Enfermedad de paget mamaria. presentación de un caso / Mammary paget disease. case report

RESUMEN: La enfermedad de Paget mamaria es una patología poco común de la mama que tiene una gran importancia por su alta asociación a carcinoma mamario y por requerir de un alto índice de sospecha para arribar a su diagnóstico. Se presenta el caso de una mujer de 65 años de edad, con diagnóstico de enfermedad de Paget mamaria asociada a carcinoma ductal infiltrante de mama izquierda con compromiso ganglionar axilar homolateral. Se realizó la revisión bibliográfica de esta patología, con especial énfasis en la clínica, diagnóstico, estadificación, tratamientoy pronóstico.

ABSTRACT: Paget's disease of the breast is a rare pathology in the breast, however, it is very important because of its high association with mammary carcinoma and because it requires a high index of suspicion. We present the case of a 65-year-old woman with Paget's disease of the breast associated with an infiltrating ductal carcinoma of the left breast with homolateral axillary lymph node involvement. A bibliographic review of this pathology was carried out, with special emphasis on the clinic, diagnosis, staging, treatment and prognosis.

Demographic profile and treatment outcomes of Filipino patients with hepatocellular carcinoma in a liver tumor registry

BACKGROUND AND OBJECTIVES: Previous studies using older diagnostic criteria indicated chronic Hepatitis B and alcohol as the most common etiologies of HCC in the Philippines. No recent studies updated criteria for diagnosis have been published. This study used the diagnostic criteria from the latest APASL guidelines to describe the demographic profile of patients with HCC. METHODS: This is a cross-sectional study of adult HCC cases from a liver tumor registry in the Philippine General Hospital from 2009 to 2012. Demographics, AFP levels, BCLC stage, Child-Pugh Score, ECOG performance status, treatments received, and mortality were assessed. RESULTS: The HCC prevalence rate was 7.8%, mostly occurring between ages 40 to 65 years. It is more common in males (M:F=4:1). Most of the HCC cases were diagnosed at early stages, with less severity of liver functional impairment compared to older studies. Resection was the common treatment undertaken (50%) and overall mortality rate at the time of hospital discharge was 25%.  CONCLUSION: The profile of HCC patients in this study is similar to previous studies. More cases were recognized at earlier stages with better liver function, implying better treatment outcomes with surgery, although selection bias is recognized.

Rehidratación oral en SDA del lactante con solución Na 75 y Na 90 / Oral rehidration in infant acute diarrhea syndrome with Na 75 and Na 90 solution

Se analizan comparativamente 2 soluciones para la hidratación del lactante hospitalizado por Síndrome Diarréico Agudo (SDA) en la Unidad de Lactantes, Hospital Regional de Temuco, Enero-Marzo 1987. Se someten al estudio 39 pacientes divididos en 2 grupos randomizados y con sistema de doble ciego. En 17 se usó la solución glucoelectrolítica con 75 meq/L de Na y en 22 lactantes se utilizó la solución OMS de 90 meq/L de Na. Ambas soluciones fueron suficientes para hidratar y corregir acidosis metabólica en todos los pacientes. Ninguno presentó hipernatremia en su evolución. A partir de esta experiencia se propone el uso normado de la solución OMS en la terapia de hidratación oral del lactante hospitalizado por SDA con deshidratación moderada a grave, con el consiguiente menor costo de tratamiento, ahorro de días de hospitalización y el subsecuente menor riesgo de deshidratación y/o infección cruzada