RESUMEN
Superficial siderosis of the central nervous system is produced by the deposit of hemosiderin within the subpial layers of the central nervous system and central parts of the cranial nerves, leading to progressive degeneration. We report a 55-year-old male who consulted for hearing loss and long-standing progressive decrease in visual acuity, associated with sudden onset of left hemiparesis. A brain CAT scan showed subacute ischemic lesions in the territory of the right posterior cerebral artery (thalamus and right subcortical temporal regions), old ischemic lesions in the right subcortical occipital regions and cerebellar atrophy. A magnetic resonance confirmed the lesions and the presence of superficial diffuse siderosis. A cerebrospinal fluid analysis showed slight xanthochromia, 26 leukocytes/mm3, glucose 51 mg/dL and proteins 1.23 g/L. He was managed with aspirin in low doses and statins. His motor function improved and was discharged two weeks after admission.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Siderosis/complicaciones , Siderosis/patología , Siderosis/diagnóstico por imagen , Pérdida Auditiva , Imagen por Resonancia Magnética , Sistema Nervioso CentralRESUMEN
Superficial siderosis of the central nervous system is produced by the deposit of hemosiderin within the subpial layers of the central nervous system and central parts of the cranial nerves, leading to progressive degeneration. We report a 55-year-old male who consulted for hearing loss and long-standing progressive decrease in visual acuity, associated with sudden onset of left hemiparesis. A brain CAT scan showed subacute ischemic lesions in the territory of the right posterior cerebral artery (thalamus and right subcortical temporal regions), old ischemic lesions in the right subcortical occipital regions and cerebellar atrophy. A magnetic resonance confirmed the lesions and the presence of superficial diffuse siderosis. A cerebrospinal fluid analysis showed slight xanthochromia, 26 leukocytes/mm3, glucose 51 mg/dL and proteins 1.23 g/L. He was managed with aspirin in low doses and statins. His motor function improved and was discharged two weeks after admission.
Asunto(s)
Pérdida Auditiva , Siderosis , Masculino , Humanos , Persona de Mediana Edad , Siderosis/diagnóstico por imagen , Siderosis/complicaciones , Siderosis/patología , Sistema Nervioso Central , Imagen por Resonancia MagnéticaRESUMEN
There are many unanswered questions about the population history of the Central and South Central Andes, particularly regarding the impact of large-scale societies, such as the Moche, Wari, Tiwanaku, and Inca. We assembled genome-wide data on 89 individuals dating from â¼9,000-500 years ago (BP), with a particular focus on the period of the rise and fall of state societies. Today's genetic structure began to develop by 5,800 BP, followed by bi-directional gene flow between the North and South Highlands, and between the Highlands and Coast. We detect minimal admixture among neighboring groups between â¼2,000-500 BP, although we do detect cosmopolitanism (people of diverse ancestries living side-by-side) in the heartlands of the Tiwanaku and Inca polities. We also highlight cases of long-range mobility connecting the Andes to Argentina and the Northwest Andes to the Amazon Basin. VIDEO ABSTRACT.
