Breast Lump: A Rare Presentation of Tuberculosis in an Elderly Man.

INTRODUCTION: Chest wall masses are caused by various entities and have diverse aetiologies. A careful history and physical examination are crucial to establish the correct diagnosis. CASE REPORT: A 77-year-old man presented with depressive mood, anorexia (weight loss of 20 kg) and a 1-month history of a non-painful breast lump with well-defined contours, which was about 6 cm in diameter. There was no history of trauma. Computed tomography of the thorax revealed a collection of liquid in the left anterior thoracic wall, associated with discontinuity of the 4th left costal cartilage, and upper left lobe cavitation, suggesting pulmonary tuberculosis. The patient was started on quadruple therapy with anti-tuberculosis drugs and discharged after a negative smear. CONCLUSION: In this case, the indolent onset of unspecific symptoms made it difficult to reach a diagnosis of pulmonary tuberculosis, which was confirmed by positive culture and imaging. A breast lump in an elderly patient with unspecific clinical manifestations is an unusual presentation of pulmonary tuberculosis. It is important to be aware of rib invasion and exclude tuberculosis in a patient with a chest wall mass. As tuberculosis is treatable, early diagnosis is vital as diagnostic delay can lead to contagion. LEARNING POINTS: Chest wall tuberculosis is a rare complication of pulmonary tuberculosis.As smears and acid-fast bacilli cultures are often negative, polymerase chain reaction and imaging should be performed.Tuberculosis should be treated with first-line drugs; the role of surgery is still controversial.

Pain improvement in Camurati-Engelmann disease after anti-TNFα therapy.

Camurati-Engelmann disease (CED) is a rare disorder included in the group of craniotubular hyperostosis diseases. Corticosteroids are used for pain management in CED, but in refractory or corticosteroid-non-tolerant patients, pain management is limited. We report the case of a woman with CED diagnosed in early infancy whose initial complaints included persistent bone pain associated with progressive functional disability. She was treated with steroids but over time became dependent on higher doses with only mild pain relief. In her third decade, she was diagnosed with ulcerative colitis (UC) and was treated with mesalazine, azathioprine and prednisolone. Due to recurrent exacerbations of UC, treatment was changed to infliximab, an antitumour necrosis factor-alpha (TNFα). Remission of UC was achieved and CED-associated pain also improved with infliximab. This is the first report showing a possible role of anti-TNFα in pain management in CED with unsatisfactory response to steroids.

Dementia in a patient with Thymoma and hypogammaglobulinaemia (Good's syndrome).

Good's syndrome is extremely rare and refers to an acquired B and T cell immunodeficiency in thymoma patients. The authors of this article present a case report of a 75-year-old, caucasian male patient previously subjected to examinations for secondary dementia and recurrent infections, which revealed paraneoplastic syndrome arose from thymoma. He underwent thymectomy, while his immunodeficiency syndrome sustained with frequent opportunistic infections, constantly requiring intravenous immunoglobulin treatment.

Las leyes de la dialéctica materialista en el desarrollo de la computación

La introducción acelerada de las técnicas y equipos de computación es hoy una realidad en nuestro país. Dicha tendencia está en estrecha relación con las expectativas de desarrollo de la producción, la técnica y el progreso científico que debemos lograr en años venideros. Las leyes fundamentales de la dialéctica se ponen de manifiesto, de forma evidente, en el avance histórico de la computación y es un elemento básico para dar cumplimiento a los objetivos generales educativos de los programas de las asignaturas de Informática que se imparten en los distintos niveles de enseñanza, en lo referido a la consolidación de la concepción científica del mundo. La sustitución constante de la nueva tecnología por la vieja, el cambio tecnológico que experimenta el perfeccionamiento del hardware y la utilización, cada vez más marcada, de elementos nuevos y novedosos del software, crean la premisa para comprender el papel que juegan las leyes fundamentales de la dialéctica en el desarrollo histórico de la computación(AU)

The quick introduction of the techniques and computer teams are today a reality in our country. This tendency is in narrow relationship with the expectations of the production development, the technique and the scientific development that we should achieve in coming years. The main dialectics laws are in an evident way in the historical development of the computing and it is a basic element to give execution to the educational general objectives of the programs of Computing science subjects that are imparted in the different teaching levels, referring to the consolidation of the scientific conception of the world. The constant substitution of the new technology for the old one, the technological change that experiences the development of the hardware and the use, more and more marked, of new and novel elements of the software, create the premise to understand the main dialectics laws rall in the historical development of the computing(AU)

El método científico en las ciencias médicas

El trabajo contiene una revisión bibliográfica sobre los aspectos más novedosos del método científico aplicado a la universidad médica, como certera guía que permite evitar el error filosófico, en las ciencias particulares, en el momento de la interpretación de resultados, además abarca una reseña histórica del método científico desde su surgimiento hasta el presente(AU)

¿Cómo evitar el error filosófico en las ciencias particulares? / How to avoid the physiologic error in the particular sciences

Se ha realizado una revisión bibliográfica sobre como evitar el error filosófico en las ciencias particulares, sobre elementos filosóficos que deben estar presentes en las valoraciones teóricas de las ciencias particulares, que están directamente relacionadas con la actividad práctica transformadora. Los componentes estructurales con que cuentan las ciencias particulares, como son, el componente empírico que permite conocer las características fenoménicas del objeto, y el componente teórico que penetra hasta la esencia de la realidad objetiva, y las bases y deducciones filosóficas que permiten arribar a la materialidad y cognocibilidad del mundo y una comprensión filosófica materialista dialéctica de la realidad objetiva(AU)

El proyecto de investigación intervención / The project of investigation intervention

El proyecto de intervención permite introducir acciones en el objeto de estudio que será seleccionado. Los estudiantes de pregrado y postgrado cuentan con una guía segura para poder confeccionar sus proyectos de investigación, los profesores son los más beneficiados con el uso de esta herramienta metodológica en la práctica científica(AU)

The intervention project allows to introduce actions in the study object that will be selected. The pregrado students and graduate degree have a sure guide to be able to make their investigation projects, the professors are those more beneficiaries with the use of this methodological tool in the scientific practice(AU)