The Asociación Mexicana de Gastroenterología consensus on the diagnosis and treatment of acute pancreatitis in children and adolescents.

Acute pancreatitis (AP) and recurrent acute pancreatitis (RAP) are conditions, whose incidence is apparently on the rise. Despite the ever-increasing evidence regarding the management of AP in children and adults, therapeutic actions that could potentially affect having a poor prognosis in those patients, especially in the pediatric population, continue to be carried out. Therefore, the Asociación Mexicana de Gastroenterología convened a group of 24 expert pediatric gastroenterologists from different institutions and areas of Mexico, as well as 2 pediatric nutritionists and 2 specialists in pediatric surgery, to discuss different aspects of the epidemiology, diagnosis, and treatment of AP and RAP in the pediatric population. The aim of this document is to present the consensus results. Different AP topics were addressed by 6 working groups, each of which reviewed the information and formulated statements considered pertinent for each module, on themes involving recommendations and points of debate, concerning diagnostic or therapeutic approaches. All the statements were presented and discussed. They were then evaluated through a Delphi process, with electronic and anonymous voting, to determine the level of agreement on the statements. A total of 29 statements were formulated, all of which reached above 75% agreement in the first round of voting.

Consensus on the management of complications of cirrhosis of the liver in pediatrics.

The Asociación Mexicana de Hepatología A.C. carried out the Consensus on the Management of Complications of Cirrhosis of the Liver in Pediatrics to provide physicians with useful information for treating said complications. A group of pediatric gastroenterologists and experts in nutrition, nephrology, and infectious diseases participated and reviewed the medical literature. The Delphi method was applied to obtain the level of agreement on the statements that were formulated. The statements were sent to the participants to be analyzed and voted upon, after which they were discussed in virtual sessions, and the final versions were produced. The aim of the consensus results was to issue indications for the management of pediatric patients with liver cirrhosis, to prevent or control complications.

Poblaciones silvestres y domiciliadas de Triatoma Infestans en comunidades del municipio de Mecapaca próximas a la ciudad de La Paz / Wild and domiciled populations of Triatoma Infestans in communities of the municipality of Mecapaca next to the city of La Paz

OBJETIVO: determinar la presencia de Triatoma infestans y las características de sus poblaciones en algunas comunidades del Municipio de Mecapaca cercanas a la cuidad de La Paz. MÉTODOS: la búsqueda entomológica de Triatoma infestans con trampas cebo ratón en sitios silvestres y peridomiciliares o manuales dentro de domicilios, fue realizada en 11 zonas de 8 comunidades del Municipio de Mecapaca, determinando la altura sobre el nivel del mar y la ubicación geográfica de las mismas. Mediante claves dicotómicas según Lent y Wygodzinski se ha realizado la identificación morfológica de los especímenes capturados. Con la observación directa en microscopio óptico de las deyecciones de los especímenes y análisis molecular por PCR Multiplex se ha determinado la infección por Trypanosoma cruzi y las DTUs (Unidades Discretas de Tipificación). RESULTADOS: se encontraron sitios positivos para la presencia de T. infestan, siendo el Indice de Dispersión Entomológica de 50%. Del total de los especímenes capturados (N=103), 91 especímenes (88%) fueron individuos en fase ninfal y 12 individuos (12%) fueron adultos. Se caracterizó T. cruzi TcI y el índice tripano triatominico fue de 50% en individuos capturados en zona silvestre de Huayhuasi y de 16% en individuos capturados en zona peridomiciliar de Huajchilla distante solo a 20 km desde la ciudad de La Paz. CONCLUSIONES: los resultados han constatado presencia de poblaciones silvestres y domiciliadas de T. infestans en sitios silvestres y domiciliares de comunidades del Municipio de Mecapaca cercanas a la ciudad de La Paz. El hallazgo determinaría nuevos esquemas de distribución geográfica de poblaciones de T. infestans e infestación de hábitat humano.

