamente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -hamartomatosos; I-PAST_MEDICAL_HISTORY -c) I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -tiroidea: I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -nódulos I-PAST_MEDICAL_HISTORY -sólidos, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -lóbulo. I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -punción I-PAST_MEDICAL_HISTORY -(PAAF) I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -diagnostica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -coloidal; I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -d) I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -tomografía I-PAST_MEDICAL_HISTORY -computerizada I-PAST_MEDICAL_HISTORY -craneal I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -demostró I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -significativas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -actualidad I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cefalea. I-PRESENT_ILLNESS -Dada B-EXPLORATION -su I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -base I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -demostrándose I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -en I-EXPLORATION -hemisferio I-EXPLORATION -cerebeloso I-EXPLORATION -derecho I-EXPLORATION -descrita I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -mal I-EXPLORATION -delimitada I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -discreta I-EXPLORATION -hipodensidad I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -discreta I-EXPLORATION -hiperdensidad I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -T2 I-EXPLORATION -y I-EXPLORATION -FLAIR I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -cortical I-EXPLORATION -cerebelosa I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -posterolateral I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -condiciona I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -desplazamiento I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -IV I-EXPLORATION -ventrículo I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -hidrocefalia I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -supratentorial. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -paramagnético I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -captación I-EXPLORATION -significativa I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -parece I-EXPLORATION -tratarse I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -gangliocitoma I-EXPLORATION -displásico I-EXPLORATION -cerebeloso I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -capas I-EXPLORATION -del I-EXPLORATION -cerebelo I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -produce I-EXPLORATION -un I-EXPLORATION -aparente I-EXPLORATION -laminado I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cortical. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -vivido I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Amazonas I-PAST_MEDICAL_HISTORY -(desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -28 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -35 I-PAST_MEDICAL_HISTORY -años), I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -profesión I-PAST_MEDICAL_HISTORY -médica, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -dispepsia I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -regular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Niega B-EXPLORATION -fiebre, I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -tabaquismo, I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -fármacos I-EXPLORATION -o I-EXPLORATION -drogas I-EXPLORATION -ilícitas. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -datos I-EXPLORATION -significativos I-EXPLORATION -al I-EXPLORATION -exámen I-EXPLORATION -físico. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -laboratorio, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -eritrosedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG), I-EXPLORATION -hormonas I-EXPLORATION -tiroideas, I-EXPLORATION -proteinograma I-EXPLORATION -electroforético I-EXPLORATION -y I-EXPLORATION -complemento, I-EXPLORATION -encontrándose I-EXPLORATION -todos I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -(3 I-EXPLORATION -pares I-EXPLORATION -de I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -2 I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -orina). I-EXPLORATION -Reacción I-EXPLORATION -de I-EXPLORATION -Mantoux I-EXPLORATION -y I-EXPLORATION -serologías I-EXPLORATION -virales, I-EXPLORATION -bacterianas I-EXPLORATION -y I-EXPLORATION -parasitarias I-EXPLORATION -negativas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -agregaron I-EXPLORATION -factor I-EXPLORATION -reumatoideo, I-EXPLORATION -factor I-EXPLORATION -antinuclear, I-EXPLORATION -ANCA I-EXPLORATION -C I-EXPLORATION -y I-EXPLORATION -P, I-EXPLORATION -siendo I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -patología. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -dispepsia I-EXPLORATION -y I-EXPLORATION -pirosis, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -enfermedad I-EXPLORATION -por I-EXPLORATION -RGE I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -esofagitis I-EXPLORATION -grado I-EXPLORATION -dos. I-EXPLORATION -Inició B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -omeprazol I-TREATMENT -40 I-TREATMENT -mg/día, I-TREATMENT -desapareciendo B-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -también I-EVOLUTION -la I-EVOLUTION -sudoración I-EVOLUTION -nocturna, I-EVOLUTION -y I-EVOLUTION -reapareciendo I-EVOLUTION -esta I-EVOLUTION -última I-EVOLUTION -al I-EVOLUTION -suspender I-EVOLUTION -el I-EVOLUTION -fármaco. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -pHmetría I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -no I-EXPLORATION -demostrando I-EXPLORATION -reflujo. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -leve, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -celiaca, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Graves I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -anti-tiroideas, I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vasculitis I-PAST_MEDICAL_HISTORY -ANCA I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -positiva I-PAST_MEDICAL_HISTORY -(enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Wegener I-PAST_MEDICAL_HISTORY -limitada). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -meprednisona I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ciclofosfamida I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -mg/kg/día I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -internación. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -UTI I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -súbita I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -estridor I-PRESENT_ILLNESS -laríngeo I-PRESENT_ILLNESS -inspiratorio, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -sibilancias. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS -minutos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -horas, I-PRESENT_ILLNESS -permaneciendo I-PRESENT_ILLNESS -asintomática I-PRESENT_ILLNESS -intercrisis. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -fibrolaringoscopía I-EXPLORATION -hasta I-EXPLORATION -cuarto I-EXPLORATION -anillo I-EXPLORATION -traqueal I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -lesiones I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -movilidad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cuerdas I-EXPLORATION -impresionó I-EXPLORATION -normal I-EXPLORATION -fuera I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -crisis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cuello I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -calibre I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -glótica I-EXPLORATION -en I-EXPLORATION -inspiración I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -simétrica I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -traquea I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -RGE I-EXPLORATION -y I-EXPLORATION -este I-EXPLORATION -se I-EXPLORATION -diagnóstico I-EXPLORATION -mediante I-EXPLORATION -SEGD. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -EFR I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -obstrucción I-EXPLORATION -moderada I-EXPLORATION -fija, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -curva I-EXPLORATION -inspiratoria. I-EXPLORATION -Permanece B-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -corticoides, I-TREATMENT -beta I-TREATMENT -2 I-TREATMENT -inhalados I-TREATMENT -de I-TREATMENT -larga I-TREATMENT -duración I-TREATMENT -y I-TREATMENT -omeprazol I-TREATMENT -40 I-TREATMENT -mg/día. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT -psicológico I-TREATMENT -ni I-TREATMENT -fonoudiológico. I-TREATMENT -Se B-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -desde I-EVOLUTION -hace I-EVOLUTION -4 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -leucoderma, I-PRESENT_ILLNESS -fue B-DERIVED_FROM/TO -enviado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Ambulatorio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Estomatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Clínicas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Porto I-DERIVED_FROM/TO -Alegre I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -Cirujano I-DERIVED_FROM/TO -Dentista I-DERIVED_FROM/TO -debido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -múltiples I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -papilomatosas I-DERIVED_FROM/TO -dispersas I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -mucosa I-DERIVED_FROM/TO -bucal. I-DERIVED_FROM/TO -La B-FAMILY_HISTORY -madre I-FAMILY_HISTORY -del I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -relató I-FAMILY_HISTORY -que I-FAMILY_HISTORY -la I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -del I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -presentaba I-FAMILY_HISTORY -lesiones I-FAMILY_HISTORY -semejantes, I-FAMILY_HISTORY -las I-FAMILY_HISTORY -cuales I-FAMILY_HISTORY -fueron I-FAMILY_HISTORY -tratadas I-FAMILY_HISTORY -por I-FAMILY_HISTORY -cauterización. I-FAMILY_HISTORY -En B-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -físico I-EXPLORATION -intraoral, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -papilomatosas, I-EXPLORATION -algunas I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -nodular, I-EXPLORATION -otras I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -verrugas, I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -bucal I-EXPLORATION -e I-EXPLORATION -indoloras. I-EXPLORATION -Las I-EXPLORATION -lesiones I-EXPLORATION -se I-EXPLORATION -localizaban I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -comisura I-EXPLORATION -labial I-EXPLORATION -bilateral, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -retrocomisural, I-EXPLORATION -bilateral, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -superior I-EXPLORATION -e I-EXPLORATION -inferior, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -borde I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -1/3 I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -palato I-EXPLORATION -duro, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -mediana. I-EXPLORATION -El I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -variaba I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -La I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -Hiperplasia I-EXPLORATION -Focal I-EXPLORATION -del I-EXPLORATION -Epitelio. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -excisional I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -comisura I-EXPLORATION -labial I-EXPLORATION -lado I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -aspecto I-EXPLORATION -histopatológico I-EXPLORATION -demostró I-EXPLORATION -acantosis I-EXPLORATION -del I-EXPLORATION -epitelio, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -crestas I-EXPLORATION -interpapilares I-EXPLORATION -ensanchadas, I-EXPLORATION -coilocitosis I-EXPLORATION -y I-EXPLORATION -alteración I-EXPLORATION -nuclear, I-EXPLORATION -conocida I-EXPLORATION -como I-EXPLORATION -figura I-EXPLORATION -mitosoide. I-EXPLORATION -La I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -virus I-EXPLORATION -del I-EXPLORATION -HPV I-EXPLORATION -13 I-EXPLORATION -fue I-EXPLORATION -comprobada I-EXPLORATION -por I-EXPLORATION -análisis I-EXPLORATION -inmunohistoquímica. I-EXPLORATION -Esas I-EXPLORATION -características I-EXPLORATION -llevan I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -de I-EXPLORATION -Hiperplasia I-EXPLORATION -Focal I-EXPLORATION -del I-EXPLORATION -Epitelio. I-EXPLORATION -A B-EVOLUTION -la I-EVOLUTION -madre I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -informó I-EVOLUTION -sobre I-EVOLUTION -las I-EVOLUTION -características I-EVOLUTION -de I-EVOLUTION -benignidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -y, I-EVOLUTION -se I-EVOLUTION -espera I-EVOLUTION -que I-EVOLUTION -disminuyan I-EVOLUTION -las I-EVOLUTION -lesiones. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -en I-EVOLUTION -acompañamiento I-EVOLUTION -semestral. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -84 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Estomatología I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Oral I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Universidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cartagena I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -molestia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -cavidad I-DERIVED_FROM/TO -oral. I-DERIVED_FROM/TO -Al B-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -múltiples I-EXPLORATION -placas, I-EXPLORATION -manchas I-EXPLORATION -y I-EXPLORATION -verrugosidades I-EXPLORATION -distribuidas I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -irregular I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -paladar I-EXPLORATION -duro I-EXPLORATION -comprometiendo I-EXPLORATION -tercio I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -medio, I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -derecho; I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -tonalidad I-EXPLORATION -variante I-EXPLORATION -desde I-EXPLORATION -un I-EXPLORATION -blanco I-EXPLORATION -grisáceo I-EXPLORATION -hasta I-EXPLORATION -un I-EXPLORATION -blanco I-EXPLORATION -amarillo; I-EXPLORATION -tamaño I-EXPLORATION -que I-EXPLORATION -oscila I-EXPLORATION -aproximadamente I-EXPLORATION -sobre I-EXPLORATION -3×5 I-EXPLORATION -cm, I-EXPLORATION -forma I-EXPLORATION -variada I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -verrugosa I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -blanda, I-EXPLORATION -bordes I-EXPLORATION -definidos, I-EXPLORATION -asintomática; I-EXPLORATION -no I-EXPLORATION -desprende I-EXPLORATION -al I-EXPLORATION -raspado I-EXPLORATION -e I-EXPLORATION -imperceptible I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -misma. I-EXPLORATION -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -reporta I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -invertida I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -fumar I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -esta I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -da I-EXPLORATION -una I-EXPLORATION -impresión I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -leucoplasia I-EXPLORATION -homogénea I-EXPLORATION -y, I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo, I-EXPLORATION -se I-EXPLORATION -programó I-EXPLORATION -biopsia I-EXPLORATION -incisional. I-EXPLORATION - I-EXPLORATION -Procedimiento B-TREATMENT - I-TREATMENT -Previo I-TREATMENT -consentimiento I-TREATMENT -informado, I-TREATMENT -se I-TREATMENT -aplica I-TREATMENT -técnica I-TREATMENT -anestésica I-TREATMENT -nasopalatina I-TREATMENT -y I-TREATMENT -palatina I-TREATMENT -anterior I-TREATMENT -bilateral, I-TREATMENT -utilizando I-TREATMENT -lidocaína I-TREATMENT -con I-TREATMENT -epinefrina I-TREATMENT -al I-TREATMENT -2%; I-TREATMENT -luego I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -incisión I-TREATMENT -romboidal I-TREATMENT -con I-TREATMENT -hoja I-TREATMENT -de I-TREATMENT -bisturí I-TREATMENT -número I-TREATMENT -15 I-TREATMENT -en I-TREATMENT -borde I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -paladar I-TREATMENT -duro I-TREATMENT -del I-TREATMENT -lado I-TREATMENT -derecho, I-TREATMENT -seguido I-TREATMENT -de I-TREATMENT -la I-TREATMENT -disección I-TREATMENT -del I-TREATMENT -tejido, I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -tomó I-TREATMENT -con I-TREATMENT -pinza I-TREATMENT -Alix I-TREATMENT -para I-TREATMENT -proteger I-TREATMENT -y I-TREATMENT -manipular I-TREATMENT -mejor I-TREATMENT -la I-TREATMENT -muestra I-TREATMENT -de I-TREATMENT -tejido, I-TREATMENT -se I-TREATMENT -hace I-TREATMENT -hemostasia I-TREATMENT -con I-TREATMENT -una I-TREATMENT -torunda I-TREATMENT -de I-TREATMENT -gasa I-TREATMENT -estéril, I-TREATMENT -tomando I-TREATMENT -cuatro I-TREATMENT -puntos I-TREATMENT -de I-TREATMENT -sutura I-TREATMENT -con I-TREATMENT -seda I-TREATMENT -3/0, I-TREATMENT -lavado I-TREATMENT -y I-TREATMENT -secado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -zona. I-TREATMENT -Se I-TREATMENT -dieron I-TREATMENT -indicaciones I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -verbal I-TREATMENT -y I-TREATMENT -por I-TREATMENT -escrito. