Cáncer de vesícula en colecistectomías de la región de Tarapacá. Análisis según pertenencia étnica / Prevalence of gallbladder cancer in a Northern Chilean region

BACKGROUND: Gallbladder Cancer (GBC) prevalence varies among countries, associated with different geographical and genetic factors. The Mapuche ethnicity (Ethnia mostly located between the VIII and X Chilean regions) stands out in Chile due to its high GBC prevalence. Aim: To estimate the GBC prevalence in patients undergoing cholecystectomy at a public hospital in the Northern region of Chile (Tarapaca), where other ethnical groups are common. MATERIAL AND METHODS: Pathological reports of 3270 patients (72% women) who underwent cholecystectomy between January 2016 and December 2019 were revised. Subsequently, the accreditation of ethnic belonging for each patient to one of the ten native communities in Chile was requested to the National Corporation for Native Communities Development (CONADI). RESULTS: According to the analysis of pathological reports, the global GBC prevalence was 0.3 %. The prevalence in Aymaras was 0.4% and 0% in Mapuches. The distribution of ethnic origins among analyzed patients was Aymara in 14.3, Mapuche in 2.7%, Diaguita in 1.7%, Quechua in 1.3%, Atacameña in 0.2%, and Colla in 0.2%. No specific ethnic origin was found in 79% of patients. Conclusions: There was a low GBC prevalence rate in Northern Chile and among the Aymara population.

[Prevalence of gallbladder cancer in a Northern Chilean region]. / Cáncer de vesícula en colecistectomías de la región de Tarapacá. Análisis según pertenencia étnica.

BACKGROUND: Gallbladder Cancer (GBC) prevalence varies among countries, associated with different geographical and genetic factors. The Mapuche ethnicity (Ethnia mostly located between the VIII and X Chilean regions) stands out in Chile due to its high GBC prevalence. AIM: To estimate the GBC prevalence in patients undergoing cholecystectomy at a public hospital in the Northern region of Chile (Tarapaca), where other ethnical groups are common. MATERIAL AND METHODS: Pathological reports of 3270 patients (72% women) who underwent cholecystectomy between January 2016 and December 2019 were revised. Subsequently, the accreditation of ethnic belonging for each patient to one of the ten native communities in Chile was requested to the National Corporation for Native Communities Development (CONADI). RESULTS: According to the analysis of pathological reports, the global GBC prevalence was 0.3 %. The prevalence in Aymaras was 0.4% and 0% in Mapuches. The distribution of ethnic origins among analyzed patients was Aymara in 14.3, Mapuche in 2.7%, Diaguita in 1.7%, Quechua in 1.3%, Atacameña in 0.2%, and Colla in 0.2%. No specific ethnic origin was found in 79% of patients. CONCLUSIONS: There was a low GBC prevalence rate in Northern Chile and among the Aymara population.

Prevalencia de colecistolitiasis y cáncer de vesícula en una población rural aymara de Chile

Background: The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups. Aim: To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals. Material and Methods: An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed. Results: Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported. Conclusions: There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.

[Prevalence of cholelithiasis and gallbladder cancer among Aymara individuals]. / Prevalencia de colecistolitiasis y cáncer de vesícula en una población rural aymara de Chile.

BACKGROUND: The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups. AIM: To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals. MATERIAL AND METHODS: An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed. RESULTS: Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported. CONCLUSIONS: There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.

Inmovilización de un politraumatizado: técnica y material / No disponible

«El 43% de las lesiones medulares en España se producenpor accidentes de tráfico (1).» Ante este titular deprensa, nosotros como sanitarios lo que pensamos en primerlugar es cómo ayudar en la prevención de estos, peroademás hemos de analizar y mejorar lainmovilización/movilización de pacientes politraumatizados/polifracturados.Como objetivo general nos planteamos poner en conocimientode los profesionales de la emergencia, además delos últimos anexos aparecidos al respecto en la prevenciónde lesiones medulares, la mejora en la calidad de nuestrotrabajo para disminuir ese porcentaje que se producen poruna mala praxis. Consideramos necesario una reducciónen las lesiones que ocurren después del accidente inicial,durante el transporte y que se estima están entre el 3-25 %.Como objetivos específicos decidimos plasmar de formadetallada, todos y cada uno de los sistemas existentes pararecogida y transporte adecuado de pacientes, tanto adultoscomo pediátricos en la emergencia extrahospitalaria. Porqué no dar a conocer las últimas estadísticas existentes enlesión medular o los casos nuevos que aparecen cada año olas diferentes zonas de la columna que en mayor medida seven afectadas.Para finalizar recalcamos la importancia de una correctainmovilización/movilización para evitar y no agravarestas lesiones u otras que pudieran aparecer a posteriori.Tanto el material como las técnicas, en gran parte, son conocidas por los profesionales pero decidimos analizartodo esto desde otro prisma e incluir la parte de pediatría(AU)