Asunto(s)
Antropología/métodos , ADN Antiguo/análisis , Flujo Génico/genética , América Central , ADN Mitocondrial/genética , Flujo Génico/fisiología , Genética de Población/métodos , Haplotipos , Humanos , Análisis de Secuencia de ADN , América del SurRESUMEN
Consenso acerca de los aspectos epidemiológicos, clínicos, terapéuticos y preventivos más importantes de la Difteria
Consensus about the most important epidemiological, clinical, therapeutic and preventive aspects of Diphtheria
RESUMEN
Introducción: Actualmente el uso de adhesivos tisulares como el cianoacrilato ha sido beneficioso en el área odontológica, reduciendo el tiempo del acto quirúrgico, disminuyendo el tiempo de cicatrización y la cicatriz postoperatoria, así también el dolor postoperatorio. Objetivo: El objetivo de este artículo es reportar diversas aplicaciones del cianoacrilato en tratamientos quirúrgicos periodontales, como recontorneo estético, gingivectomía, colgajo posicionado apical y preservación alveolar. Materiales y métodos/Presentación de casos: Los protocolos de tratamiento utilizados fueron los tradicionales para cada caso en particular más la adición de tres capas de cianoacrilato, con lapso de aplicación de 30 segundos entre cada capa. Conclusión: Los resultados clínicos de los casos presentados muestran una eficacia en la cicatrización al utilizar cianoacrilato, sin embargo, no sustituye los métodos tradicionales de los protocolos de cada tratamiento (AU)
Introduction: Currently, the use of tissue adhesives such as cyanoacrylate has been beneficial in the dental area, reducing the time of the surgical act, decreasing the time of healing and the postoperative scar, as well as the postoperative pain. Objective: The objective of this article is to report various applications of cyanoacrylate in periodontal surgical treatments, such as aesthetic crown lengthening, gingivectomy, apically positioned flap, and alveolar preservation. Materials and methods/Case presentation: The treatment protocols were the traditional ones for each particular case plus the addition of three layers of cyanoacrylate, with application time of 30 seconds between each layer. Conclusion: The clinical results of the presented cases show an efficacy in the cicatrization when using cyanoacrylate adhesives, nevertheless it does not substitute the traditional methods of the protocols of each treatment (AU)
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Colgajos Quirúrgicos , Cianoacrilatos , Estética Dental , Proceso Alveolar , Gingivectomía , Sonrisa , Cicatrización de Heridas , Membranas Artificiales , MicrocirugiaRESUMEN
El apoyo social puede favorecer la salud creando un ambiente que mejore el bienestar y la autoestima de la persona, y contribuir a amortiguar los efectos negativos de acontecimientos estresantes (enfermedad) que se producen en la vida del sujeto. El presente estudio tuvo como objetivo analizar cómo influye el apoyo social desde el punto de vista estructural y funcional en la adherencia a la terapia antiretroviral en pacientes VIH del programa de atención integral del Hospital Nacional General de Neumología y Medicina Familiar "Dr. José Antonio Saldaña" durante el periodo de Marzo-Julio 2017. Se realizó un estudio descriptivo de corte transversal utilizando el cuestionario MOS para apoyo social y el Instrumento Morinsky Green para verificar adherencia, en una población de 625 pacientes activos con una muestra de 131 pacientes. El análisis de los datos se realizó por medio de estadística descriptiva y la relación entre adherencia al tratamiento y apoyo social, se obtuvo por medio de tablas 2x2 y el respectivo análisis de significancia por medio de x2, valor de p, intervalos de confianza y ODS ratio. Del total de pacientes de la muestra estadística, el 55% fueron adherentes a la TAR mientras que el 45% de ellos no fueron adherentes. Se obtuvo una proporción de pacientes con adherencia terapéutica y apoyo social máximo del 63.6 % y un 28% de los pacientes mostraron un apoyo social medio. Por lo que se puede inferir que existió una relación directamente proporcional entre el nivel de apoyo social y la adherencia del tratamiento
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Apoyo Social , VIH , Fármacos Anti-VIH , AntirretroviralesRESUMEN
Heme oxygenase from Leptospira interrogans is an important virulence factor. During catalysis, redox equivalents are provided to this enzyme by the plastidic-type ferredoxin-NADP+ reductase also found in L. interrogans. This process may have evolved to aid this bacterial pathogen to obtain heme-iron from their host and enable successful colonization. Herein we report the crystal structure of the heme oxygenase-heme complex at 1.73 Å resolution. The structure reveals several distinctive features related to its function. A hydrogen bonded network of structural water molecules that extends from the catalytic site to the protein surface was cleared observed. A depression on the surface appears to be the H+ network entrance from the aqueous environment to the catalytic site for O2 activation, a key step in the heme oxygenase reaction. We have performed a mutational analysis of the F157, located at the above-mentioned depression. The mutant enzymes were unable to carry out the complete degradation of heme to biliverdin since the reaction was arrested at the verdoheme stage. We also observed that the stability of the oxyferrous complex, the efficiency of heme hydroxylation and the subsequent conversion to verdoheme was adversely affected. These findings underscore a long-range communication between the outer fringes of the hydrogen-bonded network of structural waters and the heme active site during catalysis. Finally, by analyzing the crystal structures of ferredoxin-NADP+ reductase and heme oxygenase, we propose a model for the productive association of these proteins.
