Aporte de las neuroimágenes al diagnóstico del compromiso del sistema nervioso central en la enfermedad HIV/sida / Contribution of the neurographs to the diagnosis of the commitment of the central nervous system in the HIV/sida disease

El compromiso del sistema nervioso central en la enfermedad HIV/SIDA avanzada incluye un amplio espectro de manifestaciones clínicas, entre las que predominan aquellas complicaciones asociadas con el propio retrovirus, como el complejo demencial, las infecciones oportunistas y los tumores marcados de la enfermedad. En esta revisión analizamos el aporte de las neuroimágenes al diagnóstico no invasivo de las complicaciones intracraneales más comunes en estos pacientes asociados con la inmodeficiencia severa a la que conduce el retrovirus.

Pancreatitis aguda: de la evidencia al caso real / Acute Pancreatitis: from the evidence to the reality

Pancreatitis is classified as acute or chronic.Usually, acute pancreatitis is a consequence of gallstones or is idiopathic...Since the early 20th century, Moynihan described the acute pancreatitis as the most terrible intraabdominal calamity, and subsequently emphasized the prevalent role of surgical tyreatment to remove the toxins accumulated in the abdominal cavity. Likewise this treatment modality was adapted by most surgeons and it was maintained during 20 years as the key to optimal management...A opatient with acute pancreatitis was studied along, the evidence available was revised and also its real applicability since the retrospective analysis of the case, in a pathogenesis with several diagnostic and therapeutic guidelines determined by their usefulness but not because of evidence and viceversa enhanced by this one but with a difficult application

Hemorragia alveolar difusa / Diffuse alveolar hemorrhage

We report here a critically ill patient with renal-lung syndrome and multiple organ failure who was admitted at our Critical Care Service 40 days after onset. The clinical and biological findings suggested an immunological disorder like a systemic lupus eritematosus (SLE) inmmediate battery of immunological tests was carried out with metilprednisolane therapy and vital support measures. We confirm a SLE by serology after the patient died six days later. prompt diagnosis and treatment of these disorders may be life-preserving but the diagnosis may be complicated by the vagaries of serologic testing and the understandable hesitancy in utilizing invasive procedures, including open or thoracoscopic lung biopsy, fibrobronchoscopy with transbronchial biopsy and lavage in these critically ill patients