«43% of spinal injuries occurring in Spain by trafficaccidents (1).» Faced with this headline news, we ashealth care what we think first is how to help preventthem, but we also analyze and improve the immobilization/mobilization patient-polytraumatized/ multiple trauma.As a general objective to us to inform professionals ofthe emergency, the latest addition to annexes in thisregard appeared in preventing spinal cord injuries, improvingthe quality of our work to reduce that percentage to beproduced by a malpractice.We consider necessary a reductionin injuries that occur after the initial accident, duringtransport and are estimated to be between 3-25%.As we reflect specific objectives in detail each of theexisting systems for proper collection and transport ofpatients, both adult and pediatric emergency extrahospital.Why not give the latest statistics released in spinal cordinjury and new cases appear every year or for differentareas of the spine most affected?In conclusion we stress the importance of proper immobilization/mobilization to prevent and not aggravate theinjury or that might appear later. Both the material andtechniques, mainly, are known to professionals but wedecided to examine this from another perspective andinclude the part of pediatrics(AU)

Suprasellar chordoid glioma.

Brat et al. (J Neuropathol Exp Neurol 57:288-290, 1998) reported eight cases of a new clinico-pathological entity, which occurs mainly in the third ventricle of middle-aged females, which they described as chordoid glioma of the third ventricle. We report a new case of a 41-year-old woman with a suprasellar chordoid glioma with histological, immunohistochemical and ultrastructural studies. We discuss the differential diagnosis between chordoma, chordoid meningioma, germinoma and pituitary adenoma. Histologically, the tumour showed cords and lobules of isomorphic epithelioid cells in a vacuolated matrix with prominent multifocal lymphoplasmacytic infiltrates in which some histiocytes and isolated Touton-type giant cells were seen; cells were immunoreactive for glial fibrillary acidic protein but negative for epithelial membrane antigen. Ultrastructural examination revealed abundant intermediate filament but no desmosomes, microvilli nor cilia were seen.

Fatal familial insomnia: clinical, neuropathological, and genetic description of a Spanish family.

The clinical presentation and evolution, neuropathological findings, and genotyping of three members of a Spanish family affected with fatal familial insomnia are reported. The mother and two of her offspring developed a rapidly evolving disease with insomnia and behavioural disorders as the initial symptoms and died between 5 and 10 months after the onset of the illness. Frontal brain biopsy in the mother disclosed only non-significant spongiosis, and full neuropathological examination of her offspring showed thalamic and olivary degeneration with isolated focal cortical spongiosis. Genetic examination could only be performed in the contemporary patients and both harboured the prion protein (PrP) 178Asn mutation and homozygous 129 Met/Met genotype.

Mapeo cerebral del electroencefalograma y los potenciales evacados visuales en pacientes con dislexia / Electroencephalogram with automatic analysis and visual evoked potentials in patients with dyslexia

Se dice que un niño tiene un trastorno del aprendizaje si su actuación es subnormal en una actividad específica que no puede ser atribuida a déficit intelectual o a limitaciones sensoriales, motoras, emocionales o motivacionales. El mejor ejemlo es el del niño con pobre aprendizaje del lenguaje de la lecto-escritura en relación a su edad. Esta alteración conocida como dislexia se hace estudios neurofisiológicos para tratar de establecer una relación en esta entidad. Se estudió esta anormalidad por electroencefalografía con una prueba de discriminación auditiva y potenciales evocadas visuales. Nuestros resultados mostraron una diferencia significativa en la potencia del alfa en la región parietotemporo-occipital izquierda (T3-T5-O1), entre el grupo control y el grupo de pacientes disléxicos. No se registraron cambios significativos en los potenciales evocados visuales

[Electroencephalographic alterations in patients with migraine with and without aura]. / Alteraciones electroencefalográficas en pacientes con migraña con y sin aura.

