Symbol Digit Modalities Test: Normative data for Spanish-speaking pediatric population.

OBJECTIVE: To generate normative data for the Symbol Digit Modalities Test (SDMT) in Spanish-speaking pediatric populations. METHOD: The sample consisted of 4,373 healthy children from nine countries in Latin America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico) and Spain. Each participant was administered the SDMT as part of a larger neuropsychological battery. SDMT scores were normed using multiple linear regressions and standard deviations of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. RESULTS: The final multiple linear regression models showed main effects for age in all countries, such that score increased linearly as a function of age. In addition, age2 had a significant effect in all countries, except in Honduras and Puerto Rico. Models indicated that children whose parent(s) had a MLPE >12 years of education obtained higher score compared to children whose parent(s) had a MLPE ≤12 years for Chile, Guatemala, Mexico, and Spain. Sex affected SDMT score for Paraguay and Spain. CONCLUSIONS: This is the largest Spanish-speaking pediatric normative study in the world, and it will allow neuropsychologists from these countries to have a more accurate interpretation of the SDMT with pediatric populations.

Anestesia para colonoscopia: anestesia inhalatoria con sevoflurano frente a anestesia intravenosa con propofol / Colonoscopic anesthesia: Inhalatory anesthesia with sevoflurane versus intravenous anesthesia with propofol

Introducción: Las exploraciones endoscópicas como la colonoscopia son actualmente cada vez más frecuentes, tanto por prescripción clínica, como para despistaje del cáncer de colon, siendo precisa Anestesia/sedación practicamente en todos los casos. La técnica más frecuentemente usada es la intravenosa con propofol, en algunos casos no puede realizarse, y se plantea una alternativa inhalatoria. Objetivo: comparación de las características de una técnica habitual con propofol (A) y de una inhalatoria con Sevoflurano (B). Sujetos y Método: Se estudian las características de ambas técnicas en dos grupos de 150 pacientes cada uno, valorándose las ventajas de cada una, complicaciones,tolerancia, tiempo de recuperación, aceptación por el endoscopista y el paciente de ambas técnicas. Resultados: en ambas técnicas las complicaciones son muy escasas, el grado de tolerancia es buena/muy buena en el 99% del grupo (A), frente a un 97% del grupo (B). Discusión: Aunque no hemos encontrado publicaciones comparando ambas técnicas en anestesia para colonoscopia, el uso de Sevoflurano ha demostrado características similarmente favorables en pacientes contraindicados para el uso de propofol, siempre que cambiemos el esquema de anestésia intravenosa por inhalatoria. Conclusión: Ambas técnicas son igualmente útiles y seguras, pudiendo emplearse la técnica inhalatoria con Sevoflurano en los pacientes en los que el propofol resulte inadecuado, con iguales prestaciones y versatilidad (AU)

Introduction: The exploratory endoscopy and colonoscopy are now increasingly common, both clinical prescription, and for colon cancer screening, needing Anesthesia / sedation in virtually all cases. The most commonly used is intravenous propofol, which in some cases cannot be performed, and an alternative is inhaled. Objective: To compare the characteristics of a standard technique with propofol (A) and an inhalation with sevoflurane (B). Subjects and Methods: We studied the characteristics of both techniques in two groups of 150 patients each, valuing the benefits of each, complications, tolerance, recovery time, acceptation by the endoscopist and the patient for both techniques. Results: In both techniques few complications, the degree of tolerance is good / very good in 99% of the group (A), compared to 97% of the group (B). Discussion: Although we found no publications comparing both techniques in anesthesia for colonoscopy, the use of sevoflurane has been shown similarly favorable characteristics in patients contraindicated for use of propofol, whenever we change the pattern of intravenous anesthesia by inhalation. Conclusion: Both techniques are equally useful and reliable and can be used with sevoflurane inhalation technique in patients if the propofol is inappropriate, with equal performance and versatility (AU)

Disnea y anemia en relación con herniación de estómago y ángulo esplénico de colon a través del hiato esofágico / Disnea and anemia in relation to esophageal herniation and splenic colon angle throught esophageal hiatus

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[Peritoneal tuberculosis: evaluation of the response to treatment by analysing the CA 125 levels]. / Tuberculosis peritoneal: valoración de la respuesta al tratamiento mediante los niveles de CA 125.

A case of a 32 years old woman with fever and exudative ascites is described. Tuberculous peritonitis was confirmed by abdominal laparoscopy, peritoneal biopsy and Lowënstein culture. A serum CA 125 level was 861 U/ml before therapy. The CA 125 level decreased a 30% after three weeks of antituberculous treatment. This tumor marker may be used to follow disease activity in tuberculous ascites.

[Primary esophageal melanoma]. / Melanoma esofágico primario.

Primary malignant melanoma of the esophagus is an extremely rare non-epithelial neoplasm with a fatal prognosis. At present, approximately 184 cases have been published in the world literature. Of all published cases, 10 (5.4%) occurred in Spain. A 76 year-old man with malignant melanoma of the esophagus presented with dysphagia and weight loss, and treated by subtotal esophageal resection is reported. There was no history of previous cutaneous melanoma and ophthalmologic examination had been normal. At esophagoscopy a polypoid and pigmented mass (diameter 5 cm) almost completely occluding the lumen in the lower third of the esophagus was found. Multiple tumor biopsies were obtained. Histological diagnoses were made by examining endoscopic biopsy specimens and confirmed with resected specimens. The purpose of this communication is to present a case of primary esophageal malignant melanoma proved preoperatively by histological and immunohistochemical studies (positive reaction to the HMB-45 and S-100 antigen), followed by a review of the literature of these exceptional tumors.