Calcificaciones pulmonares metastásicas, 3 casos clínicos / Metastatic pulmonary calcifications: three clinical cases

Las calcificaciones pulmonares metastásicas, hacen referencia a una enfermedad metabólica, caracterizada por depósitos de calcio en tejido pulmonar sano. La etiología es amplia e incluye enfermedades malignas y benignas, siendo la falla renal la causa más frecuente. Es una condición, que, a pesar de ser frecuente, suele ser subdiagnosticada, por presentar pocos o ningún síntoma. Presentamos tres casos clínicos asociados a enfermedad renal crónica, pre y post trasplante.

Metastatic pulmonary calcifications refer to a metabolic disease, characterized by calcium deposits in healthy lung tissue. The etiology is broad and includes malignant and benign diseases, the kidney failure being the most frequent cause. It is a condition, which, despite being frequent, is usually underdiagnosed, because it presents few or no symptoms. We present three clinical cases associated with pre- and post-transplant kidney disease.

Apróximación teórica al constructo resiliencia / Theoretical approach to the resilience construct

This essay aims to carry out a theoretical approach to the resilience construct through some reflections. Every day humans get on in various levels, achieving various roles and facing constant challenges of all kinds. The period lived as a student during the individual life cycle does not constitute an exception to these facts; and, it requires the appropriate use of all competences which he has. However, the occasions in which the student reflects that it does not have the necessary tools to have a triumphant result cannot be ruled out or be weakened, taking into account that the conditions for the achievement of goals are not always the best, and there are various obstacles that go beyond the individual, either personally or interpersonal, coupled with the system and own current context in which this develops; and, it must be survived by the Venezuelan citizen. That is why, the ability of people to develop psychologically well, despite of living in contexts of risk, refers both to individuals as to groups that are able to minimize and overcome the damaging effects of adversities and disadvantaged contexts.

El presente ensayo tiene como propósito llevar a cabo una aproximación teórica al constructo de la resiliencia a través de algunas reflexiones. Diariamente los seres humanos se desenvuelven en diferentes niveles, cumpliendo variados roles y afrontando constantes retos de toda índole, el período que se vive como estudiante durante el ciclo vital individual no constituye una excepción a estos hechos y el mismo exige el uso adecuado de todas las competencias con las cuales se cuenta. Sin embargo, no se pueden descartar las ocasiones en que el estudiante refleja que no posee las herramientas necesarias para tener un resultado triunfante o se encuentran debilitadas, teniendo en cuenta que las condiciones para la consecución de las metas no siempre son las mejores y existen diferentes obstáculos que superan al individuo, ya sea en lo personal, lo interpersonal, aunado al sistema y contexto actual propio en el que se desarrolla y debe subsistir el ciudadano venezolano. Es por esto que la capacidad que tienen las personas para desarrollarse psicológicamente con normalidad, a pesar de vivir en contextos de riesgo, se refiere tanto a los individuos en particular como a los grupos que son capaces de minimizar y sobreponerse a los efectos nocivos de las adversidades y los contextos desfavorecidos.

Tenosinovitis estenosante digital en pacientes de un Hospital Universitario / Digital stenosing tenosynovitis in patients of a University Hospital

La tenosinovitis es el engrosamiento del recubrimiento alrededor de los tendones de los dedos que resulta en una condición estenosante o dedo en resorte/gatillo (DR).Objetivo: Analizar la tenosinovitis estenosante en los pacientes que acudieron a la consulta de reumatología del hospital "Dr. Adolfo Prince Lara". Materiales y Métodos: Investigación cuantitativa, correlacional, transversal. Población integrada por 285 pacientes, muestra 105 pacientes con diagnóstico clínico de tenosinovitis estenosante. Resultados: Edad promedio de 55,32 años. Siendo 80% del sexo femenino. Ocupación predominante oficios del hogar 71,43%. Patologías médicas asociadas: Diabetes Mellitus 61,19%, Hipertensión Arterial 49,225% y Reumatológi cas: Osteoartrosis 48,49%, Tendinitis de D´Quervain 46,77%. Localización anatómica más frecuente el dedo anular (45,71%) seguida por el dedo pulgar (23,81%; 25 casos). Diagnóstico clínico en el 100% de los casos. Tratamiento más utilizado Aines con infiltración 75,24% remisión en 80% de los pacientes. Conclusión: La tenosinovitis estenosante representa más de un terc io de los pacientes que acuden a la consulta de reumatología, afecta principalmente a los adultos contemporáneos, de sexo femenino, diabéticos, de ocupación oficios del hogar u obreros, siendo el digito más afectado el anular, con 80% de remisión posterior a infiltración local y AINES administrado por via oral.