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -regresa I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -control I-EVOLUTION -posquirúrgico I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -observándose I-EVOLUTION -tejidos I-EVOLUTION -en I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -proceso I-EVOLUTION -de I-EVOLUTION -cicatrización. I-EVOLUTION -El B-EXPLORATION -reporte I-EXPLORATION -histopatológico I-EXPLORATION -indica I-EXPLORATION -mucosa I-EXPLORATION -palatina I-EXPLORATION -con I-EXPLORATION -marcada I-EXPLORATION -queratosis I-EXPLORATION -sin I-EXPLORATION -"displasia". I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -controles I-EXPLORATION -mensuales I-EXPLORATION -observando I-EXPLORATION -la I-EXPLORATION -desaparición I-EXPLORATION -casi I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -patología; I-EXPLORATION -sin B-EVOLUTION -embargo I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -reporta I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -iniciado I-EVOLUTION -otra I-EVOLUTION -vez I-EVOLUTION -el I-EVOLUTION -hábito I-EVOLUTION -de I-EVOLUTION -fumar I-EVOLUTION -invertido I-EVOLUTION -y, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -último I-EVOLUTION -control, I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -aparición I-EVOLUTION -nuevamente I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -placas I-EVOLUTION -blancas. I-EVOLUTION -Observamos I-EVOLUTION -entonces I-EVOLUTION -una I-EVOLUTION -fuerte I-EVOLUTION -asociación I-EVOLUTION -entre I-EVOLUTION -el I-EVOLUTION -fumar I-EVOLUTION -invertido I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -lesiones I-EVOLUTION -premalignas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino; I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -reiterados I-PRESENT_ILLNESS -accesos I-PRESENT_ILLNESS -dolorosos I-PRESENT_ILLNESS -caracterizados I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hemicrania I-PRESENT_ILLNESS -pulsátil, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -urente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -neurálgico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -retroorbitaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fenómenos I-PRESENT_ILLNESS -productivos I-PRESENT_ILLNESS -autonómicos I-PRESENT_ILLNESS -homolaterales I-PRESENT_ILLNESS -(rinorrea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lagrimeo). I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -eran I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -corta I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -(de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -segundos I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -minutos), I-PRESENT_ILLNESS -reiterados, I-PRESENT_ILLNESS -subintrantes, I-PRESENT_ILLNESS -postraban I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deterioraban I-PRESENT_ILLNESS -sensiblemente I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -actividad I-PRESENT_ILLNESS -diaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -vigilia. I-PRESENT_ILLNESS -Ocasionalmente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompañaban I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -Este I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -presentaba, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio, I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución; I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -analgésico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -antimigrañoso I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -totalmente I-PRESENT_ILLNESS -ineficaz. I-PRESENT_ILLNESS -Examen B-EXPLORATION -neurológico I-EXPLORATION -intercrítico I-EXPLORATION -normal. I-EXPLORATION -Valoración I-EXPLORATION -oftalmológica I-EXPLORATION -y I-EXPLORATION -otorrinolaringológica I-EXPLORATION -normales. I-EXPLORATION -Psicodiagnóstico I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -de I-EXPLORATION -personalidad I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -remarcables. I-EXPLORATION -Se I-EXPLORATION -efectuaron I-EXPLORATION -neuroimágenes I-EXPLORATION -(RMN/RMN I-EXPLORATION -angiográfica), I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -empleó I-TREATMENT -indometacina, I-TREATMENT -con I-TREATMENT -muy I-TREATMENT -pobres I-TREATMENT -resultados. I-TREATMENT -Los B-EVOLUTION -indicadores I-EVOLUTION -de I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -calendario I-EVOLUTION -de I-EVOLUTION -cefaleas I-EVOLUTION -mostraban I-EVOLUTION -un I-EVOLUTION -importante I-EVOLUTION -deterioro. I-EVOLUTION - I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -usar I-TREATMENT -entonces I-TREATMENT -alguno I-TREATMENT -de I-TREATMENT -los I-TREATMENT -fármacos I-TREATMENT -que I-TREATMENT -cumplen I-TREATMENT -un I-TREATMENT -rol I-TREATMENT -de I-TREATMENT -estabilizadores I-TREATMENT -de I-TREATMENT -membrana, I-TREATMENT -como I-TREATMENT -el I-TREATMENT -grupo I-TREATMENT -de I-TREATMENT -drogas I-TREATMENT -antiepilépticas I-TREATMENT -(DAE) I-TREATMENT -relativamente I-TREATMENT -nuevas, I-TREATMENT -entre I-TREATMENT -las I-TREATMENT -cuales I-TREATMENT -se I-TREATMENT -eligió I-TREATMENT -el I-TREATMENT -topiramato I-TREATMENT -(TPM). I-TREATMENT -Tal I-TREATMENT -decisión I-TREATMENT -tuvo I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -informes I-TREATMENT -sobre I-TREATMENT -indicios I-TREATMENT -de I-TREATMENT -eficacia I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -del I-TREATMENT -SUNCT8 I-TREATMENT -y I-TREATMENT -su I-TREATMENT -mejor I-TREATMENT -perfil I-TREATMENT -de I-TREATMENT -bioseguridad, I-TREATMENT -respecto I-TREATMENT -de I-TREATMENT -los I-TREATMENT -otros I-TREATMENT -agentes I-TREATMENT -(gabapentín, I-TREATMENT -lamotrigina). I-TREATMENT -Se I-TREATMENT -comenzó I-TREATMENT -con I-TREATMENT -25 I-TREATMENT -mg/d I-TREATMENT -en I-TREATMENT -una I-TREATMENT -sola I-TREATMENT -toma I-TREATMENT -nocturna I-TREATMENT -hasta I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -75 I-TREATMENT -mg/d I-TREATMENT -con I-TREATMENT -idéntica I-TREATMENT -posología. I-TREATMENT -La B-EVOLUTION -introducción I-EVOLUTION -del I-EVOLUTION -TPM I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -esquema I-EVOLUTION -redundó I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -reducción I-EVOLUTION -parcial I-EVOLUTION -importante I-EVOLUTION -(50-75%, I-EVOLUTION -no I-EVOLUTION -completa) I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -episodios, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -evidente I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -documentada I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -MIDAS, I-EVOLUTION -instrumento I-EVOLUTION -que I-EVOLUTION -si I-EVOLUTION -bien I-EVOLUTION -no I-EVOLUTION -fue I-EVOLUTION -desarrollado I-EVOLUTION -específicamente I-EVOLUTION -para I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -cuadro I-EVOLUTION -permite I-EVOLUTION -valorar, I-EVOLUTION -mediante I-EVOLUTION -una I-EVOLUTION -escala I-EVOLUTION -global, I-EVOLUTION -el I-EVOLUTION -compromiso I-EVOLUTION -diario I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -afectado. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -relevantes, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -foco I-PRESENT_ILLNESS -detectable. I-PRESENT_ILLNESS -A B-EXPLORATION -las I-EXPLORATION -72 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -iniciado I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico, I-EXPLORATION -el I-EXPLORATION -niño I-EXPLORATION -refiere I-EXPLORATION -dolor I-EXPLORATION -e I-EXPLORATION -impotencia I-EXPLORATION -funcional I-EXPLORATION -en I-EXPLORATION -hombro I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -flogosis I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -inicial I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -del I-EXPLORATION -hombro I-EXPLORATION -afectado, I-EXPLORATION -ambos I-EXPLORATION -estudios I-EXPLORATION -con I-EXPLORATION -resultados I-EXPLORATION -normales. I-EXPLORATION -Luego I-EXPLORATION -de I-EXPLORATION -presentar I-EXPLORATION -fiebre I-EXPLORATION -elevada I-EXPLORATION -y I-EXPLORATION -persistente I-EXPLORATION -durante I-EXPLORATION -6 I-EXPLORATION -días, I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -eritema I-EXPLORATION -y I-EXPLORATION -edema I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -esternoclavicular I-EXPLORATION -derecha, I-EXPLORATION -motivo I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -su I-EXPLORATION -internación. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -iniciales I-EXPLORATION -revelan I-EXPLORATION -leucocitosis I-EXPLORATION -(GB: I-EXPLORATION -19.890/mm3 I-EXPLORATION -) I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(85%) I-EXPLORATION -proteína I-EXPLORATION -C-reactiva I-EXPLORATION -(PC-R: I-EXPLORATION -90) I-EXPLORATION -y I-EXPLORATION -eritrosedimentación I-EXPLORATION -elevadas I-EXPLORATION -(ERS: I-EXPLORATION -57 I-EXPLORATION -mm). I-EXPLORATION -La I-EXPLORATION -CPK I-EXPLORATION -informa I-EXPLORATION -valores I-EXPLORATION -normales I-EXPLORATION -(50 I-EXPLORATION -UI/L). I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -foco I-EXPLORATION -profundo I-EXPLORATION -de I-EXPLORATION -infección, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RMN) I-EXPLORATION -que I-EXPLORATION -evidencia I-EXPLORATION -un I-EXPLORATION -intenso I-EXPLORATION -mioedema I-EXPLORATION -que I-EXPLORATION -compromete I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -trapecio I-EXPLORATION -y I-EXPLORATION -pectoral I-EXPLORATION -mayor I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefalotina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -parenteral. I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -continúa I-EVOLUTION -febril; I-EVOLUTION -además, I-EVOLUTION -presenta I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -eritema I-EVOLUTION -y I-EVOLUTION -edema I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -afectada. I-EVOLUTION -Se B-EXPLORATION -reciben I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -tomados I-EXPLORATION -al I-EXPLORATION -ingreso, I-EXPLORATION -que I-EXPLORATION -resultan I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -SAMRC I-EXPLORATION -(resistente I-EXPLORATION -a I-EXPLORATION -clindamicina); I-EXPLORATION -se B-TREATMENT -modifica I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -terapéutico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -indica I-TREATMENT -vancomicina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endovenosa I-TREATMENT -y I-TREATMENT -rifampicina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -Dos B-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -la I-EVOLUTION -fiebre I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -disminuir I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -se I-EVOLUTION -torna I-EVOLUTION -circunscripta I-EVOLUTION -y I-EVOLUTION -fluctuante. I-EVOLUTION -Aparece I-EVOLUTION -además I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -cutáneo I-EVOLUTION -eritematopustuloso I-EVOLUTION -con I-EVOLUTION -descamación I-EVOLUTION -que I-EVOLUTION -predomina I-EVOLUTION -en I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -axila. I-EVOLUTION -Se B-EXPLORATION -realiza I-EXPLORATION -hisopado I-EXPLORATION -nasal, I-EXPLORATION -axilar I-EXPLORATION -y I-EXPLORATION -anal, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -obtiene I-EXPLORATION -el I-EXPLORATION -germen I-EXPLORATION -aislado I-EXPLORATION -previamente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -nasal. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -RMN, I-EXPLORATION -se I-EXPLORATION -comprueba I-EXPLORATION -mayor I-EXPLORATION -jerarquía I-EXPLORATION -del I-EXPLORATION -edema I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -trapecio I-EXPLORATION -y I-EXPLORATION -pectoral I-EXPLORATION -mayor I-EXPLORATION -derecho, I-EXPLORATION -extendiéndose I-EXPLORATION -el I-EXPLORATION -proceso I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -pectoral I-EXPLORATION -menor, I-EXPLORATION -subclavio, I-EXPLORATION -romboides I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -tejido I-EXPLORATION -blando I-EXPLORATION -adyacente. I-EXPLORATION -Formación I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -que I-EXPLORATION -rodea I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -proximal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -clavícula I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Posteriormente, B-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -del I-TREATMENT -absceso I-TREATMENT -por I-TREATMENT -punción I-TREATMENT -y I-TREATMENT -se I-TREATMENT -solicita I-TREATMENT -un I-TREATMENT -centellograma I-TREATMENT -que I-TREATMENT -descarta I-TREATMENT -el I-TREATMENT -compromiso I-TREATMENT -óseo. I-TREATMENT -El B-EVOLUTION -niño I-EVOLUTION -evoluciona I-EVOLUTION -favorablemente I-EVOLUTION -y B-TREATMENT -completa I-TREATMENT -diez I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -parenteral I-TREATMENT -y I-TREATMENT -luego, I-TREATMENT -veinte I-TREATMENT -días I-TREATMENT -con I-TREATMENT -trimetroprimasulfametoxasol I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT - I-TREATMENT - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -patología I-PAST_MEDICAL_HISTORY -alérgica, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -angioedema I-PRESENT_ILLNESS -intratable I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Pese B-TREATMENT -a I-TREATMENT -utilizarse I-TREATMENT -dosis I-TREATMENT -máximas I-TREATMENT -de I-TREATMENT -varios I-TREATMENT -antihistamínicos I-TREATMENT -combinados, I-TREATMENT -antileucotrienos I-TREATMENT -y I-TREATMENT -esteroides I-TREATMENT -orales I-TREATMENT -no I-TREATMENT -se I-TREATMENT -observó I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT -tratamiento. I-TREATMENT - I-TREATMENT -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -repercutía I-PRESENT_ILLNESS -sobremanera I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -niña, I-PRESENT_ILLNESS -tanto I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -continuo I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -placa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -angioedema I-PRESENT_ILLNESS -claramente I-PRESENT_ILLNESS -visibles, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -afectan I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sueño, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -escolaridad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -interpersonal. I-PRESENT_ILLNESS -El B-EXPLORATION -laboratorio I-EXPLORATION -presentaba, I-EXPLORATION -como I-EXPLORATION -datos I-EXPLORATION -positivos: I-EXPLORATION -PCR, I-EXPLORATION -21; I-EXPLORATION -factor I-EXPLORATION -reumatoideo, I-EXPLORATION -24 I-EXPLORATION -UI/ml I-EXPLORATION -(normal I-EXPLORATION -hasta I-EXPLORATION -20). I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -posibles I-EXPLORATION -causas I-EXPLORATION -infecciosas. I-EXPLORATION - I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -vasculitis. I-EXPLORATION -Se I-EXPLORATION -efectuaron I-EXPLORATION -dietas I-EXPLORATION -de I-EXPLORATION -exclusión I-EXPLORATION -de I-EXPLORATION -alimentos, I-EXPLORATION -aditivos I-EXPLORATION -y I-EXPLORATION -colorantes, I-EXPLORATION -sin I-EXPLORATION -mejoría I-EXPLORATION -sintomática. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -suero I-EXPLORATION -autólogo, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -hasta I-EXPLORATION -una I-EXPLORATION -dilución I-EXPLORATION -1: I-EXPLORATION -100, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -urticaria I-EXPLORATION -crónica I-EXPLORATION -autoinmunitaria. I-EXPLORATION -Previamente B-TREATMENT -a I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -omalizumab I-TREATMENT -se I-TREATMENT -evaluaron I-TREATMENT -los I-TREATMENT -beneficios I-TREATMENT -y I-TREATMENT -riesgos I-TREATMENT -de I-TREATMENT -otros I-TREATMENT -tratamientos, I-TREATMENT -como I-TREATMENT -ciclosporina I-TREATMENT -o I-TREATMENT -gammaglobulina I-TREATMENT -intravenosa, I-TREATMENT -y I-TREATMENT -dadas I-TREATMENT -las I-TREATMENT -potenciales I-TREATMENT -y I-TREATMENT -mayores I-TREATMENT -complicaciones I-TREATMENT -y I-TREATMENT -riesgos I-TREATMENT -de I-TREATMENT -estos I-TREATMENT -tratamientos, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -omalizumab I-TREATMENT -en I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -calculada I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -al I-TREATMENT -valor I-TREATMENT -de I-TREATMENT -IgE I-TREATMENT -total I-TREATMENT -y I-TREATMENT -del I-TREATMENT -peso I-TREATMENT -corporal, I-TREATMENT -según I-TREATMENT -la I-TREATMENT -dosificación I-TREATMENT -aprobada I-TREATMENT -para I-TREATMENT -asma I-TREATMENT -bronquial I-TREATMENT -(150 I-TREATMENT -mg I-TREATMENT -subcutáneos I-TREATMENT -mensuales). I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -dosis I-EVOLUTION -recrudecieron I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -por I-EVOLUTION -3 I-EVOLUTION -días I-EVOLUTION -y, I-EVOLUTION -posteriormente, I-EVOLUTION -la I-EVOLUTION -urticaria I-EVOLUTION -permaneció I-EVOLUTION -activa, I-EVOLUTION -pero I-EVOLUTION -estable. I-EVOLUTION -Luego I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -dosis I-EVOLUTION -se I-EVOLUTION -repite I-EVOLUTION -el I-EVOLUTION -patrón, I-EVOLUTION -pero I-EVOLUTION -posteriormente I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -disminuir I-EVOLUTION -la I-EVOLUTION -intensidad I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pápulas I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -angioedema; I-EVOLUTION -esta I-EVOLUTION -mejoría I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -torna I-EVOLUTION -más I-EVOLUTION -notable I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -tercera I-EVOLUTION -dosis, I-EVOLUTION -al I-EVOLUTION -cuarto I-EVOLUTION -mes I-EVOLUTION -(cuarta I-EVOLUTION -dosis) I-EVOLUTION -llega I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -aparente I-EVOLUTION -remisión, I-EVOLUTION -hecho B-TREATMENT -que I-TREATMENT -permite I-TREATMENT -suspender I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -sucesiva I-TREATMENT -el I-TREATMENT -montelukast I-TREATMENT -y I-TREATMENT -la I-TREATMENT -ranitidina, I-TREATMENT -y I-TREATMENT -reducir I-TREATMENT -a I-TREATMENT -la I-TREATMENT -mitad I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -hidroxicina I-TREATMENT -sin I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -recaída. I-TREATMENT -Hacia B-EVOLUTION -el I-EVOLUTION -quinto I-EVOLUTION -mes, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -por I-EVOLUTION -completo I-EVOLUTION -asintomática, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspenden I-TREATMENT -los I-TREATMENT -antihistamínicos I-TREATMENT -remanentes. I-TREATMENT -Al B-EXPLORATION -sexto I-EXPLORATION -mes, I-EXPLORATION -se I-EXPLORATION -repite I-EXPLORATION -la I-EXPLORATION -prueba I-EXPLORATION -del I-EXPLORATION -suero I-EXPLORATION -autólogo, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -negativa; I-EXPLORATION -se I-EXPLORATION -verifica I-EXPLORATION -normalización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -factor I-EXPLORATION -reumatoideo. I-EXPLORATION -Posteriormente B-EVOLUTION -se I-EVOLUTION -completan I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -omalizumab. I-EVOLUTION -Seis I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -continuó I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -alteraciones I-EVOLUTION -del I-EVOLUTION -laboratorio. