Pseudoaneurisma Postraumático de Arteria Radial / Postraumatic pseudoaneurysm of the Radial Artery

Los aneurismas se clasifican en verdaderos o falsos (pseudoaneurismas) dependiendo del daño de la pared arterial. La mayoría de los aneurismas distales de la extremidad superior surgen de la arteria cubital. Las lesiones con origen en la arteria radial son poco comunes y casi siempre se deben a traumatismos penetrantes o lesiones iatrogénicas. La mayor parte se localizan a nivel distal, en la caravolar del antebrazo. La clínica de un pseudoaneurisma de arteria radial puede manifestarse horas después de la lesión o insidiosamente a los meses o años siendo a menudo mal diagnosticado. El diagnóstico y tratamiento se realiza por medios no invasivos en el momento actual, aunque de fallar estas opciones se puede recurrir a métodos invasivos, tanto en el diagnóstico (arteriografía) como en el tratamiento (cirugía), permitiendo lograr un resultado satisfactorio en ausencia de complicaciones isquémicas. Presentamos el caso de un varón de 25 años de edad que sufrió una herida penetrante en primera comisura de manoizquierda y que fue enviado 1 O días después de la lesión inicial, con una masa pulsátil a dicho nivel. Una vez realizado el diagnóstico, se intento la trombosis del mismo y tras fracasar esta opción se opto por la resección.Ocho meses después se encuentra sin recidiva (AU)

Aneurysms are classified as "true" or "false" (pseudoaneurysrns), depending upon the extent of arterial wall damage. Most distal upper extremity aneurysms arise from the ulnarartery. Rare lesions originating from the radial artery are almost always related either to penetrating trauma or to iatrogenic injury. Most of them are located on the volar aspect of the distal foreann. The clinical picture of a radial artery aneurysm may appear within hours following injury or insidiously over a period of months to years and frequently is misdiagnosed. Actually the diagnosis and treatment can be made by non­invasive methods, but in case of failure of these options, the invasive methods, as in diagnostic (arteriography) or in treatment (surgery), can be feasibles too, obtaining a satisfactory result in absent of ischemic complications. We report the case of a man 25 years old who presented a penetrating injury on the first web of the left hand and was sent 10 days after the original injury with a pulsatil mass at this level. After the diagnosis we tried to embolizate it without suc­ cess and then we had to remove it. Patient is in absent of recidiva eight rnonths later (AU)

Eficacia de la Linfadenectomía Ilio-Obturatriz en cirugía oncológica / Efficacy of Ilioobturator node dissection in oncologic surgery

La disección ilio-obturatriz ha sido utilizada como técnica electiva o terapeútica en cirugía oncológica. En un pequeño porcentaje de pacientes portadores de adenopatías en la cadena ilíaca, puede tener un fin curativo, si se aplican unas indicaciones muy selectivas basadas en los hallazgos clínicos, radiológicos e histopatológicos. Además, esta técnica proporciona un beneficio paliativo en el control de la recidiva ilíaca, al evitar la comprensión del uréter y de la vena ilíaca por el crecimiento de la adenopatía metastásica, sin aumentar significativamente la morbilidad con respecto a la linfadenectomía inguinal superficial. Otro de los beneficios de la linfadenectomía inguinal superficial. Otro de los beneficios de la linfadenectomía ilio-obturatriz es su ayuda al mejor estadiaje de la enfermedad con un fin pronóstico (AU)

Dissimilatory Fe(III) reduction by Clostridium beijerinckii isolated from freshwater sediment using Fe(III) maltol enrichment.

A microorganism which reduces Fe(III) during the fermentation of glucose was isolated from freshwater sediment. The Fe(III) was supplied to enrichment cultures as a soluble complex with the bidentate ligand maltol (3-hydroxy-2-methyl-4-pyrone). Advantages that were afforded by the use of Fe(III)(maltol)3 over previously published methods included negation of the requirement for assays of Fe(II) formation. Because Fe(III)(maltol)3 has a characteristic deep red colour, Fe(III) reduction could be quantified spectrophotometrically by monitoring the disappearance of the complex in liquid cultures. Furthermore, Fe(III) reduction on agar plates containing the complex was apparent by zones of decolourisation around the bacterial colonies. 16S rRNA gene sequencing indicated the isolate to be a strain of Clostridium beijerinckii. Growth experiments were performed on the isolate in batch cultures with varying concentrations of Fe(III) citrate and 50 mM glucose. Increasing the level of Fe(III) citrate present was found to alter the fermentation balance, with less acidic products being formed. The presence of Fe(III) led to increases in the growth rate and growth yield, which were both approximately doubled when the supply of the cation reached 25 mM. A NAD(P)H-dependent Fe(III) reductase activity was localised to the bacterial membrane and found not to be sensitive to respiratory inhibitors. Taken together, these data suggest that dissimilatory Fe(III) reduction by the isolate provides a means of utilising the cation as an electron sink, thus facilitating pyridine nucleotide to be recycled during fermentative metabolism.

[Continuous quality improvement in the control of the type2 diabetes in Navarra. GEDAPSNA study 1996]. / Mejora continua de la calidad en el control del diabético tipo 2 en Navarra. Estudio GEDAPSNA 1996.