We studied 14 patients with migraine with aura (group 1) and 16 patients with migraine without aura (group 2), 92.8% had EEG alterations in ictal and 57% in the interictal phase in group 1. 37.5% had EEG alterations in ictal and 18.7% in the interictal phase in group 2. There was a statistical difference between the two groups and between both phases. We think that patients with EEG alterations during both phase, may have a lower ischemic threshold.

[Diagnostic imaging in Lemierre's+ syndrome]. / Diagnóstico por imagen en el síndrome de Lemierre.

BACKGROUND: The Lemierre syndrome is a septic picture with jugular thrombophlebitis and secondary septic embolisms usually produced by Fusobacterium necrophorum. In previous reports published in the literature, imaging techniques are seldom referred to report the presence of jugular thrombophlebitis. A case of the Lemierre syndrome is presented with the aim of calling attention to this process and its current diagnostic possibilities. METHODS: The case of a patient who was diagnosed of having a Lemierre syndrome with sepsis by Fusobacterium is presented, with radiologic pulmonary embolisms. The echo-Doppler exam showed the presence of internal jugular involvement in absence of signs and symptoms leading to suspicion. A review of 6 cases is also made with special attention being given to the data on jugular vein involvement. RESULTS: Only in 2 of the 6 patients reviewed were imaging techniques used on the internal jugular view (in one 2D echography and in the other computerized axial tomography) with the diagnosis being performed on the base of symptomatic and physical exam data in the remaining 4 cases. CONCLUSIONS: The Lemierre syndrome should be suspect in all patients with bacteremia by Fusobacterium and radiologic imaging of pulmonary embolism, even in the absence of signs and symptoms of oropharyngeal and jugular involvement. Modern imaging techniques, particularly echo-Doppler, may play an important diagnostic role.

[Spontaneous pneumothorax and Pneumocystis carinii pneumonia. Something more than a casual association?]. / Neumotórax espontáneo y neumonía por Pneumocystis carinii. Algo más que una asociación casual?

The association of spontaneous pneumothorax and Pneumocystis pneumonia is not frequent. The medical literature reports a ratio between 0 and 5.7%. In 18 patients admitted in our hospital, in the last two years, and diagnosed of AIDS and Pneumocystis pneumonia, we observed two cases of pneumothorax spontaneous. They represent the 11%. In one of them spontaneous pneumothorax was the first manifestation and in the other a complication of the illness. It was not possible to isolate an agent different from Pneumocystis carinii. Considering the lack of predisposition factors and the previous clinical history, we think that Pneumocystis carinii is by itself the agent responsible of this complication. In view of this possibility, spontaneous pneumothorax in a patient who belongs to an AIDS' risk group will alert the clinician to the possibility of infection with Pneumocystis carinii.

[Usefulness of drug holiday in patients with Parkinson's disease of more than 5 years of development]. / Utilidad de la terapia "holiday" en pacientes con enfermedad de Parkinson de más de 5 años de evolución.

We studied 15 patients with Parkinson's disease of 40 to 70 years of age; they had more than five years of evolution and of using levodopa. They had "on-off", "wearing-off" phenomena and dyskinesia. The duration of therapy suspension was seven days: they were evaluated daily in the seven days, and every month for six months. The Webster and the Hoehn and Yahr scales were used. Only two patients did not show significant improvement. Thirteen of fifteen patients showed a significant decrease in the Webster scale of up to 8 points. A p value of 0.005 was found at three months which was maintained until the sixth month with a p value of 0.0005; a decrease in this scale was present since the first month. There were no complications following therapy withdrawal. There was a decreased related to depression in most of them and also there was a levodopa dose decrease in seven of them.

[POEMS syndrome. Report of a case and review of the literature]. / Síndrome de POEMS. Reporte de un caso y revisión de la literatura.

A 47 years old male with POEMS syndrome is presented. His illness started seven months before admission. He was in poor general conditions and had malnutrition. He had cutaneous hyperpigmentation, skin changes, hepatomegaly, edema of the limbs, quadriplegia, myotatic reflexes abolished, hypotrophy of muscular masses and bilateral papilledema. Immunoglobulins IgA and IgM were abnormal. Bone scanning showed multiple lytic lesions. The study of bone marrow showed megaloblastic changes. Electromyography revealed severe neuropathy and biopsy from sural nerve showed severe demyelinization. At first, he showed improvement with steroids; nevertheless he died two months afterwards from possible bronchoaspiration. The autopsy revealed changes compatible with the clinical diagnosis and in addition an adenoma of the hypophysis. We emphasize the importance of POEMS syndrome in the differential diagnosis of polyneuropathies.