OBJECTIVE: to determine the presence of Triatoma infestans and the characteristics of their populations in some communities of the Municipality of Mecapaca next to the city of La Paz. METHODS: The entomological search of Triatoma infestans with mouse bait traps in wild and peridomiciliary or manual sites within homes, was carried out in 11 areas of 8 communities of the Municipality of Mecapaca, determining the altitude above sea level and their geographical location. By means of dichotomous keys according to Lent and Wygodzinski, the morphological identification of the captured specimens has been carried out. With direct microscopic observation of specimen dejections and molecular analysis by Multiplex PCR, Trypanosoma cruzi infection and DTUs (Discrete Typification Units) have been determined. RESULTS: positive sites were found for the presence of T. infestan, with the Entomological Dispersion Index being 50%. Of the total of the specimens captured (N = 103), 91 specimens (88%) were individuals in the nymphal phase and 12 individuals (12%) were adults. T. cruzi TcI was characterized and the triatominic trypan index was 50% in individuals captured in the wild zone of Huayhuasi and 16% in individuals captured in the peridomiciliary area of Huajchilla, only 20 km away from the city of La Paz. CONCLUSIONS: the results have confirmed the presence of wild and domiciled populations of T. infestans in wild and domiciliary sites of communities of the Municipality of Mecapaca near the city of La Paz. The finding would determine new geographical distribution schemes of T. infestans populations and human habitat infestation.

Retinopatía vasoproliferativa secundaria a enfermedad de Waldenström / Vasoproliferative retinopathy secondary to Waldenström's disease

Paciente de 66 años en seguimiento por retinopatía diabética refractaria a múltiples modalidades de tratamiento a pesar del buen control metabólico que refiere pérdida de peso progresiva. Por este motivo se decide realizar un estudio sistémico, detectándose anemia, elevación de la velocidad de sedimentación globular e hiperproteinemia a expensas de un pico monoclonal de IgM. Posteriormente, mediante la biopsia de médula ósea y el estudio genético, se llega al diagnóstico de macroglobulinemia de Waldenström. La macroglobulinemia de Waldenström es una patología linfoproliferativa de escasa frecuencia cuya principal manifestación es a través del síndrome de hiperviscosidad. Este puede producir signos oftalmológicos detectables mediante funduscopia y pruebas de imagen. El estudio multimodal es útil en el diagnóstico y seguimiento de la afectación retiniana. La incorporación de la angiografía por tomografía de coherencia óptica permite un estudio más preciso de los trastornos microvasculares que se pueden presentar a nivel del polo posterior

A 66 year-old patient, monitored for diabetic retinopathy refractory to multiple treatment methods despite a good metabolic control, referred to progressive weight loss. For this reason, a systemic study was performed, detecting anaemia, elevation of the erythrocyte sedimentation rate, and hyperproteinaemia due to elevated serum levels of monoclonal IgM. Subsequently, by performing a bone marrow biopsy and genetic study, the diagnosis of Waldenström macroglobulinaemia was made. Waldenström's macroglobulinaemia is a low frequency lymphoproliferative disease, for which the main manifestation is a hyperviscosity syndrome that can produce ophthalmological signs detectable by funduscopy and imaging tests. A multimodal study is useful in the diagnosis and monitoring of retinal involvement. The incorporation of angiography by optical coherence tomography allows a more precise study of the microvascular disorders that may occur at the posterior pole level

Vasoproliferative retinopathy secondary to Waldenström's disease. / Retinopatía vasoproliferativa secundaria a enfermedad de Waldenström.

A 66 year-old patient, monitored for diabetic retinopathy refractory to multiple treatment methods despite a good metabolic control, referred to progressive weight loss. For this reason, a systemic study was performed, detecting anaemia, elevation of the erythrocyte sedimentation rate, and hyperproteinaemia due to elevated serum levels of monoclonal IgM. Subsequently, by performing a bone marrow biopsy and genetic study, the diagnosis of Waldenström macroglobulinaemia was made. Waldenström's macroglobulinaemia is a low frequency lymphoproliferative disease, for which the main manifestation is a hyperviscosity syndrome that can produce ophthalmological signs detectable by funduscopy and imaging tests. A multimodal study is useful in the diagnosis and monitoring of retinal involvement. The incorporation of angiography by optical coherence tomography allows a more precise study of the microvascular disorders that may occur at the posterior pole level.