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -concurre I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -consultorio I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -interpretado, I-PRESENT_ILLNESS -doce I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia, I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -broncoobstrucción I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -trató I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -salbutamol I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -prednisolona. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -niño I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -eutrófico, I-PAST_MEDICAL_HISTORY -recién I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -destacar. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presenta I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -fiebre I-EXPLORATION -de I-EXPLORATION -38, I-EXPLORATION -2ºC, I-EXPLORATION -tumoración I-EXPLORATION -bilateral I-EXPLORATION -en I-EXPLORATION -cuello, I-EXPLORATION -blanda, I-EXPLORATION -dolorosa I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -crepitación I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -submandibular. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -es I-EXPLORATION -normal, I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -otitis I-EXPLORATION -media I-EXPLORATION -aguda I-EXPLORATION -(OMA) I-EXPLORATION -congestiva I-EXPLORATION -izquierda. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -respiratorio I-EXPLORATION -presenta I-EXPLORATION -tos I-EXPLORATION -húmeda I-EXPLORATION -leve, I-EXPLORATION -sin I-EXPLORATION -disnea I-EXPLORATION -ni I-EXPLORATION -polipnea; I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -30 I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -sin I-EXPLORATION -tiraje; I-EXPLORATION -buena I-EXPLORATION -entrada I-EXPLORATION -de I-EXPLORATION -aire I-EXPLORATION -bilateral; I-EXPLORATION -rales I-EXPLORATION -subcrepitantes I-EXPLORATION -diseminados. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -auscultan I-EXPLORATION -roncus I-EXPLORATION -o I-EXPLORATION -sibilancias I-EXPLORATION -(última I-EXPLORATION -nebulización I-EXPLORATION -con I-EXPLORATION -salbutamol I-EXPLORATION -hacía I-EXPLORATION -7 I-EXPLORATION -h). I-EXPLORATION -Se I-EXPLORATION -interpreta I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -como I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -acceso I-EXPLORATION -de I-EXPLORATION -tos I-EXPLORATION -intensa I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -solicitan I-EXPLORATION -radiografías I-EXPLORATION -con I-EXPLORATION -nota I-EXPLORATION -al I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Urgencias I-EXPLORATION -para I-EXPLORATION -eventual I-EXPLORATION -internación. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -interna I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza: I-EXPLORATION -saturometría I-EXPLORATION -O2 I-EXPLORATION -(FIO2 I-EXPLORATION -aire I-EXPLORATION -ambiental): I-EXPLORATION -97%, I-EXPLORATION -hemograma: I-EXPLORATION -glóbulos I-EXPLORATION -blancos: I-EXPLORATION -6.000 I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION -hemoglobina: I-EXPLORATION -11 I-EXPLORATION -g%, I-EXPLORATION -fórmula I-EXPLORATION -leucocitaria: I-EXPLORATION -6/72/2/0/16/4; I-EXPLORATION -proteína I-EXPLORATION -C-reactiva: I-EXPLORATION -45 I-EXPLORATION -mg/dl; I-EXPLORATION -medio I-EXPLORATION -interno I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -bacterias I-EXPLORATION -atípicas. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -TAC. I-EXPLORATION -Se I-EXPLORATION -interna I-EXPLORATION -por I-EXPLORATION -72 I-EXPLORATION -h, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -constatan I-EXPLORATION -sibilancias I-EXPLORATION -ni I-EXPLORATION -espiración I-EXPLORATION -prolongada I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -da I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -sostén I-TREATMENT -con I-TREATMENT -analgesia, I-TREATMENT -O2 I-TREATMENT -por I-TREATMENT -cánula I-TREATMENT -nasal I-TREATMENT -y I-TREATMENT -amoxicilina I-TREATMENT -para I-TREATMENT -la I-TREATMENT -OMA. I-TREATMENT -Presenta B-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -tumoración I-EVOLUTION -cervical, I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -cervical I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -fiebre. I-EVOLUTION -La B-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -al I-EXPLORATION -alta I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -5 I-EXPLORATION -to I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -evolución, I-EXPLORATION -ya I-EXPLORATION -en I-EXPLORATION -seguimiento I-EXPLORATION -ambulatorio, I-EXPLORATION -se I-EXPLORATION -recibe I-EXPLORATION -serología: I-EXPLORATION -IgM I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -anti-Clamidia I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -anti-Mycoplasma I-EXPLORATION -pneumoniae: I-EXPLORATION -negativos. I-EXPLORATION -La I-EXPLORATION -IgG I-EXPLORATION -anti-Mycoplasma I-EXPLORATION -pneumoniae I-EXPLORATION -fue I-EXPLORATION -positiva: I-EXPLORATION -1/80 I-EXPLORATION -por I-EXPLORATION -inmunofluorescencia I-EXPLORATION -indirecta. I-EXPLORATION -Se B-TREATMENT -decide I-TREATMENT -rotar I-TREATMENT -la I-TREATMENT -amoxicilina I-TREATMENT -por I-TREATMENT -claritromicina I-TREATMENT -y I-TREATMENT -repetir I-TREATMENT -serología I-TREATMENT -a I-TREATMENT -los I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -evolución. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -d I-EVOLUTION -ías I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático. I-EVOLUTION -Serología: B-EXPLORATION -IgM I-EXPLORATION -anti-Mycoplasma: I-EXPLORATION -negativa I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -anti-Mycoplasma: I-EXPLORATION -positiva I-EXPLORATION -1/64 I-EXPLORATION -(IFI). I-EXPLORATION -IgA: I-EXPLORATION -108 I-EXPLORATION -mg/dl, I-EXPLORATION -IgE: I-EXPLORATION -31, I-EXPLORATION -1 I-EXPLORATION -UI/ml I-EXPLORATION -(vn: I-EXPLORATION -60-144), I-EXPLORATION -IgG: I-EXPLORATION -818 I-EXPLORATION -mg/dl I-EXPLORATION -(vn: I-EXPLORATION -315-1236), I-EXPLORATION -IgM: I-EXPLORATION -72 I-EXPLORATION -mg/dl I-EXPLORATION -(vn: I-EXPLORATION -43-207), I-EXPLORATION -proteinograma: I-EXPLORATION -proteínas I-EXPLORATION -totales: I-EXPLORATION -7, I-EXPLORATION -51, I-EXPLORATION -albúmina: I-EXPLORATION -4, I-EXPLORATION -49, I-EXPLORATION -alfa I-EXPLORATION -1: I-EXPLORATION -0, I-EXPLORATION -27, I-EXPLORATION -alfa I-EXPLORATION -2: I-EXPLORATION -101 I-EXPLORATION -(elevada), I-EXPLORATION -β-globulina: I-EXPLORATION -0, I-EXPLORATION -90, I-EXPLORATION -gamma: I-EXPLORATION -0, I-EXPLORATION -84. I-EXPLORATION -Relación I-EXPLORATION -albúmina-globulina: I-EXPLORATION -1, I-EXPLORATION -49 I-EXPLORATION -(normal). I-EXPLORATION -Luego B-EVOLUTION -de I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -recurrencias. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -salud I-PAST_MEDICAL_HISTORY -relevantes, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Universitario I-PRESENT_ILLNESS -Austral I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Se B-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -normotenso I-EXPLORATION -y I-EXPLORATION -afebril; I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -placa I-EXPLORATION -eritematosa I-EXPLORATION -y I-EXPLORATION -dolorosa I-EXPLORATION -en I-EXPLORATION -planta I-EXPLORATION -izquierda. I-EXPLORATION -Por B-EVOLUTION -sospecha I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -proceso I-EVOLUTION -infeccioso I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -su I-EVOLUTION -internación. I-EVOLUTION -Se B-EXPLORATION -realizaron I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -que I-EXPLORATION -demostraron I-EXPLORATION -leucocitosis I-EXPLORATION -leve I-EXPLORATION -y I-EXPLORATION -eritrosedimentación I-EXPLORATION -elevada; I-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -punción I-EXPLORATION -por I-EXPLORATION -piel I-EXPLORATION -sana, I-EXPLORATION -todos I-EXPLORATION -ellos I-EXPLORATION -negativos. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -solicitaron: I-EXPLORATION -radiografía, I-EXPLORATION -centellografía I-EXPLORATION -y I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -afectado, I-EXPLORATION -descartándose I-EXPLORATION -compromiso I-EXPLORATION -óseo. I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -ibuprofeno I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -cefalotina I-TREATMENT -100 I-TREATMENT -mg/kg/día I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -h I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -gentamicina I-TREATMENT -5 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -días. I-TREATMENT -Por I-TREATMENT -evolución I-TREATMENT -desfavorable I-TREATMENT -se I-TREATMENT -rotó I-TREATMENT -a I-TREATMENT -clindamicina, I-TREATMENT -40 I-TREATMENT -mg/kg/día I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -rifampicina, I-TREATMENT -20 I-TREATMENT -mg/kg/día I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h. I-TREATMENT -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -internación, I-EVOLUTION -por I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -nódulos I-EVOLUTION -en I-EVOLUTION -miembros I-EVOLUTION -superiores, I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -artralgias I-EVOLUTION -de I-EVOLUTION -tobillos I-EVOLUTION -y I-EVOLUTION -muñecas I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -una I-EVOLUTION -interconsulta I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Dermatología. I-EVOLUTION -En B-EXPLORATION -esa I-EXPLORATION -oportunidad, I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION -eritematosos, I-EXPLORATION -dolorosos, I-EXPLORATION -de I-EXPLORATION -1-2 I-EXPLORATION -cm, I-EXPLORATION -agrupados I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores; I-EXPLORATION -otros I-EXPLORATION -nódulos I-EXPLORATION -eritematopurpúricos, I-EXPLORATION -de I-EXPLORATION -mayor I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -en I-EXPLORATION -arco I-EXPLORATION -interno I-EXPLORATION -de I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -otro I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -tobillo I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpaban I-EXPLORATION -adenomegalias I-EXPLORATION -ni I-EXPLORATION -se I-EXPLORATION -evidenciaban I-EXPLORATION -livedo I-EXPLORATION -reticular, I-EXPLORATION -ulceraciones I-EXPLORATION -u I-EXPLORATION -otros I-EXPLORATION -signos I-EXPLORATION -cutáneos. I-EXPLORATION -Con I-EXPLORATION -diagnósticos I-EXPLORATION -presuntivos I-EXPLORATION -de I-EXPLORATION -panarteritis I-EXPLORATION -nudosa I-EXPLORATION -cutánea I-EXPLORATION -(PANC), I-EXPLORATION -eritema I-EXPLORATION -nudoso I-EXPLORATION -atípico I-EXPLORATION -u I-EXPLORATION -otras I-EXPLORATION -paniculitis, I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -estudios I-EXPLORATION -complementarios: I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -glóbulos I-EXPLORATION -blancos, I-EXPLORATION -10.900 I-EXPLORATION -(neutrófilos I-EXPLORATION -61%; I-EXPLORATION -linfocitos I-EXPLORATION -29%); I-EXPLORATION -hemoglobina, I-EXPLORATION -13, I-EXPLORATION -5 I-EXPLORATION -mg/dl; I-EXPLORATION -hematocrito, I-EXPLORATION -40%; I-EXPLORATION -plaquetas, I-EXPLORATION -292.000/ I-EXPLORATION -mm3; I-EXPLORATION -ESD I-EXPLORATION -32 I-EXPLORATION -mm/h, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina, I-EXPLORATION -96%; I-EXPLORATION -KPTT I-EXPLORATION -36 I-EXPLORATION -seg; I-EXPLORATION -ASTO I-EXPLORATION -400 I-EXPLORATION -UI/ml I-EXPLORATION -(VN<200 I-EXPLORATION -UI/ I-EXPLORATION -ml); I-EXPLORATION -complemento: I-EXPLORATION -C3 I-EXPLORATION -214 I-EXPLORATION -(VN: I-EXPLORATION -90-180); I-EXPLORATION -C4 I-EXPLORATION -45, I-EXPLORATION -3 I-EXPLORATION -(VN: I-EXPLORATION -10-40); I-EXPLORATION -FAN, I-EXPLORATION -ANCA, I-EXPLORATION -FR, I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -VHB, I-EXPLORATION -VHC, I-EXPLORATION -Bartonella, I-EXPLORATION -Mycoplasma I-EXPLORATION -y I-EXPLORATION -EBV: I-EXPLORATION -negativas. I-EXPLORATION -Cultivo I-EXPLORATION -de I-EXPLORATION -fauces: I-EXPLORATION -negativo. I-EXPLORATION -La I-EXPLORATION -PPD I-EXPLORATION -2 I-EXPLORATION -UT I-EXPLORATION -fue I-EXPLORATION -no I-EXPLORATION -reactiva. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -compromiso I-EXPLORATION -sistémico: I-EXPLORATION -hepatograma, I-EXPLORATION -urea, I-EXPLORATION -creatinina, I-EXPLORATION -ionograma, I-EXPLORATION -gases I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -orina, I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo, I-EXPLORATION -presión I-EXPLORATION -ocular, I-EXPLORATION -ecocardiografía I-EXPLORATION -Doppler, I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -de I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -sin I-EXPLORATION -evidenciarse I-EXPLORATION -alteraciones. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -demostró I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -interfaz I-EXPLORATION -dermohipodérmica I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -hipodermis, I-EXPLORATION -compromiso I-EXPLORATION -inflamatorio I-EXPLORATION -neutrofílico I-EXPLORATION -y I-EXPLORATION -material I-EXPLORATION -fibrinoide I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -y I-EXPLORATION -arterias I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -calibre, I-EXPLORATION -con I-EXPLORATION -oclusión I-EXPLORATION -luminal I-EXPLORATION -focal I-EXPLORATION -y I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -algunos I-EXPLORATION -linfocitos I-EXPLORATION -y I-EXPLORATION -numerosos I-EXPLORATION -eosinófilos. I-EXPLORATION -Estos I-EXPLORATION -hallazgos I-EXPLORATION -histopatológicos I-EXPLORATION -permiten I-EXPLORATION -arribar I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -vasculitis I-EXPLORATION -de I-EXPLORATION -pequeños I-EXPLORATION -vasos I-EXPLORATION -dermohipodérmicos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -arterias I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -calibre. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -las I-EXPLORATION -manifestaciones I-EXPLORATION -cutáneas I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -complementarios I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -PANC. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -suspensión I-TREATMENT -del I-TREATMENT -antibiótico I-TREATMENT -y I-TREATMENT -comenzar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -meprednisona I-TREATMENT -1 I-TREATMENT -mg/kg/día, I-TREATMENT -dosis I-TREATMENT -diaria I-TREATMENT -total I-TREATMENT -de I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -penicilina I-TREATMENT -profiláctica, I-TREATMENT -por I-TREATMENT -el I-TREATMENT -antecedente I-TREATMENT -de I-TREATMENT -un I-TREATMENT -ASTO I-TREATMENT -positivo. I-TREATMENT -Hubo B-EVOLUTION -mejoría I-EVOLUTION -parcial I-EVOLUTION -al I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -pero I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -lesiones, I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -artralgias, I-EVOLUTION -se B-TREATMENT -aumentó I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -meprednisona I-TREATMENT -a I-TREATMENT -60 I-TREATMENT -mg/día I-TREATMENT -a I-TREATMENT -los I-TREATMENT -ocho I-TREATMENT -días I-TREATMENT -con B-EVOLUTION -respuesta I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -rebrote I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -posteriores. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -derivada B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -guardia I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -sanatorio I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -celulitis I-DERIVED_FROM/TO -orbitaria I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -internación, I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -antibiótico I-DERIVED_FROM/TO -endovenoso I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -evaluación I-DERIVED_FROM/TO -urgente I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -oftalmología. I-DERIVED_FROM/TO -Datos B-EXPLORATION -positivos I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico: I-EXPLORATION -eritema I-EXPLORATION -y I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -párpado I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -que I-EXPLORATION -dificultaba I-EXPLORATION -la I-EXPLORATION -apertura I-EXPLORATION -ocular, I-EXPLORATION -limitación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mirada I-EXPLORATION -vertical, I-EXPLORATION -prurito I-EXPLORATION -y I-EXPLORATION -crepitación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -del I-EXPLORATION -párpado. I-EXPLORATION -Se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -afebril. I-EXPLORATION - I-EXPLORATION -Al B-PAST_MEDICAL_HISTORY -profundizar I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -interrogatorio, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -descubre I-PAST_MEDICAL_HISTORY -mínimo I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -ocurrido I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estornudo I-PAST_MEDICAL_HISTORY -inmediatamente I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -clínico. I-PAST_MEDICAL_HISTORY -Con B-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -fractura I-EXPLORATION -de I-EXPLORATION -seno I-EXPLORATION -etmoidal I-EXPLORATION -se I-EXPLORATION -solicita: I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -senos I-EXPLORATION -paranasales I-EXPLORATION -(velamiento I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho), I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -orbita I-EXPLORATION -en I-EXPLORATION -cortes I-EXPLORATION -axiales I-EXPLORATION -y I-EXPLORATION -coronales I-EXPLORATION -(zona I-EXPLORATION -de I-EXPLORATION -hipodensidad I-EXPLORATION -en I-EXPLORATION -párpado I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho I-EXPLORATION -levemente I-EXPLORATION -hiperdensa, I-EXPLORATION -desplazamiento I-EXPLORATION -del I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION -derecho I-EXPLORATION -hacia I-EXPLORATION -abajo). I-EXPLORATION -Lámpara I-EXPLORATION -de I-EXPLORATION -hendidura, I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -y I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -diagnostica I-EXPLORATION -fractura I-EXPLORATION -de I-EXPLORATION -lámina I-EXPLORATION -papirácea I-EXPLORATION -del I-EXPLORATION -etmoides. I-EXPLORATION -El B-EVOLUTION -enfisema I-EVOLUTION -subcutáneo I-EVOLUTION -secundario I-EVOLUTION -se I-EVOLUTION -reabsorbe I-EVOLUTION -espontáneamente I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -completa I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución. I-EVOLUTION -Recibió B-TREATMENT -tratamiento I-TREATMENT -profiláctico I-TREATMENT -con I-TREATMENT -amoxicilina/clavulánico I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -sintomático. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(39 I-PRESENT_ILLNESS -ºC) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -recién I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gesta I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -controlado, I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -normal, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -(40 I-PAST_MEDICAL_HISTORY -semanas), I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -(3360 I-PAST_MEDICAL_HISTORY -kg). I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -diagnosticaron I-PAST_MEDICAL_HISTORY -miopía, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encuentra I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -oftalmología. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tracto I-PAST_MEDICAL_HISTORY -urinario I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Escherichia I-PAST_MEDICAL_HISTORY -coli, I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -ambulatorio, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -realizaron I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -posteriores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esta I-PAST_MEDICAL_HISTORY -patología. I-PAST_MEDICAL_HISTORY -Refiere I-PAST_MEDICAL_HISTORY -poliuria I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -polidipsia I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -temprana I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -Antecedentes B-FAMILY_HISTORY -familiares: I-FAMILY_HISTORY -abuela I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -hipoacúsica, I-FAMILY_HISTORY -primo I-FAMILY_HISTORY -paterno I-FAMILY_HISTORY -con I-FAMILY_HISTORY -litiasis I-FAMILY_HISTORY -renal, I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -con I-FAMILY_HISTORY -microhematuria. I-FAMILY_HISTORY -Al B-EXPLORATION -ingreso, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -eutrófica I-EXPLORATION -(peso: I-EXPLORATION -17.400 I-EXPLORATION -kg, I-EXPLORATION -talla: I-EXPLORATION -104 I-EXPLORATION -cm), I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -febril, I-EXPLORATION -normotensa. I-EXPLORATION -Por I-EXPLORATION -presentar I-EXPLORATION -orina I-EXPLORATION -patológica I-EXPLORATION -se I-EXPLORATION -solicitan: I-EXPLORATION -urocultivo, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -informa I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Escherichia I-EXPLORATION -coli, I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -renal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -evidencian I-EXPLORATION -imágenes I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -nefrocalcinosis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -calcificaciones I-EXPLORATION -renales. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -manifestaron I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -(depuración I-EXPLORATION -de I-EXPLORATION -creatinina I-EXPLORATION -50 I-EXPLORATION -ml/min/1, I-EXPLORATION -73, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -calculó I-EXPLORATION -por I-EXPLORATION -fórmula), I-EXPLORATION -hipercalciuria I-EXPLORATION -(13 I-EXPLORATION -mg/kg/d), I-EXPLORATION -hipomagnesemia, I-EXPLORATION -hipermagnesuria, I-EXPLORATION -anemia I-EXPLORATION -y I-EXPLORATION -acidosis. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION -cardiológica I-EXPLORATION -y I-EXPLORATION -otorrinolaringológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -oftalmología I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -"coriorretinitis I-EXPLORATION -cicatrizal I-EXPLORATION -macular, I-EXPLORATION -coriopatía I-EXPLORATION -miópica". I-EXPLORATION -Se I-EXPLORATION -arriba I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -hipercalciuria, I-EXPLORATION -nefrocalcinosis, I-EXPLORATION -hipomagnesemia, I-EXPLORATION -hipermagnesuria I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -renal, I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -patología I-EXPLORATION -ocular I-EXPLORATION -y I-EXPLORATION -antecedentes I-EXPLORATION -personales I-EXPLORATION -y I-EXPLORATION -familiares I-EXPLORATION -compatibles. I-EXPLORATION -Cumplió B-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -infección I-TREATMENT -urinaria. I-TREATMENT -Se I-TREATMENT -indicó I-TREATMENT -citrato I-TREATMENT -de I-TREATMENT -potasio, I-TREATMENT -amiloride-hidroclorotiazida I-TREATMENT -25 I-TREATMENT -mg/día, I-TREATMENT -pidolato I-TREATMENT -de I-TREATMENT -magnesio I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -g/ I-TREATMENT -día, I-TREATMENT -ácido I-TREATMENT -fólico I-TREATMENT -5 I-TREATMENT -mg/día, I-TREATMENT -sulfato I-TREATMENT -ferroso I-TREATMENT -3 I-TREATMENT -mg/ I-TREATMENT -kg/día, I-TREATMENT -dieta I-TREATMENT -hiposódica I-TREATMENT -controlada I-TREATMENT -en I-TREATMENT -proteínas I-TREATMENT -y I-TREATMENT -líquidos I-TREATMENT -a I-TREATMENT -demanda. I-TREATMENT -Durante B-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -presentó I-EVOLUTION -nueva I-EVOLUTION -infección I-EVOLUTION -urinaria I-EVOLUTION -a I-EVOLUTION -E. I-EVOLUTION -coli, I-EVOLUTION -se B-EXPLORATION -realizó I-EXPLORATION -cistouretrografía I-EXPLORATION -miccional, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inició I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT -con I-TREATMENT -nitrofurantoína. I-TREATMENT -Se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -hidroclorotiazida I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -por I-TREATMENT -brusco I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -urea I-TREATMENT -y I-TREATMENT -creatinina, I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -posterior I-TREATMENT -y I-TREATMENT -mantenimiento I-TREATMENT -de I-TREATMENT -valores I-TREATMENT -de I-TREATMENT -calciuria I-TREATMENT -dentro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -normalidad. I-TREATMENT -Se B-EVOLUTION -mantiene I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -el I-EVOLUTION -resto I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -medicación. I-EVOLUTION - I-EVOLUTION - -Embarazada B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -procedente B-FAMILY_HISTORY -de I-FAMILY_HISTORY -Embarcación I-FAMILY_HISTORY -(Salta), I-FAMILY_HISTORY -que I-FAMILY_HISTORY -cursaba I-FAMILY_HISTORY -su I-FAMILY_HISTORY -segunda I-FAMILY_HISTORY -gesta I-FAMILY_HISTORY -en I-FAMILY_HISTORY -semana I-FAMILY_HISTORY -38 I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -patológicos. I-FAMILY_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(39,4°C), I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -internó I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tratamiento. I-PRESENT_ILLNESS -Al B-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -sangrado I-EVOLUTION -de I-EVOLUTION -mucosas, I-EVOLUTION -en I-EVOLUTION -zonas I-EVOLUTION -de I-EVOLUTION -venopuntura I-EVOLUTION -y I-EVOLUTION -deterioro I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general. I-EVOLUTION -Veinticuatro B-TREATMENT -horas I-TREATMENT -más I-TREATMENT -tarde I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -cesárea I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -por I-TREATMENT -sufrimiento I-TREATMENT -fetal I-TREATMENT -agudo, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -grave I-TREATMENT -metrorragia I-TREATMENT -posparto. I-TREATMENT -La B-EVOLUTION -madre I-EVOLUTION -recibió I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -sostén I-EVOLUTION -que I-EVOLUTION -requirió I-EVOLUTION -múltiples I-EVOLUTION -transfusiones I-EVOLUTION -sanguíneas. I-EVOLUTION -Se I-EVOLUTION -recuperó I-EVOLUTION -favorablemente I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -h I-EVOLUTION -posparto. I-EVOLUTION -El I-EVOLUTION -niño I-EVOLUTION -nació I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -38 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -edad I-EVOLUTION -gestacional, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -3900 I-EVOLUTION -g I-EVOLUTION -y I-EVOLUTION -puntaje I-EVOLUTION -de I-EVOLUTION -Apgar I-EVOLUTION -4/4. I-EVOLUTION -Durante I-EVOLUTION -la I-EVOLUTION -internación I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -cuidado I-EVOLUTION -intensivo I-EVOLUTION -neonatal I-EVOLUTION -requirió I-EVOLUTION -asistencia I-EVOLUTION -respiratoria I-EVOLUTION -mecánica I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -aspiración I-EVOLUTION -meconial I-EVOLUTION -e I-EVOLUTION -hipertensión I-EVOLUTION -pulmonar I-EVOLUTION -y I-EVOLUTION -luminoterapia I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -ictericia. I-EVOLUTION -Al I-EVOLUTION -5to I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -(39°C), I-EVOLUTION -hepatomegalia I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -evanescente I-EVOLUTION -generalizado. I-EVOLUTION -Pasadas I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -se I-EVOLUTION -agregaron I-EVOLUTION -hemorragias I-EVOLUTION -por I-EVOLUTION -sonda I-EVOLUTION -nasogástrica I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -venopunturas. I-EVOLUTION -El B-EXPLORATION -hemograma I-EXPLORATION -presentó I-EXPLORATION -5800 I-EXPLORATION -glóbulos I-EXPLORATION -blancos I-EXPLORATION -(linfocitos I-EXPLORATION -43%, I-EXPLORATION -neutrófilos I-EXPLORATION -segmentados I-EXPLORATION -47%, I-EXPLORATION -monocitos I-EXPLORATION -6%, I-EXPLORATION -basófilos I-EXPLORATION -4%), I-EXPLORATION -hematócrito I-EXPLORATION -34%, I-EXPLORATION -hemoglobina I-EXPLORATION -11, I-EXPLORATION -2 I-EXPLORATION -mg% I-EXPLORATION -y I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -de I-EXPLORATION -13 I-EXPLORATION -000/mm³. I-EXPLORATION -Con I-EXPLORATION -diagnóstico I-EXPLORATION -presuntivo I-EXPLORATION -de I-EXPLORATION -sepsis I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizaron I-EXPLORATION -hemocultivos, I-EXPLORATION -urocultivo I-EXPLORATION -y I-EXPLORATION -punción I-EXPLORATION -lumbar. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -solicitó I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -IgM I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -dengue. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -indicaron I-EXPLORATION -antibióticos I-EXPLORATION -y I-EXPLORATION -transfusiones I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -plaquetas. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -para I-EXPLORATION -gérmenes I-EXPLORATION -comunes I-EXPLORATION -y I-EXPLORATION -hongos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -informó I-EXPLORATION -IgM I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -ELISA I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -dengue. I-EXPLORATION -Para I-EXPLORATION -la I-EXPLORATION -confirmación I-EXPLORATION -del I-EXPLORATION -resultado I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -al I-EXPLORATION -Instituto I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Enfermedades I-EXPLORATION -Virales I-EXPLORATION -Humanas I-EXPLORATION -de I-EXPLORATION -Pergamino, I-EXPLORATION -quienes I-EXPLORATION -certificaron I-EXPLORATION -por I-EXPLORATION -pruebas I-EXPLORATION -serológicas I-EXPLORATION -de I-EXPLORATION -ELISA, I-EXPLORATION -neutralización I-EXPLORATION -y I-EXPLORATION -detección I-EXPLORATION -molecular I-EXPLORATION -del I-EXPLORATION -genoma I-EXPLORATION -viral I-EXPLORATION -(RT-PCR), I-EXPLORATION -la I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -serotipo I-EXPLORATION -DEN-1. I-EXPLORATION -Se B-EVOLUTION -administró I-EVOLUTION -oxígeno I-EVOLUTION -hasta I-EVOLUTION -los I-EVOLUTION -26 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -comienzo I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -se I-EVOLUTION -normalizó I-EVOLUTION -el I-EVOLUTION -recuento I-EVOLUTION -de I-EVOLUTION -plaquetas. I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -dio I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION -Como I-EVOLUTION -consecuencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -asfixia I-EVOLUTION -perinatal I-EVOLUTION -relacionada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -forma I-EVOLUTION -de I-EVOLUTION -dengue I-EVOLUTION -grave I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -madre, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -presentó I-EVOLUTION -encefalopatía I-EVOLUTION -hipóxico-isquémica I-EVOLUTION -y I-EVOLUTION -compromiso I-EVOLUTION -respiratorio I-EVOLUTION -secuelar. I-EVOLUTION -Se I-EVOLUTION -le I-EVOLUTION -realizaron I-EVOLUTION -controles I-EVOLUTION -clínicos I-EVOLUTION -y I-EVOLUTION -serológicos I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -y I-EVOLUTION -13 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -títulos I-EVOLUTION -de I-EVOLUTION -anticuerpos I-EVOLUTION -IgG I-EVOLUTION -antidengue, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -confirmó I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -infección I-EVOLUTION -congénita. I-EVOLUTION -Los B-EXPLORATION -resultados I-EXPLORATION -serológicos I-EXPLORATION -mediante I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -ELISA I-EXPLORATION -mostraron I-EXPLORATION -títulos I-EXPLORATION -positivos I-EXPLORATION -elevados, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -RP I-EXPLORATION -1, I-EXPLORATION -92 I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -37 I-EXPLORATION -para I-EXPLORATION -dengue I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -8 I-EXPLORATION -y I-EXPLORATION -13 I-EXPLORATION -meses, I-EXPLORATION -respectivamente. I-EXPLORATION -Actualmente, B-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -realiza I-EVOLUTION -estimulación I-EVOLUTION -neurológica I-EVOLUTION -y I-EVOLUTION -tratamiento I-EVOLUTION -preventivo I-EVOLUTION -respiratorio I-EVOLUTION -con I-EVOLUTION -corticoides I-EVOLUTION -inhalatorios, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -evolución. I-EVOLUTION - I-EVOLUTION - -Neonato B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida, I-PRESENT_ILLNESS -nacida B-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -7/9, I-PAST_MEDICAL_HISTORY -de B-FAMILY_HISTORY -padres I-FAMILY_HISTORY -sanos, I-FAMILY_HISTORY -no I-FAMILY_HISTORY -consanguíneos. I-FAMILY_HISTORY -Tiene I-FAMILY_HISTORY -tres I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -vivos I-FAMILY_HISTORY -y I-FAMILY_HISTORY -sanos. I-FAMILY_HISTORY -Sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -abortos I-FAMILY_HISTORY -maternos. I-FAMILY_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ampollas, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentaron I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -nacimiento, I-PRESENT_ILLNESS -dispuestas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -(MI) I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -siguiendo I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -líneas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Blaschko, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -correr I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -aumentaron I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -número. I-PRESENT_ILLNESS -Recibe B-TREATMENT -cefotaxima-oxacilina I-TREATMENT -parenteral I-TREATMENT -(VP) I-TREATMENT -por I-TREATMENT -dos I-TREATMENT -días, I-TREATMENT -con I-TREATMENT -mejoría. I-TREATMENT -Es B-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -e I-EVOLUTION -indicación I-EVOLUTION -de I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -cefixima I-EVOLUTION -oral I-EVOLUTION -(VO). I-EVOLUTION -Dos I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -aparecen I-EVOLUTION -nuevas I-EVOLUTION -lesiones I-EVOLUTION -de I-EVOLUTION -iguales I-EVOLUTION -características I-EVOLUTION -en I-EVOLUTION -MI I-EVOLUTION -derecho I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -miembro I-EVOLUTION -superior I-EVOLUTION -(MS) I-EVOLUTION -izquierdo, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -queda I-EVOLUTION -internada. I-EVOLUTION -Se B-TREATMENT -reinicia I-TREATMENT -cefotaxima-oxacilina I-TREATMENT -VP, I-TREATMENT -se B-EXPLORATION -solicitan I-EXPLORATION -frotis I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -lesiones, I-EXPLORATION -y I-EXPLORATION -VDRL. I-EXPLORATION -Con I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -negativos I-EXPLORATION -se B-EVOLUTION -decide I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -y B-TREATMENT -se I-TREATMENT -indica I-TREATMENT -aplicar I-TREATMENT -ácido I-TREATMENT -fusídico I-TREATMENT -tópico I-TREATMENT -sobre I-TREATMENT -las I-TREATMENT -vesículas I-TREATMENT -cutáneas I-TREATMENT -y I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -cefixima I-TREATMENT -VO. I-TREATMENT -Dos B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -consulta I-EVOLUTION -a I-EVOLUTION -nuestro I-EVOLUTION -servicio I-EVOLUTION -por I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -lesiones. I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -dermatológico I-EXPLORATION -se I-EXPLORATION -constatan I-EXPLORATION -múltiples I-EXPLORATION -vesículas, I-EXPLORATION -firmes, I-EXPLORATION -amarillentas, I-EXPLORATION -sobre I-EXPLORATION -una I-EXPLORATION -base I-EXPLORATION -inflamatoria, I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -lineal I-EXPLORATION -que I-EXPLORATION -afectan I-EXPLORATION -MS I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -ambos I-EXPLORATION -MI. I-EXPLORATION -El I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -es I-EXPLORATION -variable, I-EXPLORATION -con I-EXPLORATION -diámetros I-EXPLORATION -que I-EXPLORATION -oscilan I-EXPLORATION -entre I-EXPLORATION -0, I-EXPLORATION -1-1 I-EXPLORATION -cm. