Diagnóstico y manejo perinatal del linfangioma gigante de cuello / Perinatal diagnosis and treatment of giant lymphangioma of the neck

Con el avance de la ecografía prenatal, se diagnostican muchas anomalías congénitas, lo que permite planificar un tratamiento temprano. Las linfagiomas son la lesión cogénita benigna más común de todas las malformaciones encontradas por ecografía prenatal, en algunas ocasiones asociadas a otras malformaciones y/o con cariotipo anormal. La gravedad de los linfangiomas se basa en el tipo, la localización, la extensión y la infiltración a otras estructuras. El tratamiento quirúrgico es el más aceptado, con el objetivo principal de lograr la resección completa, sin causar daño a las estructuras anexas y, aunque hay otras alternativas de tratamiento, creemos que se debe individualizar la mejor opción según la localización e infiltración del linfangioma a otras estructuras, motivo de nuestra revisión

With the advances in prenatal ultrasound, most congenital malformations can be diagnosed prior to birth, allowing for the planning of early treatment. Lymphangiomas are the most common benign congenital lesions observed with this technique. In some cases, they are associated with other malformations or chromosomal anomalies. The seriousness of a lymphangioma depends on the type, location, extension and whether or not others structures are involved. The most widespread therapeutic option is surgery, the objective of which is the complete resection of the lesion without damaging adjacent structures. Although there are other treatment options, we think that the choice of the approach depends on each patient, on the site of the lymphangioma and on the involvement of other structures. We discuss these aspects in the present review

[Vaccine storage cold chain at primary care centers in one area of Madrid: keeping the chain intact and degree of knowledge]. / Cadena del frío para la conservación de las vacunas en los centros de atención primaria de un area de Madrid: mantenimiento y nivel de conocimientos.

BACKGROUND: Vaccines are heat-labile medications, and to guarantee their immunogenicity and safeguarding effectiveness as part of immunization programs, it is absolutely essential that the "Cold Chain" go unbroken. Fundamental thereto is the personnel responsible for the vaccines, who must know the stability-related characteristics of each preparation so as to prevent handling errors. The purpose of this study was that of ascertaining how the cold chain is kept intact in primary care systems in one healthcare area of the Autonomous Community of Madrid, as well as determining the degree of information possessed by those responsible for vaccines as far as their heat-stability is concerned. METHODS: A cross-sectional study has been made at 46 primary care vaccination points. The data was gathered by means of a personal interview by one single researcher. RESULTS: The participation rate was 93.5% (43/46). In all cases, there was a maximum and minimum thermometer and monthly temperature record. An unsuitable temperature was found in three cases (6.97%). The percentage of professionals who were aware of the effect freezing has on vaccines varied greatly: 53.5%, 51.2%, 44.2% and 53.5% for diphtheria-tetanus-pertussis (DTP), hepatitis B (HBV), oral polio (OPV) and measles-mumps-rubella (MMR) respectively. And only 32% were familiar with the shake test. CONCLUSION: The professionals were found to be properly trained regarding the effect which high temperatures have on vaccines, but it is necessary for their training with regard to the instability of adsorbed preparations when frozen must be further strengthened.

Cadena del frío para la conservación de las vacunas en los centros de atención primaria de un area de Madrid: mantenimiento y nivel de conocimientos / Vaccine Storage Cold Chain at Primary Care Centers in one Area of Madrid: Keeping the Chain Intact and Degree of Knowledge

Fundamento. Las vacunas son medicamentos termolábiles y para garantizar su inmunogenicidad y eficacia protectora, dentro de los programas de inmunización, es imprescindible mantener la cadena de frío. El elemento fundamental en esta cadena es el personal responsable de las vacunas, que debe conocer las características de estabilidad de cada preparado con el fin de evitar errores durante su manipulación. El objetivo de este trabajo fue conocer cómo se realiza el mantenimiento de la cadena del frío en equipos de atención primaria de un área sanitaria de la Comunidad Autónoma de Madrid, así como establecer el grado de información que poseen los responsables de las vacunas con respecto a la termoestabilidad de las mismas.Métodos. Se ha realizado un estudio transversal en 46 puntos de vacunación en atención primaria. La recogida de los datos se realizó mediante entrevista personal por un único investigador.Resultados. La tasa de participación fue del 93,5 per cent (43/46). En todos los casos existía termómetro de máxima y mínima y registro mensual de la temperatura. Se observó una temperatura inadecuada en tres ocasiones (6,97 per cent). El porcentaje de profesionales que conocía el efecto que la congelación producía sobre las vacunas fue muy diverso: 53.5 per cent, 51.2 per cent, 44.2 per cent y 53.5 per cent para difteria-tétanos-pertussis (DTP), hepatitis B (VHB), polio oral (VPO) y rubéola-sarampión-paperas (RSP) respectivamente. Y sólo el 32 per cent conocía el test de agitación.Conclusión. La formación de los profesionales sobre el efecto que las altas temperaturas ocasionan en las vacunas era correcta, pero es necesario reforzar su formación sobre la inestabilidad que presentan los preparados adsorbidos cuando se someten a congelación (AU)