TC-PTP regulates the IL-7 transcriptional response during murine early T cell development.

Cytokines play a critical role in directing the discrete and gradual transcriptional changes that define T cell development. The interleukin-7 receptor (IL-7R), via its activation of the JAK-STAT pathway, promotes gene programs that change dynamically as cells progress through T cell differentiation. The molecular mechanism(s) directing differential gene expression downstream of the IL-7R are not fully elucidated. Here, we have identified T cell protein tyrosine phosphatase (TC-PTP), also known as PTPN2, as a negative regulator of IL-7R-STAT signaling in T cell progenitors, contributing to both the quantitative and qualitative nature of STAT-gene targeting. Novel genetic strategies used to modulate TC-PTP expression demonstrate that depletion of TC-PTP expression heightens the phosphorylation of STAT family members, causing aberrant expression of an interferon-response gene profile. Such molecular re-programming results in deregulation of early development checkpoints culminating in inefficient differentiation of CD4+CD8+ double positive cells. TC-PTP is therefore shown to be required to safeguard the dynamic transcriptome necessary for efficient T cell differentiation.

The protein tyrosine phosphatase PRL-2 interacts with the magnesium transporter CNNM3 to promote oncogenesis.

The three PRL (phosphatases of regenerating liver) protein tyrosine phosphatases (PRL-1, -2 and -3) have been identified as key contributors to metastasis in several human cancers, yet the molecular basis of their pro-oncogenic property is unclear. Among the subfamily of PRL phosphatases, overexpression of PRL-2 in breast cancer cells has been shown to promote tumor growth by a mechanism that remains to be uncovered. Here we show that PRL-2 regulates intracellular magnesium levels by forming a functional heterodimer with the magnesium transporter CNNM3. We further reveal that CNNM3 is not a phosphorylated substrate of PRL-2, and that the interaction occurs through a loop unique to the CBS pair domains of CNNM3 that exists only in organisms having PRL orthologs. Supporting the role of PRL-2 in cellular magnesium transport is the observation that PRL-2 knockdown results in a substantial decrease of cellular magnesium influx. Furthermore, in PRL-2 knockout mice, serum magnesium levels were significantly elevated as compared with control animals, indicating a pivotal role for PRL-2 in regulating cellular magnesium homeostasis. Although the expression levels of CNNM3 remained unchanged after magnesium depletion of various cancer cell lines, the interaction between endogenous PRL-2 and CNNM3 was markedly increased. Importantly, xenograft tumor assays with CNNM3 and a mutant form that does not associate with PRL-2 confirm that CNNM3 is itself pro-oncogenic, and that the PRL-2/CNNM3 association is important for conferring transforming activities. This finding is further confirmed from data in human breast cancer tissues showing that CNNM3 levels correlate positively with both PRL-2 expression and the tumor proliferative index. In summary, we demonstrate that oncogenic PRL-2 controls tumor growth by modulating intracellular magnesium levels through binding with the CNNM3 magnesium transporter.

Ultrasound as predictor of histologic subtypes linked to recurrence in basal cell carcinoma of the skin.