Asunto(s)
Hemo Oxigenasa (Desciclizante)/química , Hemo Oxigenasa (Desciclizante)/genética , Leptospira interrogans/patogenicidad , Mutagénesis Sitio-Dirigida/métodos , Proteínas Bacterianas/química , Proteínas Bacterianas/genética , Dominio Catalítico , Cristalografía por Rayos X , Activación Enzimática , Enlace de Hidrógeno , Leptospira interrogans/enzimología , Leptospira interrogans/genética , Modelos Moleculares , Conformación Proteica , Estabilidad Proteica , Factores de Virulencia/química , Factores de Virulencia/genéticaRESUMEN
Introducción: El cáncer de mama es uno de los tumores malignos más frecuentes en mujeres, y representa el principal carcinoma que genera metástasis cutáneas (MC), excluyendo al melanoma. Objetivos: Realizar una revisión de las MC del carcinoma mamario y mostrar las principales formas de presentación clínica. Discusión: Las MC pueden presentarse mediante diferentes manifestaciones dermatológicas, aunque lo más frecuente es un infiltrado eritematoso papulonodular único o múltiple, generalmente localizado en la piel subyacente o próxima al área del tumor primario. Las células tumorales alcanzan la piel por 3 vías de diseminación: hemática, linfática y por contigüidad. Los carcinomas mamarios, normalmente, se diseminan por la vía linfática y llegan a zonas de la piel cercanas; así, las MC de mama adoptan como sitio de implantación principal la piel del tórax. Conclusiones: Las MC pueden ser la manifestación inicial de un cáncer, o bien un signo de recurrencia de este. Es necesario tener un alto nivel de sospecha diagnóstica debido a su gran polimorfismo clínico.
Introduction: Breast cancer is one of the most frequent malignant tumors in women and is the main carcinoma leading cutaneous metastasis (CMs), excluding melanoma. Objectives: To present a literature review about CMs from breast cancer and to show the mainly clinical forms. Discussion: CMs can present different skin manifestations, but single or multiple papulonodular erythematosus infiltrate are the most common, generally located in the underlying skin or close to the primary tumor area. Tumor cells reach the skin through three dissemination forms -hematogeneus, lymphatic, and contiguity-. Breast carcinomas normally disseminate through lymphatic via and reach close skin zones; thus, breast CMs mainly allocate in the thorax skin. Conclusions: CMs can be the initial manifestation of a cancer or a sign of its recurrence. There must be a high level of suspicion because its clinical polymorphism.
Asunto(s)
Humanos , Femenino , Neoplasias de la Mama/patología , Carcinoma/patología , Neoplasias Cutáneas/secundarioRESUMEN
The exact timing, route, and process of the initial peopling of the Americas remains uncertain despite much research. Archaeological evidence indicates the presence of humans as far as southern Chile by 14.6 thousand years ago (ka), shortly after the Pleistocene ice sheets blocking access from eastern Beringia began to retreat. Genetic estimates of the timing and route of entry have been constrained by the lack of suitable calibration points and low genetic diversity of Native Americans. We sequenced 92 whole mitochondrial genomes from pre-Columbian South American skeletons dating from 8.6 to 0.5 ka, allowing a detailed, temporally calibrated reconstruction of the peopling of the Americas in a Bayesian coalescent analysis. The data suggest that a small population entered the Americas via a coastal route around 16.0 ka, following previous isolation in eastern Beringia for ~2.4 to 9 thousand years after separation from eastern Siberian populations. Following a rapid movement throughout the Americas, limited gene flow in South America resulted in a marked phylogeographic structure of populations, which persisted through time. All of the ancient mitochondrial lineages detected in this study were absent from modern data sets, suggesting a high extinction rate. To investigate this further, we applied a novel principal components multiple logistic regression test to Bayesian serial coalescent simulations. The analysis supported a scenario in which European colonization caused a substantial loss of pre-Columbian lineages.
