Anorexia nerviosa y psiquiatría transcultural / Anorexia nervosa and transcultural psychiatry

Se presenta el caso de una adolescente de 16 años, descendiente de una familia de origen chino, que ingresa en la Unidad de Psiquiatría Infanto-Juvenil por pérdida importante de peso e hipocalemia. Se realiza una revisión de las características de la psiquiatría transcultural y las consecuencias derivadas del proceso migratorio

The case that is presented is a 16 years old female descendant of a family of Chinese origin. She was admitted to the hospitalisation unit of the children's ward due to significant weight loss and hypokalemia. This article carries out a review of transcultural psychiatry and the consequences derived from the migratory process

El trastorno de conducta alimentaria como fachada del síndrome de alienación parental / Eating disorders as a façade of parental alienation syndrome

Se presenta el caso de una niña de 11 años que ingresa, en dos ocasiones, en la Unidad de Psiquiatría InfantoJuvenil por restricción completa de la ingesta alimentaria. Se realiza una revisión de las características del síndrome de alienación parental. En este síndrome, un progenitor transforma la conciencia de sus hijos mediante distintas estrategias, con objeto de destruir los vínculos de éstos con su pareja, hasta hacer que la odien y la rechacen

The following is a presentation of a case about an 11-years-old girl who has been an inpatient on two occasions in the Children's Psychiatric Ward for a complete stoppage of the consumption of alimentary products. A review along the lines of a syndrome involving parental alienation is carried out. In this syndrome, a parent may transform/modify the conscious of their child through various strategies, with the objective of destroying the ties that the child may have with their partner, up to hating and rejecting them

Endarteritis de tubo valvulado aórtico por Propionibacterium acnes / Aortic tube infections due to Propionibacterium acnes

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Mechanical behaviour and rupture of normal and pathological human ascending aortic wall.

The mechanical properties of aortic wall, both healthy and pathological, are needed in order to develop and improve diagnostic and interventional criteria, and for the development of mechanical models to assess arterial integrity. This study focuses on the mechanical behaviour and rupture conditions of the human ascending aorta and its relationship with age and pathologies. Fresh ascending aortic specimens harvested from 23 healthy donors, 12 patients with bicuspid aortic valve (BAV) and 14 with aneurysm were tensile-tested in vitro under physiological conditions. Tensile strength, stretch at failure and elbow stress were measured. The obtained results showed that age causes a major reduction in the mechanical parameters of healthy ascending aortic tissue, and that no significant differences are found between the mechanical strength of aneurysmal or BAV aortic specimens and the corresponding age-matched control group. The physiological level of the stress in the circumferential direction was also computed to assess the physiological operation range of healthy and diseased ascending aortas. The mean physiological wall stress acting on pathologic aortas was found to be far from rupture, with factors of safety (defined as the ratio of tensile strength to the mean wall stress) larger than six. In contrast, the physiological operation of pathologic vessels lays in the stiff part of the response curve, losing part of its function of damping the pressure waves from the heart.

[Treatment of an infection from an intravenous cardiac stimulation lead with extracorporeal circulation]. / Tratamiento de la infección del cable de estimulación cardíaca intravenoso mediante circulación extracorpórea.

The infection of a transvenous lead implanted for cardiac stimulation is a rare but serious complication, because it can lead to the development of septicemia, tricuspid endocarditis, recurrent pulmonary emboli or thrombus formation in right cardiac chambers. The most efficient treatment is the removal of the entire pacing system (generator and lead). We describe our experience with the removal of infected leads with the aid of cardiopulmonary bypass. Indications of this technique and its advantages and disadvantages over the percutaneous extraction methods are discussed. A review of the literature is also presented.

[Biphasic graft preservation for lung transplantation]. / Preservación bifásica del injerto en el trasplante pulmonar.