BACKGROUND: Basal cell carcinoma (BCC) recurrences, especially in the facial region, represent a complex cosmetic problem. To date the possibility of predicting recurrence is supported solely by the histologic subtype. OBJECTIVE: To evaluate the relationship between BCC histologic subtypes linked to high and low risk of recurrence and the presence of hyperechoic spots on sonography. METHODS: Retrospective analysis of the pre-surgical ultrasound examinations of primary BCC tumours with visualization and counting of intra-tumoural hyperechoic spots. The data were then correlated with the corresponding histologic subtype. RESULTS: Thirty one patients with histologically proven BCC were included in the study. Hyperechoic spots were detected in all cases and there was a positive, statistically significant association between hyperechoic spots count and high recurrence risk histologic subtypes. Higher hyperechoic spots count was found in the recurrence-prone micronodular, sclerosing variant and morpheiform BCC subtypes. Low risk and high risk of recurrence showed a significant difference on the mean hyperechoic spots count of 5.5 (range: 3-25) and 8 (4-81). A cut-off point ≥7 hyperechoic spots presented a sensitivity of 79% and specificity of 53% for predicting the high risk of recurrence subtypes. CONCLUSION: The presence and count of hyperechoic spots within BCC lesions may help predicting the high risk of recurrence histologic subtypes.

Ictiosis congénita tipo laminar: reporte de un caso / Congenital lamellar ichthyosis: a case report

INTRODUCCIÓN: La ictiosis tipo laminar es una enfermedad dermatológica infrecuente perteneciente al grupo de las llamadas genodermatosis. Es una forma de ictiosis congénita que es evidente desde el nacimiento. PRESENTACIÓN DEL CASO: Recién nacido por cesárea, sexo masculino, de 36 semanas de gestación, adecuado para la edad gestacional y con APGAR 8. Antecedentes familiares: padres no consanguíneos y hermano con ictiosis tipo laminar. Luego de nacer es hospitalizado en la Unidad de Neonatología del Hospital de San Fernando, por presentar piel de aspecto rojo brillante, engrosada en cara y parte anterior de tronco con algunas fisuras en zona torácica, sin presencia de láminas de queratina, por lo que estableció el diagnóstico clínico de ictiosis tipo laminar. Se manejó con precauciones de contacto, analgesia, lubricación de la piel y suplementación con ácido retinoico. Evolucionó con descamación y aumento delas fisuras, las que posteriormente empezaron a disminuir quedando una membrana residual y con una adecuada hidratación de piel. Durante su estadía presentó alzas febriles intermitentes por lo que se realizó un hemocultivo que fue positivo a Staphylococcus aureus y cultivos de axilas, ombligo y zona inguinal que resultaron positivos para Enterococcus y Staphylococcus aureus, iniciando tratamiento con Vancomicina. Luego de 7 días de tratamiento, evolucionó favorablemente con disminución de sus lesiones dermatológicas por lo que se dio alta médica. DISCUSIÓN: El diagnóstico oportuno en base al cuadro clínico y manejo adecuado de este paciente ha permitido una adecuada evolución en ausencia de complicaciones.

INTRODUCTION: Lamellar Ichthyosis is a rare skin diseases belonging to the Group of the so-called genodermatoses. It is a form of congenital ichthyosis evident at birth. CASE REPORT: Male neonate, born at 36 weeks of gestation via cesarian section, appropriate for gestational age and Apgar Score 8. Nonconsanguineous parents. Affected brother with Ichthyosis lamellar. Is hospitalized in the Neonatal Intermediary Care Unit of the Hospital of San Fernando due to presence of Glossy red skin, thicker in face and fissures in the chest without collodion membrane. The patient was diagnosed with Lamellar Ichthyosis. Treatment was initiated with insolations precautions, pain relievers and lubrication of the skin, as well as retinoic acid supplementation. Progressed with cracked skin and scaling that subsequently improves leaving a residual membrane and an adequate skin hydration. During his stay, he also presented intermittent fever. Blood culture was positive for Staphylococcus aureus. Skin cultures of Armpits, navel and groin were positive for Enterococcusand Staphylococcus aureus, so treatment with vancomycin was started. After 7 days of antibiotic treatment and a favourable evolution with evident improvement of his skin lesions, the patient was discharged from hospital for outpatient management. DISCUSSION: Early diagnosis based on clinical presentation and an appropriate management of this patient, allowed an adequate evolution in the absence of complications.

Benzothiadiazole (BTH) induces resistance to Pepper golden mosaic virus (PepGMV) in pepper (Capsicum annuum L.).