Asunto(s)
ADN Mitocondrial/genética , Variación Genética , Genética de Población , Filogenia , Américas , Arqueología , Teorema de Bayes , Chile , ADN Antiguo , Emigración e Inmigración , Genoma Mitocondrial/genética , Haplotipos/genética , Humanos , Indígenas Norteamericanos/genética , América del SurRESUMEN
Stable isotope composition of marine top predator's tissues provides insight information of its trophic ecology and migratory behavior. Previous reports have shown that dermal tissues could record longer patterns of hunting and movement. Based on this, the aim of this study was to describe the feeding and migratory habits of the white shark from Isla Guadalupe, using stable isotopic analysis of dermis. We considered a small subset of many possible prey taxa that the sharks could have eaten throughout their migration: pinnipeds, squid and tuna. We grouped the data in five focal areas: Gulf of California, Coast of California, Isla Guadalupe, SOFA and Hawaii. We performed a Bayesian mixing model to study the trophic ecology of this top predator. Average isotopic values for dermis tissue of white shark were delta13C (-14.5 per thousand) and delta15N (19.1 per thousand). Corrected white shark dermal mean values to resemble muscle were delta13C (-16.6 per thousand) and delta15N (21.2 per thousand). Mixing model data from dermis showed predation in offshore areas such the SOFA and a main importance of pinnipeds as prey of the white shark in Isla Guadalupe.
Asunto(s)
Migración Animal/fisiología , Isótopos de Carbono/metabolismo , Conducta Alimentaria/fisiología , Músculo Esquelético/metabolismo , Isótopos de Nitrógeno/metabolismo , Tiburones/fisiología , Animales , Modelos BiológicosRESUMEN
BACKGROUND: Heme oxygenase catalyzes the conversion of heme to iron, carbon monoxide and biliverdin employing oxygen and reducing equivalents. This enzyme is essential for heme-iron utilization and contributes to virulence in Leptospira interrogans. METHODS: A phylogenetic analysis was performed using heme oxygenases sequences from different organisms including saprophytic and pathogenic Leptospira species. L. interrogans heme oxygenase (LepHO) was cloned, overexpressed and purified. The structural and enzymatic properties of LepHO were analyzed by UV-vis spectrophotometry and (1)H NMR. Heme-degrading activity, ferrous iron release and biliverdin production were studied with different redox partners. RESULTS: A plastidic type, high efficiently ferredoxin-NADP(+) reductase (LepFNR) provides the electrons for heme turnover by heme oxygenase in L. interrogans. This catalytic reaction does not require a ferredoxin. Moreover, LepFNR drives the heme degradation to completeness producing free iron and α-biliverdin as the final products. The phylogenetic divergence between heme oxygenases from saprophytic and pathogenic species supports the functional role of this enzyme in L. interrogans pathogenesis. CONCLUSIONS: Heme-iron scavenging by LepHO in L. interrogans requires only LepFNR as redox partner. Thus, we report a new substrate of ferredoxin-NADP(+) reductases different to ferredoxin and flavodoxin, the only recognized protein substrates of this flavoenzyme to date. The results presented here uncover a fundamental step of heme degradation in L. interrogans. GENERAL SIGNIFICANCE: Our findings contribute to understand the heme-iron utilization pathway in Leptospira. Since iron is required for pathogen survival and infectivity, heme degradation pathway may be relevant for therapeutic applications.