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -afectación I-EXPLORATION -ungueal. I-EXPLORATION -Se B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -remite I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -neurólogo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -oftalmólogo, I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -descartan I-DERIVED_FROM/TO -afectación I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -tales I-DERIVED_FROM/TO -áreas. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Métodos B-EXPLORATION -auxiliares I-EXPLORATION -de I-EXPLORATION -diagnóstico: I-EXPLORATION -hemograma: I-EXPLORATION -Hb: I-EXPLORATION -15, I-EXPLORATION -4 I-EXPLORATION -g/dl; I-EXPLORATION -leucocitos: I-EXPLORATION -16 I-EXPLORATION -700 I-EXPLORATION -cél./mm3; I-EXPLORATION -N: I-EXPLORATION -68%; I-EXPLORATION -L: I-EXPLORATION -20%; I-EXPLORATION -Eo: I-EXPLORATION -10%; I-EXPLORATION -plaquetas: I-EXPLORATION -330 I-EXPLORATION -000 I-EXPLORATION -cél./mm3. I-EXPLORATION -Examen I-EXPLORATION -directo I-EXPLORATION -y I-EXPLORATION -cultivo: I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -bacterias. I-EXPLORATION -Dos I-EXPLORATION -hemocultivos: I-EXPLORATION -negativos. I-EXPLORATION -VDRL: I-EXPLORATION -no I-EXPLORATION -reactiva. I-EXPLORATION -Biopsia I-EXPLORATION -cutánea: I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -biopsia I-EXPLORATION -cutánea I-EXPLORATION -incisional I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -vesículas I-EXPLORATION -de I-EXPLORATION -MI, I-EXPLORATION -se I-EXPLORATION -fija I-EXPLORATION -en I-EXPLORATION -formol I-EXPLORATION -neutro I-EXPLORATION -tamponado I-EXPLORATION -al I-EXPLORATION -10% I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -procesa I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -convencional. I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -coloración I-EXPLORATION -HE. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informa: I-EXPLORATION -dermatitis I-EXPLORATION -psoriasiforme I-EXPLORATION -perivascular I-EXPLORATION -superficial, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -marcada I-EXPLORATION -espongiosis I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION -con I-EXPLORATION -exocitosis I-EXPLORATION -eosinofílica I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -disqueratósicas. I-EXPLORATION -En I-EXPLORATION -dermis I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -perivascular I-EXPLORATION -superficial I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -con I-EXPLORATION -eosinófilos I-EXPLORATION -y I-EXPLORATION -edema. I-EXPLORATION - I-EXPLORATION -Diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -final: I-EXPLORATION -incontinentia I-EXPLORATION -pigmenti I-EXPLORATION -estadio I-EXPLORATION -eritemato-ampollar. I-EXPLORATION -Evolución B-TREATMENT -y I-TREATMENT -tratamiento: I-TREATMENT -Se I-TREATMENT -higienizan I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -con I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -manzanilla I-TREATMENT -fría I-TREATMENT -y I-TREATMENT -pasta I-TREATMENT -al I-TREATMENT -agua I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -la I-TREATMENT -higiene, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -por I-TREATMENT -día, I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -desaparición I-TREATMENT -de I-TREATMENT -las I-TREATMENT -ampollas. I-TREATMENT -Acude B-EVOLUTION -a I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días, I-EVOLUTION -con I-EVOLUTION -marcada I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -ampollas I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -lesiones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -producto B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tercera I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -34 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consanguíneos; I-PAST_MEDICAL_HISTORY -con B-FAMILY_HISTORY -dos I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -aparentemente I-FAMILY_HISTORY -sanos; I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia. I-FAMILY_HISTORY -Durante I-FAMILY_HISTORY -todo I-FAMILY_HISTORY -el I-FAMILY_HISTORY -embarazo I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -cursó I-FAMILY_HISTORY -con I-FAMILY_HISTORY -tos I-FAMILY_HISTORY -productiva, I-FAMILY_HISTORY -persistente, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -predominio I-FAMILY_HISTORY -de I-FAMILY_HISTORY -horario, I-FAMILY_HISTORY -tratada I-FAMILY_HISTORY -con I-FAMILY_HISTORY -nebulizaciones I-FAMILY_HISTORY -con I-FAMILY_HISTORY -salbutamol I-FAMILY_HISTORY -y, I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -segundo I-FAMILY_HISTORY -trimestre I-FAMILY_HISTORY -de I-FAMILY_HISTORY -gestación, I-FAMILY_HISTORY -con I-FAMILY_HISTORY -infecciones I-FAMILY_HISTORY -vaginales I-FAMILY_HISTORY -reiteradas I-FAMILY_HISTORY -cuyo I-FAMILY_HISTORY -manejo I-FAMILY_HISTORY -se I-FAMILY_HISTORY -desconoce. I-FAMILY_HISTORY -El B-PAST_MEDICAL_HISTORY -producto I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -obtenido I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -36 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación; I-PAST_MEDICAL_HISTORY -peso: I-PAST_MEDICAL_HISTORY -2800 I-PAST_MEDICAL_HISTORY -g, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -atresia I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -coanas I-PAST_MEDICAL_HISTORY -(ABC), I-PAST_MEDICAL_HISTORY -encefalocele, I-PAST_MEDICAL_HISTORY -hidrocefalia, I-PAST_MEDICAL_HISTORY -microftalmía I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -restos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bandas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -constricción I-PAST_MEDICAL_HISTORY -oscuras I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dedos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pies; I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -características I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -placenta. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -5to I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -colocó I-PAST_MEDICAL_HISTORY -válvula I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -derivación I-PAST_MEDICAL_HISTORY -ventriculoperitoneal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -plastia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -encefalocele; I-PAST_MEDICAL_HISTORY -a B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -desarrolla I-PRESENT_ILLNESS -neumonía I-PRESENT_ILLNESS -nosocomial. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -actual, I-EXPLORATION -peso: I-EXPLORATION -3150 I-EXPLORATION -g I-EXPLORATION -(percentil I-EXPLORATION -3); I-EXPLORATION -talla: I-EXPLORATION -52 I-EXPLORATION -cm I-EXPLORATION -(percentil I-EXPLORATION -20); I-EXPLORATION -plagiocefalia I-EXPLORATION -frontotemporal I-EXPLORATION -izquierda, I-EXPLORATION -dolicocefalia, I-EXPLORATION -cicatriz I-EXPLORATION -de I-EXPLORATION -plastia I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -occipital I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -y I-EXPLORATION -válvula I-EXPLORATION -de I-EXPLORATION -pudens I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -temporal I-EXPLORATION -derecha, I-EXPLORATION -frontal I-EXPLORATION -prominente; I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -cejas; I-EXPLORATION -microftalmía I-EXPLORATION -derecha; I-EXPLORATION -puente I-EXPLORATION -nasal I-EXPLORATION -deprimido; I-EXPLORATION -hiperplasia I-EXPLORATION -gingival; I-EXPLORATION -paladar I-EXPLORATION -ojival; I-EXPLORATION -pectus I-EXPLORATION -excavatum; I-EXPLORATION -hernia I-EXPLORATION -umbilical; I-EXPLORATION -marca I-EXPLORATION -de I-EXPLORATION -constricción I-EXPLORATION -circular I-EXPLORATION -por I-EXPLORATION -bandas I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -antebrazo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -dedos I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -y I-EXPLORATION -4; I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -aplasia I-EXPLORATION -ungueal I-EXPLORATION -y I-EXPLORATION -acrosindactilia I-EXPLORATION -de I-EXPLORATION -éstos; I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -marca I-EXPLORATION -de I-EXPLORATION -constricción I-EXPLORATION -circular I-EXPLORATION -por I-EXPLORATION -bandas I-EXPLORATION -en I-EXPLORATION -4to I-EXPLORATION -dedo I-EXPLORATION -y I-EXPLORATION -acrosindactilia I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -ungueal I-EXPLORATION -de I-EXPLORATION -dedos I-EXPLORATION -2do I-EXPLORATION -y I-EXPLORATION -3ro; I-EXPLORATION -pie I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -acrosindactilia I-EXPLORATION -de I-EXPLORATION -dedos I-EXPLORATION -2do I-EXPLORATION -y I-EXPLORATION -3ro; I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -dedos I-EXPLORATION -1ro, I-EXPLORATION -2do I-EXPLORATION -y I-EXPLORATION -3ro, I-EXPLORATION -acrosindactilia I-EXPLORATION -y I-EXPLORATION -marca I-EXPLORATION -de I-EXPLORATION -banda I-EXPLORATION -de I-EXPLORATION -constricción I-EXPLORATION -de I-EXPLORATION -5to I-EXPLORATION -dedo. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -normales; I-EXPLORATION -el I-EXPLORATION -cariotipo I-EXPLORATION -con I-EXPLORATION -resolución I-EXPLORATION -de I-EXPLORATION -550 I-EXPLORATION -bandas I-EXPLORATION -y I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -bandeo I-EXPLORATION -G I-EXPLORATION -en I-EXPLORATION -40 I-EXPLORATION -metafases I-EXPLORATION -se I-EXPLORATION -informó: I-EXPLORATION -46, I-EXPLORATION -XY; I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -radiografías I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -2da I-EXPLORATION -falange I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -2da I-EXPLORATION -y I-EXPLORATION -3era I-EXPLORATION -falanges I-EXPLORATION -distales I-EXPLORATION -en I-EXPLORATION -mano I-EXPLORATION -izquierda; I-EXPLORATION -pie I-EXPLORATION -derecho, I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -falanges I-EXPLORATION -medias I-EXPLORATION -y I-EXPLORATION -distales; I-EXPLORATION -en I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -falanges I-EXPLORATION -distales. I-EXPLORATION -Ecocardiograma I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -reveló: I-EXPLORATION -microftalmía I-EXPLORATION -derecha, I-EXPLORATION -encefalocele I-EXPLORATION -frontoparietal I-EXPLORATION -y I-EXPLORATION -megaventrículo I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -ABC I-EXPLORATION -con I-EXPLORATION -placa I-EXPLORATION -atrésica I-EXPLORATION -mixta I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -por I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada, I-EXPLORATION -realizándose I-EXPLORATION -corrección I-EXPLORATION -vía I-EXPLORATION -endoscópica I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -edad. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -recién I-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5ºC I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hora I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rechazo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -alimentación. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -controlado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -normal; I-PAST_MEDICAL_HISTORY -serologías I-PAST_MEDICAL_HISTORY -negativas I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -C, I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -inmunodeficiencia I-PAST_MEDICAL_HISTORY -humana, I-PAST_MEDICAL_HISTORY -sífilis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -toxoplasma; I-PAST_MEDICAL_HISTORY -frotis I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -negativo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -Streptococcus I-PAST_MEDICAL_HISTORY -grupo I-PAST_MEDICAL_HISTORY -B; I-PAST_MEDICAL_HISTORY -ruptura I-PAST_MEDICAL_HISTORY -espontánea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -membranas I-PAST_MEDICAL_HISTORY -intraparto, I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -instrumental I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fórceps I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -41 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3880 I-PAST_MEDICAL_HISTORY -g. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -prueba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -minuto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -minutos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -9, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -requerir I-PAST_MEDICAL_HISTORY -reanimación. I-PAST_MEDICAL_HISTORY -Comenzó I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -esquema I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inmunización. I-PAST_MEDICAL_HISTORY -Alimentación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lactancia I-PAST_MEDICAL_HISTORY -materna I-PAST_MEDICAL_HISTORY -exclusiva. I-PAST_MEDICAL_HISTORY -Respecto B-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares, I-FAMILY_HISTORY -los I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -refirieron I-FAMILY_HISTORY -haber I-FAMILY_HISTORY -padecido I-FAMILY_HISTORY -amigdalitis I-FAMILY_HISTORY -los I-FAMILY_HISTORY -días I-FAMILY_HISTORY -previos. I-FAMILY_HISTORY -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -mostró I-EXPLORATION -decaimiento I-EXPLORATION -y I-EXPLORATION -regular I-EXPLORATION -perfusión I-EXPLORATION -periférica I-EXPLORATION -con I-EXPLORATION -constantes I-EXPLORATION -vitales I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -objetivasen I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -foco. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -inicial I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -cuantitativa I-EXPLORATION -(PC-R) I-EXPLORATION -133, I-EXPLORATION -4 I-EXPLORATION -mg/L, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -coagulado I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -resultó I-EXPLORATION -hemorrágica. I-EXPLORATION -Ingresó B-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -síndrome I-TREATMENT -febril I-TREATMENT -sin I-TREATMENT -foco I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -antibioterapia I-TREATMENT -empírica I-TREATMENT -con I-TREATMENT -ampicilina I-TREATMENT -y I-TREATMENT -cefotaxima I-TREATMENT -intravenosas I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -cultivos. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -repetido I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -5800 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -con I-EXPLORATION -fórmula I-EXPLORATION -normal, I-EXPLORATION -13, I-EXPLORATION -4 I-EXPLORATION -g/dl I-EXPLORATION -de I-EXPLORATION -hemoglobina, I-EXPLORATION -32 I-EXPLORATION -000 I-EXPLORATION -plaquetas/mm3. I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -18 I-EVOLUTION -h I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -empeoró I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -y I-EVOLUTION -presentó I-EVOLUTION -crisis I-EVOLUTION -convulsivas I-EVOLUTION -generalizadas I-EVOLUTION -que B-TREATMENT -requirieron I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -fenobarbital I-TREATMENT -y I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -midazolam. I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -desarrolló I-EVOLUTION -afectación I-EVOLUTION -sistémica I-EVOLUTION -con I-EVOLUTION -hipotensión I-EVOLUTION -arterial, I-EVOLUTION -acidosis I-EVOLUTION -metabólica, I-EVOLUTION -hiponatremia, I-EVOLUTION -oliguria I-EVOLUTION -y I-EVOLUTION -plaquetopenia I-EVOLUTION -grave; I-EVOLUTION -requirió B-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -convencional, I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -hemoderivados, I-TREATMENT -soporte I-TREATMENT -inotrópico I-TREATMENT -con I-TREATMENT -dopamina I-TREATMENT -y I-TREATMENT -diurético I-TREATMENT -con I-TREATMENT -furosemida. I-TREATMENT -El B-EXPLORATION -tercer I-EXPLORATION -día I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -el I-EXPLORATION -aislamiento I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemocultivo I-EXPLORATION -de I-EXPLORATION -Streptococcus I-EXPLORATION -pyogenes I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -penicilina, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -ampicilina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefotaxima I-TREATMENT -intravenosa. I-TREATMENT -Tras B-EVOLUTION -su I-EVOLUTION -estabilización I-EVOLUTION -presentó I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -analítica, I-EVOLUTION -que B-TREATMENT -permitió I-TREATMENT -suspender I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -inotrópico I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -realizar I-TREATMENT -extubación I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día. I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -repitieron I-EVOLUTION -las I-EVOLUTION -crisis I-EVOLUTION -clínicas I-EVOLUTION -y B-EXPLORATION -el I-EXPLORATION -electroencefalograma I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -anticomicial. I-TREATMENT -Se B-EXPLORATION -repitió I-EXPLORATION -la I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -sin I-EXPLORATION -éxito. