[Eight theses on planning, development, and the spatial distribution of the population]. / Ocho tesis sobre planificacion, desarrollo y distribucion espacial de la poblacion

PIP: The author examines the interrelationships between economic development in Latin America and demographic factors, with particular reference to the spatial distribution of population. Eight alternative hypotheses are examined, including consideration of whether population growth, international trade and competition, and urbanization hinder or encourage the development process.^ieng

Upper gastrointestinal disease in chronic renal failure. A prospective evaluation.

A prospective study was undertaken to determine the incidence of upper gastrointestinal disease in 85 chronic renal failure (CRF) patients on hemodialysis. Upper gastrointestinal x-rays were obtained for 83 patients, and enlarged gastric and duodenal folds were seen in 12% (10/83) and 42% (35/83) of the cases, respectively. Panendoscopy performed on 60 persons revealed gastritis in 22% (13/60), nodular duodenitis in 60% (35/60), and esophagitis in 13% (8/60). No peptic ulcers were identified either radiologically or endoscopically. Pathologic examination of mucosal biopsy specimens demonstrated gastritis in 46% (21/46) and duodenitis in 43% (22/51) of patients. A highly significant correlation was found between endoscopic and radiologic duodenitis (P less than .0001) and also between endoscopic and pathologic duodenitis. We have demonstrated a high incidence of mucosal inflammation but not ulcer disease in CRF patients. These lesions may predispose these individuals to gastrointestinal bleeding following renal transplantation.

Complementary use of ultrasound and computed tomography in studies of the pancreas and kidney.

113 cases of pancreatic and renal disease studied by both ultrasound and computed tomography (CT) were analyzed retrospectively. CT provided a diagnosis when pancreatic ultrasound was unsuccessful due to overlying bowel gas or obesity and when renal ultrasound was unsuccessful due to obesity, reverberations from ribs, small lesions, or multiple lesions. Conversely, ultrasound provided a diagnosis when CT was unsuccessful due to lack of fat planes or respiratory motion. CT usualy distinguished carcinoma from pancreatitis when ultrasound showed a focal echogenic mass. CT resolved renal cyst from neoplasm when ultrasound showed a mixed echo pattern mass.

Computed tomography of the kidney.

Computed tomography is an extremely accurate method of obtaining more definitive diagnostic information about a renal mass discovered on a urogram. Benign renal cysts are readily distinguished from solid renal neoplasms, and CT is often valuable in characterizing possible juxtarenal masses. The cause of a nonfunctioning kidney(s) on a urogram can often be discerned, and hydronephrosis is easily detected.

Epidermoid cysts of the spleen.

In the two cases presented here, the sonographic findings were unique. At low gain settings the rounded masses appeared sonolucent and smooth walled. As the gain was increased, multiple internal echoes appeared close to the inner wall, indicating the thick and irregular wall lining. It is presumed that these echoes were produced by the trabeculae. It is felt that the sonographic findings in epidermoid cysts of the spleen may be diagnostic, obviating the need for arteriography.

The role of Ga-67 citrate imaging and diagnostic ultrasound in patients with suspected abdominal abscesses.

Fifty patients with suspected abdominal abscesses were examined by [67Ga[ Gallium citrate imaging and abdominal sonography. Fifteen of the patients had a proven intra-abdominal abscess; Gallium-67 images were positive in 13 (87%), while the sonogram detected the abscess in 11 (73%). Nineteen patients had true-negative radionuclide images and sonography, and one had a false-positive result by both procedures. The remaining 15 patients did not have abdominal abscesses, but did have other abnormalities (e.g., pyelonephritis, extra-abdominal sites of inflammation) which were detected by the nuclide study. Gallium-67 imaging and abdominal ultrasound have similar sensitivity for detection of abdominal abscesses. A significant advantage of Gallium imaging is its ability to detect other inflammatory foci (both within and outside the abdomen).

Spontaneous nephro-duodenal fistula.

Nephroduodenal fistulas are an uncommon clinical entity characterized by upper abdominal pain and associated with pyelonephritis and renal calculus formation. Most of the recent cases reported are secondary to inflammatory changes in the kidney. Two cases are reported here, one of a nephroduodenal fistula and another of a combined nephroduodenal and nephrocolic fistulae. Carefully monitored X-ray studies determined in both cases the exact site and extent of the fistulae. The optimal treatment is nephrectomy.

Selective intraarterial infusion of vasopressin for control of gastrointestinal bleeding: experience with 35 cases.

Selective intraarterial infusion of vasopressin was performed in 32 patients for 35 episodes of gastrointestinal bleeding. Active bleeding was from esophageal varices in 11 cases and from an arterial site in 22 (stomach 11, duodenum 1, jejunum 2, colon 7, liver 1), including a jejunal diverticulum and a colonic ulcer in Behcet's disease. Two patients, not actively bleeding, were infused for portal decompression before an elective mesocaval shunt. Active bleeding was controlled in 64% of patients with variceal hemorrhage and in 59% of those with arterial sources. Infusion periods ranged from 15 minutes to 70 hours. There were no significant complications directly attributable to this therapy.

Cavernous hemangioma of the kidney.

Three patients with cavernous hemangiomas of the kidney all presented with hematuria. In each there was found a poorly defined renal medullary mass with displacement of the calyces and renal vessels and paradoxical hypovascularity of the mass. This rare, benign tumor of the kidney should be considered in the presence of this characteristic clinical picture.

The colitis of Behcet's disease: a clinical-radiographic correlation.

The radiographic, colonoscopic, and pathologic findings in this case of Behcet's colitis differ completely from ulcerative or granulomatous colitis as well as from other, less commonly seen inflammatory colitides. Discrete, peptic-type ulcers, with normal intervening mucosa and normal overall configuration of the colon, are seen on radiography and endoscopy. The angiographic features are not diagnostic but differ considerably from findings in other inflammatory colitides. No tortuous arterioles, mucosal hyperemia or early venous filling was encountered.