RESUMEN
Stable isotope composition of marine top predators tissues provides insight information of its trophic ecology and migratory behavior. Previous reports have shown that dermal tissues could record longer patterns of hunting and movement. Based on this, the aim of this study was to describe the feeding and migratory habits of the white shark from Isla Guadalupe, using stable isotopic analysis of dermis. We considered a small subset of many possible prey taxa that the sharks could have eaten throughout their migration: pinnipeds, squid and tuna. We grouped the data in five focal areas: Gulf of California, Coast of California, Isla Guadalupe, SOFA and Hawaii. We performed a Bayesian mixing model to study the trophic ecology of this top predator. Average isotopic values for dermis tissue of white shark were δ13C (-14.5) and δ15N (19.1). Corrected white shark dermal mean values to resemble muscle were δ13C (-16.6) and δ15N (21.2). Mixing model data from dermis showed predation in offshore areas such the SOFA and a main importance of pinnipeds as prey of the white shark in Isla Guadalupe. Rev. Biol. Trop. 62 (2): 637-647. Epub 2014 June 01.
La composición isotópica de los tejidos de los depredadores tope en el ambiente marino provee información sobre su ecología trófica y su comportamiento migratorio. Estudios previos han mostrado que el tejido dérmico puede registrar patrones largos de movimiento y caza. El objetivo de este estudio fue describir los hábitos tróficos y migratorios de los tiburones blancos de Isla Guadalupe realizando un análisis de isótopos estables de su tejido dérmico. Consideramos un pequeño grupo de muchos posibles taxa que los tiburones pudieron haber comido a lo largo de su migración: pinípedos, calamares y atunes. Estas presas fueron agrupadas en cinco áreas focales: Golfo de California, Isla Guadalupe, Costa de California, SOFA y Hawái. Realizamos un modelo de mezcla bayesiano para estudiar la ecología trófica de este depredador tope. Los promedios del valor isotópico de la dermis del tiburón blanco fueron δ13C (-14.5) y δ15N (19.1). Los promedios del valor isotópico de la dermis transformada para semejar músculo fueron δ13C (-16.6 ) y δ15N (21.2). El modelo de mezcla mostró una probable depredación de los tiburones en áreas oceánicas como el SOFA y confirmó la importancia de los pinnípedos como presa principal del tiburón blanco en Isla Guadalupe.
Asunto(s)
Animales , Migración Animal/fisiología , Isótopos de Carbono/metabolismo , Conducta Alimentaria/fisiología , Músculo Esquelético/metabolismo , Isótopos de Nitrógeno/metabolismo , Tiburones/fisiología , Modelos BiológicosRESUMEN
Three different lineages of head lice are known to parasitize humans. Clade A, which is currently worldwide in distribution, was previously demonstrated to be present in the Americas before the time of Columbus. The two other types of head lice are geographically restricted to America and Australia for clade B and to Africa and Asia for clade C. In this study, we tested two operculated nits from a 4,000-year-old Chilean mummy of Camarones for the presence of the partial Cytb mitochondrial gene (270 bp). Our finding shows that clade B head lice were present in America before the arrival of the European colonists.
