Ácido úrico herramienta de tamización para preeclampsia. Una revisión sistemática de la literatura / Uric acid screening tool for preeclampsia a systematic review

Introducción: El ácido úrico se ha descrito como un posible marcador de riesgo para la aparición de preeclampsia; sin embargo, hasta el momento no hay evidencia sólida que lo soporte. El objetivo de este estudio es sintetizar la literatura disponible que permita conocer la utilidad del ácido úrico como una herramienta de tamización para preeclampsia. Metodología: Revisión sistemática de la literatura de estudios primarios que analicen los niveles séricos de ácido úrico en el primer y segundo trimestre de gestación con el desarrollo de preeclampsia. Búsqueda en Pubmed (n: 639). Resultados: Se incluyeron 2 estudios de cohorte con un total de 9.746 gestantes y 398 casos de preeclampsia. En los estudios se encontraron mayores niveles séricos de ácido úrico en las gestantes que desarrollaron preeclampsia (OR 1,8 a 2,0). Conclusiones: El ácido úrico se relaciona con la aparición de preeclampsia y su fisiopatología. Se invita a la comunidad científica a seguir investigando acerca de la utilidad del ácido úrico para su implementación como herramienta de tamización en el primer y el segundo trimestre de embarazo.(AU)

Introduction: Uric acid has been described as a possible risk marker for the appearance of pre-eclampsia. However, so far there is no solid evidence to support it. The objective of this study is to synthesize the available literature to determine the usefulness of uric acid as a screening tool for pre-eclampsia. Methodology: Systematic review of the literature of primary studies that analyse serum uric acid levels in the first and second trimesters of gestation with the development of pre-eclampsia. Search in PubMed (n: 639). Results: Two studies (2 cohort studies) were included with a total of 9,746 pregnant women and 398 cases of pre-eclampsia. In the studies, higher serum uric acid levels were found in pregnant women who developed preeclampsia (OR 1.8 to 2.0). Conclusions: Uric acid is related to the presence of preeclampsia and its pathophysiology. The scientific community is invited to continue investigating the applicability of uric acid for its implementation as a screening tool in the first and second trimester of pregnancy.(AU)

Síndrome de Hamman como complicación inusual de COVID-19 / Hamman syndrome as an unusual complication of covid-19

La enfermedad por SARS-CoV-2 ha sido bien conocida por su capacidad de infección y afectación multiórgano con cierta preferencia y gravedad a los pulmones incluyendo lesiones parenquimatosas, alveolares e intersticiales. En esta oportunidad se presenta un caso infrecuente como lo es el síndrome de Hamman en un paciente masculino de 35 años con neumonía viral por COVID-19, Entidad que podría ser un indicador potencial de progresión y agravante de la enfermedad como de los síntomas asociados al patrón usual de la infección. Su tratamiento lo definirá la estabilidad clínica y el tamaño del neumomediastino (AU)

SARS-CoV-2 disease has been well known for its capacity for infection and multi-organ involvement with some preference and severity to the lungs including parenchymal, alveolar and interstitial lesions. On this occasion, an infrequent case such as Hamman syndrome is presented in a 35-year-old male patient with viral pneumonia due to COVID-19. Entity that could be a potential indicator of progression and aggravation of the disease as well as the symptoms associated with the pattern usual infection. His treatment will define the clinical stability and size of the pneumomediastinum (AU)

Vascular endothelial growth factor plasma levels in patients with systemic lupus erythematosus and primary antiphospholipid syndrome.

The objective of this study was to assess the possible role of vascular endothelial growth factor (VEGF) in the pathogenesis of systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (PAPS). We studied 28 patients with SLE, 10 patients with PAPS, and 24 healthy controls. VEGF plasma levels were measured by ELISA. Immunolocalization of VEGF was done in renal tissue from SLE patients and cadaveric controls. Our results showed that VEGF plasma levels were increased in SLE patients compared with PAPS and controls. The correlation between clinical manifestations and VEGF levels revealed that SLE patients with renal failure had significantly increased plasma VEGF levels (134.1 + 91.0 pg/ml) compared with SLE patients with normal renal function (42.9 + 19.0 pg/ml), PAPS patients (41.9 + 26.6 pg/ml), and controls (36.2 + 27.0 pg/ml; P < 0.01). Immunostaining showed a strong expression of VEGF in SLE renal tissue samples. Our preliminary results indicate that VEGF is increased in plasma from patients with lupus nephritis and a moderate degree of renal failure and is overexpressed in renal tissue from these patients.

Manganese in lung tissue: study of Mexico City residents' autopsy records from the 1960s and 1990s.

