Repeated threat (without direct harm) alters metabolic capacity in select regions that drive defensive behavior.

To understand the behavioral consequences of intermittent anticipatory stress resulting from threats without accompanying physiological challenges, we developed a semi-naturalistic rodent housing and foraging environment that can include threats that are unpredictable in timing. Behavior is automatically recorded while rats forage for food or water. Over three weeks, the threats have been shown to elicit risk assessment behaviors, increase defensive burying and increase adrenal gland weight. To identify brain regions activated by this manipulation, we measured cytochrome c oxidase (COX), which is tightly coupled to neural activity. Adolescent male Sprague-Dawley rats were randomly assigned to control (CT) or unpredictable threat/stress (ST) housing conditions consisting of two tub cages, one with food and another with water, separated by a tunnel. Over three weeks (P31-P52), the ST group received randomly timed (probability of 0.25), simultaneous presentations of ferret odor, an abrupt light, and sound at the center of the tunnel. The ST group had consistently fewer tunnel crossings than the CT group, but similar body weights. Group differences in COX activity were detected in regions implicated in the control of defensive burying. There was an increase in COX activity in the hypothalamic premammillary dorsal nucleus (PMD) and lateral septum (LS), whereas a decrease was observed in the periaqueductal gray (PAG) and CA3 region of the hippocampus. There were no significant differences in the anterior cingulate cortex, prefrontal cortex, striatum or motor cortex. The sites with changes in metabolic capacity are candidates for the sites of plasticity that may underlie the behavioral adaptations to intermittent threats.

Prevalencia de puntos gatillo miofasciales en el flautista. Estudio piloto / Prevalence of myofascial trigger points in flute players. A pilot study

Objetivo: Conocer la prevalencia de puntos gatillo miofasciales en los músculos más implicados en la posición que adopta el flautista. Sujetos y metodología: Trece flautistas de entre 12 y 66 años que tocaban la flauta travesera como primer instrumento en el momento de la valoración en la Escuela de Música y en la Banda Municipal de Alcobendas fueron valorados por una fisioterapeuta entre enero y abril del 2013. Se exploraron los músculos del cuello, de la cintura escapular y del miembro superior en busca de puntos gatillo miofasciales activos y latentes siguiendo los criterios diagnósticos de Simons, Travell y Simons. Resultados: De los 13 flautistas explorados, el 69,2% (9 participantes) presentaron puntos gatillo miofasciales latentes y el 23,1% (3 participantes) puntos gatillo miofasciales activos. La musculatura respiratoria accesoria fue la más afectada: músculos trapecio superior, escalenos y esternocleidomastoideo. Conclusiones: El síndrome de dolor miofascial es una entidad clínica presente en el flautista. Existe una elevada frecuencia de puntos gatillo miofasciales activos y latentes, principalmente en músculos implicados en la respiración. Son necesarios más estudios con mayor tamaño muestral que corroboren lo hallado en este estudio piloto

Objective: To determine the prevalence of myofascial trigger points in the muscles involved in the position adopted by the flutist. Subjects and methods: Thirteen flutists aged 12 to 66 years, who played the flute as first instrument at the time of the assessment, at the School of Music and the Municipal Band of Alcobendas, Madrid (Spain) were considered for inclusion in the study between January and April 2013. Neck, shoulder girdle and upper limb muscles were studied to detect active and latent myofascial trigger points following the Simons, Travell & Simons diagnostic criteria. Results: Of the 13 flutists studied, 69.2% (9 participants) had latent myofascial trigger points and 23.1% (3 participants) had active myofascial trigger points. The accessory respiratory muscles were the most affected, these being the upper trapezius muscles, scalene and sternocleidomastoid. Conclusions: Myofascial pain syndrome is a common clinical condition in flute players. There is a high frequency of active and latent myofascial trigger points, mainly in the muscles involved in breathing. Further studies with larger sample sizes are needed to clarify the results of this pilot study

Usefulness of endoscopic ultrasonography in preoperative gastric cancer staging: diagnostic yield and therapeutic impact.