Diabetes mellitus type 2 constitutes one of the principal public health problems today, representing an important burden on care and involving extremely high economic costs, both direct and indirect. To provide an adequate response from the different public health systems, the St. Vincent Declaration was drawn up containing certain recommendations on the protocol of care and the carrying out of controls of continuous quality improvement, since it is a chronic pathology that requires a proactive health policy, which prevents, and provides early detection of its complications. In the present work we set out the results of the first study carried out in Navarra on the indicators of quality in the care provided to diabetics in Primary Health care, carried out by the Study Group on Diabetes Mellitus in Primary Care (GEDAPSNA). The study was made of an aleatory sample of 496 patients, by means of gathering data about their clinical records for the year 1996. 12 process indicators and 12 indicators of intermediate and final results were used. The results detect some important deficiencies that require early intervention: lack of exploration and management of the lesions that make up so-called diabetic foot; low achievement of results in the control of arterial hypertension in this group of patients; and absence of exploration of the lesions of the fundus of the eye in more than 50% of type 2 diabetics.

Eccrine porocarcinoma. Report of nine cases.

BACKGROUND: Eccrine porocarcinoma is a rare malignancy of the eccrine sweat gland and usually has a long-standing growth on a lower extremity. OBJECTIVE: The aim of this review was to analyze clinical and histopathological findings of eccrine porocarcinoma. METHODS: We report nine cases of eccrine porocarcinoma that we have seen during last 10 years. RESULTS: Eccrine porocarcinoma affects elderly patients in both sexes and is usually found on the lower extremities, but in our review it is similar on the head. The mean size was 1.9 cm in our cases. Elective primary treatment was excision and we did not perform elective lymph node dissection. We have not found evidence of metastases in any of our cases.

[Reconstructive techniques in cutaneous defects of the nasal tip]. / Técnicas reconstructivas de los defectos cutáneos de la punta nasal.

Many techniques are used for repairing nasal tip defects. Our own guidelines are reviewed: Small defects often can be closed directly. Lesions of the nasal tip over 0.5 cm in diameter usually require a skin graft or flap. Postauricular, preauricular, and nasolabial full-thickness skin grafts may produce noticeable color or contour differences. The type of local skin flap used depends on defect size: Local rotation-transposition flaps or the nasalis myocutaneous sliding flap described by Rybka are used for defects 2 cm or less in diameter. Rieger and de Marchac frontonasal flaps are used for defects 2-3.5 cm in diameter. Forehead flaps are used for defects of 3.5 cm or more. We prefer Rybka's flap for nasal tip defects less of 2 cm because it has cosmetic advantages: incisions do not deform natural cutaneous crease lines and chronic edema and "dog ears" secondary to rotation-transposition pedicle flaps are avoided. For more extensive defects, we prefer frontonasal or forehead flaps.

[Ureteral endometriosis. Report of a case]. / Endometriosis ureteral. A propósito de un caso.

Presentation of one case of ureteral tumour with the patho-anatomical label of intrinsic multifocal endometriosis, who underwent surgical treatment. Endometriosis is a clinic-gynaecological problem affecting 10-20% of pre-menopausal women. The urinary tract compromise happens in 1-10% of women with endometriosis. In spite of being an uncommon pathology, early diagnosis is of great importance due to the large number of non-saveable kidneys that it causes (25-43%). In our opinion, in cases with established fibrosis we regard surgery as the choice therapy. A presentation is made of the clinical case, pathological anatomy, treatment and comments on the disease.

[Superficial cutaneous nevus lipomatosus of Hoffmann-Zurhelle. Report of a case]. / Nevus lipomatoso cutáneo superficial de Hoffmann-Zurhelle. A propósitde un caso.

Nevus lipomatosus cutaneous superficialis is a rare idiopathic abnormality characterized by ectopic adipose tissue in the dermis. We present a typical case, making reference to the main clinical characteristics, histological peculiarities, pathogenical hypothesis and treatment of this tumor.

[Calcification and contamination as complications in the use of double-J catheters: incidence and correlation]. / Calcificación y contaminación como complicaciones en el uso de catéteres ureterales doble-J: incidencia y correlación.

We present a series of cases of complex renal lithiasis, in which we carried out temporary internal urinary bypassing, prior to extracorporeal lithotripsy, by means of the retrograde insertion of a double-J urethral catheter, studying the time of stay, the presence or not of contamination in the catheter and its relationship with the calcifications found in them. We also carried out a metabolic-functional study of each patient, determining the urinary pH and the serum and urinary calcium, phosphorous and uric acid concentrations, and observing their possible influence on the above-mentioned complications. Of the 25 catheters studied, we observed calcification in 11 cases (44%). In these we observed urealytic germs (Proteus and Pseudomonas), without finding modifications of urinary pH. We observed no relationship between the calcium deposits and serum and urinary calcium, phosphorous and uric acid concentration.

Immobilization of enzymes on alumina by means of pyridoxal 5'-phosphate.

A number of proteases have been immobilized on alumina in a two-step procedure: the first step converted them into semisynthetic phosphoproteins which, in the second step, spontaneously bonded to alumina through their phosphate function. The immobilized enzymes thus obtained showed the physical properties typical of the inorganic carrier and a high activity on low molecular weight substrates.

Incidence of group A and atypical rotaviruses in Brazilian pig herds.

The incidence of rotaviruses as a gastroenteritis causal agent in piglets was studied in 19 pig herds of Sao Paulo State, Brazil, during 1985. From 302 diarrhoea samples collected during January (summer), 65 were positive for rotavirus when analysed by enzyme-linked immunosorbent assay (ELISA) and polyacrylamide gel electrophoresis (PAGE). Sixty-two of these samples belonged to the classical group A rotavirus, three to atypical rotaviruses (ELISA negative and probably group B) and one elicited a mixed electropherotype of group A and atypical rotavirus and was ELISA positive. Atypical viruses appear to be very fragile and were rapidly degraded upon storage of samples at -20 degrees C. Three herds where atypical rotaviruses were present in January were sampled again in August (winter). Nine atypical isolates out of a total 21 positive samples (assayed by electron microscopy and PAGE) were detected again in two of them.