Pepper is an economically important crop in many countries around the world but it is susceptible to many diseases. In Mexico, diseases caused by bipartite begomoviruses have emerged as important problems in pepper. Several control strategies have been explored wiht little success; most of them are based on the avoidance of virus transmission and the breeding for resistance. Abiotic inducers can act at various points in the signaling pathways involved in disease resistance, providing long-lasting, wide-spectrum resistance. Benzothiadiazole (BTH) shares the property of activating the systemic acquired resistance pathway downstream from the SA signaling. In this work, resistance to PepGMV infection was induced in pepper plants by activating the SA pathway using BTH treatment. The resistance was characterized by evaluating symptom appearance, virus accumulation and viral movement. Our results showed that BTH could be an attractive alternative to induce geminivirus resistance in pepper plants without a significant damage of the fruit quality and productivity.

Benzothiadiazole (BTH) induces resistance to Pepper golden mosaic virus (PepGMV) in pepper (Capsicum annuum L.)

Pepper is an economically important crop in many countries around the world but it is susceptible to many diseases. In Mexico, diseases caused by bipartite begomoviruses have emerged as important problems in pepper. Several control strategies have been explored wiht little success; most of them are based on the avoidance of virus transmission and the breeding for resistance. Abiotic inducers can act at various points in the signaling pathways involved in disease resistance, providing long-lasting, wide-spectrum resistance. Benzothiadiazole (BTH) shares the property of activating the systemic acquired resistance pathway downstream from the SA signaling. In this work, resistance to PepGMV infection was induced in pepper plants by activating the SA pathway using BTH treatment. The resistance was characterized by evaluating symptom appearance, virus accumulation and viral movement. Our results showed that BTH could be an attractive alternative to induce geminivirus resistance in pepper plants without a significant damage of the fruit quality and productivity.

Effect of an aqueous extract of Cucurbita ficifolia Bouché on the glutathione redox cycle in mice with STZ-induced diabetes.

ETHNOPHARMACOLOGICAL IMPORTANCE: Cucurbita ficifolia is used in Mexican traditional medicine as an anti-diabetic and anti-inflammatory agent and its actions can be mediated by antioxidant mechanisms. Disturbance in the homeostasis of glutathione has been implicated in the etiology and progression of diabetes mellitus and its complications. MATERIAL AND METHODS: It was evaluated, the effect of an aqueous extract of Cucurbita ficifolia on glycemia, plasma lipid peroxidation; as well as levels of reduced (GSH) and oxidized (GSSG) glutathione and activities of enzymes involved in glutathione redox cycle: glutathione peroxidase (GPx) and glutathione reductase (GR) in liver, pancreas, kidney and heart homogenates of streptozotocin-induced diabetic mice. RESULTS: Increased blood glucose and lipid peroxidation, together with decreased of GSH concentration, GSH/GSSG ratio and its redox potential (E(h)), and enhanced activity of GPx and GR in liver, pancreas and kidney were the salient features observed in diabetic mice. Administration of the aqueous extract of Cucurbita ficifolia to diabetic mice for 30 days, used at a dose of 200 mg/kg, resulted in a significant reduction in glycemia, polydipsia, hyperphagia and plasma lipid peroxidation. Moreover, GSH was increased in liver, pancreas and kidney, and GSSG was reduced in liver, pancreas and heart, therefore GSH/GSSG ratio and its E(h) were restored. Also, the activities involved in the glutathione cycle were decreased, reaching similar values to controls. CONCLUSIONS: An aqueous extract of Cucurbita ficifolia with hypoglycemic action, improve GSH redox state, increasing glutathione pool, GSH, GSH/GSSG ratio and its E(h), mechanism that can explain, at least in part, its antioxidant properties, supporting its use as an alternative treatment for the control of diabetes mellitus, and prevent the induction of complications by oxidative stress.