Tenosynovitis is the thickening of the lining around the tendons of fingers resulting in a condition stricturing, or spring/ trigger (ST) finger. Objective: Analyze the tenosynovitis in patients who come to the Rheumatology consult of the "Dr. Adolfo Prince Lara" hospital. Materials and methods: Quantitative, correlational and cross-sectional research. Population composed of 285 patients, sample of 105 patients with clinical diagnosis of tenosynovitis. Results: Average age of 5 5.32. 80% were female. Predominant occupation was home offices with 71.43%. Medical conditions associated: Diabetes Mellitus 61.19%, hypertension 49.22% and rheumatologic: 48.49% osteoarthritis, D´Quervain Tendinitis 46.77%. Anatomic location more frequent the ring finger (45.71%) followed by the thumb finger (23.81%; 25 cases). Clinical diagnosis in 100% of cases . Treatment most used nonsteroidal anti-inflammatory drugs (NSAIDs) with infiltration 75.24%, remission in 80% of patients. Conclusion: Tenosynovitis represents more than one third of the patients who come to the rehumatology consultation, mainly affects adult contemporary, female sex, diabetic, occupation offices of home or workers, being the ring finger the most affected, with 80% of remission after local infiltration and NSAIDs.

Conocimiento sobre el Virus del Papiloma Humano en estudiantes de Citotecnología de una Universidad Nacional / Knowledge on the human papilloma virus in students of Cytotechnology of a National University

Las infecciones de transmisión sexual incluyendo el Virus de Papiloma Humano (VPH) son muy comunes a nivel mundial. Objetivo. Determinar el conocimiento sobre el VPH en estudiantes de Citotecnología. Métodos. Investigación descriptiva. Se aplicó un cuestionario a 73 alumnos que incluyó edad, procedencia, ejercicio de función sexual, parejas sexuales, etiología del VPH, modo de transmisión, clínica y prevención. Resultados. La mediana de la edad fue 20 ± 0,5 años. Predominó significativamente el sexo femenino (Z = 8,28; p < 0,001) y los estudiantes que refirieron no tener más de una pareja sexual (42 de 73, 57,5%), con Z = 3,34; p < 0,001. Al existir 95,9% con un conocimiento muy bueno o excelente y significativamente mayor que quienes lo presentaron como bueno, (4,11%), no hubo diferencias estadísticamente significativas entre la medianas de puntajes de sexo. Conclusión: El conocimiento se puede asociar a un ejercicio responsable de la sexualidad en ambos géneros. Se recomienda reforzar las campañas de información y formación a los adolescentes respecto al VPH.

The sexual transmission infections including the Human Papilloma Virus (HPV) infection are very common in the world. Objective. To determine the knowledge on HPV in students of Cytotechnology. Methods. Descriptive investigation. A questionnaire was applied in 73 students, was included age, origin, exercise of sexual function, sex partners, etiology of HPV, transmission way, clinic and prevention. Results. The median of age was 20 ± 0.5 years. There was a significant predominance of female gender (Z = 8.28; p <0.001) and the students which refer to have more than a sexual partner (42 de 73, 57.5 %), with Z = 3.34; p < 0.001. There was a 95.9% a very good or excellent knowledge and significantly higher than whom had a good one (4.11%), whithout statistically significant differences between the medians of scores according sex, it is concluded that this knowledge could be associated to a responsible excercise of sexuality in both genders. It is recommended reinforce the information and tuition to the adolescents in respect of HPV.

Características epidemiológicas de pacientes atendidas en la consulta de endometriosis de un hospital universitario / Epidemiological characteristics of patients attended at the outpatient clinic of endometriosis in universitary hospital

Establecer las características epidemiológicas de pacientes con endometriosis. Es un trabajo descriptivo y transversal. La población fue de 54 pacientes. La recolección de la información mediante la revisión documental en una ficha. Consulta de endometriosis del Hospital Universitario Dr. Angel Larralde de Valencia. Edad promedio 30 ± 5,8 años. Motivos de consulta: dismenorrea (70,7 por ciento), dolor pélvico (58,5 por ciento) y dispareunia (36,6 por ciento). Edad promedio de menarquía 12 años. El 29 por ciento reportó algún tipo de trastorno menstrual, el más frecuente la metrorragia (17 por ciento). El 41,5 por ciento refirió uso previo de anticonceptivos orales. El 34 por ciento de las pacientes no habían estado embarazadas, 26,88 por ciento primigesta. Entre los antecedentes quirúrgicos gineco-obstétricos, 39 por ciento reportó cesáreas, 26,88 por ciento ooforectomía y 19,55 por ciento legrado uterino. Las endometriosis más frecuentes fueron la ovárica (56,09 por ciento) y en cicatriz abdominal postcesárea (24,39 por ciento). La endometriosis es una patología típica de la mujer en edad reproductiva, que puede darse inclusive en la adolescencia.

