Factores pronósticos de fracaso terapéutico al radioyodo en enfermedad de Graves / Frequency and prognostic factors of radioiodine treatment failure in basedow Graves disease

Background: Radioiodine treatment fails in 17 percent of patients with Basedow Graves disease (BGD). Aim: To assess the frequency and possible associated factors of treatment failure of the first radioiodine dose in patients with BGD. Material and Methods: Review of medical records of patients with BGD treated with radioiodine at a general hospital between 2004 and 2008. Normal thyroid function or hypothyroidism ensuing after treatment were considered as treatment success criteria. Results: According to the databases of the hospital, 298 patients received radioiodine in the study period. Of these, 254 medical records were recovered and 86 were analyzed. Treatment success and failure was recorded in 67 (78 percent) and 19 (22 percent) patients, respectively. The mean dose used was 12 +/- 2 mCi. Clinically determined goiter size and a high free thyroxin level were significantly associated to treatment failure. The area under the receiver operating characteristic curve (ROC) for a thyroid weight over 60 g, estimated clinically was 0.73, rendering a sensitivity and specificity of 63 and 89 percent respectively, for this parameter as predictor or treatment failure. Conclusions: Thyroid gland size may be a predictor of radioiodine treatment failure. However the variability of the clinical estimation of this parameter casts doubts about its usefulness.

Hipertensión renovascular y soplo abdominal en un caso: ¿ha modificado la tecnología su interpretación? / Renovascular hipertension and abdominal bruit: diagnostic implications of modern technological assessments: report of one case

A lateral abdominal bruit is considered an important finding for the detection of renovascular hypertension. However, the precision and accuracy of new techniques such as angiography, Doppler ultrasound and studies with radioisotopes have changed its value and clinical interpretation. We report a 75 years old woman with a bilateral renal artery stenosis in whom a bruit was heard over the artery that did not contribute to the genesis of hypertension and the significant arterial stenosis causing hypertension was silent. This particular situation could lead to erroneous clinical decisions

Hipoplasia pulmonar unilateral en un adulto joven / Unilateral pulmonary hypoplasia in a young adult male

Caso clínico de un hombre joven, previamente asintomático, quien consultó por síntomas de un cuadro infeccioso respiratorio alto. El hallazgo de asimetría torácica y signología de condensación basal izquierda motivó el estudio broncográfico, angiográfico y de función diafragmática, lo que permitió comprobar una hipoplasia pulmonar izquierda. Se presenta una revisión bibliográfica sobre el desarrollo normal del pulmón y algunas alteraciones del desarrollo del aparato respiratorio