Biopsia estereotáctica cerebral guiada tomográficamente: Análisis de una serie de 192 casos / Tomographically guided stereotactic brain biopsy: Review of a series of 192 cases

Objective. Stereotactic CT-guided biopsy is a safe procedure for the diagnosis of brain lesions unsuitable for surgical treatment because of their location, number, histology or poor medical status. The objective of this study is to analyze the indications,demography, topography, anatomopathologic diagnosis and complications in a series of stereotactic CT-guided brain biopsies. Method. 192 CT assisted stereotactic brain biopsies in 186 patients were retrospectively reviewed from june 1998 to june of 2008. Results. 186 patients, 101males (54.3%) and 85 females (45.7%), were analyzed. Mean age was 54.5 years. 144 (75%) of the biopsies were performed in hemispheric lesions, 43 (22.4%) in “deep seated” localization. The most frequent anatomopathologic diagnosis were glioblastoma (36,5%) and anaplasic astrocytoma (17%). 90,62% of the biopsies were positive, 7,3% were negative and 2,08% nondiagnostic. Morbility rate was 3,64% and mortality 2,08%. Conclusion.Stereotactic brain biopsy is a safe and effective procedure providing tissue for definitive anatomopathological diagnosis; it offers low morbidity and mortality rate. Our findings are similar to the literature.

Hemangioma capilar medular: Reporte de un caso y revisión de la literatura / Spinal cord capillary hemangioma: Report of a case and bibliographical review

Objective. To describe a rare case of intramedullary capillary haemangioma of the thoracic spinal cord asociated with extensive cord edema and review of the literature. Description. A 65-yeard-old male pacient presented a 4-months history of dorsal back pain, progressive 4/5 paraparesis and sensory abnormality of the lower extremities. MR studies of the thoracic spine show a well-defined intramedullary mass at the D6 level, isointense on T1, hiperintense on T2 and homogeneous, strong enhancement with gadolinium, compatible with vascular lesion, asociated with extensive cord edema from D8-C2. Intervention. A D6-D7 laminectomy was performed and the tumor was completly removed en bloc by using standard microneurosurgical technique. Conclusion. It is very important to know about the existence of intramedullary capillary haemangiomas. Despite of being extremely rare, they are benign vascular neoplasms with a good outcome after their complete resection. Therefore, it´s necessary to distinguish them of other malignant tumors, to avoid overtreatment of these benign lesions.

Tratamiento quirúrgico de la neuralgia del trigémino: Experiencia en 10 años / Surgical treatment of trigeminal neuralgia: A 10 years experience

Introduction. Surgical treatment of trigeminal neuralgia remains a matter of debate since there are no studies comparing long term effectiveness of the different surgical techniques. We present our 10 year experience. Description. Series: 40 patients. Period: 1998 - 2008. Surgical techniques: microvascular decompression, radiofrequency thermorhizotomy and balloon compression. Analyzed parameters: age, sex, nerve root involved, pain relief, recurrence, complications, need to restart medication and reintervention. Discussion. Microvascular decompression offers better long term results, radiofrequency is adequate for special cases (higher recurrence rate), and balloon compression is better for V1 neuralgia. Our sample is too small for statistics, yet our findings are coincident with the literature. Conclusion. Better patient selection criteria for each technique are needed. Microvascular decompression should be the treatment of choice when possible. How to treat recurrence remains unanswered.

Estudio nacional de enfermeria 1985-1987: actualidad y perspectiva / National study of nursing 1985-1987: present and perspectives

Para mejorar la calidad y la prestacion oportuna de los servicios de salud con la participacion de enfermeria enmarcada en las politicas regionales y nacionales para el desarrollo de la profesion, el presente estudio actualiza el diagnostico de enfermeria (1972) y lo complementa con la determinacion cuantitativa de la situacion y distribucion del personal, la presentacion de las causas de los problemas mas prominentes, y las proyecciones futuras para formular politicas y adoptar estrategias proyectivas de acuerdo a la informacion obtenida, la fuerza laboral de enfermeria esta formada por mujeres (90%) entre 20 y 39 anos y actualmente tiene una vida laboral activa de por lo menos 15 anos; la mayor parte se concentra en el area de servicio hospitalario en las regiones del pais con mayor grado de desarrollo socio-politico y economico. El aspecto educativo presenta modificaciones sustanciales duratne los ultimos 10 anos a nivel de pre y postgrado aun cuando el tendimiento de las unidades docentes fue bajo, comparativamente con el tendimiento del sector salud responsable de la formacion de auxiliares de enefermia. La investigacion es un proceso apenas incipiente en enfermeria,pero es mayor la produccion de escritos, por otra parte son pocas las acciones de articulacion docente-asistencial respecto a las instituciones de salud se observa que la administracion continua dentro de esquemas rigidos de poca utilidad operativa y la situacion laboral de enfermeria se ve agravada por falta de definicion de las funciones del personal, poca calidad en la imagen y demanda de