Síndrome convulsivo neonatal: enfoque diagnóstico a propósito de un caso de epilepsia focal sintomática / Neonatal seizure syndrome: diagnostic approach about a case of focal epilepsy symptomatic

INTRODUCCIÓN: Las convulsiones neonatales son una descarga hipersincrónica de un grupo neuronal cortical, cuya sintomatología puede ser motora, sensitiva, neurovegetativa o mixta. De etiología variable, deben ser pesquisadas y estudiadas desde un inicio. PRESENTACIÓN DEL CASO: Recién nacido de término, femenino, 38 semanas de gestación, nacido de parto eutócico con Apgar 9-9. Hijo de madre primigesta de 24 años, sin antecedentes mórbidos ni antecedentes durante el embarazo. Presenta dos cuadros cianóticos súbitos descartándose en ese momento hipoglicemia, hipocalemia o alguna infección. Se hospitaliza presentando una convulsión tónico-clónica manejada con fenobarbital dejando dosis de mantención. Persiste con convulsiones agregándose piridoxina al tratamiento. Luego de48 horas fue dado de alta para su manejo y control ambulatorio con fenobarbital y piridoxina vía oral en espera de evaluación de electroencefalograma. Eco tomografía cerebral normal. Perfil Neonatal Ampliado normal. Luego de una semana presenta nuevamente un cuadro convulsivo por lo que se re-hospitaliza. El primer electroencefalograma fue informado como normal, pero el segundo, cuatro días después, mostró presencia de lentitud continua centro-temporal izquierda asociada a un compromiso cortical focal corroborado por tomografía axial computarizada cerebral posterior, realizando el diagnóstico final de epilepsia focal sintomática. DISCUSIÓN: El abordaje de un cuadro de convulsión neonatal obliga en primera instancia a descartar etiologías potencialmente reversibles y que permitirían la resolución de cuadros convulsivos de forma basal. No siempre una convulsión neonatal corresponde a una causa común, llevando en algunas ocasiones a estudios más acabados y donde cuadros como la epilepsia aparecen como una opción importante de considerar.

INTRODUCTION: Neonatal seizures are a hypersynchronic depolarization of a finite set of cortical neurons. The symptoms that manifest are motor, sensory, autonomic, or mixed. The etiology must be studied from the beginning. CASE REPORT: Term newborn, female, 38 weeks gestation, born of vaginal delivery with Apgar score 9-9. Mother of 24 years, no history or background morbid during pregnancy. It presents two episodes of sudden cyanosis boxes discarded at the time of hypoglycemia, hypokalemia, or infection. She is hospitalized for study where he presented a tonic-clonic seizure that was treated with Phenobarbital, following a maintenance dose. Persists with convulsions adding pyridoxine to therapy. After 48 hours without convulsions was discharged for outpatient management with oral phenobarbital and pyridoxine. Electroencephalogram pending. Normal brain ultrasound. Profile Expanded Neonatal normal. After a week presents again seizure so she was hospitalized again. The first electroencephalogram was under normal parameters, but the second made four days later showed the presence of slow continuous center-left temporal cortex associated with focal involvement confirmed by computed tomography brain back, so the diagnosis is made symptomatic focal epilepsy. DISCUSSION: The approach of a neonatal seizure box forces us in the first instance to rule out potentially reversible etiologies and those that allow the resolution of convulsions at baseline. Not always a neonatal seizure corresponds to a common cause, leading sometimes to continue studies and where a epilepsy appears as an important option to consider.

Sonography in pathologies of scalp and hair.

Disorders of the scalp often result in severe cosmetic interference with quality of life, creating the need for optimal medical surveillance. We tested the latest generation of ultrasound machines in patients with scalp pathology and prepared a cross-sectional library encompassing a wide assortment of conditions. Normative data on the sonographic anatomy of scalp and human hair, and important methodological considerations, are also included.

