[Value of scintigraphy with 99mTc-MIBI in the diagnosis and follow-up of Hodgkin's and non-Hodgkin's lymphomas]. / Valor de la gammagrafía con 99mTc-MIBI en el diagnóstico y seguimiento de los linfomas Hodgkin y no Hodgkin.

UNLABELLED: This work aimed to assess the utility of 99mTc-MIBI scintigraphy in the diagnosis and follow-up of lymphoma patients. Seventy-two patients with a previous diagnosis of lymphoma (41 with Hodgkin's and 31 with non-Hodgkin's disease) and a control group of 8 patients with palpable lymph nodes and a negative diagnosis of lymphoma based on the clinical examination, chest x-ray, lymphography, ultrasounds and biopsy were studied. Whole body scintigraphies were performed 20 min and 2 h after i.v. administration of 740 MBq of 99mTc-MIBI. The joint result of the already mentioned standard diagnostic tests was considered as the confirmation criterion. A sensitivity, specificity and accuracy of 96,2%, 100% and 97,4% respectively were obtained. Kappa coefficient was k = 0,94 +/- 0,11. CONCLUSION: Scintigraphy with 99mTc-MIBI is a useful tool for the diagnosis and follow-up of lymphomas regardless of their classification.

Valor de la gammagrafía con 99mTc-MIBI en el diagnóstico y seguimiento de los linfomas Hodgkin y no Hodgkin / Value of the scintigraphy with 99mTc-MIBI in the diagnosis and follow-up of Hodgkin's and Non-Hodgkin's lymphomas

El objetivo del presente trabajo fue evaluar la utilidad de la gammagrafía con 99mTc-metoxi-isobutil-isonitrilo (MIBI) en el diagnóstico y seguimiento de pacientes que padecen de linfoma. Se estudiaron 72 pacientes con diagnóstico de linfoma (41 Hodgkin y 31 no Hodgkin) y un grupo control de 8 pacientes con ganglios palpables y diagnóstico negativo de linfoma producto de la evaluación clínica, radiografía de tórax, linfografía, ultrasonido y la biopsia. Se realizaron rastreos gammagráficos 20 min y 2 h después de la administración i.v. de 740 MBq de 99mTc-MIBI. El resultado conjunto de los instrumentos diagnósticos antes señalados se tomó como criterio de confirmación. Se obtuvo una sensibilidad, especificidad y exactitud de 96,2 per cent, 100 per cent y 97,4 per cent respectivamente. El coeficiente Kappa fue de 0,94 ñ 0,11. Conclusión: La gammagrafía con 99mTc-MIBI es útil para el diagnóstico y seguimiento de los linfomas, independientemente de su clasificación (AU)

Double-blind comparison of fluoxetine versus clomipramine in the treatment of obsessive compulsive disorder.

There is evidence of the clinical efficacy and safety of clomipramine and the newer selective serotonin reuptake inhibitors (SSRIs) for the treatment of obsessive-compulsive disorder (OCD). In the present study, we have compared the efficacy and safety of 40 mg/day of fluoxetine and 150 mg/day of clomipramine in patients with OCD, diagnosed according to DSM-IIIR. A total of 55 patients entered this 8-week, double-blind controlled study. Efficacy for both drugs was comparable. The primary efficacy criterion, the Y-BOCS Total score, did not show any significant differences between treatment arms. Response rate was higher with clomipramine, using a 25% decrease in Y-BOCS Total score as response threshold, but there were no significant differences between treatment arms using a 35% threshold. Overall safety and tolerability were good for both drugs, being slightly better for fluoxetine.

[Dysmorphophobia: past and present of a centuries-old disorders]. / Dismorfofobia: pasado y presente de un trastorno centenario.

Dysmorphophobia is a very interesting psychiatric syndrome that remains controversial, despite it being described more than a century ago. Current knowledge allow us to think of it as a clinical entity in itself, but its relationship with affective disorders and obsessive-compulsive disorder remain unclear. Delusional and non-delusional dysmorphophobia might be two separate disorders or, more likely, variants of the same disorder. Several therapeutic approaches have shown efficacy in the treatment of this condition, like pimozide, serotonergic antidepressants and cognitive-behaviour therapy, but well controlled clinical trials are lacking. It has still to be determined to what extent all this findings about dysmorphophobia in clinical samples do apply to people with body image disorders in the general population.

First record of Angiostrongylus cantonensis (Chen, 1935) (Nematoda: Metastrongylidae) in the Dominican Republic.

