Trombosis venosa cerebral por hipotensión de líquido cefalorraquídeo / No disponible

No disponible

Microhamartomas hepáticos (complejos de Von Meyenburg) / Multiple bile-duct hamartomas (Von Meyemburg complexes)

No disponible

[Current status of endoscopic retrograde cholangiopancreatography. What is the effect of the introduction of magnetic resonance cholangiography?]. / Estado actual de la CPRE. Cómo se refleja la introducción de la colangiorresonancia magnética?

AIM: To determine the current status of endoscopic retrograde cholangiopancreatography (ERCP) and the effects of the introduction of magnetic resonance cholangiography (MRC) on ERCP and to evaluate the diagnostic yield of MRC since its introduction in obstructive biliary disease. MATERIAL AND METHODS: We performed a retrospective analysis of the ERCP carried out between January 1998 and December 2000 and of the MRC performed for suspected obstructive biliary disease from May 1999 to December 2000. When both techniques were performed, the diagnostic yield of MRC was evaluated. RESULTS: We performed 927 ERCP. A total of 45.3% of the patients were men. Mean age was 69.2 14.6 years. Treatment was performed on 688 occasions (77%), mainly sphincterotomy (69.9%) and placement of polyethylene (21.8%) or self-expanding (9.9%) prostheses. The number of ERCP performed each year was 261, 330 and 336 in 1998, 1999 and 2000, respectively; of these 76.6%, 80% and 76.9% were therapeutic. MRC was performed in 63 patients with suspected biliary disease. In 27 of 59 patients (45.8%) MRC was sufficient for diagnosis, avoiding the need for ERCP. In the 35 patients in whom both techniques (MRC and ERCP) were performed, the diagnostic yield of MRC compared with that of ERCP was: sensitivity 100%, specificity 50%, positive predictive value 87.1%, negative predictive value 100% and overall value 89%. The cases responsible for the low specificity (all due to choledocholithiases) were analyzed and a significant time lapse was found between the performance of MRC and ERCP (range: 7-35 days) during which choledocholithiasis probably resolved spontaneously. CONCLUSIONS: a) Contrary to what could be expected, the number of ERCP seems to be increasing with a high percentage of endoscopic treatment; b) Because of its diagnostic sensitivity, MRC is the ideal technique for eliminating the need for diagnostic ERCP, thus allowing greater development of the therapeutic aspect of ERCP.

Ileo meconial familiar complicado no asociado a fibrosis quística: presentación de casos clínicos / Complicated familiar meconium ileus non associated with cyst fibrosis: Clinical cases

Se reportan los casos de tres pacientes pediátricos, hermanos consanguíneos, que presentaron al nacimiento una de las tres formas clínicas de íleo meconial. Aun cuando es un caso de presentación familiar, se realizaron estudios genéticos en los que fue posible descartar alteración genética asociada con fibrosis quística o enfermedad de Hirschsprung, considerándose a estos pacientes portadores de una enfermedad meconial familiar, poco descrita en la literatura internacional

A large-scale program in laparoscopic intrauterine insemination with frozen-thawed semen in Australian Merino sheep in Argentine Patagonia.

This report shows the results of a large-scale laparoscopic intrauterine insemination program on a flock of Australian Merino sheep in Argentine Patagonia. The study was carried out on a total of 1824 ewes (3-to-7-yr-old) and 480 ewe hoggets (19-20 months old) on 2 farms in the southeastern region of Santa Cruz Province, in April and May 1996. The animals, divided into 15 groups, were synchronized with vaginal sponges containing 60 mg medroxyprogesterone acetate for 14 d and injected with 200 IU PMSG upon sponge removal. Estrus was screened every 12 h by means of vasectomized marker rams. The animals were inseminated laparoscopically by the intrauterine route using 2 schemes: 1) at a fixed time (12 h) after estrus detection, or 2) at a fixed time (60 h) after sponge removal irrespective of estrus. Pregnancy was determined at 30 d by transrectal ultrasound imaging. The results showed that 1) the onset of estrus occurs most often between 24 and 48 h after sponge removal, 2) ewe hoggets undergo estrus significantly earlier than sexually mature ewes, 3) in those animals showing estrus, there appears to be no relationship between fertility (as assessed by pregnancy outcome) and time of estrus, 4) there is a significant association between the percentage of estrus occurrence and pregnancy rate, 5) fertility is significantly higher in ewes than in hoggets, 6) for practical purposes insemination at a fixed time after the onset of estrus has no advantage over that of to insemination at a fixed time after sponge removal. It is concluded that large-scale laparoscopic intrauterine insemination can be successfully applied in Australian Merino ewes and ewe hoggets in low-productivity areas such as that of Argentine Patagonia and that estrus detection is unnecessary when insemination is performed at 60 h after sponge removal.

Wastage of family income on skin disease in Mexico.