OBJECTIVES: To evaluate the diagnostic yield of endoscopic ultrasonography in loco-regional staging of gastric cancer in our medium and to determine the impact of this technique on later therapeutic management. MATERIAL AND METHODS: This is a retrospective study carried out on patients histologically diagnosed with gastric adenocarcinoma who had been referred for endoscopic ultrasonographic examination. The technique results were compared with those obtained from surgical samples and/or from exploratory laparoscopy- laparotomy. We compared the initial therapeutic decision based on conventional diagnostic techniques with the final therapeutic management based on the endoscopic ultrasonography results. RESULTS: Forty-six patients with gastric adenocarcinoma were included in the study (a reference exploration was available in 36 cases). Diagnostic precision was 70% in stage T, while in stages T1, T2, T3 y T4 was 100, 38, 82, and 100%, respectively. The sensitivity and specificity to differentiate T1-2 from T3-4 was 94 and 85%, respectively. We could not identify factors associated with obtaining a correct diagnosis in staging T. Diagnostic precision was 72% for stage N (N0: 58%; Nx 88%). The presence of free perigastric fluid was identified in 7 cases; the presence of peritoneal carcinomatosis was later confirmed in 5 of these. The result of endoscopic ultrasonography led to a modification in the subsequent therapeutic management in 13 patients (28%). CONCLUSIONS: Endoscopic ultrasonography is a useful technique for loco-regional staging of gastric adenocarcinoma, which may have important implications in the therapeutic management of these patients.

Utilidad de la ecoendoscopia en la estadificiación preoperatoria del cáncer gástrico: rentabilidad diagnóstica e impacto terapéutico / No disponible

Objetivos: valorar la rentabilidad diagnóstica de la ecoendoscopiaen la estadificación locorregional del cáncer gástrico ennuestro medio y determinar el impacto de la técnica sobre el manejoterapéutico posterior.Material y métodos: estudio retrospectivo realizado en pacientesdiagnosticados histológicamente de adenocarcinoma gástricoque habían sido remitidos para la realización de ecoendoscopia.Se comparó el resultado de la técnica con el estudio final obtenidoen la pieza operatoria y/o laparoscopia-laparotomía exploradora.Se comparó la decisión terapéutica inicial basada en los resultadosde las técnicas diagnósticas convencionales, con el manejo terapéuticofinal basado en el resultado de la ecoendoscopia.Resultados: se incluyeron en el estudio 46 pacientes conadenocarcinoma gástrico (en 36 de los cuales se disponía de exploraciónde referencia). La precisión diagnóstica fue del 70%para el estadio T, y para T1, T2, T3 y T4 del 100, 38, 82 y100%, respectivamente. La sensibilidad y especificidad para diferenciarel estadio T1-2 del T3-4 fue del 94 y 85% respectivamente.No se identificaron factores relacionados con la obtención deun diagnóstico correcto en la estadificación T. La precisión diagnósticafue del 72% para el estadio N (N0: 58%; Nx 88%). En 7pacientes se identificó la presencia de líquido libre perigástrico, en5 de los cuales se confirmó posteriormente la existencia de carcinomatosisperitoneal. En 13 pacientes (28%) del resultado de laecoendoscopia se derivó una modificación en el manejo terapéuticoposterior.Conclusiones: la ecoendoscopia es una técnica útil en la estadificaciónlocorregional del adenocarcinoma gástrico, lo quepuede tener importantes implicaciones en el manejo terapéuticode estos pacientes(AU)

Objectives: to evaluate the diagnostic yield of endoscopic ultrasonographyin loco-regional staging of gastric cancer in ourmedium and to determine the impact of this technique on latertherapeutic management.Material and methods: this is a retrospective study carriedout on patients histologically diagnosed with gastric adenocarcinomawho had been referred for endoscopic ultrasonographic examination.The technique results were compared with those obtainedfrom surgical samples and/or from exploratory laparoscopylaparotomy.We compared the initial therapeutic decision basedon conventional diagnostic techniques with the final therapeuticmanagement based on the endoscopic ultrasonography results.Results: forty-six patients with gastric adenocarcinoma wereincluded in the study (a reference exploration was available in 36cases). Diagnostic precision was 70% in stage T, while in stagesT1, T2, T3 y T4 was 100, 38, 82, and 100%, respectively. Thesensitivity and specificity to differentiate T1-2 from T3-4 was 94and 85%, respectively. We could not identify factors associatedwith obtaining a correct diagnosis in staging T. Diagnostic precisionwas 72% for stage N (N0: 58%; Nx 88%). The presence offree perigastric fluid was identified in 7 cases; the presence of peritonealcarcinomatosis was later confirmed in 5 of these. The resultof endoscopic ultrasonography led to a modification in thesubsequent therapeutic management in 13 patients (28%).Conclusions: endoscopic ultrasonography is a useful techniquefor loco-regional staging of gastric adenocarcinoma, whichmay have important implications in the therapeutic managementof these patients(AU)

[Usefulness of contrast-enhanced ultrasonography in daily clinical practice: a multicenter study in Spain]. / Utilidad de la ecografía con contraste en la práctica clínica diaria. Estudio multicéntrico español CEUS.

