Cáncer de próstata, el problema del diagnóstico: ¿es la resonancia multiparamétrica de próstata la solución? / Prostate cancer, the problem of diagnosis: is multiparametric prostate magnetic resonance imaging the solution?

Junto con un aumento sostenido en la incidencia de cáncer de próstata en los países desarrollados ha habido un cambio en el enfrentamiento diagnóstico en estos pacientes. El diagnóstico tradicional basado en la medición del antígeno prostático específico y la biopsia randomizada ha mostrado tener muchas falencias ya que sobre-diagnostica cánceres no significativos y sub-diagnostica cánceres clínicamente significativos. La resonancia magnética de próstata multiparamétrica ha demostrado ser útil ya que disminuye este tipo de falencias. En este artículo se revisará la historia de la resonancia magnética de próstata y del PI-RADS, con el objeto de revisar el rendimiento de estos métodos y sus indicaciones actuales.

Along with a sustained increase in the incidence of prostate cancer in developed countries, there has been a change in the diagnostic approach in these patients. The traditional diagnosis based on the measurement of the specific prostate antigen and randomized biopsy has shown to have many shortcomings as it leads to overdiagnosis of non-significant cancers and underdiagnosis of clinically significant cancers. The multiparametric prostate magnetic resonance imaging has proven to be useful since it diminishes these shortcomings. In this article we will review part of the history of prostate magnetic resonance imaging and PI-RADS, in order to review the performance of these methods and their current indications.

Estrongiloidiasis gastrointestinal en paciente inmunocompetente: a propósito de un caso / Gastrointestinal strongyloidosis in an immunocompetent patient: a case report

Intestinal parasitic infections cause a not insignificant number of chronic diarrhea in children, however, with the sociodemographic change that our country has experienced, the number of cases and new parasites (immigration from tropical endemic areas) could increase. We report the case of an immunocompetent patient who presents with chronic diarrhea associated with Strongyloides stercoralis infection. The patient migrated two years ago from an endemic area for this helminth. The diagnosis is challenging, and the chances of a successful outcome depend on the administration of the antiparasitic.

Las infecciones parasitarias intestinales provocan un número no despreciable de causas de diarrea crónica en niños, sin embargo, con el cambio sociodemográfico que ha vivido nuestro país se podría incrementar el número de casos y de nuevos parásitos (inmigración de áreas endémicas tropicales). Reportamos el caso de un paciente inmunocompetente, que presenta cuadro de diarrea crónica asociada a infección por Strongyloides stercoralis. El paciente habría migrado hace dos años desde zona endémica para este helminto. El diagnóstico es desafiante y las posibilidades de un resultado exitoso dependen de la administración del antiparasitario.

Charmonium: comparison between potential models / Charmonio: comparación entre modelos potenciales

Abstract Heavy quark c c ¯ has been studied in the non relativistic framework using a quark-quark potential as a sum of power of the corresponding distance. The form of potential is based on phenomenological facts. The problem was solved numerically using a program written on C++. Mass spectra and the expectation value of the radius have been estimated for different quantum-mechanical states for c c ¯ system. The results have been compared with other similar and recent works. The mass spectra obtained is in acceptable agreement with the experimental data for c c ¯.

Resumen El sistema de quarks pesados c c ¯ ha sido estudiado en el marco no relativista usando un potencial quark-quark de la forma de la suma de potencias de la distancia entre las partículas. El problema se resolvió numéricamente usando un programa escrito en C++. Se estimaron el espectro de masa y el valor esperado del radio para diferentes estados de excitación. Los resultados fueron comparados con otros trabajos similares recientes. El espectro de masa obtenido concuerda de manera aceptable con los datos experimentales para el sistema c c ¯.

Study of light-particle multiplicities in p + non-fissionable nuclei events in the 0.5 - 2 GeV energy range / Estudio de la multiplicidad de partículas ligeras en proto-reacciones con núcleos no fisionables en el rango energético 0.5 - 2 GeV

Abstract In recent years, the investigation of spallation reactions have caught the attention of scientific community due to their application in the transmutation of nuclear waste by using the Accelerator Driven System (ADS) reactors. Due to the experimental difficulties that nuclear reactions researches face; the study of spallation reaction by using simulation codes is more suitable for generating more complete database for different energy ranges. This work aims to study spallation reactions induced by protons at intermediate energies 0.5 - 2 GeV on non-fissionable nuclei by using the Monte Carlo code: CRISP (Collaboration Rio-Ilhéus-São Paulo). The target nuclei studied were: 184 W, 197 Au and 208 Pb, focusing on the last one. Multiplicity of light particles obtained with CRISP was compared with the available experimental data and other Monte Carlo codes involved in the study of spallation reactions, resulting on a quite satisfactory agreement.

