[Postanoxic encaphalopathy after and episode of resuscitated sudden death. Minimizing sequelae]. / Encefalopatía postanóxica tras episodio de muerte súbita reanimada. Cómo minimizar los daños.

Sudden death in young people while performing intense physical activity has a very low prevalence but a significant burden in terms of loss of years of life in society and a strong social impact. We present the case of a 19-year-old man who had a cardiac arrest while playing a football match, with prolonged resuscitation, and multiple subsequent complications (acute renal failure, coagulopathy, digestive bleeding, ischaemic colitis, and need for implantable cardioverter-defibrillator placement and hemicolectomy). The onset of intensive early rehabilitation in a specialised centre minimised the sequels, improving the Rankin score from 4 to 2 and Barthel index from 0 to 95 points, allowing the patient to lead an almost autonomous life.

[Short-term results of Weils osteotomy in patients with propulsive metatarsalgia]. / Resultados funcionales a corto plazo de la osteotomía de Weil en pacientes con metatarsalgia propulsiva.

INTRODUCTION: Metatarsalgia is the most common reason for consultation in orthopedic pathology of the foot. The key to its treatment lies in the correct determination of the symptoms, which are biological, morphological and mechanical alterations responsible for pain. Weil´s osteotomy is commonly used for multiple forefoot pathologies, including metatarsalgias. MATERIAL AND METHODS: We included patients with first-line failure syndrome and associated mechanical metatarsalgia-producing deformities. The minimum follow-up was six months. All individuals were interviewed with a standardized questionnaire based on the AOFAS, a survey to know their degree of satisfaction about the surgery. RESULTS: Twelve female subjects with a mean age of 51 years were recruited between March and September of 2013. Seven right feet, five left. The AOFAS values improved only in six, in which an excellent result was obtained; five rated them as good and six as unsatisfactory. CONCLUSIONS: In a very small series, postoperative complications were observed when the shortening of the metatarsal was greater than four millimeters, with the appearance of stiffness (floating finger).

INTRODUCCIÓN: La metatarsalgia es el motivo de consulta más frecuente en patología ortopédica del pie. La clave de su tratamiento radica en la correcta determinación del síntoma, que son alteraciones biológicas, morfológicas y mecánicas responsables del dolor. La osteotomía de Weil es comúnmente utilizada para múltiples patologías del antepié, incluyendo las metatarsalgias. MATERIAL Y MÉTODOS: Se estudiaron pacientes intervenidos por síndrome de insuficiencia del primer rayo y deformidades asociadas productoras de metatarsalgia mecánica. El seguimiento mínimo fue de seis meses. Se entrevistó a todos los individuos con un cuestionario estandarizado basado en la AOFAS, una encuesta para saber su grado de satisfacción acerca de la cirugía. RESULTADOS: Se obtuvieron 12 sujetos femeninos con un promedio de 51 años de edad en el período entre Marzo y Septiembre de 2013. Siete pies derechos, cinco izquierdos. Los valores de AOFAS mejoraron sólo en seis, se obtuvo un resultado excelente; cinco los calificaron como buenos y seis como no satisfactorio. CONCLUSIONES: En una serie muy pequeña, se identificaron complicaciones postquirúrgicas cuando el acortamiento del metatarsiano es mayor a cuatro milímetros, con la aparición de rigidez (dedo flotante).

[Comparative study on animal model of acute Achilles tendon rupture with surgical treatment using platelet-rich plasma]. / Estudio comparativo en modelo animal con ruptura aguda de tendón calcáneo con tratamiento quirúrgico aplicando plasma rico en plaquetas.

OBJECTIVE: To compare the functional and histologicalal course of two animal model groups with acute Achilles tendon tears using platelet rich plasma. MATERIAL AND METHODS: An open clinical trial was conducted with dogs donated by the animal facility of the Autonomous University of Puebla (BUAP, for its acronym in Spanish). Dogs were divided into 2 groups: a control group and a problem group. Intentional surgical Achilles tendon tear was performed to them. The Krackow technique was used to repair the tendon and the control group received platelet rich plasma (PRP) as a clot; the other group did not receive PRP. The dogs were seen at 4 weeks to check functionality using the Farell and Schwarz scale to assess the degree of limping. They were sacrificed at week 5; the tendons were removed and sent to the histopathology lab. RESULTS: Functionality results according to the Farell and Schwarz scale showed grades I and II in the problem group, and grades IV and V in the control group. Histologically, the problem group showed moderate vascular proliferation and abundant fibroblastic proliferation. The control group had mild to moderate vascular proliferation and moderate fibroblastic proliferation. CONCLUSIONS: PRP improves tendon healing and this has repercussions on functional recovery.