OBJECTIVES: We aimed to determine whether the use of ultrasonographic contrast agents improves the diagnostic performance of ultrasonography (US). MATERIAL AND METHODS: We carried out a prospective multicenter study in 42 hospitals. We included 1786 patients with inconclusive US; 84.9% of the inconclusive studies were abdominal US (including studies of the liver, kidneys, spleen, and other sites), 6.2% were studies of the peripheral vessels, 4.3% were breast studies, and 4.6% were other studies. We evaluated the type of contrast-enhanced US (color Doppler or contrast-specific method), type of contrast agent, dose and number of doses, and type of administration (bolus or infusion). We evaluated whether the findings at contrast-enhanced US improved the diagnostic performance of unenhanced US and whether they enabled a conclusive diagnosis to be reached. RESULTS: The contrast agent SonoVue was used in 99.9% of the studies; a single dose of contrast agent was used in 84.8%, and the contrast agent was administered in bolus in 98.5%. Contrast-enhanced US improved the diagnostic performance in 91.6% of cases and enabled the conclusive diagnosis in 69.2%. The best diagnostic performance was obtained in the supraaortic trunks, where a definitive diagnosis was reached in 95.4% of cases, followed by the abdominal area, with a conclusive diagnosis in 72.6% of cases. CONCLUSIONS: The use of contrast-enhanced US significantly improved the diagnostic performance of US and enabled a conclusive diagnosis in most cases.

[Endosonographic examination of the common bile duct in patients with acute biliary pancreatitis]. / Estudio por ecoendoscopia de la vía biliar extrahepática en pacientes con pancreatitis aguda biliar.

OBJECTIVE: the objective of our study was to evaluate the usefulness of endoscopic ultrasonography (EUS) for the study of the common bile duct in patients diagnosed with acute biliary pancreatitis, and to establish clinical and laboratory factors related to this technique. MATERIALS AND METHODS: seventy-three consecutive patients with acute biliary pancreatitis were included in the study (31 males and 42 females with a mean age of 64 +/- 15) who were admitted to our department for biliopancreatic EUS. In all patients the technique was followed by ERCP with sphincterotomy, and endoscopy to remove stones when endoscopy revealed choledocholithiasis. RESULTS: mean time from admission to echoendoscopy was 7 +/- 6 days. In 18 patients (24%) the presence of choledocholithiasis was revealed by EUS, and in 17 a sphincterotomy was performed. Choledocholithiasis was more frequent in patients with common bile duct dilation (55 vs. 14%; p < 0.05). Thirteen patients (18%) showed severe acute pancreatitis. Fourteen (19%) showed complications related to acute pancreatitis, and one patient died. Four patients had a new episode of acute pancreatitis. No significant difference was seen in the percentage of complications between patients treated conservatively and patients with choledocholithiasis treated with endoscopic sphincterotomy (18 vs. 22%; p > 0.05). No difference was also detected for the subgroup of patients with severe acute pancreatitis (45 vs. 55%; p > 0.05). CONCLUSIONS: EUS is a useful technique for the selection of patients with acute biliary pancreatitis who may benefit from endoscopic sphincterotomy.

Estudio por ecoendoscopia de la vía biliar extrahepática en pacientes con pancreatitis aguda biliar / No disponible

