[The Herbst triad: finger clubbing, hypoproteinemia and iron deficiency anemia associated with gastroesophageal reflux]. / Tríada de Herbst: acropaquías, hipoproteinemia y anemia ferropénica, asociadas a reflujo gastroesofágico.

Gastroesophageal reflux with hiatal hernia has been associated with unusual presentations, including rumination syndrome, Sandifer syndrome (reflux esophagitis, iron deficiency anemia and head cocking) and the Herbst triad (iron deficiency anemia, hypoproteinemia and finger clubbing). We report a new case of this rare disease. Lack of awareness of gastroesophageal reflux as a possible cause of these striking symptoms could lead to complications and delayed surgery.

Molluscum contagiosum genital / Genital molluscum contagiosum

El molluscum contagiosum genital es una infección viral que se está incrementando en jóvenes sexualmente activos. El ginecólogo debe de conocer sus características y los tratamientos que se aplican sobre las lesiones, que en general son efectivos, seguros, indoloros y convenientes para la tranquilidad de los pacientes y sus parejas (AU)

Genital molluscum contagiosum is a viral infection that is becoming increasingly frequent in sexually active young adults. Gynecologists should be familiar with the clinical features of this disease and its treatment. The available treatments are generally safe, effective, painless and easy to administer in patients and their partners (AU)

Megavejiga en el primer trimestre de embarazo. Resolución espontánea / Megacystis in the first trimester of pregnancy. Spontaneous resolution

El empleo de la ecografía al inicio del embarazo permite el diagnóstico precoz de anomalías. Con la incorporación rutinaria de la ecografía diagnóstica entre las 10-14 semanas de embarazo, la detección de megavejiga en el primer trimestre ha aumentado. Su hallazgo es punto de partida para investigar su causa y la posibilidad de tratamiento intrauterino. El valor del tratamiento intrauterino es incierto y se necesitarán nuevos estudios para establecerlo (AU)

The increasing use of ultrasonography in pregnancy has allowed the early diagnosis of fetal anomalies. The incorporation of a routine 10-14 week ultrasound scan into prenatal care has increased the early detection of megacystis. The finding of a distended bladder will prompt a series of investigations to establish the etiology and the possibility of in utero treatment. The value of in utero treatment is currently uncertain and long-term randomized studies are required to establish its utility (AU)

Herpes zoster en la infancia y adolescencia / Herpes zoster in children and adolescents

El Herpes zoster (HZ) es la consecuencia clínicade la reactivación demorada del virus varicela-zoster(VVZ). La enfermedad es propia del adulto pero loscasos pediátricos no son infrecuentes. Afecta, principalmente,a niños inmunodeprimidos y a lactantespor reactivación del virus latente adquirido transplacentariamentedurante la vida intrauterina (varicelade la gestante). Rara vez sucede en niños normales.Su incidencia es mayor en niños que han padecidola infección varicelosa normal que en aquellosotros que han sido inmunizados activamente. Dadoque la vacunación contra la varicela se está extendiendorápidamente, el zoster podría llegar a seruna curiosidad en la infancia.La alteración de la inmunidad celular e inespecífica(células natural killer) parece jugar un papelesencial en su desarrollo. En el niño la enfermedadsuele ser benigna y el tratamiento se limita a medidasconservadoras. En los niños inmunodeficientesla infección puede ser severa requiriendo la administraciónintravenosa de antivirales de los que elaciclovir es el de elección

Herpes zoster (HZ) is the clinical consequence oflate reactivation of the varicella zoster virus (VZV). Itinfects mainly the elderly but pediatric cases are notuncommon. It occurs mostly in immunocompromisedchildren or in infancy after reactivation of latent VZVinfection acquired transplacentally during intrauterinelife. Rarely, HZ occurs in otherwise normal children.The incidence of HZ in children is higher afternatural varicella infection than after varicella vaccination.As the childhood population becomes increasinglyimmunized, zoster in children should becomea medical curiosity. The impairment of cellular andnon specific immunity (natural killer cells) appears tohave a particular role in the occurrence of HZ. Zosterin children typically runs a benign, mild course.Treatment of the usual form comprises antisepticmeasures and relief of pruritus. In immunocompromisedchildren, the infection is generally severe,thus requiring specific intravenous antiviral therapywith antiviral drugs without delay. Acyclovir is a firstlineagent

Herpes zoster en la infancia y adolescencia / Herpes zoster in children and adolescents