Asunto(s)
Infestaciones por Piojos/parasitología , Momias/parasitología , Pediculus/genética , Pediculus/fisiología , Filogenia , África , Américas , Animales , Asia , Australia , Secuencia de Bases , Chile , Citocromos b/clasificación , Citocromos b/genética , Genes Mitocondriales/genética , Variación Genética , Interacciones Huésped-Parásitos , Humanos , Datos de Secuencia Molecular , Paleopatología , Pediculus/clasificación , Análisis de Secuencia de ADN , Homología de Secuencia de Ácido Nucleico , Factores de TiempoRESUMEN
Las cefaleas en emergencia suelen ser un reto diagnóstico para el evaluador cuando se trata de diferenciarlas entreprimaria o secundaria a un trastorno neurológico subyacente.Objetivo: Describir la frecuencia de las señales de alarma en cefaleas secundarias y primarias en pacientes que acuden a emergencia.Materiales y Métodos: Estudio prospectivo de series de casos, que acuden a la Emergencia de Medicina de Adultos del Hospital Nacional CayetanoHeredia por cefalea, en un mes. Se excluyeron a los pacientes con cefalea traumática. Se usó un formato para laobtención de datos. Se clasificó a los pacientes en cefalea primaria o secundaria y se determinó la presencia de señales de alarma. Resultados:Se registraron 32 pacientes. Veintiséis (81%) tuvieron cefalea secundaria. De éstas, 9 se debieron a causas infecciosas y 9 a trastornos vasculares intracraneales. La cantidad de señales de alarma presentes en las cefaleas secundarias vario de 3 a 8, con una moda de 5; y en las primarias de 0 a 2, con una moda de 2. El empeoramiento progresivo y el examen neurológico anormal se presentaron en 96% de los casos de cefalea secundaria. Conclusiones: Las señales de alarma, empeoramiento progresivo y examen neurológico anormal fueronlos más frecuentes. Las cefaleas secundarias fueron más comunes que las cefaleas primarias. Se hace énfasis en la utilidad de usar esta metodología en emergencia
Headaches in the emergency room are usually a diagnostic challenge for the physician when they having to differentiate between a primary and secondary headaches and an underlying neurological disorder. Objectives: Describe the frequency of presentation of red flags in primary and secondary headaches, in patients presenting to an emergency department. Methods: A case-series prospective study was conducted in the Emergency room of Hospital Nacional Cayetano Heredia. All patients presenting with headaches within a month were evaluated. Trauma related headaches were excluded. A data collection form was used to determine the presence of red flags as well as other clinical data. The quantity of red flags was assessed in both types of headaches. Results: Thirty two patients were included for study. Twenty-six (81%) had secondary headaches. Nine of them were found to be secondary to infection and other 9 to intracranial vascular disorders. The quantity of red flags present on secondary headaches ranged from 3 to 8 with a mode of 5; on primary headaches they ranged from 0 to 2 with a mode of 2. Progressive worsening of headache and abnormal neurologic exam were present in 25 cases of secondary headache Conclusions: Red flags were progressive worsening of headache and abnormal neurologic exam. Thus the clinical assessment of red flags is useful in the evaluation of patients with secondary headache in the emergency room.
Asunto(s)
Femenino , Adulto Joven , Persona de Mediana Edad , Anciano de 80 o más Años , Cefalea , Cefalea/diagnóstico , Estudios Prospectivos , Estudios de Casos y ControlesRESUMEN
El síndrome de Sturge-weber es una enfermedad muy rara y cuyo signo cardinal es la " Mancha en vino de Oporto". Objetivo: presentar un caso inusual de un paciente de ochenta años de edad con síndrome de Sturge-Weber, se hospitalizó en múltiples ocasiones por presentar severas alteraciones oftalmológicas y neurológicas. El caso se clasificó como un síndrome de Sturge-Weber tipo I. Método: se presenta un paciente, sexo masculino, ochenta años y antecedentes de "Mancha en vino de Oporto" desde su nacimiento, con crisis epiléptica, cefalea casi constantes, crisis de isquemia vascular transitoria en múltiples ocasiones e ingresado por accidente vascular encefálico isquémico en dos oportunidades como resultado de la misma, una hemiplejía izquierda residual. El diagnóstico se realizó por la clínica, tomografía axial computarizada, electroencefalograma y características del LCR. Llamó la atención la no presentación de deterioro mental grave. Conclusiones: ante la presencia en la niñez y la juventud de una " Mancha en vino de Oporto" en la región del nervio trigémino, obliga a un estudio exhaustivo del paciente para lograr mejorías oftalmológicas, neurológicas y cutáneas con la terapéutica actual, sino se logran los resultados deseados, pues se debe utilizar la cirugía como medio para evitar el deterioro mental y oftalmológico, el cual puede ocasionar pérdida de la visión (AU)