Frecuencia de aspergiloma en pacientes con antecedente de tuberculosis, hemoptisis, radiografía anormal y baciloscopía negativa / Frequency of aspergilloma in patients with history of tuberculosis, hemoptysis, abnormal chest x-ray films and negative sputum smears

Objetivo: Determinar la frecuencia de aspergilomas en pacientes con antecedentes de tuberculosis pulmonar curada,hemoptisis, radiografía de tórax anormal y BK negativo. Materiales y métodos: Se enroló 28 pacientes entre diciembrede 2002 y septiembre de 2004 en el Hospital Nacional Hipólito Unanue de Lima y Hospital Belén de Trujillo. A los pacientesevaluados en el Hospital Belén se les solicitó tres muestras de esputo, seriadas y consecutivas, mientras que lospacientes evaluados en el Hospital Nacional Hipólito Unanue y que fueron sometidos a cirugía de tórax, se les colectóuna porción de la pieza quirúrgica tisular pulmonar. Ambas muestras biológicas fueron cultivadas en agar sabourauddextrosa - cloramfenicol 0,05 por ciento e incubados a temperatura ambiente y 37 °C por 15 días. A todos los pacientes se lesextrajo 5 mL de sangre total para realizar la prueba de inmunodifusión contra Aspergillus sp. Resultados: La frecuenciade aspergiloma fue de 43 por ciento (12/28). Se identificó por cultivo Aspergillus fumigatus en cinco casos, Aspergillus sp endos, A. niger en uno, A. flavus en uno y en dos casos positivos por serología no se logró aislar el hongo. En los dospacientes donde se identificó A. niger, no se detectó presencia de anticuerpos contra Aspergillus sp. En el HospitalBelén la frecuencia de aspergiloma fue 39 por ciento (7/18) y en el Hospital Hipólito Unanue 50 por ciento (5/10). Conclusiones: Lafrecuencia de aspergiloma en los 28 pacientes investigados en ambos hospitales fue de 43 por ciento y el principal agenteetiológico fue A. fumigatus.

Objective: To determine the frequency of aspergilloma in patients with history of cured pulmonary tuberculosis, hemoptysis, abnormal chest X-ray films, and negative sputum smears for acid-fast bacilli. Materials and methods: 28 patients were enrolled between December 2002 and September 2004 in Hipolito Unanue National Hospital in Lima and Belen Hospital in Trujillo. Patients from Belen Hospital had three serial and consecutive sputum samples taken, while those patients from Hipolito Unanue Hospital who underwent thoracic surgery had a portion of the surgical specimen collected. Both biological samples were cultured in Sabouraud dextrose agar – 0,05% chloramphenicol, and they were incubated at room temperature and at 37° C for 15 days. All patients had a 5-mL blood sample taken in order to perform immunodifusion tests for Aspergillus sp. Results: The frequency of aspergilloma was 43%) (12/28). Aspergillus fumigatus was identified in cultures in five cases, Aspergillus sp. was identified in two cases, A. niger in one, A. flavus in one, and in two cases reported as positive for serological tests the fungus could not be isolated. In the two patients in whom A. niger was identified, no presence of antibodies against Aspergillus sp. was detected. In Belen Hospital the frequency of aspergilloma was 39% (7/18), and in Hipolito Unanue Hospital it was 50% (5/10). Conclusions: Aspergilloma frequency in 28 patients studied in both hospitals was 43%, and the main etiological agent was A. fumigatus.