Objetivo: el objetivo de nuestro estudio fue valorar la utilidad de laecoendoscopia en el estudio de la vía biliar extrahepática en los pacientesdiagnosticados de pancreatitis aguda biliar y determinar los factoresclínicos y analíticos relacionados con el resultado de la técnica.Material y métodos: se incluyeron en el estudio de modo consecutivo73 pacientes (31 varones, 42 mujeres; media de edad 64 ±15 años) con pancreatitis aguda biliar remitidos a nuestro serviciopara la realización de ecoendoscopia biliopancreática. En todos lospacientes se realizó la técnica seguida de CPRE con esfinterotomía ytécnica endoscópica para la extracción de cálculos cuando se identificópor ecoendoscopia la existencia de coledocolitiasis. Se compararonlas características clínico-evolutivas de estos pacientes con respectoal resultado obtenido con la ecoendoscopia.Resultados: la media de tiempo transcurrido desde el ingresohasta la realización de la ecoendoscopia fue de 7 ± 6 días. En 18pacientes (24%) se observó en la ecoendoscopia la existencia decoledocolitiasis y en 17 de ellos se realizó esfinterotomía endoscópica.La presencia de coledocolitiasis fue más frecuente en aquellospacientes con dilatación de la vía biliar extrahepática (55 vs.14%; p < 0,05) y en aquellos con bilirrubina sérica superior a 3mg/dl (41 vs. 18%; p < 0,05). Trece pacientes (18%) presentaronpancreatitis aguda severa. Catorce (19%) presentaron algunacomplicación en relación con la pancreatitis aguda y un pacientemurió. Se observó una complicación relacionada con la esfinterotomíaendoscópica. Cuatro pacientes presentaron un nuevo episodiode pancreatitis aguda. No se observaron diferencias significativasen el porcentaje de complicaciones en los pacientestratados de modo conservador respecto a aquellos con coledocolitiasistratados con esfinterotomía endoscópica (18 vs. 22%; p >0,05). Tampoco se observó esta diferencia en el subgrupo de pacientescon pancreatitis aguda severa (45 vs. 55%; p > 0,05).Conclusiones: la ecoendoscopia es una técnica útil en la selecciónde los pacientes con pancreatitis aguda biliar que se beneficiaránde la realización de una esfinterotomía endoscópica

Objective: the objective of our study was to evaluate the usefulnessof endoscopic ultrasonography (EUS) for the study of thecommon bile duct in patients diagnosed with acute biliary pancreatitis,and to establish clinical and laboratory factors related to thistechnique.Materials and methods: seventy-three consecutive patientswith acute biliary pancreatitis were included in the study (31 malesand 42 females with a mean age of 64 ± 15) who were admittedto our department for biliopancreatic EUS. In all patients the techniquewas followed by ERCP with sphincterotomy, and endoscopyto remove stones when endoscopy revealed choledocholithiasis.Results: mean time from admission to echoendoscopy was7 ± 6 days. In 18 patients (24%) the presence of choledocholithiasiswas revealed by EUS, and in 17 a sphincterotomywas performed. Choledocholithiasis was more frequent in patientswith common bile duct dilation (55 vs. 14%; p < 0.05).Thirteen patients (18%) showed severe acute pancreatitis. Fourteen(19%) showed complications related to acute pancreatitis,and one patient died. Four patients had a new episode of acutepancreatitis. No significant difference was seen in the percentageof complications between patients treated conservativelyand patients with choledocholithiasis treated with endoscopicsphincterotomy (18 vs. 22%; p > 0.05). No difference was alsodetected for the subgroup of patients with severe acute pancreatitis(45 vs. 55%; p > 0.05).Conclusions: EUS is a useful technique for the selection ofpatients with acute biliary pancreatitis who may benefit from endoscopicsphincterotomy

[Ultrasound-guided biopsy of the pancreas: a multicenter study]. / Punción pancreática ecodirigida: estudio multicéntrico.

OBJECTIVE: Members of "Asociación de Ecografía Digestiva" decided to carry out a multicenter retrospective study on fine-needle aspiration biopsy for pancreatic space-occupying lesions under ultrasonographic guidance and via the percutaneous route in order to assess this technique s performance versus endoscopic ultrasound-guided biopsy. SUBJECTS: 10 hospitals for a total of 222 patients with suspiciously malignant, 8-120-mm pancreatic lesions were included in the study. RESULTS: The analysis of results shows a sensitivity of 89%, a specificity of 98%, a positive predictive value of 99%, and a negative predictive value of 74%, for an overall diagnostic accuracy of 91%. No major complications occurred. CONCLUSION: Percutaneous fine-needle aspiration for pancreatic lesions is highly cost-effective and has few and mild complications.

