Síndrome opsoclonus mioclonus de evolución benigna y cáncer de próstata / Benign opsoclonus myoclonus syndrome and prostate cancer

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Acidos biliares sericos en la enfermedad hepatobiliar. / Serum biliary acids in hepatobiliary disease

Se determinaron los niveles sericos, de los acidos biliares colilglicina y sulfolitocolilglicina, por radioinmunoanalisis en varias enfermedades hepatobiliares como son: cirrosis secundaria a alcoholismo, cirrosis post-hepatitis, colestasis extrahepatica, absceso hepatico amibiano, hepatitis cronica activa y un grupo miscelaneo. La colilglicina se elevo principalmente, en aquellos padecimientos que cursaban con alteraciones hepatocelulares y obstruccion extrahepatica; los valores mas altos se observaron en pacientes con cirrosis hepatica secundaria a alcoholismo que cursaban con encefalopatia y en aquellos con obstruccion maligna. La sulfolitocolilglicina solo se incremento en la obstruccion extrahepatica por lo que se considera mas especifica y posiblemente de utilidad, para el diagnostico diferencial de colestasis. Se discuten las posibles causas que pueden intervenir en la elevacion de estos acidos biliares en los padecimientos hepatobiliares

[Cytology by gastric washing in the diagnosis of gastric neoplasms]. / La citología por lavado en el diagnóstico de las neoplasias gástricas.

A prospective and comparative study between the citology obtained through gastric washing and endoscopic (biopsy and brushing) for the diagnostic of the gastric neoplasias was carried at the Hospital de Especialidades del Centro Médico La Raza. Twenty one patients with benign gastric ulcer and 18 patients with gastric neoplasia (Two lymphomas and 16 adenocarcinomas) which we checked through surgery, necropsy or clinic evolution were studied. From 21 cases of gastric ulcer, the washing produced enough material for diagnosis in 17 of them (81%); in 16 of these neoplasia was excluded (94.1%) with false positive (5.9%). The endoscopic regained 100% of useful material and in a 100% ignored neoplasia. From 18 neoplasia cases, gastric washing produced material for 14 of them (77.8%); in 10 of these (71.4%) it made a diagnostic with 4 false negatives (28.6%); Endoscopic collected material in a 100% and the accuracy diagnostic was of 17 (94.4%) with one false negative (5.6%). Gastric washing has a high index of uselless for diagnostic from 39 samples, 8 were useless and from these, autolisis was the mein cause. Citology through gastric washing is usefull for neoplasm diagnosis in those cases in which endoscopy would be contraindicated or in those in which it is absent.

[Various considerations in the treatment of amebic liver abscess]. / Algunas consideraciones en el tratamiento del absceso hepático amibiano.

From 1974 to 1976 Acute Amoebic Hepatic Abscess treatment was viewed retrospectively with a random double blind prospective study administering metronidazol emetine, or a combination of both to three groups of 20 patients per group. The retrospective study of 1974 underlines the then predominant tendency toward a surgical management with a higher mortality (p less than 0.002). In 1976 medical treatment patients increased with a corresponding diminution of mortality (p less than 0.001). The prospective study showed no statistically significant response difference to the pharmacologic treatment variations. Here only 1.6% of patients underwent surgery and 1/3 of them received puncture drainage due to medical treatment failure. We conclude that non complicated acute amoebic liver abscess treatment should be medical, preferably with only one antiamoebic drug.

[Amylase/creatinine clearance in the differential diagnosis of acute pancreatitis]. / Indice de depuración amilasa/creatinina en el diagnóstico diferencial de la pancreatitis aguda.

In the Department of Gastroenterology of "El Centro Médico La Raza, I.M.S.S.", three groups of 20 patients were studied: group I with acute pancreatitis; group II with acute abdomen without pancreatic pathology, in both groups the diagnosis was demonstrated surgically or in necropsy; group III was formed by 20 normal voluntary persons, and served as control. A 4 per cent amilase/creatinine clearence index was considered as a high normal value. The diagnosis accuracy in group I was 90 per cent. In group II there was five false positive results, in 80 per cent of the cases the results of the amilase/creatinine clearence index was found within normal limits. The difference between group I and group III was significant (P less than 0.002). The difference between group I and group II was also significant (P less than 0.05). There was no significant difference between group II and group III. The amilase/creatinine clearence index has the advantage that it can be obtained with only one blood and urine samples taken simultaneously. We concluded that amilase/creatine clearence index is useful for the differential diagnosis in acute pancreatitis and that is probably due to an alteration in the tubular renal reabsorption.