Policondritis recurrente / Relapsing polychondritis

Se presenta el caso de una paciente mujer de 17 años con cuadro de obstrucción de la vía aérea superior (estenosis traqueal), inflamación del oído externo, nariz en silla de montar y vértigo. Mejoró con la administración de corticoides.

It is reported the case of a 17 years-old female with upper airway obstruction (tracheal stenosis), inflammation of the both external ear, saddle nose and vertigo. She improved with corticosteroids.Key words. Relapsing polychondritis, tracheal stenosis, auricular chondritis, saddle nose.

Trauma torácico severo (TTS): experiencia en el Hospital Domingo Luciani: Caracas / Severe thoracic trauma (TTS): experience in the Hospital Domingo Luciani: Caracas

Describir la incidencia y manejo del trauma torácico severo en los Servicios de Cirugía del Hospital "Dr. Domingo Luciani" durante el período 2008-2009. Estudio retrospectivo, descriptivo, transversal. Se seleccionaron pacientes diagnósticados como traumatismo torácico en el centro, que presentaron fracturas del primer, segundo o tercer arco costal, fractura escapular, fractura esternal, ó la combinación de cualquiera de estas, desde enero de 2008 hasta diciembre 2009. Se evaluo edad, sexo, evento traumático, radiología, días hospitalización, toracotomía mínima, valores de laboratorio e ingreso a UTI. El grupo mayormente afectado fue 41 a 50 años con 31,1% y el sexo masculino (68,8%) 44% Accidentes en vehículos 50,9% de los casos evidenciaron fracturas del 2do-3er arco costal, 86,6% de los casos ameritaron drenaje torácico y 11% requirieron manejo en UTI. El TTS es una entidad seria, comprende fracturas de los 3 primeros arcos costales y/o fracturas de esternón y/o fracturas de escapula. Englobamos todas estas como TTS pues hay relación probada entre estas fracturas y traumas de alto impacto, causando lesiones potencialmente fatales. Consideramos la necesidad de redefinir el término de TTS, crear un protocolo de atención y estandarización para optimizar la atención del paciente lesionado.

To describe the incidence and management of severe thoracic trauma (STT) in General Surgery Service of Hospital "Dr. Domingo Luciani" during 2008-2009 period. A retrospective study descriptive, trasnversal. Patients diagnosed with severe thoracic trauma, (first, second or third rib fracture, sternal or scapular fracture or a combination of any), during January 2008 to December 2009. We reviewed, age, sex, traumatic event, radiologic images, hospitalization time, chest tube drainage, laboratory values and ICU admission. Group most affected was 41 to 50 years (31,1%) and males (68,8%). Traffic accidents caused 44% of trauma. In 50,9%, 2nd and 3rd rib fractures was present. 86,6% Needed chest tube dranage and 11% required ICU admission. The STT is a serious entity. It is defined by fracture of any of the 3 first ribs and/or sternal or scapular fracture. We included all these injuries as STT because there is a relationship between these fractures and high energy trauma, leading to potentially fatal consequences. We consider the need of redefining the STT term, creating an approach protocol and setting it up for optimizing the injured patient attention.

Policondritis recurrente. Estudio de 19 casos en Colombia / Relapsing polychondritis. An study of 19 cases in Colombia

Objective: To describe clinical and paraclinical involvement in RP in a Colombian populationand compare it with another series previously published.Methods and materials: Retrospective review of 19 cases of RP presented in 4 rheumatologycenters in our country in the last 10 years. All patients met diagnostic criteria previouslyestablished. In every case, each clinical feature was analized and then compared with another9 series of RP previously published between 1966 y 2007.Results: Mean age at diagnosis was 46 years. A female predominance was observed ina relation 4:1. Mean follow-up was 4 years. Auricular condritis was the initial clinicalfeature in 89 percent of patients and finally was observed in the 100 percent of our report. Comparedwith other series, we found less frequently arthritis (21percent), ocular (10percent) and dermatologicinvolvement (10percent). Renal and neurologic involvement and the association between RPand another autoimmune disorder were found in the expected frequency. We not observedany cardiovascular involvement in our serie. All of the patients received corticosteroidsand 57percent had had another immunosuppressive medication. Observed mortality was 10percentby complications associated to RP.Conclusions: In contrast with another series from Caucasian and Oriental population, weobserved a marked predominance of female sex, a minor frequency of systemic involvementand auricular condritis is our most frequent initial clinical feature. Probably, these findingsare the result of a different genetic, immunological and environmental background.

Objetivo: Describir el comportamiento clínico y paraclínico de la PR en la poblacióncolombiana y comparar nuestros resultados con otras series publicadas.Materiales y métodos: Estudio descriptivo observacional de 19 casos de PR presentadosen 4 centros de reumatología del país durante los últimos 10 años. Los pacientes cumplieroncon el diagnóstico de PR de acuerdo al parámetro establecido...

Dolor torácico de origen desconocido: causas musculoesqueléticas

El dolor torácico puede tener origen no cardíaco y no pulmonar. En este artículo los autores enumeran posibles causas y formas de presentación clínica de diversas formas de dolor torácico musculoesquelético al tiempo que comentan las claves relievantes para el diagnóstico y para el tratamiento.