Rats, Rattus norvegicus, trapped in some sections (barrios) of the city of Santo Domingo, the capital of the Dominican Republic showed that 5 of them from two barrios harbored the nematode Angiostrongylus cantonensis in the pulmonary artery. Macerated and digested terrestrial snails, Subulina octona, collected from the backyards of houses where the rats were trapped contained L2 and L3 larvae of the nematode. The morphology of the adult worms and the larvae was consistent with that described for A. cantonensis in the literature. This is the first report of this Oriental and Western Pacific nematode in the Dominican Republic and the fourth in the Americas. Gastrointestinal hemorrhage, a rare symptom due to another species, the American A. costaricensis, which occurs in mesenteric arterioles of rodents and humans, is in the recent literature; the patient was a 41-year old Dominican. Thus the Dominican Republic is the first country in the Western Hemisphere to have the two species of Angiostrongylus.

Displacement of Biomphalaria glabrata by Thiara granifera under natural conditions in the Dominican Republic.

After a study of the population dynamics of Biomphalaria glabrata snails in several breeding places in the Dominican Republic, the snail Thiara granifera was introduced in some B. glabrata habitats. T. granifera became established in one point in one habitat in the town of Quisqueya, in the east of the country. Around this point of establishment 6 points were selected in order to observe the population dynamics of both species of snails and the chemical and biological characteristics at each point. Four of these points already harbored B. glabrata. One control point was selected also harboring B. glabrata. After 14 months of observations, the results showed that T. granifera was competing with and displacing B. glabrata. This competition does not seem to be competition for food or vital space. Rather, B. glabrata avoids the presence of T. granifera and moves away to new areas, and this is possibly due to a chemical substance(s) secreted by T. granifera or by physical contact with the large number of individuals of T. granifera.

Enfermedad Arteriosclerótica y sus complicaciones relacionadas con la mortalidad por cáncer: estudio necrópsico de diez años

Se realiza el estudio de 615 necropsias por cáncer desde el año 1975 hasta 1984 y se comparan con 4 457 necropsias en muertes de causa general. La arteriosclerosis fue más frecuente en las edades de 65 a 79 años y estuvo presente en el 34,9 porciento de los cancerosos y en el 22,6 porciento de los controles (p<0,05). El Tromboembolismo pulmonar representó el 2,3 porciento de los pacientes seguidos del infarto pulmonar y cerebral(1,5 porciento) y fue menor que en los controles (p<0,05). Se ha de notar que para el cáncer laríngeo y esofágico la arteriosclerosís, infartos o tromboembolismo. Los tumores más asociados a la arteriosclerosis fueron los de pulmón, hígado y recto sigmoides, por encima del valor promedio (36,4 porciento). (AU)

El habito de fumar y el alcoholismo como factores de riesgo en el cáncer de labio

Se estudian 32 pacientes con cáncer de labios, en el trienio 1984-1986. El tabaquismo se asoció en el 87,5 porciento de los casos y el alcoholismo en el 21,8 porciento coincidiendo ambos hábitos en el 25 porciento de los pacientes. La diferencia con respecto al grupo control según el hábito de fumar fue significativa (t>1,96) y fumaron más hombres que las mujeres. La localización superior o inferior del tumor no se relacionó con el alcoholismo y sí con el hábito de fumar. No hubo influencia en la diferenciación celular del tumor con relación a ambos métodos. (AU)

Schistosomiasis mansoni in the Dominican Republic; prevalence and intensity in the city of Higuey by coprological and serological methods.

The prevalence and intensity of infection with Schistosoma mansoni were determined in a sample of the population of the city of Higuey, Dominican Republic. The quantitative formol-ether stool sedimentation technique of Ritchie, as modified by Knight et al., was performed on stools from 1,025 (65.5%) of 1,563 individuals greater than 1 year old. The highest prevalence rates (21.4%) were observed in women 25-29 years old and in men 15-19 years old (20%). The maximum fecal egg count was in the 15- to 19-year age group, with a geometric mean of 30 eggs/g feces among men and 15.8 eggs/g feces in men and women. The overall prevalence of S. mansoni-infection was 11.8% with a geometric mean excretion of 8.8 eggs/g feces. In addition, the circumoval precipitin test was carried out on 639 sera and 110 (17.2%) were positive, increasing the prevalence in all age groups. Examination of Biomphalaria glabrata snails collected in early 1986 showed 7.8% to be positive for S. mansoni cercariae. Despite the moderate prevalence rates and the low intensity of infection among the human population, we consider Higuey to be an important focus of schistosomiasis in the Dominican Republic. The sensitive coprological and serodiagnostic techniques we employed have helped to identify the age- and sex-specific groups most deserving of treatment in order to reduce transmission of infection and disease prevalence.