Punción pancreática ecodirigida: estudio multicéntrico / Ultrasound-guided biopsy of the páncreas: a multicenter study

Objetivo: en el seno de la Asociación de Ecografía Digestivase decidió realizar un estudio retrospectivo multicéntrico sobre lapunción-aspiración con aguja fina (PAAF) de lesiones ocupantesde espacio pancreáticas, mediante control ecográfico y por víapercutánea, con el objetivo de valorar el rendimiento de dicha técnicay poder compararla con la punción mediante ultrasonografíaendoscópica.Participantes: en el estudio han participado 10 hospitalescon 222 pacientes con lesiones pancreáticas entre 8 y 120 mm,sospechosas de malignidad.Resultados: el análisis de los resultados muestra una sensibilidaddel 89%, especificidad 98%, valor predictivo positivo 99% ynegativo 74%, con precisión diagnóstica global 91%. No encontramosninguna complicación significativa.Conclusión: la PAAF de lesiones pancreáticas por vía percutáneaes de alta rentabilidad diagnóstica y con pocas y leves complicaciones

Objective: members of “Asociación de Ecografía Digestiva”decided to carry out a multicenter retrospective study on fine-needleaspiration biopsy for pancreatic space-occupying lesions underultrasonographic guidance and via the percutaneous route in orderto assess this technique’s performance versus endoscopic ultrasound-guided biopsy.Subjects: 10 hospitals for a total of 222 patients with suspiciouslymalignant, 8-120-mm pancreatic lesions were included inthe study.Results: the analysis of results shows a sensitivity of 89%, aspecificity of 98%, a positive predictive value of 99%, and a negativepredictive value of 74%, for an overall diagnostic accuracy of91%. No major complications occurred.Conclusion: percutaneous fine-needle aspiration for pancreaticlesions is highly cost-effective and has few and mild complications

[Angioma-like liver lesions in patients with chronic liver disease]. / Lesiones hepáticas sugestivas de angioma en pacientes con hepatopatía crónica.

OBJECTIVE: The aim of this study was to evaluate in our healthcare area the clinical, ultrasonographic, and evolutionary features of patients with chronic liver disease and angioma-like liver lesions on ultrasonography. MATERIALS AND METHODS: We conducted a retrospective study amongst patients seen at the Ultrasonography Unit, Gastroenterology Department between January 2000 and June 2004. Included in the study were patients that presented with clinical and/or laboratory complaints consistent with chronic liver disease of any etiology, and those in which abdominal ultrasounds revealed the existence of at least one angioma-like liver lesion. All relevant epidemiological, clinical, ultrasonographic, and evolutionary data were carefully collected and recorded. RESULTS: In the course of our study, 58 patients were diagnosed with chronic liver disease and angioma-like liver lesions, of which 13 showed clinical, laboratory, ultrasonographic, and/or histological signs of liver cirrhosis. In 50% of patients these lesions were less than 10 mm in diameter, and in most cases were located in the right hepatic lobe. During an average follow-up period of 35 months (6-168 months) we verified that, in two patients, these lesions, initially interpreted as angiomas were in fact malignancies (one hepatocellular carcinoma and one metastatic adenocarcinoma of the gallbladder). In both cases, the patients were cirrhotic. Thus, our study revealed that 15% of lesions found in cirrhotic patients initially interpreted as angiomas were actually malignant. CONCLUSIONS: Our study revealed that, in patients with chronic liver disease, particularly in cirrhotic patients, a considerable percentage of ultrasonographic lesions originally interpreted as angiomas are in fact malignant tumors.

Lesiones hepáticas sugestivas de angioma en pacientes con hepatopatía crónica / Angioma-like liver lesions in patients with chronic liver disease

Objetivo: el objetivo de nuestro estudio fue valorar en nuestro medio las características clínicas, ecográficas y evolutivas de los pacientes con hepatopatía crónica y lesiones ecográficas sugestivas de angiomas hepáticos. Material y métodos: estudio retrospectivo realizado entre los pacientes recogidos en la base de datos de la Unidad de Ecografías del Servicio de Aparato Digestivo entre enero de 2000 y junio de 2004. Incluimos en el estudio a pacientes que presentaban datos clínicos y/o analíticos compatibles con hepatopatía crónica de cualquier etiología y en los que la ecografía abdominal ponía de manifiesto la existencia de al menos una lesión hepática compatible con angioma. Se han recogido los datos epidemiológicos, clínicos, ecográficos y evolutivos de estos pacientes. Resultados: durante el periodo de estudio se diagnosticaron 58 pacientes con hepatopatía crónica y lesiones hepáticas sugestivas de angioma, de los cuales trece presentaban datos clínicos, analíticos, ecográficos y/o histológicos compatibles con cirrosis hepática. Ecográficamente se trataban de lesiones menores de 10 mm en el 50% de los pacientes y en la mayoría de los casos localizadas en lóbulo hepático derecho. Durante el periodo de medio de 35 meses (6 a 168 meses) se pudo comprobar cómo en dos pacientes (3%) las lesiones inicialmente interpretadas como angiomas se trataban en realidad de lesiones malignas (un hepatocarcinoma y unas metástasis de adenocarcinoma vesicular). En ambos casos los pacientes eran cirróticos. Por tanto, en el 15% de los pacientes cirróticos de nuestra serie se demostró la naturaleza maligna de las lesiones inicialmente interpretadas como angiomas. Conclusiones: en pacientes con hepatopatía crónica, sobre todo en cirróticos, un porcentaje no despreciable de las lesiones ecográficas interpretadas inicialmente como angiomas se tratan realmente de lesiones malignas