During the conduct of autopsies performed on residents of Mexico City during the 1960s (20 males, 19 females) and 1990s (30 males and 18 females), concentrations of manganese in lung were studied with atomic absorption spectrometry. Concentrations of manganese were not significantly greater in the samples obtained in the 1990s (1.87+/-0.8 microg/gm [mean +/- standard deviation]) than in samples from the 1960s (1.72+/-1.2 microg/gm). Concentrations were not correlated with gender, smoking habit, age, or cause of death; however, there was a correlation with occupation. The findings suggest that manganese exposure via air does not represent a health hazard to residents of Mexico City, given that lung concentrations of manganese remained stable during the 30-y period studied. Investigators should monitor concentrations of manganese in suspended particles to follow-up on these findings.

[Primary pericardial angiosarcoma with multiple lung and a solitary liver metastases: the clinical and anatomicopathological findings]. / Angiosarcoma pericárdico primario con metástasis pulmonares múltiples y hepática solitaria: hallazgos clínicos y anatomopatológicos.

A case of 66-year-old woman with cardiac tamponade and bilateral pulmonary infiltrates is reported. These infiltrates were "pseudonodulars" and confluent. We practice pericardiocentesis and a hemorrhagic fluid is pulled out. Its cytology shown not neoplastic cells. She died and the necropsy shown an angiosarcoma of pericardium with multiple pulmonary and alone hepatic metastases.

[Acute postpartal myocardial infarct: the role of methylergometrin in its etiopathogenesis]. / Infarto agudo de miocardio posparto: papel de la metilergometrina en su etiopatogenia.

We report a 28-year-old patient with an acute myocardial infarction, without previous symptomatology of ischemic heart disease, 5 hours after a delivery. We discuss the role of methylergometrine, used for avoid the bleeding postpartum, in its etiopathology and its specific therapy.

[Aortic insufficiency in an asymptomatic girl: valve prolapse as the only finding]. / Insuficiencia aórtica en niña asintomática: prolapso valvular como único hallazgo.

A case of an asymptomatic 9-year-old girl is reported. She was diagnosed of aortic regurgitation by valvular prolapse without other systemic or valvular pathology associated. We discuss her etiology and physiopathology.

[Swallowing syncope in a patient with diffuse esophageal spasm]. / Síncope deglutorio en paciente portador de un espasmo esofágico difuso.

We present a patient with swallowing syncope. The esophageal manometric examination showed a diffuse spasm. This induces a vagovagal reflex mediated by tensoreceptors from the esophageal wall, which block the AV and/or sinus nodes.

[Prevention of coronary atherosclerosis. (III). Prevalence of risk factors among civil servants of Mexico City, Federal District]. / Prevención de la aterosclerosis coronaria. (III). Prevalencia de factores de riesgo en burócratas de la ciudad de México, Distrito Federal.

The prevalence of risk factors in civil servants living in Mexico City was investigated prospectively in 1942 individuals. Risk factors tended to increase with age and in some cases were related to sex. Hypertension was found to be as high as fifteen percent in the older age groups despite the fact that the critical limit was 160/95 in all decades. Hypercholesterolemia was found to be close to the rates reported in the so-called developed countries. Diabetes mellitus varied between 1 and 14%. Obesity and hypertrygliceridemia were also common findings and related. Smoking was independent of sex. Prevalence of the association between the major risk factors are presented. These data, are in agreement with the death causes among civil servants and indicate that preventive programs for ischemic heart disease are needed in civil servants in Mexico City.

[Prevention of coronary atherosclerosis. II: Topography and morphology of "protruding" lesions. Epidemiologic, diagnostic and therapeutic implications]. / Prevención de la aterosclerosis coronaria. II: Topografía y morfología de lesiones "protruyentes". Implicaciones epidemiológicas, diagnósticas y terapéuticas.

Topographic and morphologic aspects of coronary atherosclerotic "protruding" lesions were investigated in 119 accidental deaths in males living in Mexico City. Morphology and topography varied according to the arterial trunk studied and age. Left anterior descending and circumflex lesions were almost always confined to the initial 5 cms and if a lesion was present after the 3rd cm there was always a proximal lesion. Right coronary lesions occasionally were found distally even in the absence of proximal lesions. Third decade lesions were usually not calcified. Stenosis if present was rarely multivascular. Some fourth decade lesions were calcified; plurivascular stenosis was present in some cases. Fifth decade lesions show sequential stenotic lesions in the same vessel; calcium and plurivascular stenosis were often observed. However the features observed in the 3rd decade could be observed in the older subjects. Reference is made to lesions which are found in both the left main trunk and the left anterior descending. Epidemiological and clinical applications related with preventive programs are mentioned.