Antibacterial and antifungal activities of some Mexican medicinal plants.

In Mexico about 4,000 plant species have some medicinal use. The aim of this work was to evaluate the antimicrobial activity of six Mexican medicinal plants against fungi and Gram-positive and Gram-negative bacteria. Methanolic extracts were prepared from the Mexican medicinal plants Amphypteringium adstrigens, Castella tortuosa, Coutarea latiflora, Ibervillea sonorae, Jatropha cuneata, and Selaginella lepidophylla. The antibacterial and antifungal activities of the plants were determined by the broth microdilution method and the radial growth inhibition assay, respectively. All Mexican plants tested showed antimicrobial activity. Among the six plant extracts analyzed, J. cuneata showed the highest growth-inhibitory activity against fungi, Gram-positive and Gram-negative bacteria (J. cuneata > A. adstrigens > C. latiflora > C. tortuosa > I. sonorae approximately S. lepidophylla). Shigella flexneri and Staphylococcus aureus were the most susceptible bacteria to plant extracts. Complete inhibition of S. flexneri growth was observed with J. cuneata methanolic extract at 90 microg/mL. This plant extract also showed the strongest antifungal activity against Fusarium verticillioides and Aspergillus niger. Our data suggest that the medicinal plants tested have important antimicrobial properties. This is the first report describing the antimicrobial activities of several of the Mexican medicinal plants used in this study.

Estudio descriptivo y abstinencia al año en una consulta de tabaquismo / Descriptive study and abstinence at one year of a smoking consultation

Objetivos: Estudio retrospectivo de datos procedentes de revisiónde historias clínicas, obteniendo: características demográficas y de tabaquismo,diferencias en función del género, abstinencia obtenida y predictoresde abstinencia.Pacientes y métodos: Se trata de una consulta individual basada enel tratamiento farmacológico y psicológico mínimo. A los pacientes seles realizó una anamnesis sobre antecedentes y tabaquismo, el test deFagerström, peso y CO en aire espirado. El seguimiento se realizó segúnel esquema propuesto por la SEPAR.Resultados: Sobre datos de 225 historias, la edad media fue de 47 ±10 años, siendo el 57% varones. El 7,4% no presentaba otras enfermedadesaparte del tabaquismo. La media del test de Fagerström, cigarrillos/día,paquetes año y CO fueron de 6,74 ± 2,10, 33,74 ± 15,77, 36,89 ± 20,23 y31,36 ± 15,91 respectivamente. Encontramos diferencias significativas enfunción del sexo en los paquetes-año (p = 0,009), CO (p = 0,004) y test deFagerström (p = 0,003). La abstinencia máxima se alcanzó a las tres semanasy fue del 83%, a los seis meses fue del 37% y al año del 28%.Conclusiones: Concluimos que consultan similar proporción de varonesy mujeres, en edad media, con enfermedades producidas por el tabacoy con alta dependencia a la nicotina; encontramos diferencias porgénero y obtenemos buenos resultados a corto plazo, aunque son menoresa seis meses y un año

Objectives: Retrospective study of data from clinical history review,obtaining: demographic and smoking characteristics, differences basedon gender, abstinence obtained and abstinence predictors.Patients and methods: This is an individual consultation based onminimum drug and psychological treatment. The patients wereadministered an anamnesis on background and smoking, the Fagerströmtest, weight and CO in exhaled air. Follow-up was done according to theSEPAR proposed schedule.Results: Based on data from 225 histories, mean age was 47 ± 10years, 57% being men. Atotal of 7.4% had no other diseases except forsmoking. The mean of the Fagerström test, cigarettes/day, packs per yearand CO were 6.74 ± 2.10, 33.74 ± 15.77, 36.89 ± 20.23 and 31.36 ±15.91 respectively. We found significant differences according to genderin packs-year (p = 0.009), CO (p = 0.004) and Fagerström test (p = 0.003).Maximum abstinence was reached at three weeks and was 83%. It was37% at six months and 28% at one year.Conclusions: We conclude that a similar proportion of consultationfrom men and women who are middle aged, with diseases producedby tobacco and with high dependence to nicotine. We found differencesby gender and obtained good short-term results, although they are lessat six months and one year

Giardia lamblia infection induces different secretory and systemic antibody responses in mice.