Resumen En años recientes la investigación de las reacciones nucleares de "espalación" han causado atención en la comunidad científica debido a su aplicación en la transmutación de los residuos nucleares usando reactores ADS (AcceleratorDriven System). Debido a las dificultades experimentales en el estudio de las reacciones nucleares, su estudio vía simulación es adecuado para generar una base de datos más completa en un amplio rango de energía. Este trabajo tiene como objetivo principal el estudio de reacciones nucleares inducidas por protones a energías intermedias, 0.5 - 2 GeV, en núcleos no fisionables, utilizando el código de Monte Carlo: CRISP (Collaboration Rio-Ilhéus-São Paulo). Los núcleos estudiados fueron: 184W, 197Au y 208Pb, con un enfoque en el último. La multiplicidad de partículas ligeras obtenida con el CRISPfue comparada con los datos experimentales disponibles y con otros códigos de Monte Carlo y se obtuvieron resultados satisfactorios.

Caracterización de enfermedad metastásica con PET/CT en cáncer de mama en etapificación y con recidiva postratamiento / Characterization of metastatic disease in recently diagnosed breast cancer and relapsed breast cancer (after treatment), with PET/CT

Objetivo: Describir la enfermedad metastásica detectada por PET/CT en cáncer de mama (CM) y estimar el aporte relativo del PET y del CT interpretados por separado. Pacientes y método. Se separaron dos grupos de pacientes con CM: 1) en etapificación 2) ya tratados con recidiva al PET/CT. Se describieron las lesiones encontradas exclusivamente con PET y exclusivamente con CT. Resultados. Los pacientes en etapificación (n=17) presentaron 88 por ciento adenopatías, 29 por ciento metástasis óseas (MO), 17 por ciento pulmonares, 17 por ciento hepáticas y 11 por ciento en otras localizaciones. Para los pacientes en seguimiento (n=35) estos porcentajes fueron de 54 por ciento, 62 por ciento, 34 por ciento, 31 por ciento y 28 por ciento, respectivamente. El CT detectó más nódulos pulmonares y MO escleróticas que el PET. El PET detectó más adenopatías, MO medulares y lesiones hepáticas. Se encontró cáncer sincrónico en 6 por ciento de los pacientes en etapificación y 11 por ciento en seguimiento. Conclusión. Las pacientes con CM presentaron principalmente metástasis ganglionares y óseas. El estudio híbrido PET/CT detectó más lesiones que el PET y el CT analizados por separado.

Purpose: To describe metastatic disease detected by PET/CT in breast cancer (BC), and to evaluate the relative contribution of PET and CT analyzed separately. Patients and Method. We defined two groups of patients with BC: 1) recently diagnosed with no treatment, 2) with relapse after treatment. We described findings which are visible exclusively with CT and exclusively with PET. Results. In recently diagnosed patients (n=17) 88 percent show lymphadenopathies, 29 percent bone metastases (BM), 17 percent lung metastases, 17 percent hepatic metastases, and 11 percent other localizations. For relapsed patients (n=35) these percentages were 54 percent, 62 percent, 34 percent, 31 percent and 28 percent, respectively. CT detected more lung nodules and sclerotic bone lesions than PET. PET detected more lymphadenopathies, medullary bone and hepatic lesions than CT. There were synchronous cancers in 6 percent of recently diagnosed patients and in 11 percent of relapsed patients. Conclusion. BC patients show mainly lymph nodal and bone metastasis. The PET/CT hybrid study detected more lesions than PET and CT analyzed separately.

Localization of sweet potato chlorotic stunt virus (SPCSV) in synergic infection with potyviruses in sweet potato

Among diseases reported worldwidely for sweet potato (Ipomoea batatas (L) Lam) crop, one of the most frequent is the Sweet potato virus disease (SPVD), caused by sweet potato chlorotic stunt virus (SPCSV) and sweet potato feathery mottle virus (SPFMV) co-infection. In Argentina, there exists the sweet potato chlorotic dwarf (SPCD), a sweet potato disease caused by triple co-infection with SPCSV, SPFMV and sweet potato mild speckling virus (SPMSV). Both diseases cause a synergism between the potyviruses (SPFMV and SPMSV) and the crinivirus (SPCSV). Up to date, studies carried out on the interaction among these three viruses have not described their localization in the infected tissues. In single infections, virions of the crinivirus genus are limited to the phloem while potyviral virions are found in most tissues of the infected plant. The purpose of this work was to localize the heat shock protein 70 homolog (HSP70h), a movement protein for genus crinivirus, of an Argentinean SPCSV isolate in its single infection and in its double and triple co-infection with SPFMV and SPMSV. The localization was made by in situ hybridization (ISH) for electron microscopy (EM) on ultrathin sections of sweet potato cv. Morada INTA infected tissues. The results demonstrated that viral RNA coding HSP70h is restricted to phloem cells during crinivirus single infection, while it was detected outside the phloem in infections combined with the potyviruses involved in chlorotic dwarf disease.

