Edema hemorrágico agudo en un lactante / Acute hemorrhagic edema of infancy

Niña de 20 meses de edad que había presentado la semana previa un cuadro catarral febril, en la que aparecieron placas edematosas, equimótico-purpúricas en las extremidades inferiores de forma simétrica, ni dolorosas a la palpación ni pruriginosas. No había lesiones en la cara y su estado general era bueno. Se realizó el diagnóstico de edema agudo hemorrágico del lactante (EAHL) por el aspecto clínico de las lesiones. Se le realizó un control evolutivo en el centro de salud, sin que requiriera tratamiento específico, y las lesiones desaparecieron completamente en el plazo de 2 semanas. El edema agudo hemorrágico del lactante es una vasculitis leucocitoclástica de pequeños vasos, con unas manifestaciones cutáneas muy llamativas, por el aspecto, la rapidez y la brusquedad de aparición de las lesiones, a pesar de lo cual tiene una evolución benigna, puesto que no hay afectación del estado general. El diagnóstico debe ser clínico y no es preciso instaurar ningún tratamiento (AU)

We present a case of a 20-month baby girl who had shown the previous week a febrile upper respiratory tract infection. During this process edematous plaques appeared, ecchymotic purpuric with symmetrical form on the lower extremities, they did not itch or were painful to touch. There were no lesions on the face and the patient's general medical state was satisfactory. A diagnosis of acute hemorrhagic edema of infancy (AHEI) was made based on the clinical aspect of the lesions. Regular checkups were performed in the clinic to monitor the progress of the condition and without requiring specific treatment the lesions disappeared completely within a period of two weeks. AHEI is a type of cutaneous leukocyteclastic vasculitis of small blood vessels and is striking due to its appearance the speed and abruptness at which the lesions spreads. Despite all it has a benign prognosis given that it does not negatively affect the general medical state of the patient. The diagnosis should be clinical and no treatment is necessary (AU)

[Expression of receptors of estrogens and androgens in the testicular appendices]. / Expresión de receptores de estrógenos y andrógenos en los apéndices testiculares.

INTRODUCTION: The appendices or hidátides of the testicle are structures that are considered an embryonic rest. In testicular hidátide estrogen receivers have been demonstrated but in the epididimys the results vary. Has been theorized that the elevation of the estrogen levels in the puberty can produce an inflammation and torsion of hidátide, nevertheless, in the epididimys in which the estrogen expression is not clear (and also they are twisted) the theory is put in doubt. This controversy takes us to the accomplishment of this work. MATERIAL AND METHOD: A prospective study is made in 20 testicular appendices, of which 7 from the epididimys are extirpated of patients to whom an escrotal exploration is made in the development of surgery of processes of the inguino-escrotal channel (hidroceles, hernias). Optical microscopy and inmunohistoquímical study are analyzed by means of using prediluted monoclonales antibodies, for receivers of estrogens, androgens and proliferative index. The results were proceed and analyzed by means of SPSS statistical program. RESULTS: All hidátides, testicular and from the epididimarys expressed receivers for estrogens without significant difference among them, not existing differences as far as the location of receiving sayings within the three compartments of hidátide. The number of estrogen receivers was in relation to the age of the patient. Only hidátides from the epididimys fundamentally expressed receivers of located androgens and at level of ductus. We have not found significant relation between the proliferative index and the expression of estrogen receivers. The proliferative index was more elevated at level of ductus. CONCLUSIONS: 1) As much the testicular appendices as those from the epididimays expressed receivers of estrogens at level of the three compartments. It makes think about a same embryonic origin, although only the epididimal ones expressed androgen receivers. 2) the observation of estrogen receivers in both types of hidátides, as well as the relation of the number of such with the age of the patient, makes think that the increase of estrogens in the puberty can participate in patogénia of the torsion of these appendices.