Sturge-Weber syndrome is a very rare disease whose cardinal sign´s is the port-wine stain". Objective: to present an unusual case of an eighty years old patient with a Sturge-Weber syndrome who has been admitted in several occasions for presenting severe ophthalmological and neurological alterations that warns to deepen in the study of these patients. The case was classified as a type I Sturge-Weber syndrome. Method: an eighty year-old male with port-wine stain" antecedents from his birth, with epileptic seizure, almost constant cephalea, crisis of transient vascular ischemia in multiple occasions and admitted by ischemic encephalic vascular accident in two opportunities as a result of this, a residual left hemiplegia. Diagnosis is carried out by the clinic, computerized axial tomography, electroencephalogram and LCR characteristic. Attracting the attention he did not present a serious mental impairment. Results: important finding in this syndrome is the presence of port-wine stain with convulsions, glaucoma, cephalea and mental impairment. At present neuroimaging study is fundamental. Conclusions: under the presence of a port-wine stain" in the region of the trigeminal nerve in childhood and youth forces to the patient's exhaustive study to achieve ophthalmological, neurological and cutaneous improvements with the current therapy and if wanted results are not achieved, to use surgery as mean of avoiding ophthalmologic and mental impairment that may reach to the loss of vision like it happened to our patient (AU)
Asunto(s)
Humanos , Anciano de 80 o más Años , Síndrome de Sturge-Weber/diagnósticoRESUMEN
Fundamento: el síndrome de Sturge-weber es una enfermedad muy rara y cuyo signo cardinal es la " Mancha en vino de Oporto". Objetivo: presentar un caso inusual de un paciente de ochenta años de edad con síndrome de Sturge-Weber, se hospitalizó en múltiples ocasiones por presentar severas alteraciones oftalmológicas y neurológicas. El caso se clasificó como un síndrome de Sturge-Weber tipo I. Método: se presenta un paciente, sexo masculino, ochenta años y antecedentes de "Mancha en vino de Oporto" desde su nacimiento, con crisis epiléptica, cefalea casi constantes, crisis de isquemia vascular transitoria en múltiples ocasiones e ingresado por accidente vascular encefálico isquémico en dos oportunidades como resultado de la misma, una hemiplejía izquierda residual. El diagnóstico se realizó por la clínica, tomografía axial computarizada, electroencefalograma y características del LCR. Llamó la atención la no presentación de deterioro mental grave. Conclusiones: ante la presencia en la niñez y la juventud de una " Mancha en vino de Oporto" en la región del nervio trigémino, obliga a un estudio exhaustivo del paciente para lograr mejorías oftalmológicas, neurológicas y cutáneas con la terapéutica actual, sino se logran los resultados deseados, pues se debe utilizar la cirugía como medio para evitar el deterioro mental y oftalmológico, el cual puede ocasionar pérdida de la visión.
Background: Sturge-Weber syndrome is a very rare disease whose cardinal sign´s is the port-wine stain". Objective: to present an unusual case of an eighty years old patient with a Sturge-Weber syndrome who has been admitted in several occasions for presenting severe ophthalmological and neurological alterations that warns to deepen in the study of these patients. The case was classified as a type I Sturge-Weber syndrome. Method: an eighty year-old male with port-wine stain" antecedents from his birth, with epileptic seizure, almost constant cephalea, crisis of transient vascular ischemia in multiple occasions and admitted by ischemic encephalic vascular accident in two opportunities as a result of this, a residual left hemiplegia. Diagnosis is carried out by the clinic, computerized axial tomography, electroencephalogram and LCR characteristic. Attracting the attention he did not present a serious mental impairment. Results: important finding in this syndrome is the presence of port-wine stain with convulsions, glaucoma, cephalea and mental impairment. At present neuroimaging study is fundamental. Conclusions: under the presence of a port-wine stain" in the region of the trigeminal nerve in childhood and youth forces to the patient's exhaustive study to achieve ophthalmological, neurological and cutaneous improvements with the current therapy and if wanted results are not achieved, to use surgery as mean of avoiding ophthalmologic and mental impairment that may reach to the loss of vision like it happened to our patient.
