[Frequency of NAFLD in a group of patients with metabolic syndrome in Veracruz, Mexico]. / Frecuencia del hígado graso no alcohólico en un grupo de pacientes con sindrome metabólico estudiado en la ciudad de veracruz.

INTRODUCTION: Nonalcoholic fatty liver disease is a very common disease that is being described principally in obese, diabetic and hiperlipidemic patients without significant alcohol consumption (less than 28 ethanol Units per week). Nowadays it is considered as the hepatic manifestation of the metabolic syndrome. The frequency of Non Alcoholic Sreatohepatic (NASH) is 30 to 35% in general population, but it reaches to 70% in patients whose Body Mass Index (BMI) is above 30 kg/m2 as it occurs with diabetic patients. In Mexico there are only isolated reports about it's frequency, nearly 7.1% in general population and 18.5% in diabetic patients. OBJECTIVE: To know the frequency of the Nonalcoholic fatty liver disease in patients who receive medical attention at the city of Veracruz. MATERIAL AND METHODS: We studied 337 patients, who were divided into 4 groups: Normal Weight, Overweight, Obese and Diabetes type 2 patients. The individuals who reported previous hepatitis and alcohol consumption were excluded. All patients made a test in order to determinate: age, gender, presence of hepatic stigmata and complaints. Laboratory tests were done to all patients including: Blood glucose, seric lipids, transaminases, proteins and alkaline phosphatase. In those cases with impairment in transaminases results, it was done upper abdominal ultrasound (USG) and hepatic biopsy, in patients who accepted. RESULTS: We identified 53 cases (15.72%) with characteristics of Nonalcoholic fatty liver disease. The frequency in patient with normal weight and overweight was 7.14% to 7.76%, while in obese subjects it was 14.15% and 28% in diabetic patients; 73.58% of all patients were female and the other 28.41% were males. The average age of the group was 48.11 years, it was similar the specific age of the normal weight and obese patients, in overweight patients was 61.5 years and the average age in diabetics was 56.42 years. There were significant differences in the results of blood glucose level, glycosilated hemoglobin, cholesterol, seric lipid values and aminotransferases in obese and diabetic patients compared with normal subjects and overweight patients in our study, the USG did not show sensibility and specificity to detect Non alcoholic fatty liver disease (NAFLD). DISCUSSION: The results of this study show a lower frequency compared with the rest of the world, however it was higher in diabetic population than the frequency published by Bernal in Hidalgo, Mexico. The aminotransferases level resulted elevated in all patients with metabolic syndrome and NAFLD so we consider that elevated aminotransferases levels is the best predictor to suspect the presence of NAFLD. That is why it's very important to consider the possibility to avoid the progression to cirrhosis and hepatocarcinoma.

Cefixima para quimioprofilaxis antimeningocócica / Cefixime for antimeningococcal chemoprophylaxis

En una escuela pública, ubicada en un sector de Antofagasta con alta incidencia de enfermedad meningocócica, se tomaron muestras de secreción faríngea a 216 niños de 5 a 14 años de edad. Se encontraron 18 portadores de N. meningitidis grupo B (8,3 por ciento). Con el propósito de probar la eficacia de la cefixima para erradicar a esta bacteria en portadores sanos se administró a ellos cefixima en suspensión, 8 mgùkg de pesoùdía en una dosis diaria durante dos días. En 13/18 casos (72,2 por ciento) no se registraron reacciones adversas, los demás sufrieron reacciones leves que cedieron espontáneamente. Ningún cultivo faríngeo dio resultados positivos a los 7, 14 y 90 días después del tratamiento. A pesar de las limitaciones de nuestro estudio, la cefixima pudiese ser opción de alternativa eficaz para la quimioprofilaxis meningocócica

Pronóstico en niños con enfermedad meningocócica / Prognosis in children with meningoccocal disease

Entre el 1 de enero de 1987 y el 31 de diciembre de 1992 en forma retrospectiva y prospectivamente desde el 1 de enero de 1993 al 31 de julio de 1994, se reunieron antecedentes clínicos y de laboratorio de 67 niños que sufrieron enfermedad meningocócica en Antofagasta, con el propósito de probar el sistema de calificación de Stiehm y Damrosch y otros factores como predictores de la evolución de la enfermedad. Cada factor (púrpura de menos de 12 horas de evolución previo al ingreso; choque; ausencia de meningitis; menos de 10 000 glóbulos blancos por mm3 de sangre; VHS igual o menor a 1o mmHg, mostró asociación con mayor riesgo de fallecer y también el purpura fulminans y el compromiso de conciencia. La letalidad de la enfermedad fue mayor a 75 por ciento en los pacientes con tres o más de los cinco factores de riesgo del criterio de Stiehm y Damrosch. Se requieren estudios prospectivos y de análisis multivariados más completos para definir mejor las interrelaciones de los factores estudiados individualmente

A distinct dysmorphic syndrome with congenital glaucoma and probable autosomal recessive inheritance.

Three sisters with congenital glaucoma, peculiar facies and mild skeletal anomalies are described. It is concluded that such an aggregate of anomalies probably corresponds to a 'new' autosomal recessive syndrome.

Guadalajara camptodactyly syndrome. A distinct probably autosomal recessive disorder.

Two sisters, aged 18 and 11 years, were found to have an intrauterine growth retardation-malformation syndrome which included camptodactyly as a typical sign. The overall analysis of the clinical and radiological findings permitted the individualization of a distinct entity. The family data suggested autosomal recessive inheritance.