Síndrome de tako-tsubo. Discinesia transitoria del ventrículo izquierdo. Presentación de nuestra casuística / Tako-tsubo syndrome. Transient left ventricular dyskinesia. Presentation of our casuistics

Este síndrome fue descrito en 1990, y se caracteriza por dolor torácico que simula un síndrome coronario agudo (SCA), alteraciones en el ECG y coronarias sin lesiones. Presentamos 16 pacientes ingresados en nuestra UCI, con criterios de síndrome de discinesia transitoria del ventrículo izquierdo (SDTVI). Todos nuestros pacientes menos uno eran mujeres con edad, en general, mayor de 55 años. Se detectó dolor torácico en el 75% de los pacientes. Un 43% tuvo como desencadenante una situación estresante emocional. Un 56% tuvo elevación del ST. La elevación de biomarcadores fue ligera-moderada, salvo en un paciente que fue especialmente elevado. A todos se les realizó coronariografía y ventriculografía, detectándose una discinesia septal o anterolateral, con fracción de eyección normal en el 75% de los casos. La discinesia desapareció entre los 4 días y las 6 semanas (AU)

This syndrome was described in 1990. It is characterized by chest pain that simulatesan acute coronary syndrome (ACS), with alterations in the ECG, but with normal coronaryarteries. We present 16 patients admitted in our ICU, who met the criteria of transient leftventricular dysfunction syndrome (TLVDS). All but 1 patient were women, with age in generalhigher than 55 years. Chest pain was detected in the 75% of them. A total of 43% had emotionalstress as 56% had an elevation of the ST segment, essentially anterolateral. The increase of thebiomarkers was slight-to-moderate, with the exception of one patient in whom it was especiallyhigh. All of them had undergone a coronary arteriogram and ventriculography, and either septalor anterolateral dyskinesia had been detected, with normal ejection fraction. In 75% of the casesthe dyskinesia had disappeared between 4 days to 6 weeks (AU)

[Tako-tsubo syndrome. Transient left ventricular dyskinesia. Presentation of our casuistics]. / Síndrome de tako-tsubo. Discinesia transitoria del ventrículo izquierdo. Presentación de nuestra casuística.

This syndrome was described in 1990. It is characterized by chest pain that simulates an acute coronary syndrome (ACS), with alterations in the ECG, but with normal coronary arteries. We present 16 patients admitted in our ICU, who met the criteria of transient left ventricular dysfunction syndrome (TLVDS). All but 1 patient were women, with age in general higher than 55 years. Chest pain was detected in the 75% of them. A total of 43% had emotional stress as 56% had an elevation of the ST segment, essentially anterolateral. The increase of the biomarkers was slight-to-moderate, with the exception of one patient in whom it was especially high. All of them had undergone a coronary arteriogram and ventriculography, and either septal or anterolateral dyskinesia had been detected, with normal ejection fraction. In 75% of the cases the dyskinesia had disappeared between 4 days to 6 weeks.

Siringomas vulvares: una causa infrecuente de prurito vulvar / Vulvar syringoma: a rare cause of vulvar pruritus

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Cirugía de Mohs: nuestros primeros cien pacientes / Mohs micrographic surgery: our first 100 patients

Definición. Descrita por Frederic Mohs en 1941, la cirugía de Mohs es una técnica quirúrgica con control histológico de los bordes, utilizada para eliminar tumores cutáneos de alto riesgo. Objetivo. El objetivo de este artículo es informar de los hallazgos clínicos y comparar la agresividad-extensión subclínica del tumor, medida como número de estadios de Mohs necesarios para eliminar completamente el tumor, en función de que el tumor presente o no factores de alto riesgo. Métodos. Se incluyen 100 pacientes con 105 tumores y en todos los casos se obtuvieron las variables de edad y sexo del paciente, localización, tipo de tumor y subtipo histológico en el caso del carcinoma basocelular, tamaño, existencia de recurrencias, número de estadios de Mohs y técnica de reconstrucción. Resultados. Se incluyen 44 hombres y 56 mujeres de edades comprendidas entre los 28 y 88 años (media 72,6). El 80 % eran carcinomas basocelulares, el 12,38 % carcinomas espinocelulares, el 4,76 % dermatofibrosarcomas protuberans, el 0,95 % carcinoma de células de Merkel, el 0,95 % carcinoma anexial microquístico y el 0,95 % lentigo maligno melanoma. La mayoría estaban localizados en la cabeza y el 60 % precisó más de un estadio de Mohs para ser eliminado. Conclusión. Esta serie se caracteriza por presentar un alto porcentaje de tumores cutáneos de alto riesgo. Valorando estos factores de riesgo de forma independiente podemos concluir que el tamaño del tumor es el factor de riesgo que más se relaciona con la agresividad y la extensión subclínica en el caso del carcinoma basocelular, no pudiendo llegar a conclusiones similares para el resto de los tumores incluidos en este trabajo (AU)

Introduction. Mohs surgery was first described by Frederic Mohs in 1941 to eliminate high-risk cutaneous tumors. The technique involves histological examination of the margins. Objective. The aim of this study was to describe the clinical findings and compare the grade and subclinical extension of the tumor —as measured by the number of Mohs stages needed for complete elimination—according to whether the tumor presented high-risk factors. Methods. We included 100 patients with 105 tumors. In all cases, age, sex, tumor site, tumor type, histological subtype in the case of basal cell carcinoma, size, recurrences, number of Mohs stages, and reconstruction technique were recorded. Results. The study group comprised 44 men and 56 women aged between 28 and 88 years (mean, 72.6 years). Of the tumors, 80 % corresponded to basal cell carcinoma, 12.38 % to squamous cell carcinoma, 4.76 % to dermatofibrosarcoma protuberans, 0.95 % to Merkel cell carcinoma, 0.95 % to microcystic adnexal carcinoma, and 0.95 % to lentigo maligna melanoma. Most tumors were located on the head and 60 % required more than one Mohs stage for complete elimination. Conclusion. This series is characterized by a high percentage of high-risk cutaneous tumors. After assessing the risk factors independently, we found that the size of the tumor is the risk factor most closely related to grade and subclinical extension in the case of basal cell carcinoma, although similar conclusions cannot be drawn for the other types of tumor studied (AU)

[Mohs micrographic surgery: our first 100 patients]. / Cirugía de Mohs: nuestros primeros cien pacientes.