Background: Vaccines are heat-labile medications, and to guarantee their immunogenicity and safeguarding effectiveness as part of immunization programs, it is absolutely essential that the «Cold Chain» go unbroken. Fundamental thereto is the personnel responsible for the vaccines, who must know the stability-related characteristics of each preparation so as to prevent handling errors. The purpose of this study was that of ascertaining how the cold chain is kept intact in primary care systems in one healthcare area of the Autonomous Community of Madrid, as well as determining the degree of information possessed by those responsible for vaccines as far as their heat-stability is concerned. Methods. A cross-sectional study has been made at 46 primary care vaccination points. The data was gathered by means of a personal interview by one single researcher. Results. The participation rate was 93.5% (43/46). In all cases, there was a maximum and minimum thermometer and monthly temperature record. An unsuitable temperature was found in three cases (6.97%). The percentage of professionals who were aware of the effect freezing has on vaccines varied greatly: 53.5%, 51.2%, 44.2% and 53.5% for diphtheria-tetanus-pertussis (DTP), hepatitis B (HBV), oral polio (OPV) and measles-mumps-rubella (MMR) respectively. And only 32% were familiar with the shake test. Conclusion. The professionals were found to be properly trained regarding the effect which high temperatures have on vaccines, but it is necessary for their training with regard to the instability of adsorbed preparations when frozen must be further strengthened (AU)

Acumulación temprana de gentamicina en el suero de pacientes cancerosos con insuficiencia renal / Accumulation of serum gentamicin levels of cancer patients with renal impairment

Se realizó la cuantificación de gentamicina en el suero, dos horas después de la aplicación, en 11 pacientes cancerosos (seis con función renal y cinco con insuficiencia renal). Se utilizó el método inmunoenzimático EMIT. Los enfermos con función renal normal mostraron concentraciones de gentamicina que variaron entre 1.75 y 3.85 ug/ml de suero y una media de 2.5 ñ 0.8 de desviación estándar (DE), mientras que en los pacientes con insuficiencia renal los valores fluctuaron entre 2.25 y 10.00 ug/ml de suero y promediaron 5.3 ñ 3.2 de DE. El análisis estadístico mostró que existen diferencias significativas entre ambos grupos p < 0.01. Aparentemente la cuantificación de gentamicina en el suero, desde el inicio del tratamiento de pacientes con insuficiencia renal, parece ser el estudio de laboratorio más confiable para evitar que se produzcan lesiones renales más severas en estos enfermos. Por otro lado, cuatro de las seis pacientes con función renal normal mostraron buena respuesta al tratamiento con gentamicina, mientras que ninguna de las cinco pacientes con insuficiencia renal respondió de manera adecuada a este mismo tipo de tratamiento.

Subcellular distribution of phospholipase A2 and ATPases during capacitation and acrosome reaction in guinea pig spermatozoa.

The presence, distribution, and levels of phospholipase A2 and ATPases activities in those structures of the guinea pig spermatozoa that participate in the acrosome reaction were studied, both before and after capacitation, as well as during the acrosome reaction induced in vitro. Spermatozoa were collected from the cauda epididymis and incubated in the absence and presence of 1.15 mmol/L calcium, with and without the addition of 1 mumol/L A23187. Membrane fractions were recovered by vortexing and discontinuous sucrose density gradient centrifugation. Most of the Na+, K(+)-ATPase was recovered in the acrosome-free spermatozoa, but a clear, distinct presence of this enzyme was observed in the plasma membrane (25 against 101 nmoles Pi released per milligram of protein, respectively). The activity of this enzyme in the periacrosomal plasma and in the outer acrosomal membrane increased during calcium incubation. Ca2(+)-dependent ATPase was found in both membrane fractions, being higher in the periacrosomal plasma membrane. The addition of calcium induced a significant inhibition of this acrosomal ATPase, whereas the activity in the acrosome-free spermatozoa increased. The activity of phospholipase A2, under all experimental conditions, was found to be restricted to the soluble fraction.

