Valoración de un nuevo sistema de acreditación y reacreditación docente de centros de salud / Assessment of a new system of teaching accreditation and re-accreditation in health centres

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[Pulmonary cryptosporidiosis and AIDS. Presentation of a case and review of the literature]. / Criptosporidiasis pulmonar y SIDA. Presentación de un caso y revisiónde la literatura.

Pulmonary cryptosporidiasis is a rare disease. However, following the advent of the acquired immunodeficiency syndrome (AIDS), this rare pathology infection by Cryptosporidium and we conduct a literature review. The Cryptosporidium can be detected with the routine technique used for the identification of mycobacterias in sputum: Zichl-Neelsen, auramine O, Kinyoun, etc. The most frequent sympthomatology includes chronic cough (91%), fever (59%) and dyspnea (64%). In 78% of cases, several respiratory infectious agents coexist, mainly P. carinii (47%) and Cytomegalovirus (41%). In 76% of cases, the infection is followed by diarrhea, detecting Cryptosporidium in the feces of 80% of these patients. The most frequent cause of death is respiratory failure. The radiologic evidences are not specific. The OKT4+/OKT8+ ratio has an average value of 0.3 (0.05-0.9). There is not any treatment truly effective.

[The inappropriate antidiuretic hormone secretion syndrome associated with cryptococcal meningitis in a patient with the acquired immunodeficiency syndrome]. / Síndrome de secreción inadecuada de hormona antidiurética asociado a meningitis criptocócica en un paciente con síndrome de inmunodeficiencia adquirida.

Meningitis and other infectious diseases of the central nervous system are predisposing causes of the inadequate secretion syndrome of the antidiuretic hormone (ISADH). The association between the acquired immunodeficiency syndrome (AIDS) and ISADH is recognized but little studied. In AIDS patients hyponatremia is a frequent finding and it is responsible for ISADH in most cases. However, there is little reference material concerning the incidence of presentation and the type of osmoregulation anomaly this entity presents in these patients. A case in which ISADH is associated to cryptococcal meningitis and AIDS is described with an evaluation of the hormonal response to the test of hypertonic saline serum infusion corresponding to a release of ADH.