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -angiorresonancia I-EXPLORATION -iniciales I-EXPLORATION -mostraron I-EXPLORATION -hemorragia I-EXPLORATION -intraventricular I-EXPLORATION -con I-EXPLORATION -discreta I-EXPLORATION -ventriculomegalia I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -hemisféricas I-EXPLORATION -cortico-subcorticales I-EXPLORATION -bilaterales, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -meningoencefalitis. I-EXPLORATION -No I-EXPLORATION -superó I-EXPLORATION -el I-EXPLORATION -tamizaje I-EXPLORATION -auditivo I-EXPLORATION -realizado I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -exploración I-EXPLORATION -de I-EXPLORATION -potenciales I-EXPLORATION -provocados I-EXPLORATION -auditivos I-EXPLORATION -de I-EXPLORATION -tronco I-EXPLORATION -cerebral I-EXPLORATION -automatizados I-EXPLORATION -(PEATC-A I-EXPLORATION -> I-EXPLORATION -40 I-EXPLORATION -dB). I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -ecografías I-EXPLORATION -cerebrales I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -presentó I-EXPLORATION -buena I-EXPLORATION -evolución I-EXPLORATION -sin I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -dilatación I-EXPLORATION -ventricular. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -34 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -completar I-EVOLUTION -21 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -cefotaxima, I-EVOLUTION -se I-EVOLUTION -otorgó I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -exploración I-EVOLUTION -neurológica I-EVOLUTION -normal, I-EVOLUTION -excepto I-EVOLUTION -una I-EVOLUTION -leve I-EVOLUTION -hipotonía I-EVOLUTION -de I-EVOLUTION -eje. I-EVOLUTION -Se I-EVOLUTION -realizó I-EVOLUTION -seguimiento I-EVOLUTION -por I-EVOLUTION -especialistas I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -unidades I-EVOLUTION -de I-EVOLUTION -rehabilitación, I-EVOLUTION -otorrinolaringología I-EVOLUTION -y I-EVOLUTION -neurología; I-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -no I-EVOLUTION -presentaba I-EVOLUTION -patología I-EVOLUTION -auditiva I-EVOLUTION -ni I-EVOLUTION -neurológica I-EVOLUTION -residual. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agrega I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -atrás I-PRESENT_ILLNESS -erección I-PRESENT_ILLNESS -peneana I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -moderado, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -zonal, I-PRESENT_ILLNESS -donde B-TREATMENT -le I-TREATMENT -indican I-TREATMENT -analgésicos I-TREATMENT -y I-TREATMENT -medios I-TREATMENT -físicos I-TREATMENT -citándose I-TREATMENT -a I-TREATMENT -las I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -para I-TREATMENT -control. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -concurre I-EVOLUTION -a I-EVOLUTION -dicho I-EVOLUTION -hospital, I-EVOLUTION -donde I-EVOLUTION -por I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -erección I-EVOLUTION -peneana I-EVOLUTION -y I-EVOLUTION -palidez I-EVOLUTION -generalizada I-EVOLUTION -deciden B-EXPLORATION -realizar I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -que I-EXPLORATION -muestran: I-EXPLORATION -plaquetopenia I-EXPLORATION -(plaquetas I-EXPLORATION -60 I-EXPLORATION -000/mm3), I-EXPLORATION -anemia I-EXPLORATION -(hematócrito I-EXPLORATION -12%) I-EXPLORATION -e I-EXPLORATION -hiperleucocitosis I-EXPLORATION -(glóbulos I-EXPLORATION -blancos I-EXPLORATION -312 I-EXPLORATION -000/mm3) I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -2056 I-EXPLORATION -UI/ml, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -su I-EXPLORATION -internación I-EXPLORATION -y B-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -solicita I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -derivación I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -mayor I-DERIVED_FROM/TO -complejidad. I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -al I-EXPLORATION -Hospital I-EXPLORATION -Posadas I-EXPLORATION -se I-EXPLORATION -constata I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -palidez I-EXPLORATION -cutáneomucosa, I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -equimosis I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -inferiores. I-EXPLORATION -Se I-EXPLORATION -palpa I-EXPLORATION -esplenomegalia. I-EXPLORATION -Se I-EXPLORATION -observa I-EXPLORATION -pene I-EXPLORATION -erecto I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -del I-EXPLORATION -cuerpo, I-EXPLORATION -palidez I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -cianosis I-EXPLORATION -del I-EXPLORATION -glande. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -interconsulta I-TREATMENT -con I-TREATMENT -urología, I-TREATMENT -quien I-TREATMENT -realiza I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -cuerpos I-TREATMENT -cavernosos I-TREATMENT -con I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -y I-TREATMENT -adrenalina; I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -arroja I-TREATMENT -sangre I-TREATMENT -oscura I-TREATMENT -y I-TREATMENT -coagulada. I-TREATMENT -Por B-EVOLUTION -presentar I-EVOLUTION -registro I-EVOLUTION -febril, I-EVOLUTION -se B-EXPLORATION -realizan I-EXPLORATION -hemocultivos I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -decide I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -ceftazidima-amikacina I-TREATMENT -y I-TREATMENT -transfundir I-TREATMENT -glóbulos I-TREATMENT -rojos I-TREATMENT -desplasmatizados. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -en I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -con I-EVOLUTION -dificultad I-EVOLUTION -respiratoria I-EVOLUTION -creciente, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -lo I-EVOLUTION -traslada I-EVOLUTION -a I-EVOLUTION -terapia I-EVOLUTION -intensiva. I-EVOLUTION -Se I-EVOLUTION -realiza I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -leucemia I-EVOLUTION -mieloide I-EVOLUTION -crónica I-EVOLUTION -por I-EVOLUTION -biopsia I-EVOLUTION -de I-EVOLUTION -medula I-EVOLUTION -ósea I-EVOLUTION -y I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -blastos I-EVOLUTION -en I-EVOLUTION -sangre I-EVOLUTION -periférica. I-EVOLUTION -Se I-EVOLUTION -descartan I-EVOLUTION -otros I-EVOLUTION -diagnósticos, I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -anemia I-EVOLUTION -de I-EVOLUTION -células I-EVOLUTION -falciforme, I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -presentar I-EVOLUTION -depranocitos I-EVOLUTION -en I-EVOLUTION -frotis I-EVOLUTION -de I-EVOLUTION -sangre I-EVOLUTION -periférica; I-EVOLUTION -causa I-EVOLUTION -medicamentosa, I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -presentar I-EVOLUTION -ingesta I-EVOLUTION -de I-EVOLUTION -medicamentos; I-EVOLUTION -causa I-EVOLUTION -traumática, I-EVOLUTION -por I-EVOLUTION -falta I-EVOLUTION -de I-EVOLUTION -traumatismos I-EVOLUTION -previos I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -pene; I-EVOLUTION -asimismo, I-EVOLUTION -se I-EVOLUTION -descartan I-EVOLUTION -tumores I-EVOLUTION -sólidos I-EVOLUTION -genitourinarios I-EVOLUTION -y I-EVOLUTION -enfermedades I-EVOLUTION -neurológicas I-EVOLUTION -e I-EVOLUTION -infecciosas. I-EVOLUTION -Actualmente, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -con I-EVOLUTION -disfunción I-EVOLUTION -eréctil I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -priapismo I-EVOLUTION -y I-EVOLUTION -permanece I-EVOLUTION -en I-EVOLUTION -tratamiento I-EVOLUTION -oncológico I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -patología I-EVOLUTION -de I-EVOLUTION -base. I-EVOLUTION - I-EVOLUTION - -Una B-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cirrosis I-PRESENT_ILLNESS -fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -evaluación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -trasplante I-DERIVED_FROM/TO -hepático. I-DERIVED_FROM/TO -Se B-EXPLORATION -presentó I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -cuadro I-EXPLORATION -referido I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -reciente I-EXPLORATION -comienzo, I-EXPLORATION -aunque I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -estudios I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -hepatopatía I-EXPLORATION -crónica. I-EXPLORATION -Presentaba I-EXPLORATION -estigmas I-EXPLORATION -de I-EXPLORATION -cronicidad I-EXPLORATION -como I-EXPLORATION -eritema I-EXPLORATION -palmar, I-EXPLORATION -telangiectasias, I-EXPLORATION -circulación I-EXPLORATION -colateral I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -esplenomegalia. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -un I-EXPLORATION -hígado I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -con I-EXPLORATION -heterogeneidad I-EXPLORATION -y I-EXPLORATION -bazo I-EXPLORATION -con I-EXPLORATION -diámetro I-EXPLORATION -longitudinal I-EXPLORATION -aumentado. I-EXPLORATION -No B-TREATMENT -recibía I-TREATMENT -medicación I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -admisión I-TREATMENT -en I-TREATMENT -nuestro I-TREATMENT -hospital. I-TREATMENT -En B-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -contexto I-PAST_MEDICAL_HISTORY -social I-PAST_MEDICAL_HISTORY -complejo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -poca I-PAST_MEDICAL_HISTORY -percepción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -enfermedad, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -consultado I-PAST_MEDICAL_HISTORY -previamente. I-PAST_MEDICAL_HISTORY -Tampoco I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -periódico I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -salud. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso, I-EXPLORATION -el I-EXPLORATION -puntaje I-EXPLORATION -de I-EXPLORATION -gravedad I-EXPLORATION -PELD I-EXPLORATION -(Pediatric I-EXPLORATION -End-Stage I-EXPLORATION -Liver I-EXPLORATION -Disease, I-EXPLORATION -hepatopatía I-EXPLORATION -terminal I-EXPLORATION -pediátrica) I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -24, I-EXPLORATION -con I-EXPLORATION -bilirrubina I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -mg/dl, I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -relación I-EXPLORATION -internacional I-EXPLORATION -normalizada I-EXPLORATION -(RIN) I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5, I-EXPLORATION -albúmina I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -g/dl; I-EXPLORATION -su I-EXPLORATION -peso I-EXPLORATION -y I-EXPLORATION -talla I-EXPLORATION -eran I-EXPLORATION -de I-EXPLORATION -30 I-EXPLORATION -kg I-EXPLORATION -y I-EXPLORATION -127 I-EXPLORATION -cm, I-EXPLORATION -respectivamente. I-EXPLORATION -Mientras B-EVOLUTION -esperaba I-EVOLUTION -en I-EVOLUTION -lista I-EVOLUTION -de I-EVOLUTION -trasplante I-EVOLUTION -hepático, I-EVOLUTION -desarrolló I-EVOLUTION -encefalopatía I-EVOLUTION -hepática I-EVOLUTION -espontánea, I-EVOLUTION -de I-EVOLUTION -tipo I-EVOLUTION -C, I-EVOLUTION -grado I-EVOLUTION -II-III1 I-EVOLUTION -con I-EVOLUTION -períodos I-EVOLUTION -de I-EVOLUTION -conducta I-EVOLUTION -inapropiada I-EVOLUTION -que I-EVOLUTION -alternaban I-EVOLUTION -con I-EVOLUTION -confusión I-EVOLUTION -y I-EVOLUTION -excitación. I-EVOLUTION -Previamente, I-EVOLUTION -no I-EVOLUTION -había I-EVOLUTION -presentado I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -encefalopatía. I-EVOLUTION -Su B-EXPLORATION -amonio I-EXPLORATION -sérico I-EXPLORATION -aumentó I-EXPLORATION -de I-EXPLORATION -139 I-EXPLORATION -µg% I-EXPLORATION -a I-EXPLORATION -324 I-EXPLORATION -µg% I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -19-82 I-EXPLORATION -µg%). I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -factores I-EXPLORATION -precipitantes I-EXPLORATION -conocidos I-EXPLORATION -de I-EXPLORATION -encefalopatía I-EXPLORATION -hepática, I-EXPLORATION -como I-EXPLORATION -medicaciones, I-EXPLORATION -sangrado I-EXPLORATION -gastrointestinal, I-EXPLORATION -infecciones I-EXPLORATION -bacterianas, I-EXPLORATION -constipación, I-EXPLORATION -fallo I-EXPLORATION -renal, I-EXPLORATION -desequilibrios I-EXPLORATION -electrolíticos, I-EXPLORATION -hipovolemia I-EXPLORATION -o I-EXPLORATION -hipoxemia. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -antecedentes I-EXPLORATION -de I-EXPLORATION -ascitis I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -abdominal. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -con I-TREATMENT -restricción I-TREATMENT -de I-TREATMENT -proteínas I-TREATMENT -(0, I-TREATMENT -8 I-TREATMENT -g/kg/día) I-TREATMENT -y I-TREATMENT -lactulosa I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -(40 I-TREATMENT -ml/día, I-TREATMENT -divididos I-TREATMENT -en I-TREATMENT -4 I-TREATMENT -tomas), I-TREATMENT -logrando I-TREATMENT -3-4 I-TREATMENT -deposiciones I-TREATMENT -blandas I-TREATMENT -por I-TREATMENT -día. I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -estas I-EVOLUTION -medidas, I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -neurológico I-EVOLUTION -no I-EVOLUTION -mejoró I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -días. I-EVOLUTION -Sobre B-TREATMENT -la I-TREATMENT -base I-TREATMENT -de I-TREATMENT -experiencias I-TREATMENT -en I-TREATMENT -pacientes I-TREATMENT -adultos, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -agregar I-TREATMENT -rifaximina I-TREATMENT -(20 I-TREATMENT -mg/kg/día, I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -divididos I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -tomas), I-TREATMENT -con I-TREATMENT -previa I-TREATMENT -firma I-TREATMENT -del I-TREATMENT -consentimiento I-TREATMENT -informado I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -los I-TREATMENT -padres. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -mostró I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -días, I-EVOLUTION -sin I-EVOLUTION -confusión I-EVOLUTION -ni I-EVOLUTION -excitación I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -ritmo I-EVOLUTION -sueño/ I-EVOLUTION -vigilia I-EVOLUTION -normal. I-EVOLUTION -La I-EVOLUTION -concentración I-EVOLUTION -de I-EVOLUTION -amonio I-EVOLUTION -descendió I-EVOLUTION -gradualmente I-EVOLUTION -(236 I-EVOLUTION -µg% I-EVOLUTION -y I-EVOLUTION -162 I-EVOLUTION -µg%, I-EVOLUTION -4 I-EVOLUTION -y I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -respectivamente). I-EVOLUTION -No I-EVOLUTION -presentó I-EVOLUTION -cefaleas, I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -náuseas I-EVOLUTION -ni I-EVOLUTION -vómitos I-EVOLUTION -relacionados I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -rifaximina. I-EVOLUTION -Finalmente, B-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -pasado I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -rifaximina, I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -internada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -según I-PRESENT_ILLNESS -referencia I-PRESENT_ILLNESS -materna I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -frontoparietal I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -empeoró I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ingreso. I-PRESENT_ILLNESS -Antecedentes: B-PAST_MEDICAL_HISTORY -recién I-PAST_MEDICAL_HISTORY -nacida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional. I-PAST_MEDICAL_HISTORY -Tuvo I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -progresión I-PAST_MEDICAL_HISTORY -ponderal I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ictericia I-PAST_MEDICAL_HISTORY -clínica. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -ictericia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -siete I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida. I-PAST_MEDICAL_HISTORY -Evolución: B-EVOLUTION -al I-EVOLUTION -ingreso I-EVOLUTION -presentaba I-EVOLUTION -sopor, I-EVOLUTION -ictericia I-EVOLUTION -generalizada, I-EVOLUTION -hepatomegalia I-EVOLUTION -y I-EVOLUTION -tumoración I-EVOLUTION -frontoparietal I-EVOLUTION -izquierda. I-EVOLUTION -Laboratorio B-EXPLORATION -de I-EXPLORATION -ingreso: I-EXPLORATION -GOT I-EXPLORATION -262 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -143 I-EXPLORATION -UI/L, I-EXPLORATION -FAL I-EXPLORATION -2289 I-EXPLORATION -UI/L, I-EXPLORATION -bilirrubinemia I-EXPLORATION -total I-EXPLORATION -12, I-EXPLORATION -3 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -directa I-EXPLORATION -8, I-EXPLORATION -6 I-EXPLORATION -mg/ I-EXPLORATION -dl, I-EXPLORATION -coagulograma I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -"no I-EXPLORATION -coagula". I-EXPLORATION -TC: I-EXPLORATION -hemorragia I-EXPLORATION -de I-EXPLORATION -ventrículos I-EXPLORATION -laterales I-EXPLORATION -e I-EXPLORATION -intraparenquimatosa I-EXPLORATION -temporal I-EXPLORATION -derecha. I-EXPLORATION -Fue B-DERIVED_FROM/TO -evaluada I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -Neurocirugía I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -indicación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -conducta I-DERIVED_FROM/TO -expectante. I-DERIVED_FROM/TO -Recibió B-EXPLORATION -vitamina I-EXPLORATION -K I-EXPLORATION -5 I-EXPLORATION -mg I-EXPLORATION -diarios I-EXPLORATION -por I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -como I-EXPLORATION -único I-EXPLORATION -tratamiento I-EXPLORATION -corrector I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -coagulopatía I-EXPLORATION -con I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -normal: I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -100%, I-EXPLORATION -KPTT I-EXPLORATION -45 I-EXPLORATION -segundos, I-EXPLORATION -fibrinógeno I-EXPLORATION -274 I-EXPLORATION -mg/dl. I-EXPLORATION -El I-EXPLORATION -centellograma I-EXPLORATION -con I-EXPLORATION -HIDA I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -captación I-EXPLORATION -hepática I-EXPLORATION -del I-EXPLORATION -contraste, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -ni I-EXPLORATION -extrahepática, I-EXPLORATION -ni I-EXPLORATION -pasaje I-EXPLORATION -al I-EXPLORATION -intestino I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -h. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -portoentero-anastomosis, I-TREATMENT -después I-TREATMENT -de I-TREATMENT -confirmar I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -atresia I-TREATMENT -de I-TREATMENT -vías I-TREATMENT -biliares I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -cirugía. