Varón 46 XX, un desorden del desarrollo sexual testicular: a propósito de un caso clínico / 46 XX disturbance of testicular sexual development: report of one case

We report a previously healthy child that consulted for the first time at the age of 11 years for short stature. At that moment, his height was 138 cm, with a mid-parental target height of 175 cm. He was in an initial pubertal stage with a Tanner II pubic hair and a testicular volume of 4 ml. Initial laboratory examination was normal and the child had a concordant bone age. He consulted again at 16 years of age, with a height of 162.4 cm (percentile 5 for age), a bone age of 18 years and a Tanner IV pubic hair, but the testicular volume persisted at 4 ml. A genetic study disclosed a 46 XX karyogram and a fluorescence in situ hybridization (FISH) for chromosomes X and Y that showed a positive sex determining region Y (SRY) in X chromosome.

Sedación, seguridad y utilidad de la endoscopia digestiva alta en pediatría / Sedation, safety and usefulness of upper gastrointestinal endoscopy in pediatrics

Introduction: Upper gastrointestinal studies are routine diagnostic and therapeutic procedures. In pediatrics, however, they are limited by the need for sedation and monitoring. Objectives: Po evaluate sedation, indication, and parent perception of these exams. Patients and Methods: A prospective study of 190 pediatric upper gastrointestinal endoscopies was undertaken. Demographic data, as well as information regarding the exam was obtained. Results: Patients' average age was 8.5 +/- 4.2, mostly referred by pediatricians (60 percent) Main reason for referral was recurrent abdominal pain (29.8 percent). Patients were classified according to ASA criteria (93 percent ASA I and II). Most patients required two or more medications for optimal sedation, with satisfactory procedure in over 90 percent. Over 75.5 percent had complete amnesia, 42.7 percent presented minor discomfort after the procedure. Findings of these procedures included 61 percent of normal exams, 13.9 percent esophagitis. More findings were there result of analyses according to children's weight (over or under 14 kg), age, ASA, reason for referral, nurse's evaluation of sedation. Conclusion: Ambulatory endoscopio procedures can be performed safely in children, with moderate sedation. Requirements are adequate monitoring, and deep knowledge of resuscitation techniques.

Introducción: El estudio endoscópico alto es un procedimiento diagnóstico y terapéutico considerado de rutina, pero su realización en pediatría se encuentra limitada dada la necesidad de sedación y monitoreo adecuados. Objetivos: Evaluar la sedación, indicación y percepción de los padres del examen. Materiales y Métodos: Estudio prospectivo de 190 niños sometidos a endoscopia digestiva alta. Se obtuvieron datos bio-demográficos, tipo de sedación y resultados del examen. Resultados: La edad fue 8,5 + 4,2 años, la mayoría referidos por pediatra (60 por ciento). La principal indicación del estudio fue el dolor abdominal recurrente (29,8 por ciento). Los pacientes fueron clasificados de acuerdo al ASA (93 por ciento ASA I y II). En la mayoría se requirió de 2 ó más drogas para lograr sedación óptima. La calidad del procedimiento fue satisfactoria en más del 90 por ciento. Un 75,5 por ciento presentaron amnesia completa y un 42,7 por ciento molestias leves posterior al procedimiento. Entre los hallazgos destacaron signos de esofagitis en el 13,9 por ciento, observándose un 61 por ciento de los exámenes normales. Al analizar los pacientes por peso (mayores y menores de 14 kg), se encontraron diferencias en edad (p < 0,00001), ASA (p = 0,001), indicación de endoscopia (p = 0,001) y evaluación de la sedación por enfermera (p = 0,038). Conclusión: Procedimientos endoscópicos en niños pueden realizarse de manera segura en forma ambulatoria mediante sedación moderada. Una adecuada monitorización y conocimiento de técnicas de reanimación son básicos al momento de realizar dichos procedimientos.

Onicomicosis: consideraciones epidemiológicas de nuestra casuítica / Onychomicosis: etiologycal considerations

El objetivo del trabajo es el análisis de la frecuencia de onicomicosis y sus agentes etiológicos en un centro privado dermatológico de la ciudad de Resistencia y la revisión del tema. Se examinaron 300 pacientes de los cuales fueron seleccionados 200, de ambos sexos, con lesiones clínicamente compatibles con onicomicosis, examen micológico directo y cultivo positivos. En el análisis se determinó la frecuencia según sexo, edad, localización y etiología de las micosis ungulares. La prevalencia fue 69 por ciento en mujeres y 31 por ciento en hombres. El agente patógeno predominante fue Trichophyton rubrum. Hemos determinado además una alta frecuencia de onicomicosis por hongos filamentosos no dermatófitos (HFND) (21,5 por ciento), mayor que la informada en la bibliografía consultada