Concentraciones sanguíneas de zinc en embarazadas con partos prematuros / Embarrassed sanguineous zinc concentrations in with premature childbirths

con el objetivo de evaluar la relación entre el comportamiento del zinc durante el embarazo y algunas variables estudiadas en embarazadas que tuvieron partos prematuros, se hizo un estudio de corte trasversal en 60 gestantes cuyos hijos nacieron entre las semanas 27 y 36, en la ciudad de Medellín, Colombia. La concentración media del metal y su error estándar fueron 7,33 ± 0,23 mg/L; no se observó una correlación entre los valores encontrados y la edad gestacional. Las gestantes sanas tuvieron una concentración media de zinc de 7,20 ± 0,25 mg/L, la cual fue significativamente menor que la de quienes tuvieron niños con crecimiento restringido, p = 0,03, pero similar a la de las que sufrieron hipertensión inducida, embarazos múltiples, fetos malformados o recibieron esteroides para la maduración pulmonar fetal. El percentil 75 de la curva de valores del zinc se estableció en 8,6 mg/L, y quienes se ubicaron por encima del mismo tuvieron un número significativamente mayor de fetos de sexo femenino, p = 0,011, y una tendencia no significativa a tener más fetos con restricción del crecimiento, p = 0,07. Las ubicadas por debajo del percentil 25, o sea de 6,2 mg/L, mostraron también tendencias no significativas a un número mayor de embarazos gemelares, p = 0,05 y de fetos malformados, p = 0,08. Los hallazgos de la muestra estudiada sugieren que puede existir asociación entre las concentraciones de zinc y efectos fetales importantes que se deben verificar en estudios posteriores que incluyan poblaciones mayores. Es llamativa la relación entre un zinc materno alto y el sexo femenino del feto, la cual podría estar indicando el efecto de factores hormonales específicos.Palabras claves: zinc, embarazo, parto prematuro.

Anti-hemoptic drugs: II. action of emetine on the pulmonary circulation

1. The actions of emetine on the heart and pulmonary circulation were studied in a total of 45 anesthetized dogs2. Emetine was shown to lower both systemic and pulmonic blood pressures when injected intravenously in doses from 0.05 to 7.5 mg./Kg. The mechanism by which this hypotension was brought appeared to be solely by cardiac depression. No significant direct vasodilating action was demonstrated3. The applicability and dangers of emetine as an antihemoptic agent were discussed. (Summary)

Toxicity of oil chenopodium when administered together with castor oil

1. The L.D. of the oil of chenopodium was 0.2 per kg. when given alone, and 0.4 cc. when combined with castor oil2. The L.D. of the oil of chenopodium for Philippine cats was one-half as much as that for American cats3. The M.L.D. was not found for the pure oil. This, however, must be between 0.15 and 0.2 cc.; whereas, when combined with castor oil, it was 0.35 cc. per kg4. The maximum tolerated dose (M.T.D.) of the oil of chenopodium was 0.1 cc. per kg when given alone, and 0.3 cc. per kg. when administered with castor oil5. The admixture of the two oils reduced the number of disagreeable experiences from two to one and led to the mutual mitigation of their unpleasant odor and taste6. The usual side-effects were salivation, vomiting, and loss of desire to take food and drink7. The prominent symptoms of poisoning were vomiting, general muscular weakness, prostation, ataxia, convulsion, stupor, coma, and death. The most prominent among these was convulsion, which often lasted for several days until the animal died. (Summary)

New light on the anthelmintic action of santonin from the experimental standpoint

1. Santonin is depressant to human roundworms, Ascaris lumbricoides. Therefore, it possess a vermicidal property2. The depression is produced even in the absence of bile3. Weak sodium carbonate solution is a better solvent of santonin than plain distilled water4. Santonin depression on human ascaris is not preceded by agitation, irritation, or repellant action5. There is evidence to show that santonin may induce tolerance on repeated application6. An apparatus is here described that allows a full view of the worm so that tracing and inspection can be carried on simultaneously at body temperature or any desired temperature. (Summary and conclusion)

Quantitative comparison of atropine and tricyclamol with standard blocking agents of neuromascular transmission in cats under dial-urethane anesthesia

A quantitative comparison of atropine sulfate and tricyclamol chloride with tubocurarine chloride with tubocurarine chloride and succinylcholine chloride on neuromuscular block reveals the following salient observations: 1. Atropine and tricyclamol produce neuromuscular blockade comparable with that caused by tubocurarine and succinylcholine2. With regard to potency by dose, tubocurarine is 55 times more potent than tricyclamol and 277 times more potent than atropine; while succinylcholine is 250 times more potent than tricyclamol and 1250 times more potent than atropine3. Atropine causes the longest duration of neuromuscular block, outlasting that which is produced by tubocurarine4. Tricyclamol gives a transient blockade which closely resembles the one elicited by succinylcholine. (Summary)