Expresión de receptores de estrógenos y andrógenos en los apéndices testiculares / Expression of receivers of estrogens and androgens in the testicular appendices

Introducción. Los apéndices o hidátides del testículo son estructuras que se consideran restos embrionarios. En la hidátide testicular se han demostrado receptores estrogénicos pero en la epididimaria los resultados varían. Se ha teorizado que la elevación de los niveles de estrógenos en la pubertad puede producir una inflamación y torsión de la hidátide, sin embargo, en las epididimarias en las que no está clara la expresión de estrógenos (y también se torsionan) la teoría se pone en duda. Esta controversia nos lleva a la realización de este trabajo. Material y método. Se realiza un estudio prospectivo en 20 apéndices testiculares, de los cuales 7 son epididimarios extirpados de pacientes a los que se realiza una exploración escrotal en el desarrollo de cirugía de procesos del canal inguino-escrotal (hidroceles, criptorquídias).Se analizan mediante microscopía óptica y estudio inmunohistoquímico empleando anticuerpos monoclonales prediluidos, para receptores de estrógenos, androgenos e indice proliferativo. Los resultados fueron procesados y analizados mediante el programa estadístico SPSS. Resultados. Todas la hidátides, testiculares y epididimarias expresaron receptores para estrógenos sin diferencia significativa entre ellas, no existiendo diferencia en cuanto a la localización de dichos receptores dentro de los tres compartimentos de la hidátide. El número de receptores de estrógenos estaba en relación con la edad del paciente. Sólo las hidátides epididimarias expresaron receptores de andrógenos y localizados fundamentalmente a nivel de los ductus. No hemos encontrado relación significativa entre el índice proliferativo y la expresión de receptores de estrógenos. El índice proliferativo fue más elevado a nivel delos ductus. Conclusiones. 1) Tanto los apéndices testiculares como epididimarios expresaron receptores de estrógenos a nivel de los tres compartimentos. Ello hace pensar en un mismo origen embrionario, si bien sólo los epididimarios expresaron receptores de andrógenos. 2) La observación de receptores de estrógenos en ambos tipos de hidátides, así como la relación del número de los mismos con la edad del paciente, hace pensar que el aumento de estrógenos en la pubertad puede participar en la patogenia de la torsión de estos apéndices (AU)

Introduction. The appendices or hidátides of the testicle are structures that are considered an embryonic rest. In testicular hidátide estrogen receivers have been demonstrated but in the epididimys the results vary. Has been theorized that the elevation of the estrogen levels in the puberty can produce an inflammation and torsion of hidátide, nevertheless, in the epididimys in which the estrogen expression is not clear (and also they are twisted) the theory is put in doubt. This controversy takes us to the accomplishment of this work. Material and method. A prospective study is made in 20 testicular appendices, of which 7 from the epididimys are extirpated of patients to whom an escrotal exploration is made in the development of surgery of processes of the inguino-escrotal channel (hidroceles, hernias). Opticalmicroscopy and inmunohistoquímical study are analyzed by means of using prediluted monoclonales antibodies, for receivers of estrogens, androgens and proliferative index. The results were proceed and analyzed by means of SPSS statistical program. Results. All hidátides, testicular and from the epididimarys expressed receivers for estrogens without significant difference among them, not existing differences as far as the location of receiving sayings within the three compartments of hidátide. The number of estrogen receivers was in relation to the age of the patient. Only hidátides from the epididimys fundamentally expressed receivers of located androgens and at level of ductus. We have not found significant relation between the proliferative index and the expression of estrogen receivers. The proliferative index was more elevated at level of ductus. Conclusions. 1) As much the testicular appendices as those from the epididimays expressed receivers of estrogens at level of the three compartments. It makes think about a same embryonic origin, although only the epididimal ones expressed androgen receivers. 2) the observation of estrogen receivers in both types of hidátides, as well as the relation of the number of such with the age of the patient, makes think that the increase of estrogens in the puberty can participate in patogénia of the torsion of these appendices (AU)

[Abdominal tuberculosis]. / Tuberculosis abdominal.

We report six cases of abdominal tuberculosis, calling attention to the new increase in this illness and the difficulty of diagnosis because of the nonspecificity of the symptoms, which were mainly abdominal pain and abdominal calcifications.