The adult mouse model of Giardia lamblia infection serves as an excellent animal model to understand the immunological mechanisms involved in the control and clearance of Giardia infection. Little is known about the G. lamblia-specific antigens that stimulate the humoral immune response in this model of giardiasis. We analysed the secretory and systemic antibody responses to G. lamblia during primary and secondary infection in C3H/HeJ adult mice. Faecal IgA and Serum IgG anti-G. lamblia antibodies were observed at week 2 post-infection. Serum IgG responses remained constant over the next several weeks, whereas faecal IgA titres continued to rise from weeks 2-6 post-infection. Western blot analysis revealed that intestinal IgA and serum IgG antibody responses were directed toward several distinct proteins of G. lamblia. Certain proteins appeared to be recognized by both faecal IgA and serum IgG, whereas other antigens were specific for either the secretory or systemic antibody responses. G. lamblia primary and secondary infections were associated with differences in the antibody recognition pattern. The biochemical and immunological characterization of these antigens will help us to better understand the immunobiology of the G. lamblia-host interaction.

[Pulmonary histiocytosis X. Report of a case and review of the literature]. / Histiocitosis X pulmonar. Presentación de un caso y revisión de la literatura.

Histiocytosis X or Langerhans cell histiocytosis is an infrequent disease, which consists on proliferation of Langerhans cells. The etiology is unknown. Diagnosis is reached by electron microscope study of the biopsy, in which the Birbeck intracytoplasmatic granules of the Langerhans cells are found and/or by immunohistochemistry procedures able to detect S-100 antigen and CD1 cells. Diagnosis can also be reached with a bronchoalveolar lavage in which CD1 cells will appear in a score higher than 5%. We present the case of a 16 year-old girl that first appeared with a pulmonary lesion with a honey comb X-ray pattern and unsyntomatic mandibular bone affectation. Diagnosis was reached by biopsy study using S-100 antigen detection procedures. We consider this case an important one due to the infrequency of this particular disease.

Histiocitosis X pulmonar. Presentacion de un caso y revision de la literatura / Pulmonary histiocytosis X. A case report and literature review

La histiocitosis X o histiocitosis de células de Langerhans es una enfermedad infrecuente, que consiste en la proliferación de células de Langerhans. Su causa es desconocida. Al diagnóstico se llega mediante el estudio de biopsia de la lesión por microscopía electrónica, detectándose los gránulos de Birbeck intracitoplasmáticos de las células de Langerhans, y/o mediante técnicas inmunohistoquímicas, que detecten la proteina S100 y las células CD1. También es diagnóstico un porcentaje mayor del 5 por ciento de células CD1 en el lavado broncoalveolar. Presentamos el caso de una paciente de 16 años, que se manifestó como una lesión pulmonar con un patrón radiológico en panal de miel y una afectación ósea mandibular asintomática. Al diagnóstico se llegó mediante el estudio de la biopsia pulmonar por técnicas de detección de proteína S100. Consideramos de interés este caso por la infrecuencia de esta enfermedad (AU)

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Hemorragia digestiva baja y sindrome de Klippel-Trénaunay / Lower gastrointestinal bleeding and Klippel-Trénaunay syndrome

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Tratamiento de la hernia de spiegel con mallas de polipropileno. Nuevo enfoque terapéutico / Treatment of Spigelian hernia using polypropylene mesh. A new therapeutic approach

La hernia de Spiegel es una hernia ventrolateral, rara y generalmente mal diagnosticada. Su incidencia de presentación complicada es alta y en nuestra serie ha sido del 55,5 por ciento. La exploración complementaria ideal por su accesibilidad y fiabilidad es la ecografía. Aunque la reparación anatómica se considera suficiente por su mínima incidencia de recidivas, creemos aconsejable la utilización de mallas de polipropileno. Presentamos una amplia serie de 9 casos tratados en nuestro hospital en 16 años (AU)

Leiomioblastoma primario de epiplón. Aportación de un caso y revisión bibliográfica / Primary leiomyoblastoma of the omentum. A case report and a review of the literature

Presentamos un caso de leiomioblastoma primario de epiplón intervernido en nuestro servicio. Estos tumores son neoplasias que derivan del músculo liso y afectan fundamentalmente al estómago. La aparición como tumores primarios de epiplón es extremadamente rara. En la bibliografía médica mundial solamente se han publicado 14 casos. Aportamos un nuevo caso y realizamos una revisión bibliográfica discutiendo su clínica, diagnóstico, criterios histológicos de malignidad y tratamiento (AU)

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[Repeated hemoptysis for foreign body bronchial aspiration: presentation of a case and review of literature]. / Hemoptisis de repetición por aspiración bronquial de un cuerpo extraño: presentación de un caso y revisión de la literatura.