The standard, most widely applied way of preserving a lung for transplantation is infusion through the pulmonary artery (PA) of a pulmonaryplegic solution. In this prospective study, we analyzed the initial function of the pulmonary and cardiac graft after biphasic infusion of a solution introduced retrograde through the left auricle and antegrade through the PA. Twenty-six heart and lung grafts (9 unilateral and 17 bilateral) were preserved by cardioplegia and pulmonaryplegia (biphasic) between January 1996 and March 1997. Indicators of graft viability recorded were the ratio of arterial oxygen pressure (PaO2) to inspired fraction (FiO2), mean systemic pressure (MSP), mean pulmonary artery pressure (MPAP) cardiac output, pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR). The variables were recorded upon arrival of the grafts in the intensive care unit and in the first 24 h. Morbidity and mortality after heart transplants were recorded throughout a follow-up period of one month. After transplantation, most patients had a oxygenation coefficient (PaO2/FiO2) greater than 252 mmHg in the first 48 h. Hemodynamic parameters were also kept within normal ranges immediately after surgery and 24 h later. Mean ischemic time was 245 min for unilateral transplants, 215 for the first lung in double lung transplants, and 300 min for the second lung. In the early postoperative period, 3 patients suffered lung graft dysfunction, which was treated satisfactorily with nitric oxide (NO). No heart transplant patient suffered primary heart failure or left ventricular dilatation. We conclude that biphasic pulmonary preservation achieves satisfactory initial functional viability of the graft. Heart grafts removed simultaneously functioned successfully in the transplanted patient without additional pharmacological or mechanical support.

[Surgical treatment of hypertrophic myocardiopathy using a video-assisted technique. Apropos of a case]. / Tratamiento quirúrgico de la miocardiopatía hipertrófica mediante técnica vídeo-asistida. A propósito de un caso.

The use of endoscopic technology is gaining more and more popularity within cardiac surgery. We present a case employing endoscopic instruments in the resection of the interventricular septum in a patient with hypertrophic cardiomyopathy unresponsive to medical treatment. Advantages of this technique are discussed.

[The heart transplant in congenital cardiopathies. The surgical considerations]. / El trasplante cardíaco en las cardiopatías congénitas. Consideraciones quirúrgicas.

Structural congenital heart disease accounts for a small number of patients who undergo heart transplantation. Orthotopic heart transplantation in this group of patients necessitates special operative modifications and may be technically challenging. However, offer an effective therapeutic alternative for persons with end-stage myocardial failure in conjunction with congenital heart disease.

[Donor selection. Marginal donors]. / Selección de donantes. Donantes marginales.

The number of heart transplant candidates has increased steadily in the past several years because of improved survival and sustantial decrease in the incidence of rejection and serious infections. Unfortunately the number of available donors was remained insufficient, the method of expanding the donors pool may be to liberate the criteria for an acceptable donors heart (age, size, inotropic drugs ...). We analyzed the incidence of this factors.

[Renovascular hypertension: results of surgical treatment with a three-year follow-up (author's transl)]. / Hipertensión arterial vasculorrenal: resultados del tratamiento quirúrgico con un seguimiento medio de tres años.

Between 1966 and December 1979, 58 patients with renovascular hypertension were surgically treated at our center. Follow-up was a minimum of one year in all patients and in all cases permeability of revascularization was assessed through angiography from one to six months after surgery. The mean follow-up was 39 months. Thirty-eight (65.5%) were male and 20 (34.6%) female. Age of onset was between 3 and 53 years (mean 36.3 years). Etiology was arteriosclerotic in 27 cases and fibrous dysplasia in all its manifestations in another 27, in 2 cases vascular compression due to retroperitoneal fibrosis and renal hypoplasia in the remaining two. In 4 cases lesions were bilateral. The cure rate was 37 patients (63.8%), Improvement in 16 (27.6%), while there was no improvement in 5 (8.6%). Surgical mortality rate was nil. The different techniques used, indications, long and short term complications and different results according to etiology are discussed.