The influence of superinone on the anthelmintic action of piperazine in vitro

Superinone, a surfactant, does not possess any anthelmintic property on the ascarid (Ascaris lumbricoides) in vitro when used in dilute solutionsIt, however, potentiates the anthelmintic action of piperazine hexahydrate when applied in combinationSuperinone solution WIN-FS5607 possesses desirable physical properties. It is sweet in taste, has a pleasant aromatic odor and leaves a cleansing sensation in the mouth after rinsingThe dose of piperazine may remain the same so there will be no hazard with regards to possible toxicity incident to increasing dosage as indicated in this workThe results obtained in vitro may be transferred to in vivo use and the only possible disadvantage is that the increased intake and penetration may not only be true with the parasites but also those of the intestines of the hosts. However, while piperazine is toxic to the ascarids it is non-toxic to human beings in conventional dosagesThe addition of superinone or any surface-active agent to piperazine may make possible the shortening of duration of medication in ascariasis from the usual 5 to 7 days to two or even one day in the light of these experiments

The effect of 5-hydroxytryptamine on duodenal motility in dogs under morphine-choralose anesthesia

In dogs under morphine-chloralose anesthesia, 5 HT produced a prominent motor stimulation of the duodenum, the characteristics of which are described. Part of the motor response to 5 HT in these dogs involves atropine-sensitive receptors which require relatively larger amounts of 5 HT in order to be stimulated. (Summary)

Schistosomiasis: a fourteen year survey of cases admitted to the U.S.T. Charity Hospital

In the U.S.T. Charity Hospital for the past 14 years, 1946-1959, a total of 127 cases of schistosomiasis were admitted. The majority 150 in number, came after 1950Majority of these patients came either from Leyte or Samar, 48 from the former and 34 from the later with a slight female predominance of 56.7% and a major age distribution between 10-30 years or 68.52%Diagnosis was confirmed in 49 instances by at least one diagnostic aid, Group I, and in others without objective proof but by clinical and epidemiological evidence, Group II. The remainder of the cases, though not showing schistosomiasis in the usual form, disclosed the disease at autopsy, and/or biopsyOn the basis of Pesigans grading, our cases chiefly belong to Grades C and D with a few in Grade E. Lack of cases in Grade A and B was probably due to the distant location of our hospital from endemic areas, and therefore the unlikelihood of getting early casesClinically abdominal complaints were the predominant feature, in the form of diarrhea or dysentery, abdominal pain, liver involvement including portal hypertension, jaundice and splenomegaly. Hematemesis and melena featured in 14% of the casesStools examination with acid-ether concentration technique proved the more reliable objective diagnostic aid in our series, followed by skin test and of course histological studiesThe frequency of involvement of the appendix in our cases stresses this particular aspect of the disease. The liver, colon, lungs and spleen were also frequently affected. In most instances, co-existing parasitic disease is also found. Of special interest are 4 cases which showed co-existing malignancy of either liver or intestines, a finding deserving further study. Likewise, calcification in one of the abdominal viscera appears to be one important clue in this disease, especially in a patient coming from an endemic areaAs far as Fuadin therapy is concerned, as used in this series, results were variable. In some cases control of diarrhea, relief of abdominal pain, subsidence of fever were achieved. In the advanced cases with irreversible hepato-splenomegaly, no noticeable change was observed. (Summary)

The role of serotonia in reserpine action: a review

The preponderant opinion on the mechanism of reserpine action is that there are two distinct and separate components involved. There is a central action by which reserpine in some still unknown way irreversibly affects serotonin binding sites in the brain cell to result in stimulation of parasympathetic centers in the hypothalamus. There is also a peripheral action whereby mediators in the adrenergic nerve endings are exhausted leading to a functional sympathetic denervation. The application of this dual concept of reserpine action to its gastrointestinal effects is still untenable due to the inadequacy of experimental data and conflicting reports currently available. (Summary)

Papiloflebitis. A proposito de un caso. Hospital Central de las Fuerzas Armadas "Dr. Carlos Arvelo". / Papillophlebitis. Apropos of a case

Se presenta un caso de papiloflebitis, en vista de lo raro de este cuadro clinico, del buen pronostico y de la oportunidad que tuvimos de observar la aparicion de la circulacion colateral optociliar fundoscopicamente

Trombosis venosa retiniana. / Retinal venous thrombosis

Se hace uma revision de 13 pacientes con oclusion retiniana atendidos en la consulta externa del Servicio de Oftalmologia del Hospital Central de la Fuerzas Armadas "Dr. Carlos Arvelo" y estudiados mediante fluororretinografia. Realizamos una analisis de la retina y su importancia en el pronostico