Imágenes en la disección aórtica / Images in the aortic dissection

Presentamos imágenes de algunos pacientes atendidos en el Servicio de Emergencia del Hospital Vozandes de Quito y evaluar en forma inmediata en el Departamento de Imagen de la Institución, además se efectúa una breve reseña de aspectos básicos en la disección aórtica. El reporte destaca el aporte de la ecografía transtorácica (US) y de la tomografía computarizada helicoidal (TCH) en los casos descritos. En los pacientes con sospecha clínica de disección aórtica (DA) conociendo la alta morbi-mortalidad de esta entidad, el diagnóstico de la misma debe ser confirmado en el departamento de imagen en la forma más rápida posible con medios diagnósticos asequibles y no siempre debe esperarse a efectuar otras técnicas más complejas...

Galectin-1, an alternative signal for T cell death, is increased in activated macrophages

Galectin-1 belongs to an evolutionarily conserved family of animal ß-galactoside-binding proteins, which exert their functions by crosslinking the oligosaccharides of specific glycoconjugate ligands. During the past decade, attempts to identify the functional role of galectin-1 suggested participation in the regulation of the immune response. Only in the last few years has the molecular mechanism involved in these properties been clearly elucidated, revealing a critical role for galectin-1 as an alternative signal in the generation of T cell death. In the present study we will discuss the latest advances in galectin research in the context of the regulation of the immune response, not only at the central level but also at the periphery. Moreover, we will review the purification, biochemical properties and functional significance of a novel galectin-1-like protein from activated rat macrophages, whose expression is differentially regulated according to the activation state of the cells. The novel role of a carbohydrate-binding protein in the regulation of apoptosis is providing a breakthrough in galectin research and extending the interface between immunology, glycobiology and clinical medicine

Galectins: a key intersection between glycobiology and immunology

Galectins are a family of evolutionarily conserved animal lectins, widely distributed from lower invertebrates to mammals. They share sequence and structure similarities in the carbohydrate recognition domain and specificity for polylactosamine-enriched glycoconjugates. In the last few years significant experimental data have been accumulated concerning their participation in different biological processes requiring carbohydrate recognition such as cell adhesion, cell growth regulation, inflammation, immunomodulation, apoptosis and metastasis. In the present review we will discuss some exciting questions and advances in galectin research, highlighting the significance of these proteins in immunological processes and their implications in biomedical research, disease diagnosis and clinical intervention. Designing novel therapeutic strategies based on carbohydrate recognition will provide answers for the treatment of autoimmune disorders, inflammatory processes, allergic reactions and tumor spreading.

Cells involved in the regulation of the autoimmune response to rat male accessory glands

1. The immunization of Wistar rats with 5 mg of chemically modified rat male accessory glands saline extract (MRAG) incorporated into complete Freund's adjuvant (CFA) induced a delayed type hypersensitivity (DTH) response to rate male accessory glands (RAG). Pretreatment with peritoneal cells (PC) obtained from rats 2 h after an intraperitoneal (ip) injection of a partially purified fraction (FI) of RAG (FI-PC2h) suppressed the DTH response to MRAG after immunization with MRAG-CFA, while pretreatment with PC obtained 24 h after an ip injection of FI-RAG (FI-PC24h) induced potentiation of the DTH response to MRAG. 2. The injection of spleen mononuclear cells (SpM), obtained from rats rendered unresponsive to MRAG by pretreatment with FI-PC2h, into normal syngeneic recipients markedly prevented the DTH reaction to MRAG. The transfer of SpM cells from animals injected with FI-PC24h (potentiated animals) to suppressed recipients (recipients of FI-PC2h on days -10 and -3, prior to immunization with MRAG-CFA) showed that SpM cells did not eliminate the suppression state in these recipients, but when they were transferred to normal recipients, they were able to induce a positive response to RAG (P<0.005). 3. The study of the phenotypic characteristics of the SpM cells prior to transfer showed similar numbers of CD4 and IL-2R SpM cells in both potentiated and normal animals. However, the number of CD8 cells was significantly reduced in SpM cells from potentiated animals compared to that observed in SpM cells from normal animals (P<0.05)

Induction of humoral autoimmune response to rat male accessory glands.

Ratas macho y hembra de la cepa Wistar fueron isoinmunizadas con extracto de glandulas accesorias masculinas quimicamente modificadas o sin tratamiento siguiendo diferentes esquemas.La mayoria de los animales produjeron autoanticuerpos convencionales y homocitotropicos, especificos de organo y especie. Los anticuerpos hemaglutinantes fueron 2-ME resistentes en todos los casos. La inmunizacion con el material modificado permitio detectar mayor frecuencia de respuesta y titulo de anticuerpos mas elevados (p < 0,05) sin cambiar la especificidad. La modificacion quimica del material antigenico cumple un papel adyuvant