El Herpes zoster (HZ) es la consecuencia clínicade la reactivación demorada del virus varicela-zoster(VVZ). La enfermedad es propia del adulto pero loscasos pediátricos no son infrecuentes. Afecta, principalmente,a niños inmunodeprimidos y a lactantespor reactivación del virus latente adquirido transplacentariamentedurante la vida intrauterina (varicelade la gestante). Rara vez sucede en niños normales.Su incidencia es mayor en niños que han padecidola infección varicelosa normal que en aquellosotros que han sido inmunizados activamente. Dadoque la vacunación contra la varicela se está extendiendorápidamente, el zoster podría llegar a seruna curiosidad en la infancia.La alteración de la inmunidad celular e inespecífica(células natural killer) parece jugar un papelesencial en su desarrollo. En el niño la enfermedadsuele ser benigna y el tratamiento se limita a medidasconservadoras. En los niños inmunodeficientesla infección puede ser severa requiriendo la administraciónintravenosa de antivirales de los que elaciclovir es el de elección

Herpes zoster (HZ) is the clinical consequence oflate reactivation of the varicella zoster virus (VZV). Itinfects mainly the elderly but pediatric cases are notuncommon. It occurs mostly in immunocompromisedchildren or in infancy after reactivation of latent VZVinfection acquired transplacentally during intrauterinelife. Rarely, HZ occurs in otherwise normal children.The incidence of HZ in children is higher afternatural varicella infection than after varicella vaccination.As the childhood population becomes increasinglyimmunized, zoster in children should becomea medical curiosity. The impairment of cellular andnon specific immunity (natural killer cells) appears tohave a particular role in the occurrence of HZ. Zosterin children typically runs a benign, mild course.Treatment of the usual form comprises antisepticmeasures and relief of pruritus. In immunocompromisedchildren, the infection is generally severe,thus requiring specific intravenous antiviral therapywith antiviral drugs without delay. Acyclovir is a firstlineagent

Fascitis necrosante tras histerectomía / Necrotizing fasciitis after hysterectomy

Las infecciones de tejidos blandos son un grupo de infecciones con alta letalidad. Dentro de ellas la fascitis necrosante es una infección rara y rápidamente progresiva con extensa necrosis del tejido subcutáneo y la fascia que se acompaña de una alta toxicidad sistémica. La piedra angular del tratamiento es un diagnóstico y tratamiento rápidos. Por desgracia, un retraso en el diagnóstico o en el tratamiento puede resultar mortal

Necrotizing soft tissue infections represent a highly lethal group of infections. Necrotizing fasciitis is a rare, rapidly progressive infection with extensive necrosis of subcutaneous tissue and fascia, usually accompanied by severe systemic toxicity. The cornerstone of treatment is early diagnosis and treatment. Unfortunately, a delay in accurate diagnosis or definitive treatment may prove fatal

Prolapso de uretra / Urethral prolapse

El prolapso uretral en la mujer es infrecuente. Se define como la completa eversión de la mucosa uretral a través del meato. Ocurre frecuentemente en mujeres negras prepúperes y en mujeres blancas posmenopáusicas. El tratamiento recomendado incluye desde la terapia conservadora hasta múltiples intervenciones quirúrgicas (AU)

Prolapse of the urethra in female patients is a rare events. It is defined as the complete eversion of the urethral mucosa through the external meatus. It occurs most often in pre-puberal black girls and in postmenopausal white women. Recommended treatment ranges from conservative therapy to a diversity of operative techniques (AU)

Rotura uterina espontánea en útero no cicatrizal / Spontaneous uterine rupture ina non scarred uterus

La rotura uterina es una de las mayores catástrofes que podemos encontrar en la práctica obstétrica, ya que se asocia con una alta mortalidad materna y perinatal. En el útero sin cicatriz es un acontecimiento que ocurre habitualmente intraparto, y con frecuencia tiene consecuencias fatales para la madre y el feto (AU)

Diagnóstico ocasional de endometriosis vesical por ecografía transvaginal / The rare diagnosis of bladder endometriosis with transvaginal scanning

La endometriosis vesical es una manifestación poco frecuente de una enfermedad muy comúnmente descrita por el ginecólogo. Se asocia a una elevada morbilidad dadas su dificultad diagnóstica y la baja sospecha. Debemos pensar en esta afección en mujeres con síntomas urinarios irritativos de presentación cíclica. Orientan hacia el diagnóstico las imágenes cistoscópicas, siendo necesaria la histología para su confirmación (AU)

Characterization of an inhibitory seric factor from tuberculosis anergic patients that acts on non-adherent PPD reactive cells.