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -presentaba I-EVOLUTION -valoración I-EVOLUTION -clínico-neurológica I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -recibió I-EVOLUTION -trasplante I-EVOLUTION -de I-EVOLUTION -hígado I-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -edad. I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -lactante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vacunación I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -calendario I-PAST_MEDICAL_HISTORY -(primera I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -HBV), I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -después B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -recibir I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vacuna I-PRESENT_ILLNESS -correspondiente I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -subsector I-PRESENT_ILLNESS -privado I-PRESENT_ILLNESS -(vacuna I-PRESENT_ILLNESS -séxtuple I-PRESENT_ILLNESS -[DTPa, I-PRESENT_ILLNESS -Hib, I-PRESENT_ILLNESS -IPV, I-PRESENT_ILLNESS -HB] I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -meningocócica I-PRESENT_ILLNESS -C), I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -llevado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -instauración I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -palidez I-PRESENT_ILLNESS -cutánea I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipotonía I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hiporreactividad. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -se I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -con I-EXPLORATION -cianosis I-EXPLORATION -y I-EXPLORATION -frialdad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -hipotonía I-EXPLORATION -y I-EXPLORATION -escasa I-EXPLORATION -respuesta I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -estímulos. I-EXPLORATION -Las I-EXPLORATION -constantes I-EXPLORATION -vitales I-EXPLORATION -(frecuencia I-EXPLORATION -cardíaca, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria, I-EXPLORATION -tensión I-EXPLORATION -arterial) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -oxígeno I-EXPLORATION -respirando I-EXPLORATION -aire I-EXPLORATION -ambiente I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -en I-EXPLORATION -rangos I-EXPLORATION -normales; I-EXPLORATION -la I-EXPLORATION -temperatura I-EXPLORATION -rectal I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -38, I-EXPLORATION -6ºC. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -inicial I-TREATMENT -de I-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT -séptico, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -expansión I-TREATMENT -volumétrica I-TREATMENT -y, I-TREATMENT -después I-TREATMENT -de I-TREATMENT -practicar I-TREATMENT -un I-TREATMENT -estudio I-TREATMENT -analítico I-TREATMENT -y I-TREATMENT -de I-TREATMENT -obtener I-TREATMENT -muestras I-TREATMENT -para I-TREATMENT -cultivo, I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -empírico. I-TREATMENT -En B-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -horas I-EVOLUTION -sucesivas I-EVOLUTION -al I-EVOLUTION -ingreso, I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -llamativa, I-EVOLUTION -con I-EVOLUTION -recuperación I-EVOLUTION -del I-EVOLUTION -tono I-EVOLUTION -muscular I-EVOLUTION -y I-EVOLUTION -reactividad I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -estímulos I-EVOLUTION -normales, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -buena I-EVOLUTION -perfusión I-EVOLUTION -tisular, I-EVOLUTION -observándose I-EVOLUTION -un I-EVOLUTION -lactante I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -normal. I-EVOLUTION -Tanto B-EXPLORATION -el I-EXPLORATION -despistaje I-EXPLORATION -infeccioso I-EXPLORATION -inicial I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -diversos I-EXPLORATION -cultivos I-EXPLORATION -obtenidos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sangre, I-EXPLORATION -la I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -resultaron I-EXPLORATION -negativos, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -replanteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -sepsis I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -atribuyó I-EXPLORATION -el I-EXPLORATION -episodio I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -efecto I-EXPLORATION -adverso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vacuna I-EXPLORATION -acelular I-EXPLORATION -contra I-EXPLORATION -la I-EXPLORATION -tos I-EXPLORATION -ferina. I-EXPLORATION -Siguiendo B-TREATMENT -las I-TREATMENT -recomendaciones I-TREATMENT -del I-TREATMENT -Comité I-TREATMENT -de I-TREATMENT -Enfermedades I-TREATMENT -Infecciosas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Academia I-TREATMENT -Estadounidense I-TREATMENT -de I-TREATMENT -Pediatría I-TREATMENT -y, I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -contraindicaciones I-TREATMENT -absolutas, I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -correspondiente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -vacunación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -4 I-TREATMENT -meses I-TREATMENT -bajo I-TREATMENT -observación I-TREATMENT -hospitalaria, I-TREATMENT -sin I-TREATMENT -que I-TREATMENT -se I-TREATMENT -presentaran I-TREATMENT -manifestaciones I-TREATMENT -clínicas I-TREATMENT -en I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -siguientes. I-TREATMENT - I-TREATMENT - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -eritematosas, I-PRESENT_ILLNESS -redondeadas, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bordes I-PRESENT_ILLNESS -definidos, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -pálido I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -rostro, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -superiores, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -reticulado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Hepatoesplenomegalia. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Madre B-FAMILY_HISTORY -y I-FAMILY_HISTORY -abuela I-FAMILY_HISTORY -materna I-FAMILY_HISTORY -con I-FAMILY_HISTORY -diagnóstico I-FAMILY_HISTORY -de I-FAMILY_HISTORY -Lupus I-FAMILY_HISTORY -Eritematoso I-FAMILY_HISTORY -sistémico I-FAMILY_HISTORY -(LES) I-FAMILY_HISTORY - I-FAMILY_HISTORY -Exámenes B-EXPLORATION -complementarios: I-EXPLORATION -Hb I-EXPLORATION -10g/dl, I-EXPLORATION -Hto I-EXPLORATION -30%, I-EXPLORATION -GPT I-EXPLORATION -78 I-EXPLORATION -UI/L, I-EXPLORATION -C3 I-EXPLORATION -53 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -3mg/dl, I-EXPLORATION -FAN+ I-EXPLORATION -1/100, I-EXPLORATION -acs. I-EXPLORATION -anti I-EXPLORATION -Ro, I-EXPLORATION -anti I-EXPLORATION -La, I-EXPLORATION -anti I-EXPLORATION -Sm I-EXPLORATION -y I-EXPLORATION -anti I-EXPLORATION -U1RNP I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Estudio I-EXPLORATION -histopatológico: I-EXPLORATION -hiperqueratosis, I-EXPLORATION -atrofia I-EXPLORATION -epidérmica, I-EXPLORATION -vacuolización I-EXPLORATION -de I-EXPLORATION -queratinocitos I-EXPLORATION -basales I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION -difuso I-EXPLORATION -mononuclear I-EXPLORATION -en I-EXPLORATION -dermis I-EXPLORATION -superficial. I-EXPLORATION -Inmunofluorescencia I-EXPLORATION -directa I-EXPLORATION -(IFD): I-EXPLORATION -banda I-EXPLORATION -segmentaria I-EXPLORATION -dermoepidérmica I-EXPLORATION -de I-EXPLORATION -disposición I-EXPLORATION -granular I-EXPLORATION -fina I-EXPLORATION -IgG+ I-EXPLORATION -y I-EXPLORATION -C3+. I-EXPLORATION - I-EXPLORATION -Valoración I-EXPLORATION -cardiológica I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Tratamiento: B-TREATMENT -hidrocortisona I-TREATMENT -1% I-TREATMENT -crema. I-TREATMENT - I-TREATMENT -Resolución B-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas, I-EVOLUTION -negativización I-EVOLUTION -del I-EVOLUTION -FAN I-EVOLUTION -y I-EVOLUTION -normalización I-EVOLUTION -del I-EVOLUTION -hepatograma I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hermano I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -anterior, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -revisión. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -hemeralopia I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tiene I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS -y, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -tiempos, I-PRESENT_ILLNESS -ligera I-PRESENT_ILLNESS -fotodisforia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -agudeza I-PRESENT_ILLNESS -visual. I-PRESENT_ILLNESS -La B-EXPLORATION -visión I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -0 I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos; I-EXPLORATION -tanto I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -angiografía I-EXPLORATION -son I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -hermano, I-EXPLORATION -aunque I-EXPLORATION -con I-EXPLORATION -menores I-EXPLORATION -alteraciones I-EXPLORATION -maculares I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -EPR. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -campimetría I-EXPLORATION -aparece I-EXPLORATION -un I-EXPLORATION -estotoma I-EXPLORATION -central. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -sendos I-EXPLORATION -estudios I-EXPLORATION -electrofisiológicos I-EXPLORATION -no I-EXPLORATION -estandarizados I-EXPLORATION -consistentes I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -electrorretinograma I-EXPLORATION -(ERG) I-EXPLORATION -basal I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -segundo I-EXPLORATION -realizado I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -180 I-EXPLORATION -minutos I-EXPLORATION -de I-EXPLORATION -adaptación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -oscuridad. I-EXPLORATION -En I-EXPLORATION -ambos I-EXPLORATION -casos, I-EXPLORATION -el I-EXPLORATION -ERG I-EXPLORATION -basal I-EXPLORATION -revela I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -evidente I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -amplitud I-EXPLORATION -de I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -ondas. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -adaptación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -oscuridad, I-EXPLORATION -se I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -caso I-EXPLORATION -una I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -flash I-EXPLORATION -y I-EXPLORATION -escotópico, I-EXPLORATION -no I-EXPLORATION -modificándose I-EXPLORATION -ni I-EXPLORATION -el I-EXPLORATION -flicker I-EXPLORATION -ni I-EXPLORATION -el I-EXPLORATION -fotópico. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -segundo I-EXPLORATION -caso, I-EXPLORATION -la I-EXPLORATION -adaptación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -oscuridad I-EXPLORATION -normaliza I-EXPLORATION -las I-EXPLORATION -ondas, I-EXPLORATION -incluido I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -conos I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -queda I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -límite I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -edad. I-EXPLORATION - I-EXPLORATION - -La B-PRESENT_ILLNESS -paciente, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -estudiada B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -retraso I-DERIVED_FROM/TO -psicomotor, I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sección I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -motilidad I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -déficit I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -fijación I-DERIVED_FROM/TO -ocular. I-DERIVED_FROM/TO -Se B-EXPLORATION -observaba I-EXPLORATION -que, I-EXPLORATION -para I-EXPLORATION -cambiar I-EXPLORATION -la I-EXPLORATION -dirección I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mirada, I-EXPLORATION -la I-EXPLORATION -niña I-EXPLORATION -se I-EXPLORATION -veía I-EXPLORATION -obligada I-EXPLORATION -a I-EXPLORATION -realizar I-EXPLORATION -unos I-EXPLORATION -movimientos I-EXPLORATION -bruscos I-EXPLORATION -laterales I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -arrastraba I-EXPLORATION -sus I-EXPLORATION -ojos I-EXPLORATION -al I-EXPLORATION -nuevo I-EXPLORATION -objeto. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -habitual I-EXPLORATION -para I-EXPLORATION -buscar I-EXPLORATION -alteraciones I-EXPLORATION -que I-EXPLORATION -justificasen I-EXPLORATION -esa I-EXPLORATION -dificultad: I-EXPLORATION -la I-EXPLORATION -motilidad I-EXPLORATION -ocular, I-EXPLORATION -BMC I-EXPLORATION -y I-EXPLORATION -F.O. I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -siguió I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -neurooftalmológica: I-EXPLORATION -el I-EXPLORATION -reflejo I-EXPLORATION -optocinético I-EXPLORATION -aparecía I-EXPLORATION -alterado I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -fase I-EXPLORATION -rápida I-EXPLORATION -(disminuida I-EXPLORATION -o I-EXPLORATION -ausente) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -plano I-EXPLORATION -horizontal. I-EXPLORATION -Los I-EXPLORATION -potenciales I-EXPLORATION -evocados I-EXPLORATION -visuales I-EXPLORATION -(P.E.V.) I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -electrorretinograma I-EXPLORATION -(ERG) I-EXPLORATION -dada I-EXPLORATION -la I-EXPLORATION -corta I-EXPLORATION -edad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -evidenciaba I-EXPLORATION -hipertonía I-EXPLORATION -de I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -con I-EXPLORATION -hiperreflexia. I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -encaminadas I-EXPLORATION -a I-EXPLORATION -detectar I-EXPLORATION -procesos I-EXPLORATION -neurológicos I-EXPLORATION -o I-EXPLORATION -sistémicos I-EXPLORATION -(EEG, I-EXPLORATION -RM I-EXPLORATION -cerebral, I-EXPLORATION -aminoácidos I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -LCR, I-EXPLORATION -amoníaco, I-EXPLORATION -ácido I-EXPLORATION -pirúvico I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -LCR, I-EXPLORATION -ácidos I-EXPLORATION -grasos I-EXPLORATION -de I-EXPLORATION -cadena I-EXPLORATION -larga, I-EXPLORATION -serología I-EXPLORATION -TORCH) I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Sólo I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -ácido I-EXPLORATION -láctico I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -levemente I-EXPLORATION -altas, I-EXPLORATION -sin I-EXPLORATION -demostrarse I-EXPLORATION -enfermedad. I-EXPLORATION -Por I-EXPLORATION -PCR I-EXPLORATION -se I-EXPLORATION -amplificó I-EXPLORATION -virus I-EXPLORATION -del I-EXPLORATION -herpes I-EXPLORATION -humano I-EXPLORATION -tipo I-EXPLORATION -6 I-EXPLORATION -(HHV-6), I-EXPLORATION -del I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -han I-EXPLORATION -descrito I-EXPLORATION -asociaciones I-EXPLORATION -con I-EXPLORATION -apraxia I-EXPLORATION -oculomotora. I-EXPLORATION - I-EXPLORATION -Fue I-EXPLORATION -diagnosticada I-EXPLORATION -de I-EXPLORATION -C.O.M.A. I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -piramidal I-EXPLORATION -bilateral I-EXPLORATION -inespecífica. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -epífora I-PRESENT_ILLNESS -bilateral, I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -(OI), I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dacriocistitis I-PRESENT_ILLNESS -aguda. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -drenaje I-PAST_MEDICAL_HISTORY -quirúrgico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -senos I-PAST_MEDICAL_HISTORY -etmoidales I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sinusitis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -juventud. I-PAST_MEDICAL_HISTORY -Presenta B-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -3 I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -Esta I-EXPLORATION -visión I-EXPLORATION -estaba I-EXPLORATION -justificada I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -cataratas I-EXPLORATION -y I-EXPLORATION -además I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -obstrucción I-EXPLORATION -bilateral I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -lagrimal. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -dacriocistografía I-TREATMENT -izquierda I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -le I-TREATMENT -implantó I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -recta I-TREATMENT -de I-TREATMENT -Wacrees I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -comienzó I-EVOLUTION -una I-EVOLUTION -inflamación I-EVOLUTION -palpebral I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -orbitaria I-EVOLUTION -izquierda. I-EVOLUTION -Tras I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -refirió I-EVOLUTION -pérdida I-EVOLUTION -brusca I-EVOLUTION -de I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -del I-EVOLUTION -OI I-EVOLUTION -con I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -y I-EVOLUTION -febrícula I-EVOLUTION -(37,6º). I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -urgencias, I-EVOLUTION -presentando I-EVOLUTION -una I-EVOLUTION -visión I-EVOLUTION -de I-EVOLUTION -movimiento I-EVOLUTION -de I-EVOLUTION -manos I-EVOLUTION -a I-EVOLUTION -50 I-EVOLUTION -cms, I-EVOLUTION -marcado I-EVOLUTION -exoftalmos I-EVOLUTION -con I-EVOLUTION -clínica I-EVOLUTION -inflamatoria I-EVOLUTION -periocular, I-EVOLUTION -oftalmoplejia I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -movimientos I-EVOLUTION -oculares I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -biomicroscopía I-EVOLUTION -midriasis I-EVOLUTION -paralítica I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI I-EVOLUTION -con I-EVOLUTION -anestesia I-EVOLUTION -corneal. I-EVOLUTION -Oftalmoscópicamente B-EXPLORATION -la I-EXPLORATION -papila I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal I-EXPLORATION -con I-EXPLORATION -pulso I-EXPLORATION -venoso I-EXPLORATION -espontáneo I-EXPLORATION -negativo. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -de I-EXPLORATION -urgencias I-EXPLORATION -presentaba I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION -realizado I-EXPLORATION -era I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -celulitis I-EXPLORATION -orbitaria I-EXPLORATION -OI. I-EXPLORATION -Asimismo I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -neuritis I-EXPLORATION -óptica I-EXPLORATION -izquierda I-EXPLORATION -por I-EXPLORATION -compresión I-EXPLORATION -intraorbitaria. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -instaura I-TREATMENT -tratamiento I-TREATMENT -sistémico I-TREATMENT -con I-TREATMENT -metil-prednisolona I-TREATMENT -(250 I-TREATMENT -mgr/iv/6 I-TREATMENT -h), I-TREATMENT -ceftriaxona I-TREATMENT -(2 I-TREATMENT -gr/iv/12 I-TREATMENT -h) I-TREATMENT -y I-TREATMENT -Vancomicina I-TREATMENT -(1 I-TREATMENT -gr/iv/12 I-TREATMENT -h), I-TREATMENT -así I-TREATMENT -como I-TREATMENT -tratamiento I-TREATMENT -tópico I-TREATMENT -en I-TREATMENT -OI. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -cuadro I-EVOLUTION -inflamatorio I-EVOLUTION -periocular I-EVOLUTION -mejoró I-EVOLUTION -notablemente I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -horas, I-EVOLUTION -pero I-EVOLUTION -no I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -limitaba I-EVOLUTION -a I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -colores I-EVOLUTION -parcheados I-EVOLUTION -(azul, I-EVOLUTION -marrón). I-EVOLUTION - I-EVOLUTION -Transcurrida B-EXPLORATION -1 I-EXPLORATION -semana I-EXPLORATION -se I-EXPLORATION -retiró I-EXPLORATION -la I-EXPLORATION -prótesis I-EXPLORATION -lacrimonasal, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -buena I-EXPLORATION -localización I-EXPLORATION -y I-EXPLORATION -funcionamiento, I-EXPLORATION -haciéndose I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -y I-EXPLORATION -aislándose I-EXPLORATION -tres I-EXPLORATION -gérmenes: I-EXPLORATION -Streptococcus I-EXPLORATION -mitis, I-EXPLORATION -Staphylococcus I-EXPLORATION -epidérmidis I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -bacilo I-EXPLORATION -gram I-EXPLORATION -negativo I-EXPLORATION -oxidasa I-EXPLORATION -positivo I-EXPLORATION -(sin I-EXPLORATION -determinar). I-EXPLORATION - I-EXPLORATION -Durante B-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -se I-TREATMENT -desarrolló I-TREATMENT -un I-TREATMENT -piocele I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -dacriocistectomía I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI I-EVOLUTION -una I-EVOLUTION -visión I-EVOLUTION -de I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -luz, I-EVOLUTION -con I-EVOLUTION -leve I-EVOLUTION -midriasis I-EVOLUTION -arreactiva I-EVOLUTION -y I-EVOLUTION -atrofia I-EVOLUTION -óptica I-EVOLUTION -izquierda. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -hipofluorescencia I-EXPLORATION -papilar I-EXPLORATION -durante I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -angiograma I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -RMN I-EXPLORATION -un I-EXPLORATION -dudoso I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -tardío I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -nervio I-EXPLORATION -óptico. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -artritis I-PAST_MEDICAL_HISTORY -reumatoide I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -leflunomida, I-PAST_MEDICAL_HISTORY -deflazacort I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antiinflamatorios I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -esteroideos I-PAST_MEDICAL_HISTORY -(AINEs), I-PAST_MEDICAL_HISTORY -es B-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Inflamación I-DERIVED_FROM/TO -Ocular I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -derecho I-DERIVED_FROM/TO -rojo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -doloroso I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -dos I-DERIVED_FROM/TO -semanas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -asociado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -empeoramiento I-DERIVED_FROM/TO -clínico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -laboratorio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -base. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -La B-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -inicial I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -6 I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION -y I-EXPLORATION -1 I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -biomicroscopía I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -ingurgitación I-EXPLORATION -vascular I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -engrosamiento I-EXPLORATION -escleral I-EXPLORATION -temporal I-EXPLORATION -superior I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -escleritis I-EXPLORATION -anterior I-EXPLORATION -difusa I-EXPLORATION -severa. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -AO. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -esteroideo I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -mg/kg/día, I-TREATMENT -manteniendo I-TREATMENT -el I-TREATMENT -resto I-TREATMENT -del I-TREATMENT -tratamiento, I-TREATMENT -sin I-TREATMENT -obtener I-TREATMENT -mejoría I-TREATMENT -clínica I-TREATMENT -tras I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -seguimiento. I-TREATMENT -Una B-EXPLORATION -vez I-EXPLORATION -realizadas I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Mantoux I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -se B-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -Infliximab I-TREATMENT -(Remicade®, I-TREATMENT -Schering-Plough, I-TREATMENT -Welwyn I-TREATMENT -Garden I-TREATMENT -City, I-TREATMENT -UK) I-TREATMENT -en I-TREATMENT -tres I-TREATMENT -dosis I-TREATMENT -intravenosas I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -mg/kg/día I-TREATMENT -en I-TREATMENT -las I-TREATMENT -semanas I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -y I-TREATMENT -6. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -dosis I-EVOLUTION -se I-EVOLUTION -objetivó I-EVOLUTION -una I-EVOLUTION -reducción I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ingurgitación I-EVOLUTION -vascular I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -edema I-EVOLUTION -escleral I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -tercera I-EVOLUTION -se I-EVOLUTION -obtuvo I-EVOLUTION -una I-EVOLUTION -desaparición I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -inflamación I-EVOLUTION -escleral, I-EVOLUTION -quedando I-EVOLUTION -un I-EVOLUTION -cierto I-EVOLUTION -adelgazamiento I-EVOLUTION -residual I-EVOLUTION -con I-EVOLUTION -transparencia I-EVOLUTION -del I-EVOLUTION -tejido I-EVOLUTION -uveal I-EVOLUTION -subyacente. I-EVOLUTION -Paralelamente, I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -signos I-EVOLUTION -y I-EVOLUTION -síntomas I-EVOLUTION -articulares, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -actividad I-EVOLUTION -global I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -representada I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -Disease I-EVOLUTION -Activity I-EVOLUTION -Score I-EVOLUTION -(DAS I-EVOLUTION -28), I-EVOLUTION -obteniéndose I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -40% I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -DAS I-EVOLUTION -28. I-EVOLUTION - I-EVOLUTION -Tras I-EVOLUTION -un I-EVOLUTION -período I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -detectado I-EVOLUTION -recidivas I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -inflamación I-EVOLUTION -escleral. I-EVOLUTION -La B-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -(AO). I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -sigue I-TREATMENT -en I-TREATMENT -la I-TREATMENT -actualidad I-TREATMENT -tratamiento I-TREATMENT -sistémico I-TREATMENT -únicamente I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -7, I-TREATMENT -5 I-TREATMENT -mg/día, I-TREATMENT -leflunomida I-TREATMENT -y I-TREATMENT -AINEs. I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -herida I-PAST_MEDICAL_HISTORY -corneal I-PAST_MEDICAL_HISTORY -postraumática I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -(OI), I-PAST_MEDICAL_HISTORY -suturada I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -accidente, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -cuerpo I-PAST_MEDICAL_HISTORY -extraño I-PAST_MEDICAL_HISTORY -intraocular, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antibióticos, I-PAST_MEDICAL_HISTORY -ciclopléjicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -esteroides I-PAST_MEDICAL_HISTORY -tópicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sistémicos. I-PAST_MEDICAL_HISTORY -Al B-DERIVED_FROM/TO -suspender I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -esteroides, I-DERIVED_FROM/TO -presentó I-DERIVED_FROM/TO -disminución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -agudeza I-DERIVED_FROM/TO -visual I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -traumatizado, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -reinició I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -administración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -prednisona I-DERIVED_FROM/TO -vía I-DERIVED_FROM/TO -oral I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -envió I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -institución I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -oftalmía I-DERIVED_FROM/TO -simpática. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -ingreso, I-EXPLORATION -un I-EXPLORATION -mes I-EXPLORATION -y I-EXPLORATION -medio I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -traumatismo, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -refería I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION -de I-EXPLORATION -21 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -escotoma I-EXPLORATION -central I-EXPLORATION -relativo I-EXPLORATION -en I-EXPLORATION -AO. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -AV I-EXPLORATION -de I-EXPLORATION -20/60 I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -20/400 I-EXPLORATION -OI, I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -mmHg I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -12 I-EXPLORATION -mmHg I-EXPLORATION -OI. I-EXPLORATION -El I-EXPLORATION -OD I-EXPLORATION -presentaba I-EXPLORATION -además I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -pigmento I-EXPLORATION -1/2 I-EXPLORATION -+ I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cámara I-EXPLORATION -anterior, I-EXPLORATION -sin I-EXPLORATION -flare. I-EXPLORATION -El I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -OI I-EXPLORATION -presentaba I-EXPLORATION -conjuntiva I-EXPLORATION -hiperémica, I-EXPLORATION -herida I-EXPLORATION -corneal I-EXPLORATION -suturada I-EXPLORATION -con I-EXPLORATION -leucoma I-EXPLORATION -temporal, I-EXPLORATION -sinequias I-EXPLORATION -posteriores I-EXPLORATION -y I-EXPLORATION -opacidad I-EXPLORATION -subcapsular I-EXPLORATION -posterior I-EXPLORATION -+. I-EXPLORATION -La I-EXPLORATION -funduscopia I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -mostraba I-EXPLORATION -pliegues I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mácula I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -lesiones I-EXPLORATION -blanco I-EXPLORATION -amarillentas I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -subretiniano; I-EXPLORATION -el I-EXPLORATION -OI I-EXPLORATION -tenía I-EXPLORATION -tres I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -similares, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -panuveítis I-EXPLORATION -bilateral. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -que I-TREATMENT -recibía I-TREATMENT -consistía I-TREATMENT -en I-TREATMENT -prednisona I-TREATMENT -75 I-TREATMENT -mg/día I-TREATMENT -po, I-TREATMENT -acetato I-TREATMENT -de I-TREATMENT -prednisolona I-TREATMENT -1% I-TREATMENT -cada I-TREATMENT -2 I-TREATMENT -h, I-TREATMENT -ciclopentolato I-TREATMENT -1% I-TREATMENT -bid, I-TREATMENT -fenilefrina I-TREATMENT -10% I-TREATMENT -bid. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -aspecto I-EXPLORATION -clínico I-EXPLORATION -hizo I-EXPLORATION -sospechar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -CSC. I-EXPLORATION -Se I-EXPLORATION -solicitaron I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -angiográfico. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -desprendimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hialoides I-EXPLORATION -posterior I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -DRS I-EXPLORATION -en I-EXPLORATION -área I-EXPLORATION -macular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OI; I-EXPLORATION -el I-EXPLORATION -grosor I-EXPLORATION -coroideo I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -AO. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -angiográfico I-EXPLORATION -mostró I-EXPLORATION -dos I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -hiperfluorescencia I-EXPLORATION -que I-EXPLORATION -aumentaban I-EXPLORATION -progresivamente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -tres I-EXPLORATION -lesiones I-EXPLORATION -similares I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OI. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -CSC I-EXPLORATION -bilateral I-EXPLORATION -de I-EXPLORATION -focos I-EXPLORATION -múltiples. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciclopléjicos I-TREATMENT -y I-TREATMENT -se I-TREATMENT -redujeron I-TREATMENT -rápidamente I-TREATMENT -los I-TREATMENT -esteroides I-TREATMENT -tópicos I-TREATMENT -y I-TREATMENT -sistémicos. I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -era I-EVOLUTION -de I-EVOLUTION -1 I-EVOLUTION -OD I-EVOLUTION -y I-EVOLUTION -0, I-EVOLUTION -2 I-EVOLUTION -OI; I-EVOLUTION -el I-EVOLUTION -aspecto I-EVOLUTION -clínico I-EVOLUTION -del I-EVOLUTION -fondo I-EVOLUTION -de I-EVOLUTION -ojo I-EVOLUTION -mostraba I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -pigmentadas I-EVOLUTION -sin I-EVOLUTION -líquido I-EVOLUTION -subretiniano I-EVOLUTION -en I-EVOLUTION -AO. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -enviado I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -evaluar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -exoftalmos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -(OD) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -visita I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -pediátrica I-EXPLORATION -general I-EXPLORATION -era I-EXPLORATION -buena I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -anomalías I-EXPLORATION -neurológicas. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica, I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -proptosis I-EXPLORATION -e I-EXPLORATION -hipertropia I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -con I-EXPLORATION -franca I-EXPLORATION -asimetría I-EXPLORATION -facial. I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -fronto-temporal I-EXPLORATION -el I-EXPLORATION -niño I-EXPLORATION -tenía I-EXPLORATION -dolor. I-EXPLORATION -El I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -explorado I-EXPLORATION -con I-EXPLORATION -linterna I-EXPLORATION -era I-EXPLORATION -aparentemente I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -motilidad I-EXPLORATION -intrínseca I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -mientras I-EXPLORATION -la I-EXPLORATION -motilidad I-EXPLORATION -extrínseca I-EXPLORATION -presentaba I-EXPLORATION -limitación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -abducción I-EXPLORATION -y I-EXPLORATION -descenso I-EXPLORATION -del I-EXPLORATION -OD. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -infiltrante I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -el I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION -hacia I-EXPLORATION -arriba I-EXPLORATION -con I-EXPLORATION -destrucción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -orbitaria I-EXPLORATION -lateral I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -sacabocado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -calota I-EXPLORATION -craneal. I-EXPLORATION -Otros I-EXPLORATION -estudios I-EXPLORATION -radiológicos I-EXPLORATION -demostraron I-EXPLORATION -lesiones I-EXPLORATION -semejantes I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -vértebras I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -huesos I-EXPLORATION -largos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -piernas. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -hematológicas I-EXPLORATION -y I-EXPLORATION -bioquímicas I-EXPLORATION -mostraron I-EXPLORATION -valores I-EXPLORATION -normales. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -ósea I-EXPLORATION -del I-EXPLORATION -fémur I-EXPLORATION -demostró I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Langerhans I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -immunohistológico I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -S100 I-EXPLORATION -(indica I-EXPLORATION -su I-EXPLORATION -origen I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cresta I-EXPLORATION -neural) I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -las I-EXPLORATION -proteínas I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -CD68 I-EXPLORATION -(proteína I-EXPLORATION -lisosomal I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -expresa I-EXPLORATION -en I-EXPLORATION -macrófagos I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -células I-EXPLORATION -dendríticas I-EXPLORATION -inmaduras) I-EXPLORATION -y I-EXPLORATION -CD1a I-EXPLORATION -(glicoproteína I-EXPLORATION -de I-EXPLORATION -membrana I-EXPLORATION -de I-EXPLORATION -49 I-EXPLORATION -KDa I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -expresa I-EXPLORATION -en I-EXPLORATION -asociación I-EXPLORATION -a I-EXPLORATION -ß2 I-EXPLORATION -microglobulinas) I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -histiocitosis I-EXPLORATION -de I-EXPLORATION -Langerhans. I-EXPLORATION -Dos B-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -estaba I-EVOLUTION -hipersomnoliento I-EVOLUTION -día I-EVOLUTION -y I-EVOLUTION -noche I-EVOLUTION -con I-EVOLUTION -ingesta I-EVOLUTION -excesiva I-EVOLUTION -de I-EVOLUTION -líquidos. I-EVOLUTION -En B-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -RMN I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -infiltrante I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -hipotálamo-hipofisaria I-EXPLORATION -con I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -añadió I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -diabetes I-EXPLORATION -insípida. I-EXPLORATION - I-EXPLORATION \ No newline at end of file