Objective: the aim of this study was to evaluate in our healthcare area the clinical, ultrasonographic, and evolutionary features of patients with chronic liver disease and angioma-like liver lesions on ultrasonography. Materials and methods: we conducted a retrospective study amongst patients seen at the Ultrasonography Unit, Gastroenterology Department between January 2000 and June 2004. Included in the study were patients that presented with clinical and/or laboratory complaints consistent with chronic liver disease of any etiology, and those in which abdominal ultrasounds revealed the existence of at least one angioma-like liver lesion. All relevant epidemiological, clinical, ultrasonographic, and evolutionary data were carefully collected and recorded. Results: in the course of our study, 58 patients were diagnosed with chronic liver disease and angioma-like liver lesions, of which 13 showed clinical, laboratory, ultrasonographic, and/or histological signs of liver cirrhosis. In 50% of patients these lesions were less than 10 mm in diameter, and in most cases were located in the right hepatic lobe. During an average follow-up period of 35 months (6-168 months) we verified that, in two patients, these lesions, initially interpreted as angiomas were in fact malignancies (one hepatocellular carcinoma and one metastatic adenocarcinoma of the gallbladder). In both cases, the patients were cirrhotic. Thus, our study revealed that 15% of lesions found in cirrhotic patients initially interpreted as angiomas were actually malignant. Conclusions: our study revealed that, in patients with chronic liver disease, particularly in cirrhotic patients, a considerable percentage of ultrasonographic lesions originally interpreted as angiomas are in fact malignant tumors

Sarcoidosis cutaneopulmonar durante el tratamiento con interferón pegilado y ribavirina / Cutaneopulmonary sarcoidosis during pegylated interferon plus ribavirin therapy

No disponible

[Epidemiologic aspects of 116 acute pancreatitis prospectively studied]. / Aspectos epidemiológicos de 116 pancreatitis agudas estudiadas prospectivamente.

OBJECTIVE: To gather epidemiological data about acute pancreatitis (A.P.) in our environment. EXPERIMENTAL DESIGN: A prospective analysis of a series of patients in whom A.P. was diagnosed. PATIENTS: 116 patients with abdominal pain, elevation of pancreatic enzymes and absence of other acute abdominal pathology. RESULTS: These patients made up 2.8% of all emergency admissions to medical departments. Frequency of A.P. was 331 cases per million inhabitants/year. The biliary etiology was the most frequent (70.7%) followed by idiopathic forms (19.8%) and those deriving from alcohol abuse (7.8%). Mean patient age was 64.88 + 15.82 years, while patients with alcoholic A.P. were significantly younger than the other two groups. Women predominated in cases with biliary etiology, while men did so in alcoholic A.P. In cases of biliary A. P. amilasemia levels were significantly higher on admission (2598) than for other groups (1132 in alcohol related cases and 1692 in idiopathic ones). The overall rate of complications was 18.1%. Finally, overall mortality was 5.1%. CONCLUSIONS: Although the mean age of our patients was advanced, morbidity and mortality rates were low.

[Prognostic value of fibrinogen measurement in acute pancreatitis]. / Valor pronóstico del fibrinógeno en las pancreatitis agudas.

To evaluate the utility of fibrinogen as a prognostic factor in acute pancreatitis (PA) it was measured within 48 hours of admission in 55 patients with acute pancreatitis studied prospectively. We found that patients with fibrinogen levels above 850 mg/dl. presented a serious evolution in 55.55% of cases as compared to 10.87% of those who had levels below this figure (p less than 0.01). We conclude that fibrinogen measurement can be useful in the early evaluation of the prognosis of acute pancreatitis.