Receptor estrogénico y actividad semejante a tripsina en cáncer de mama / Strogenic receptor and activity like tripsine in breast cancer

Se estudiaron 126 carcinomas primarios de glándula mamaria. Se investigó la presencia de receptor estrogénico (RE) por medio del método de carbón cubierto con Dextrán y se determinó la actividad semejante a tripsina (AST) con el Método de espectrofluorometría. Las muestras grado de diferenciación II con RE+ fueron 76% y la media fue 218+-91fmoles/mg de proteina, en tanto que en los casos grado de diferenciación III el porcentaje de muestras RE+fué 60% con una media de 30+-6fmoles/mg de proteina

Screening for thermostability and electrophoretic red blood cell sorbitol dehydrogenase (E.C.1.1.1.14) variants.

A screening for both thermostability and electrophoretic red blood cell sorbitol dehydrogenase (RBC-SORD) variants in blood donors was performed. SORD activity in standard conditions (unheated samples) in 274 individuals was 198 +/- 38.6 mIU/g Hb. The ratio of enzymatic activity after heating (H) to the activity in controls (C) before heating (H/C ratio) was 0.39 +/- 0.10. H/C ratios minor than 0.1 in 3 out of 274 blood donors and higher than 0.9 in 1 were observed. In 208 individuals, four electrophoretic phenotypes were observed: I) Three bands, named a, b and c, with cathodic mobility in 163 individuals (78.36%); II) Two bands a and c in 25 individuals (12.02%); III) Two bands b and c in 14 (6.73%); and IV) One band, c in 6 (2.88%). Studies carried out to characterize the three bands suggest that they are isozymes of the same locus with the observation of an interchange of the bands as a normal phenomena.

Valor pronostico del patron de proteinas en el carcinoma de glandula mamaria. / Prognostic value of protein standard in mammary gland carcinoma

Se estudio el patron de proteinas con el metodo de electroforesis en gel de poliacrilamida en 24 adenocarcinomas y en 24 muestras de tejido mamario adyacente a las neoplasias.Se observaron diferencias importantes en los patrones proteinicos de ambos tipos de tejidos. Parece existir cierta correlacion entre algunos patrones de proteinas y la presencia de actividad tumoral temprana ulterior a la mastectomia

Electrophoretic pattern of proteins in mammary gland neoplasias.

Protein pattern was studied using discontinuous polyacrylamide gel electrophoresis in 53 adenocarcinomas, 13 fibroadenomas and 66 samples of mammary tissue adjacent to neoplasias. Important differences were found in patterns of both types of neoplasias, the same as between malignant tissues and non neoplastic adjacent tissues. There seems to be a certain correlation between some protein pattern and NOS and lobular histological types. It was also observed that some protein patterns were more frequent in neoplasias with metastasis to axillary nodes and vascular invasion. On the other hand, there seems to be important correlation between some protein patterns and the presence of early tumoral activity after mastectomy that is present even in the absence of positive axillary nodes at the moment of surgery.

Estrogen receptors in human breast cancer in Mexican patients.

ER positive (+), negative (-), percentages in 86 malignant neoplasias and 27 benign lesions of the mammary gland as well as in 24 mammary gland tissue samples obtained from neighbouring areas were 69, 52 and 0 per cent respectively. Similar values have been published in other western countries. No statistically significant differences were found when comparing ER + values obtained in malignant neoplasias with those from benign lesions, nor were there differences between values obtained in pre and post menopausal patients; in spite of this fact, when grouping patients in decades according to age, significant differences are observed in ER + values between the third and sixth decades of life as well as between the fourth and the sixth (p < 0.01 and p < 0.05 respectively). No significant variances were found in ER + percentages or in its values among the different histological types of malignant neoplasias; however the highest ER + percentage was found in the combination of scirrhous histological type and post menopause (95 per cent). Results were compared with those published by other authors.

PIP: 86 malignant neoplasias, 27 benign lesions, and 24 tissue samples from mammary glands were observed to determine the presence of positive or negative estrogen receptors. Percentages found, 69%, 52%, and 0% respectively, were comparable to values in other published studies. There were no differences in values in pre- and postmenopausal patients, or when comparing positive values in malignant neoplasia with values in benign lesions. However, significant differences were observed in positive values between patients in the 3rd. and 4th. decades of life, and also between the 4th. and the 6th decades. The highest positive estrogen receptor percentage was found in postmenopausal patients with scirrhous histological type of malignant neoplasia. The article includes a review of the published literature on the subject.