Correlación entre los índices radiológicos preoperatorios y la pérdida ósea periprotésica determinada por densitometría ósea en artroplastia de cadera no cementada IAHULA 2007-2009 / Correlation between radiologic index and perioprostethic bone loss determined by bone densiometry in cementless total hip arthroplasty IAHULA 2007-2009

Se realizó un estudio observacional descriptivo en 43 caderas intervenidas por artroplastia total no cementada en el Hospital Universitario de Los Andes entre Enero de 2007 y Agosto de 2009, para determinar la correlación existente entre los índices corticodiafisario (ICD), corticometafisario (ICM) y la relación canal-cálcar (CC) preoperatorios con la pérdida ósea periprotésica evaluada mediante densitometría ósea (DEXA) postoperatoria en las zonas de Gruen. Se incluyó igualmente como variable interviniente el uso del ácido zoledrónico en dosis de 5 mg postoperatorios en 24 de los casos para determinar su asociación al aumento de la densidad mineral ósea periprotésica. Se obtuvo correlación entre el índice corticometafisario y la densidad mineral ósea en las zonas 1 y 7 de Gruen, y entre la relación canal-cálcar y la densidad mineral ósea en la zona 2 de Gruen. Por otra parte, el uso del ácido zoledrónico mostró aumento de la densidad mineral ósea en la zona 1 de Gruen.

This is a descriptive observational study of 43 hips which underwent uncemented total arthroplasty at Los Andes University Hospital since January 2007 to August 2009, to determinate correlation among preoperatory corticodiaphysary index (CDI), corticometaphysary index (CMI) and canal to calcar ratio (CCR) with periprosthetic bone loss evaluated through postoperatory bone densitometry (DEXA) in the seven Gruen´s zones. Use of postoperatory 5 mg of zoledronic acid in 24 cases was included as intervening variant to determinate its association with increase in periprosthetic bone mineral density. Correlation was obtained between corticometaphysary index and bone mineral density in Gruen´s zones 1 and 7, and canal to calcar ratio and bone mineral density in Gruen´s zone 2. Besides, it was show increased bone mineral density in Gruen´s zone 1, in patients who received zoledronic acid.

[Acute pancreatitis secondary to hypertriglyceridemia - a report of two cases]. / Pancreatitis aguda secundaria a hipertrigliceridemia: presentación de dos casos clínicos.

Acute pancreatitis is a reversible inflammatory process. Hypertriglyceridemia as a cause of acute pancreatitis reaches frequencies of 1.3-11% according to the literature when triglyceride levels reach values over 1,000 mg/dl; nevertheless hypertriglyceridemia is observed in 12-39% of acute pancreatitis cases as an associated factor. The objective of medical treatment is to increase lipoprotein-lipase activity, and to increase chylomicron breakdown thus diminishing serum triglycerides to levels smaller than 500 or even 200 mg/dl (when possible) using a variety of strategies including insulin administration. In the present article, we report two cases of severe pancreatitis induced by hypertriglyceridemia that were managed with insulin infusion; both responded adequately, as measured by a significant reduction of triglyceride levels at 48 hours post-treatment.

Multiple agenesis and anhidrotic ectodermal dysplasia: a comparative longitudinal study of dental similarities and genetic differences in two groups of children.

AIM: Dental anomalies in shape and number may be present isolated or associated with other manifestations. In anhidrotic ectodermal dysplasia they occur more frequently and severely. The authors examined a group of children with similar dental anomalies but no other ectodermal or extra-ectodermal signs. METHODS: This study makes a comparative evaluation of similarities and differences of dental anomalies between two groups: A anhidrotic ectodermal dysplasia and B similar dental finding but without extra- dental anomalies. RESULTS: In group A, the average number of agenesis in primary teeth was 3.5 (upper) and 5.33 (lower); in permanent teeth it was 5.4 and 5.8, respectively. In group B, the average was 1.62 (upper) and 0.25 (lower) in primary teeth, and 4.0 and 4.25 in permanent teeth respectively, with no constant pattern of occurrence. The study of tooth morphology of both groups revealed numerous anomalies in both dentitions. No differences were found in the average number of agenesis and morphological anomalies in the permanent teeth between both groups, but in the primary dentition group B presented a lower degree of incidence. CONCLUSION: The presence of almost normal primary dentition (regarding to number), but with morphological anomalies, should lead to suspect their exacerbation in the permanent dentition.