Ascaris in the common bile duct (a report of 10 cases)

Ascaris has been found in a variety of places aside from its usual habitat in the jejunum. Its discovery in the common bile duct is notedA study of 10 cases where ascaris has been found in the common bile duct shows that this condition brings about signs and symptoms that are considered pathognomic and characteristic of a gall bladder disease. That a gall bladder disease is really coexistent with the presence of ascaris in the common bile duct seems to be borne out by the invariable observation that the gall bladder in these cases shows at least a chronic inflammatory condition. A hypothesis is, therefore, advanced to the effect that a pre-existing gall bladder disease is responsible in attracting the ascaris into the common bile duct, or at least makes it possible for the wandering ascaris to penetrate into the biliary system by causing a dysfunction in the sphincter of Oddi which normally would impede such an entrance. It is evident that, in the presence of a gall bladder disease, the removal of the ascaris alone will not cure the disease; the gall bladder disease; the removal of the ascaris alone will not cure the disease; the gall bladder may also have to be removed. (Summary)

Gall bladder disease: an analysis of cases in the North General Hospital

An analysis of 78 patients with gall bladder disease admitted to the surgical department of the North General Hospital was made. These cases were divided into the non-operated cases (40) and the operated cases (38). There was an incidence of twice as many female as male patientsCholecystectomy and choledochostomy was the procedure of choice in this series. Unless there were signs of imminent perforation and therefore resultant peritonitis, the patients were usually subjected to a preoperative regimen designed to build them upA high incidence of ascaris in the common bile duct was noted. It is believed that the presence of ascaris in the common bile duct signifies a preceding pathology in the biliary system. (Summary)

Nefrectomia en donante vivo: Abordaje subcostal anterior extraperitoneal / Nephrectomy in living-donor

Se presentan siete pacientes a quienes se les ha practicado nefrectomía por ser donantes vivos intrafamiliares, mediante abordaje anterior extraperitoneal; se informan las ventajas de esta cirugía comparadas con el abordaje clásico de la lumbotomia ampliada

Endarterectomía carotídea con anestesia local: estudio de 22 casos / Carotid endarterectomy under local anesthesia

Se presenta un estudio descriptivo de 22 casos de endarterectomia carotidea con anestesia local en la Fundacion Santa Fe de Bogota. Se analizan los resultados que muestran una baja morbilidad postoperatoria y ausencia de mortalidad relacionada con el procedimiento. En pacientes de alto riesgo quirurgico y anestesico, esta tecnica es de práctica sencilla y el tratamiento intra y postoperatorio no presenta mayores dificultades.

The use of naltrexone to treat ambulatory patients with alcohol dependence

The purpose of this study is to evaluate the efficacy of Naltrexone in decreasing craving symptoms among Puerto Rican male veterans with alcohol dependence. METHOD: This is a double blind placebo control study with a convenience sample of eleven patients divided in two groups (placebo and Naltrexone). Scales consisting of Zung Depression, Zung Anxiety, MMSE, OCD Screener, Craving, and Somatization were administered at baseline, and weekly for four weeks as follow up. RESULTS: There were no statistically significant differences between the two groups on any of the outcome variables at baseline or follow up measurements. A statistical trend was noted toward a decrease in somatization. A decrease in craving symptoms was observed in the experimental group. CONCLUSIONS: Even though our results did not show evidence of the efficacy of Naltrexone in decreasing craving symptoms, a small number of patients did benefit from the medication. The results could have been affected by the small sample size

Endocarditis infecciosa de válvula nativa: fisiopatología, tratamiento y prevención / Primary valve infectious endocarditis: physiopathology, prevention and treatment

Se hace una revision del tema de la endocarditis infecciosa de válvula nativa, en la cual se incluye la definicion aceptada hoy en dia, los aspectos etiologicos y el daño mismo desde el punto de vista patologico, asi como las implicaciones funcionales a que puede dar lugar la presencia de esta entidad. Se analizan los factores predisponentes y las causas etiologicas asi como tambien la microbiolologia concomitante y se dan pautas tanto para la prevencion como para el tratamiento.

Manejo urologico en niños con mielomeningocele / Urologic management for children with Myelomeningocele

Se revisó el manejo Urológico en 20 pacientes del Instituto Franklin D. Roosevelt, posterior a corrección quirúrgica de mielomeningocele. El promedio de edad de los pacientes es de 8 años, de los cuales 14 tienen mielomeningocele lumbar y 6 lumbosacro. El estudio urológico incluyó parcial de orina, urocultivo, creatinina, nitrógeno ureico, urografía, ecografía renal, uretrocistografía y urodinamia. A dos de los pacientes, se les practicó reimplante vesico ureteral y a la totalidad de los pacientes dependiendo del patrón radiológico y urodinámico, se les manejó con cateterismo intermitente limpio, anticolinérgicos o con ambos, logrando mejoría. (Continencia total o parcial, resolución del reflujo, manejo de la infección urinaria persistente, etc.) o estabilización del cuadro urológico en el 100 por ciento de los casos