PIP: In developing countries skin disease prevalences may affect over 60% of the community and are often poorly managed. The impact of ineffective treatment of skin disease on family life in rural Mexico was investigated. In the community of Cayaco, a house to house questionnaire survey was conducted to study the distribution of skin disease and the use and cost of treatments. The diagnosis of skin lesions was validated by physical examination and in a separate random survey in 120 primary school children. Regression analysis was carried out. 380 households with 1528 people (713 males, 815 women) were surveyed, of whom 207 reported skin disease. 131 attended the outpatient clinic (41 males, 90 females). The commonest skin disease among them was pyoderma (27 patients), followed by scabies (26), pityriasis alba (23), acne (8), dermatophytosis (8), viral warts (8), and pediculosis capitis (8). 66 had other skin conditions ranging from urticaria (2) to scrofuloderma (1). 58 patients had more than one condition, a total of 189 dermatoses. Six conditions accounted for 102 of the dermatoses. 15 patients with scabies and 21 with pyoderma had received ineffective treatment over the previous six months at a mean cost of 66 new pesos and 136 new pesos, respectively. Many of the affected children had missed school: eight days for scabies (12 patients) and 15 days for pyoderma (10 patients). 68 of the 120 primary school children in the random survey had at least one treatable skin condition. In half of the households people had symptoms, and 57% of the children had at least one treatable skin disease. The mean total cost of ineffective treatment for the two commonest conditions over six months was a major financial burden on families where the mean daily wage was 15.2 new pesos. Both diseases are readily curable by eliminating scabies. In the area a new system of community dermatology is implemented with close collaboration between specialists and primary health care workers.^ieng

Salud: de la investigación a la acción / Health: from the research to the action

"Actividad fundamental en el desarrollo de la civilización, la investigación científica tiene por objeto conseguir información pertinente y fidedigna de fenómenos concretos y, llegado el caso, aplicar soluciones específicas a problemas definidos. Este paso -el de la investigación a la acción en materia de salud- es el que un grupo de especialistas internacionales aborda en esta obra. Jaime Martuscelli, Héctor Brust y Gladys Faba nos refieren cómo la investigación básica y la investigación orientada han contribuido a las políticas de salud en México. Avedis Donabedian trata de lo alcanzado en uno de los más recientes campos de la investigación en salud: el estudio científico de la organización de sistemas de salud. Julio Frenk examina la investigación en el sector público, centrándose en el dilema básico entre pertinencia y excelencia. La cooperación internacional, aspecto insustituible para el desarrollo de la investigación aplicada, es el tema que aborda Robin Badgley. Harvey Fineberg analiza la difusión de los resultados de la investigación clínica en la atención médica. La aplicación del conocimiento a la práctica no siempre es la apropiada, José Luis Bobadilla ilustra la situación con un estudio de la operación cesárea en México. Rodrigo Guerrero expone los resultados de un estudio sobre la regionalización de la atención quirúrgica. Los grandes logros de la investigación en salud han tenido significativas repercusiones demográficas, Henry Mosley aborda este punto medular de la sociedad contemporánea. Otro problema actual es el crecimiento explosivo de las grandes urbes; Roberto Castañón, en el último capítulo del libro, ilustra el caso con un estudio de los accidentes en la ciudad de México." (ED). Los temas de los capítulos que conforman el contenido de la obra son: I) La investigación como insumo de las políticas de salud en México. II) Cándido en el país de la investigación en servicios de salud. III) De la pertinencia a la excelencia: dilemas de la investigación. IV) Asistencia internacional para la investigación de los servicios de salud. V) De la investigación a la práctica clínica. VI) Los excesos tecnológicos: el caso de la operación cesárea en México. VII) Regionalización de la atención qirúrgica: un ejemplo de la investigación aplicada. VIII) El impacto demográfico de los programas de sobrevivencia en la infancia: propuesta para la estrategia de los programas. IX) Problemas de salud en las megalópolis

[Agenesis of the trachea. Presentation of a case and review of the literature]. / Agenesia de la tráquea. Presentación de un caso y revisión de la literatura.

Tracheal agenesis is one of the rarest and most refractory causes of neonatal respiratory distress; only 35 cases have been reported. We describe another example of this rare condition and review the literature.

Estudo experimental e tratamento psicologico de ulcera gastroduodenal em medicos anestesiologistas. / Experital study and psychotherapeutic treatment of gastric duodenal ulcer in anesthesiologists

O autor expoe os resultados de uma investigacao efetuada sobre uma populacao de 32 anestesiologistas com diagnostico de ulcera gastroduodenal. Partindo das premissas oferecidas pela moderna psicologia, o autor sugere um metodo de modificacao do ambiente e de distintas unidades comportamentais que possibilitem a eliminacao das condutas indesejaveis, o aprendizado de outras adaptadas e sucessivamente a diminuicao ou eliminacao da ulcera gastroduodenal. Os resultados evidenciam o aspecto psicologico no desenvolvimento da ulcera gastroduodenal e destacam a possibilidade de intervir sobre ela a este nivel