RESUMEN
Se presenta el caso de una paciente de 72 años con antecedentes de hipertensión arterial y acalasia de esófago de varios años de evolución que se le diagnosticó un seudoquilotórax de posible causa ideopática por tratarse de una enfermedad muy rara y que puede ser originada por múltiples desórdenes. Se destaca la clínica, el diagnóstico positivo y el diferencial; así como se enfatiza en la posible patogénesis de este tipo de enfermedad y en especial a esta paciente. Se señala la terapéutica especialmente el tratamiento no quirúrgico, así como el resultado obtenido en el estudio y los aplicados en esta entidad por otros autores(AU)
A 72 years-old patient was presented with antecedents of arterial hypertension and esophageal achalasia of several years of evolution that it was diagnosed a pseudochylothorax of possible idiopathic cause being about a very rare disease that may be originated by multiple disorders. The clinic, the differential and positive diagnosis are point out; as well as it emphasize in the possible pathogenesis in this type of disease and specially to this patient. The therapy mainly non surgical treatment is point out, also the result obtained in the study and the applied ones in this entity by other authors(AU)
Asunto(s)
Humanos , Femenino , Anciano , Hidrotórax/etiología , Quilotórax , Acalasia del Esófago , HipertensiónRESUMEN
Se presenta el caso de una paciente de 72 años con antecedentes de hipertensión arterial y acalasia de esófago de varios años de evolución que se le diagnosticó un seudoquilotórax de posible causa ideopática por tratarse de una enfermedad muy rara y que puede ser originada por múltiples desórdenes. Se destaca la clínica, el diagnóstico positivo y el diferencial; así como se enfatiza en la posible patogénesis de este tipo de enfermedad y en especial a esta paciente. Se señala la terapéutica especialmente el tratamiento no quirúrgico, así como el resultado obtenido en el estudio y los aplicados en esta entidad por otros autores.
A 72 years-old patient was presented with antecedents of arterial hypertension and esophageal achalasia of several years of evolution that it was diagnosed a pseudochylothorax of possible idiopathic cause being about a very rare disease that may be originated by multiple disorders. The clinic, the differential and positive diagnosis are point out; as well as it emphasize in the possible pathogenesis in this type of disease and specially to this patient. The therapy mainly non surgical treatment is point out, also the result obtained in the study and the applied ones in this entity by other authors.
RESUMEN
Introducción: La presente es una revisión sobre la muerte traumática durante los años 2004-2005. El objetivo es hacer una caracterización sobre las muertes violentas ocurridas en este período en la ciudad de Guatemala. Material y métodos: se revisaron los protocolos de necropcia obtenidos en la morgue del Organismo Judicial; incluyendo todos los casos de muerte violenta, no importando grupo de edad, o la procedencia de la víctima; toda vez correspondiera a la ciudad capital...
Asunto(s)
Humanos , Causas de Muerte/tendencias , Heridas y Lesiones/epidemiología , Violencia/tendenciasRESUMEN
Carbon-14 (14C) dating from mummies of the Alto Ramirez culture confirms that coca leaf chewing was an incipient practice among members of a population that peopled the valleys and coastal areas of Northern Chile by 3,000 years before the present (yr.B.P.). Out of eleven bodies from the burial site of Pisagua-7 (PSG-7, S 19 degrees 35', W 70 degrees 13') that were analyzed, two samples tested positive. Mummy 725-A C2 (dated 3,090 to 2,850 two sigma calibrated 14C years before the present) was shown to have a cocaine value of 13.3 nanograms/10 milligrams of sample (ng/10mg), and mummy 741 (2,890 to 2,760 two sigma cal yr B.P.), a 5.6 ng/10mg value.