Non-adherent cells from PPD+ tuberculosis patients (TBP PPD+) and from healthy individuals treated with whole tuberculosis anergic immune sera or with its protein A-Sepharose IgG fraction, or with sera fraction separated by PPD-Sepharose chromatography, were submitted to immunofluorescence assays. Anti-human IgG or IgM FITC-conjugate were used to reveal the assays, and results were expressed by a fluorescence percentage or fluorescence index. The presence of IgG over the surface of PPD+ non-adherent cells was detected. High fluorescence percentages were observed only in those PPD+ cells treated with whole anergic serum or with its IgG fraction. Positive fluorescence index values were obtained only in those PPD+ cells treated with anergic serum, meanwhile fluorescence index was always negative when non-bound fractions from PPD-Sepharose were used. Results suggest that non-adherent population are the cell targets for the serum inhibitory factor, which previously has been detected to inhibit antigen response in PPD reactive cells and, point out the specific behavior of this factor, since it was eliminate by PPD-Sepharose chromatography. The IgG nature of the factor was demonstrated by SDS-PAGE and immunoelectrophoresis.

[Diaper rash in Kawasaki disease]. / Erupción del área del pañal en la enfermedad de Kawasaki.

The authors presents 3 cases of Kawasaki disease where, in all cases, a perineal rash or rash located in the diaper area, was an initial or predominant sign. We highlight the interest of this discovery for the early and diagnostic of this disease, in both its classics and incomplete forms, and with this achieve efficiency in the preventive treatment of the cardiovascular complications.

Evaluation of phagolysosome fusion in acridine orange stained macrophages infected with Histoplasma capsulatum.

A phagosome-lysosome (PL) fusion was performed in vitro using peritoneal cells from normal BALB/c mice and the J774.2 macrophage cell line infected with the yeast phase of the fungus Histoplasma capsulatum at ratios of 5 x 10(5), 5 x 10(6) or 1 x 10(7) yeasts per 1 x 10(6) macrophages, and phagocytosis was allowed to proceed for 5, 30 and 60 min. Macrophage lysosomes were pre-labelled with acridine orange and the cells were challenged with the parasite. Fusion was evaluated by fluorescence microscopy and the number of macrophages with stained yeast cells was scored. The phagolysosome fusion frequency (PLFF) was calculated by subtracting the specific fusions of infected macrophages from the non-specific fusions of uninfected macrophages and normalizing the total number of bound yeasts. The PLFF was determined using different doses and strains of H. capsulatum. Results showed that PLFF in infected macrophages depends on the infection dose. Inhibition of PL fusion was detected mainly at a high infection ratio (1 x 10(7) yeasts/1 x 10(6) macrophages), and PL fusion varied with phagocytosis time. No significant differences were observed in the fusions when different Histoplasma strains were used. Results with J774.2 cells were similar to peritoneal cells, indicating that both methodology and fusion calculations employed were useful, in spite of the heterogeneity of macrophage populations used.

[Streptococcal perianal disease and balanoposthitis]. / Enfermedad perianal estreptocócica y balanopostitis.

Two cases are reported in which Lancefield group beta-haemolytic streptococci were isolated from culture- from the perineal skin. The physical examination showed perianal irritation and excoriation in both cases and seropurulent anal and balano-preputial discharge in the first only. To the best of our knowledge, this is the first case in which the streptococcal perianal disease is associated to a balanoposthitis and at the same time increments the clinical spectrum of the illness.

[Benign infantile paroxysmal torticollis. Apropos of 3 cases]. / Tortícolis paroxístico benigno infantil. A propósito de tres casos.

We report three children with benign paroxysmal torticollis (BPT) and review the literature. BPT represents a self-limited disorder that occurs mainly in infancy and in females. The condition is characterized by recurrent spells of torticollis which may, or may not, be accompanied by other symptoms such as vomiting, pallor, ataxia, irritability and drowsiness. The diagnosis of BPT should be established clinically, although, in some cases, it is necessary to rule out conditions such as posterior fossa tumor, cervical dislocation, ocular palsy, dystonia due to side effects of drugs, or Sandifer's syndrome. The etiology of the syndrome remains unknown and, at present, there is no effective therapy.

Immunosuppression transfer by spleen cells from young to adult mice previous to Histoplasma capsulatum infection.

The passive transfer of spleen cells from 1 month old mice into adult syngeneic mice, abrogates their resistance to histoplasmal infection. This suppressive state was detected in two cell populations, one non-adherent and another adherent with radioresistant characteristics. The transferred spleen cells were treated by different anti-sera: anti-theta, anti-adherent cells (produced in rabbits) and monoclonal anti-Thy 1.2 respectively. The irradiated and non-irradiated adult recipient mice were infected with Histoplasma yeasts utilizing the Lethal Dose50 for 1 month old mice. The infection course was determined by death percentage, the histoplasmosis murine signs and the number of the fungal colony forming units (CFU) from the infected spleens. The results of the anti-sera treatment suggest that non-adherent as well as adherent cells participate in the suppressive phenomena. A lower number of CFU was identified in infected animals which received cells treated with anti-Thy 1.2 anti-sera.