INTRODUCTION: Mohs surgery was first described by Frederic Mohs in 1941 to eliminate high-risk cutaneous tumors. The technique involves histological examination of the margins. OBJECTIVE: The aim of this study was to describe the clinical findings and compare the grade and subclinical extension of the tumor as measured by the number of Mohs stages needed for complete elimination according to whether the tumor presented high-risk factors. METHODS: We included 100 patients with 105 tumors. In all cases, age, sex, tumor site, tumor type, histological subtype in the case of basal cell carcinoma, size, recurrences, number of Mohs stages, and reconstruction technique were recorded. RESULTS: The study group comprised 44 men and 56 women aged between 28 and 88 years (mean, 72.6 years). Of the tumors, 80 % corresponded to basal cell carcinoma, 12.38 % to squamous cell carcinoma, 4.76 % to dermatofibrosarcoma protuberans, 0.95 % to Merkel cell carcinoma, 0.95 % to microcystic adnexal carcinoma, and 0.95 % to lentigo maligna melanoma. Most tumors were located on the head and 60 % required more than one Mohs stage for complete elimination. CONCLUSION: This series is characterized by a high percentage of high-risk cutaneous tumors. After assessing the risk factors independently, we found that the size of the tumor is the risk factor most closely related to grade and subclinical extension in the case of basal cell carcinoma, although similar conclusions cannot be drawn for the other types of tumor studied.

Efectividad de la aplicación tópica de nitroglicerina en spray en el aumento de la supervivencia de plastias cutáneas / Effectiveness of topical application of nitroglycerin spray to increase survival of cutaneous flaps and grafts

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Intraperitoneal and subcutaneous treatment of experimental endometriosis with recombinant human interferon-alpha-2b in a murine model.

OBJECTIVE: To determine the effect of human interferon (IFN)-alpha-2b on experimental endometriosis in rats. DESIGN: Experimental, controlled, double-blind randomized study. SETTING: Experimental surgery laboratory in a university department. ANIMAL(S): Ninety-six Wistar rats with endometriosis, induced by transplanting four endometrial fragments into the peritoneal cavity. INTERVENTION(S): One third of the animals served as controls (group A). The others were randomly divided into two groups and were given IFN-alpha-2b either as a single intraperitoneal dose (group B) or as three SC doses (on alternate days) (group C). MAIN OUTCOME MEASURE(S): Laparotomy was performed to measure the size of each implant at various times (days 0, 6, 12, 20, and 120 after treatment). RESULT(S): There were no differences among the groups in the size of the average implants before IFN was administered (17.3+/-6.7, 19.7+/-7.8, and 18.1+/-9.2 mm for groups A, B, and C, respectively). These values were significantly smaller after treatment in group B (14.9+/-8.0 mm) and group C (14.0+/-9.5 mm) than in the control group (17.6+/-7.5 mm) (P<.05). Intraperitoneal IFN produced an initial maximum decrease in the size of the implants (40% reduction on day 6), which diminished until day 20 (20%) and then was maintained on a plateau until day 120 (25%). By contrast, group C showed an initial minimal reduction (13% at day 6), which increased up to day 20 (19%), after which a plateau was reached (23% at day 120). Thus, the effects in both treatment groups were similar in the long term. CONCLUSION(S): Two short regimens of human IFN-alpha-2b reduced the size of experimental endometriosis in rats.

[Electrocardiographic changes in hypoglycemia]. / Alteraciones electrocardiográficas en la hipoglucemia.

Several electrocardiographic anomalies have been described in association with hypoglycaemia. We report the case of a 70-year-old woman with hypoglycaemic coma whose electrocardiogram showed significant conduction anomalies, including atrioventricular block and intraventricular conduction disturbances, and repolarization abnormalities. These electrocardiographic changes disappeared after intravenous glucose administration.

[Recurrent pericarditis: our experience with colchicine]. / Pericarditis recurrente: nuestra experiencia con colchicina.

To prove the efficacy of colchicine in the prevention of recurrences of acute pericarditis, 5 patients, age 24 to 64 years (mean 36), were treated during 18 months with 1 milligram daily. Previous treatment with steroids and/or non steroid antiinflammatory agents did not prevent 2-3 recurrences per patient, and was discontinued after entry into the study. There where no further recurrences of acute pericardial episodes during the 24 months of follow-up, and no side effects related to the treatment with colchicine were reported. We conclude that colchicine is effective in preventing the recurrences of acute idiopathic pericarditis.

Primary malignant melanoma of the uterine cervix: case report and review of the literature.

A case of primary malignant melanoma of the uterine cervix is presented. So far only 26 cases have been reported. Vaginal bleeding was the most common complaint. Total abdominal hysterectomy with bilateral salpingo-oophorectomy and adjuvant radiotherapy is the elective treatment. Prognosis for this entity is poor. The tumor seems to arise from melanocytes that are usually present in the cervix.