Síndrome de Bouveret. A propósito de un caso / A Bouveret syndrome. A case -report

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Estudio comparativo entre la herniorrafia inguinal clásica y la hernioplastia con malla de polipropileno / A comparative study of conventional inguinal hernia repair and hernioplasty with polypropylene mesh

Introducción. El objetivo de este trabajo es analizar y comparar en términos de morbilidad y recidiva la herniorrafia inguinal clásica frente a la herniorrafia inguinal con implante de malla de polipropileno. Pacientes y métodos. Se revisan un total de 356 hernias inguinales intervenidas entre enero de 1996 y enero de 1998, 251 reparadas mediante procedimientos clásicos y 105 mediante inclusión de malla de polipropileno según la técnica de Lichtenstein. Edad, sexo y antecedentes de riesgo tuvieron una distribución homogénea en ambos grupos, siendo el índice de hernias con recidiva previa superior en el grupo de hernioplastia (24,8 por ciento). Recibieron profilaxis antibiótica el 9 por ciento y sólo el 4,5 por ciento de las intervenciones tuvieron carácter de urgencia. El seguimiento medio fue de 23,8 meses (10-37 meses). Resultados. Presentaron morbilidad el 27 por ciento de los pacientes, siendo ésta superior en el grupo de hernioplastia, con valores significativos (p = 0,05). Se reconocieron dos intolerancias a la malla (1,9 por ciento). La tasa de recidivas global fue del 7,9 por ciento, siendo ésta del 8,8 por ciento para el grupo de herniorrafia y del 5,7 por ciento para el grupo de hernioplastia, no resultando estas diferencias significativas. La presencia de recidiva previa condicionó una mayor tasa de recidiva y morbilidad. Al comparar la tasa de recidivas sobre hernias primarias (un 7,9 por ciento de herniorrafia frente a un 1,3 por ciento de hernioplastia) se demuestran diferencias estadísticamente significativas (p = 0,037). Conclusiones. No hubo diferencias al comparar la estancia y el consumo de analgésicos en ambos grupos. La hernioplastia con colocación de malla se asocia estadísticamente a una menor tasa de recidivas cuando se comparan hernias primarias. Aunque la tasa de morbilidad es superior en el grupo de hernioplastia, debe valorarse el mayor índice de hernias con recidiva previa de este grupo (AU)

[The pediatrician and epidemiology]. / El pediatra y la epidemiología.

Pediatrics and epidemiology are two specialties of medicine with independent training. The pediatrician is trained in a clinical setting with practice and theoretical knowledge throughout several years in an accredited hospital, whereas the epidemiologist is trained in a more theoretical basis with field works as its practice. Nevertheless, the pediatrician constantly uses the epidemiological method although he or she may not be aware of this. The purpose of this paper is to explain in a very short way, the relationship between both disciplines. Aspects of descriptive, analytic and experimental epidemiology are given.

[Concepts of pharmacy employees concerning the management of diarrhea in children]. / Conceptos de empleados de farmacia acerca del manejo de la diarrea en niños.

The purpose of this study was to establish the concepts of the drugstore salesforce on the management of acute diarrhea in children. The study was carried out in Guatemala by means of a direct interview of 427 employees of an equal number of drugstores, that were representative of the total drugstores in the country. The results showed that one third of the employees only have grammar education or less, that they were young adults without training in medicine or drug therapy, and that it frequent that people ask for medication for diarrhea in children. For food during diarrhea, fat, milk, meat and beans were mentioned as bad foods, and starch gruels, vegetables and soups were mentioned as good food. From the total sample 82.4% stated that antibiotics are indicated always or almost always, 69.8% prescribe antidiarrheicals as caolin/pectine alone or in combination with antibiotics or sulfonamides, and 33.0% prescribe antibiotics, being ampicillin, chloramphenicol and cotrimoxazole the more common; 73.5% prescribe oral rehydration, but only 8.7% of drugstores have oral rehydration salts recommended by WHO/UNICEF. Based on these results it is recommended to establish a longitudinal program in order to train this group of people who are in primary care, on the management of acute diarrhea in children.

[Pulmonary function tests in asthmatic children in treatment with tulobuterol]. / Pruebas de función pulmonar en niños asmáticos en tratamiento con tulobuterol.

The objective of the present study was to evaluate the effectiveness and tolerance of a new beta-2 agonist, tulobuterol, in children. Fifteen patients with acute asthma were studied, during a period of 21 days. Significant increase in forced vital capacity (FVC), forced expiratory volume in the first second (FEV-1), and forced expiratory flow 25-75% (FEF 25-75%) were observed after treatment with tulobuterol (p less than 0.01). Clinical improvement was evident as measured by a clinical-scale and a functional scale. The only side effect attributable to the drug was a tremor which was observed in three patients.

[Concepts of health personnel in relation to the management of acute diarrhea]. / Conceptos del personal de salud acerca del manejo de la diarrea aguda.

With the objective of gaining more knowledge on the concepts of management of acute diarrhea in children from health personnel, a study was designed and carried out in two Central American countries. The sample was composed of pediatric residents, general practitioners, registered nurses and assistant nurses. A special form was designed and field workers were trained for this purpose. A total of 389 health personnel was interviewed. The results showed that there is a good knowledge on morbidity and mortality from diarrheal disease in children, less knowledge on the etiology of the disease and very little knowledge on the composition of oral rehydration solutions. Also there is no standard criterion on the use of drugs, being the general practitioners and nurses who have more wrong concepts. The factors most mentioned for non-acceptance of oral rehydration therapy (ORT) are little promotion of ORT, that the rehydration salts are not available in every place, that mothers do not accept ORT and that ORT seems a non-scientific therapy.