Enfermedad inflamatoria pelviana en adolescentes / Pelvic inflammatory disease in adolescents

Objetivo. Se realizó un estudio descriptivo transversal en el Hospital Materno Provincial de Camagüey, durante un período de 12 meses, con el fin de mostrar las consecuencias de la enfermedad inflamatoria pelviana en adolescentes, así como sus factores de riesgo. Material y método. Se escogió a 55 adolescentes que ingresaron en nuestro hospital con el diagnóstico de inflamación pélvica. Los parámetros estudiados incluyeron edad, primera relación sexual, método anticonceptivo, diagnóstico y tratamiento. Resultados. Se observó que el 54,5% tenía menos de 15 años y que en un 69,1% las primeras relaciones sexuales fueron antes de los 15 años; el 76,4% no usaba método anticonceptivo. Hay que señalar que, aunque el 87,3% de los casos se resolvió con tratamiento médico, en 3 pacientes fue necesario el tratamiento quirúrgico radical (AU)

Objective. A cross sectional descriptive study to determine the consequences and risk factors of pelvic inflammatory disease in adolescents was carried out over a 12-month period at the Hospital Materno Provincial in Camagüey (Cuba). Material and method. Fifty-five adolescents who were admitted to our hospital with a diagnosis of pelvic inflammatory disease were selected. The parameters studied included age, first sexual relationship, birth control method used, diagnosis, and treatment. Results. Of the group studied, age was less than 15 years in 54.5%. The first sexual relationship occurred before the age of 15 years in 69.1% and 76.4% used no contraception. Notably, pelvic inflammatory disease was resolved by medical treatment in 87.3%. Radical surgery was required in 3 patients (AU)

Morbimortalidad perinatal de la rotura prematura de membrana en el embarazo pretérmino / Perinatal morbidity and mortality in premature rupture of membranes in preterm pregnancy

Objetivo. Se realizó un estudio descriptivo y retrospectivo en el Hospital Ginecobstétrico Provincial de Camagüey Ana Betancourt de Mora, en el período de un año, para demostrar la morbimortalidad perinatal de la rotura prematura de membranas en embarazos pretérminos. Material y método. Se estudió a 52 gestantes que presentaron este accidente y concibieron en la fecha señalada. Se analizó varios parámetros como la edad de la madre, las enfermedades del embarazo, el lugar de ocurrencia, la duración de la rotura y la morbimortalidad perinatal. Resultados. Se halló que la anemia y la infección vaginal representaron las principales enfermedades asociadas. La neumonía neonatal y el trastorno de adaptación fueron las primeras causas de morbilidad en el neonato, las que guardaron estrecha relación con el período de latencia y el peso del recién nacido, y el 90,9% de los neonatos lograron sobrevivir. Conclusiones. Hay una alta incidencia de morbimortalidad perinatal asociada con la rotura prematura de membranas en el embarazo pretérmino, principalmente de índole infecciosa, siendo éste más probable mientras mayor sea el período de latencia (AU)

Objective. A retrospective and descriptive study was undertaken to determine the association between perinatal morbidity and mortality and premature rupture of membranes over a period of 1 year at the Ana Betancourt de Mora Gynecology and Obstetrics Provincial Hospital in Camagüey. Material and method. The study included 52 women who presented with premature rupture of membranes and delivered during this period. The parameters analyzed included the patient's age, pregnancy- related diseases, place of occurrence, duration of the rupture, and perinatal morbidity and mortality. Results. The main associated abnormalities were anemia and vaginal infection. The principal causes of morbidity in neonates were neonatal pneumonia and adaptation distress, which were closely associated with the latency period of membrane rupture and birth weight. A total of 90.9% of the neonates survived. Conclusions. There is a high incidence of perinatal morbidity and mortality associated with premature rupture of membranes en preterm pregnancies. This occurs mainly as a results of infections, which are more likely the longer (..) (AU)