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    Síndrome de Wilkie. Reporte de un caso
    (2017)
    González Hermosillo-Cornejo, Daniel
    ;
    Díaz Girón-Gidi, Alejandro
    ;
    Vélez-Pérez, Francisco Manuel
    ;
    Lemus-Ramírez, Ramón Ignacio
    ;
    Andrade Martínez-Garza, Pablo
    Background: Wilkie syndrome, also referred as superior mesenteric artery syndrome, is an unusual cause of a proximal small bowel obstruction. It is characterised by the compression of the duodenum in its third portion due to a narrowing of the space between the superior mesenteric artery and the aorta. Its presentation symptoms are consistent and include the obstruction of the proximal small bowel. However, the physical and laboratory findings are non-specific. Nevertheless, many imaging methods are useful for its diagnosis. The management of this condition varies between observation and surgery, depending on each particular case. Clinical case: The case is presented of a 19 year-old male who began with acute, intense abdominal pain, nausea, vomiting, and diarrhoea. On examination, he had abdominal wall rigidity and hyperesthesia. Imaging studies were requested, revealing a decreased superior mesenteric artery angle, a shortening of the aortic mesenteric distance, and a decrease in the calibre of the third duodenal portion, all findings concomitant with Wilkie syndrome. Conservative treatment was applied and the patient was discharged without complications. © Cirugía y Cirujanos
    Scopus© Citations 7  12  1
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    Supportive care for end-stage kidney disease: an integral part of kidney services across a range of income settings around the world
    (2020)
    Hole, Barnaby
    ;
    Hemmelgarn, Brenda
    ;
    Brown, Edwina
    ;
    Brown, Mark
    ;
    McCulloch, Mignon I.
    A key component of treatment for all people with advanced kidney disease is supportive care, which aims to improve quality of life and can be provided alongside therapies intended to prolong life, such as dialysis. This article addresses the key considerations of supportive care as part of integrated end-stage kidney disease care, with particular attention paid to programs in low- and middle-income countries. Supportive care should be an integrated component of care for patients with advanced chronic kidney disease, patients receiving kidney replacement therapy (KRT), and patients receiving non-KRT conservative care. Five themes are identified: improving information on prognosis and support, developing context-specific evidence, establishing appropriate metrics for monitoring care, clearly communicating the role of supportive care, and integrating supportive care into existing health care infrastructures. This report explores some general aspects of these 5 domains, before exploring their consequences in 4 health care situations/settings: in people approaching end-stage kidney disease in high-income countries and in low- and middle-income countries, and in people discontinuing KRT in high-income countries and in low- and middle-income countries. ©2020 International Society of Nephrology
    Scopus© Citations 40  27  1