Síndrome de Ramsay Hunt. A propósito de un caso / Ramsay Hunt syndrome. A case report

Presentamos el caso de una paciente con parálisis facial periférica coincidente con lesiones vesiculosas herpéticas óticas. El síndrome de Ramsay Hunt es la segunda causa más frecuente de parálisis facial periférica atraumática, con una presentación clínica muy variada. La parálisis facial de este síndrome ocurre en el 60-90 % de los casos, es periférica y puede preceder o seguir a las lesiones cutáneas con un peor pronóstico que la parálisis idiopática de Bell (AU)

We present the case of a female patient with peripheral facial paralysis coinciding with vesicular herpetic otic lesions. Ramsay Hunt syndrome is the second most common cause of atraumatic peripheral facial paralysis, with a very varied clinical presentation. The facial paralysis in this syndrome occurs in 60-90 % of cases, is peripherical and can precede or follow the cutaneous lesions with a worse prognosis than idiopathic Bell paralysis (AU)

Venous thromboembolism in patients with renal insufficiency: findings from the RIETE Registry.

BACKGROUND: Current guidelines make no specific recommendations for venous thromboembolism (VTE) treatment in patients with renal insufficiency, but some experts recommend some reduction in heparin dose. METHODS: Registro Informatizado de Enfermedad TromboEmbólica (RIETE) is an ongoing, prospective registry of consecutively enrolled patients with objectively confirmed, symptomatic, acute VTE. In this analysis we retrospectively analyzed the effect of renal insufficiency on the incidence of fatal pulmonary embolism (PE) and fatal bleeding within 15 days of diagnosis. RESULTS: Up to March 2005, 10,526 patients with acute VTE were enrolled in RIETE, of whom 9234 (88%) had a creatinine clearance (CrCl) greater than 60 mL/min, 704 (6.7%) had a CrCl 30 to 60 mL/min, and 588 (5.6%) had a CrCl less than 30 mL/min. The incidence of fatal PE during the study period was 1.0%, 2.6%, and 6.6%, respectively. Fatal bleeding occurred in 0.2%, 0.3%, and 1.2% of the patients, respectively. On multivariate analysis, patients with a CrCl less than 30 mL/min were independently associated with an increased risk for fatal PE and fatal bleeding. In addition, initial diagnosis of PE, immobility for 4 days or more, cancer, and initial therapy with unfractionated heparin were independent predictors of fatal PE; whereas immobility for 4 days or more and cancer were independent predictors of fatal bleeding. CONCLUSIONS: Patients with VTE who have renal insufficiency had an increased incidence of both fatal PE and fatal bleeding, but the risk of fatal PE far exceeded that of fatal bleeding. Our data support the use of full-dose anticoagulant therapy, even in patients with a CrCl less than 30 mL/min.

Compendio de Historia Eclesiastica

Contiene: Desde la fundacion de la Iglesia de Nuestro Señor Jesucristo hasta la conversion de Constantino el Grande, acaecida el año 312 de la era cristiana; Desde la conversion de Constantino acaecida el año 312, hasta el origen del Mahometismo en el año 622. Abraza un periodo de 310 años; Desde el establecimiento del Mahometismo en el año 622 hasta la celebracion del V Concilio de Ltran, en el año 1215. Abarca un periodo de 593 años; Desde el IV Concilio de Letran y XII Ecumenico, año 1215, hasta los principios de la reforma de Lutero, año 1517. Abraza un periodo de 302 años; Desde los principios de la reforma de Lutero en el año 1517 hasta la muerte de Pio VI en el año 1799. Abraza un periodo de 282 años; Desde la muerte de Pio VI el año 1799, hasta el año 1939; Desde Pio XII, hasta nuestros dias