The foreign body aspiration is more frequent in children. The most usual etiology is the foreign bodies of vegetable nature, which can not be observed in the chest radiograph. The clinic signs are varied, including shortness of breath, cough and wheezing. Hemoptysis is a rare symptom, whose arising is generally connected with the existence of bronchiectasis. We present the case of a child who showed repeated hemoptysis and focal neumonitis due to Eikenelle corrodens three years after the aspiration of a spike. The diagnosis of the bronchial aspiration obtained after The most unusual in this case is the clinic manifestation of repeated hemoptysis, together with the long connected to the existence of foreign body inside the bronchus.

[Lesions of the tracheobronchial tree after the aspiration of a tablet of ferrous sulfate]. / Lesiones en el árbol traqueobronquial tras aspiración de una tableta de sulfato ferroso.

Foreign body aspiration requires emergency bronchoscopic examination when the product is chemically active. We describe the case of a female patient who aspirated a ferrous sulfate tablet that, in spite of being extracted immediately, caused lesions that persisted in the bronchial tree for 6 weeks. We then discuss the potential of ferrous sulfate substance to cause damage to the tracheobronchial tree.

Hypofrontality in schizophrenia: influence of normalization methods.

1. Studies with Single Photon Emission Computed Tomography (SPECT) in schizophrenia research have utilized different approaches to normalization of data, such as cerebellar ratio and whole brain ratio methods, leading to conflicting findings. 2. The authors compared these two methods to test the hypofrontality hypothesis of schizophrenia. 3. Eighteen chronic and medicated DSM-IV schizophrenic patients and 10 healthy controls underwent two SPECT examinations using 99mTc HMPAO as a tracer at baseline and during frontal activation while applying the Wisconsin Card Sorting Test. 4. The hypofrontality hypothesis was supported with both indexes of relative perfusion, although the whole brain ratio method appeared to be more reliable and specific than the cerebellar ratio method. 5. Further studies are required to confirm these preliminary results on the specificity and sensitivity of both methods.

[Sexuality in ostomy patients]. / La sexualidad del paciente ostomizado.

Seventy adult patients out of 446 with surgical stomas were investigated to ascertain the degree of sexual disfunction caused by the operation. A questionnaire of 74 items was given to all patients. Statistical analysis was done for crossing variables using Chi Square calculations. Sexual activity decreased much more in males than in females, independently of age but in relation to the type of operation.

[Increase in glutamic-oxaloacetic and glutamic-pyruvic transaminases and lactic dehydrogenase as a diagnostic aid in perinatal asphyxia]. / Elevación de transaminasas glutámico oxalacética, glutámico pirúvica y deshidrogenasa láctica como auxiliar diagnóstico de asfixia perinatal.

In order to determine the behavior of glutamic oxalacetic (GOT), glutamic-pyruvic (GPT) and lactic dehydrogenase (LDH) transaminases after a period of asphyxia, a study was conducted in 120 newborn children which were placed into two groups: group 1 of the asphyxiated children who were given oxygen at intermittent positive pressure for more than a minute and group 2 of healthy children with an Apgar greater than 7 after the first and five minutes and without any apparent pathology. The results showed a real increase in the quantities of all three transaminases among those in the group of asphyxiated children, which on the other hand did not occur in the healthy group of children where levels remained normal. There was statistical differences (P less than 0.001) by which we can conclude that the quantification of these enzymes can be useful as a diagnostic tool in cases of perinatal asphyxia.

[Antibodies studied by the ELISA technique in 60 patients with pulmonary tuberculosis. Clinico-immunological correlation]. / Estudio de anticuerpos por la técnica de ELISA en 60 enfermos de tuberculosis pulmonar. Correlación clinicoinmunológica.

The levels of IgG and IgM antibodies were evaluated in 60 patients with pulmonary tuberculosis, who were compared with a group of 30 tuberculin-negative healthy controls and another group of 10 healthy tuberculin-positive individuals. The technique for the quantification of antibodies against M. tuberculosis was an enzyme immunoassay, using purified tuberculin as antigen. The mean (means) IgG and IgM values and their standard deviations (SD), expressed in optical density units, were as follows: for the tuberculin-negative control group: IgG 0.029 +/- 0.013, IgM 0.032 +/- 0.010; for the tuberculin-positive control group: IgG 0.023 +/- 0.007, IgM 0.033 +/- 0.012; and for the group of patients: IgG 0.054 +/- 0.016, IgM 0.051 +/- 0.017. Fifty per cent of patients (30) were positive for IgG, 46.6% (28) were positive for IgM and 28.3% (17) were positive for both immunoglobulins. Those values higher than the mean of control group plus two SD were considered as positive. In the group of tuberculous patients a significant increase of IgG was observed, which was more marked after two weeks of antituberculous chemotherapy in patients with prolonged course. There appears to be a good correlation between the levels of immunoglobulins and the clinical status.