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UNLABELLED: The purpose of this paper is to present the experience of the hospital using the Ponseti method in patients with congenital adduct clubfoot. MATERIAL AND METHODS: The study was conducted between January 2007 and December 2009. Children of both sexes were included; the Dimeglio classification was applied before surgery and their course was later assessed with the Simons scale when they resumed gait. Patients with postural clubfoot (Dimeglio I) and those with neuromuscular disease (Dimeglio IV) were excluded. Casts were placed as of 15 days of age using the Ponseti technique and then percutaneous tenotomy of the calcaneous tendon was performed in the operating room. RESULTS: Twenty patients (9 girls, 11 boys) and 28 feet were included in the study; they were Dimeglio II (8 children) and III (12 children). Mean age at the time of surgery was 2 months, and mean age at the time of gait assessment was 2 years. Upon applying the Simons scale, 25 feet (89.3%) had satisfactory results and 3 feet (10.7%) unsatisfactory results. Two of the latter underwent percutaneous tenotomy again and in one case the cast was applied again; they evolved properly. CONCLUSIONS: We found in our series that the Ponseti technique is appropriate as definitive treatment for Dimeglio II and III congenital adduct clubfoot.

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BACKGROUND: humeral fracture (HF) in children requires a specialized management to achieve an adequate reduction and fixation, as well as a prompt attention to prevent complications. Our objective was to show advantages and disadvantages of HF treatment in relation to operating time and post-surgical recovery. METHODS: Cross study, retrospective, comparative based on the reviewing of 108 patients' files with HF type II and III of Holmberg. There were two groups, one underwent an open reduction and internal fixation and the other one a close reduction and pegging. RESULTS: There were 63 males (58.3 %) and 45 females (41.7 %) with an average age of 8.6 years (range: 4 to 14 years), with the right extremity being the most affected in 50.9%; the most frequent fracture was the type III in 77.8 % (84 cases); the average operating time for an open reduction was 60.3 minutes and for a close reduction 30.8 minutes. Student t test showed a statistical difference (p < 0.01). The recovery time was 4 weeks with a flexion of 13.6 degrees for group I. Group II had a 4 week recovery time with an inflection of 38.7 degrees . CONCLUSIONS: surgical time was shorter in the closed reduction; flexion at four weeks had a better clinical recovery.

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Se presenta el caso de un paciente con hipertensión arterial sistémica, hemoptisis masiva y hemotórax izquierdo. La necropsia demostró la presencia de un aneurisma disecante del cayado de la aorta, abierto al parénquima del lóbulo superior del pulmón izquierdo y comunicación a la cavidad pleural, alteraciones que provocaron hemoptisis masiva y hemotórax en circunstancias poco frecuentes. La formación del aneurisma posiblemente estuvo relacionada con la hipertensión arterial preexistente. Se discuten aspectos relevantes en relación con la literatura consultada.

We present a 70 year old male with long standing systemic arterial hypertension that presented with massive hemoptysis and left hemothorax. Necropsy showed a dissecting aneurysm of the aortic arch rupturing into the upper lobe of the left lung and the left pleural cavity, an uncommon cause of massive hemoptysis and hemothorax. The etiology of the aneurysm and dissection were probably related to the systemic hypertension. Relevant facts regarding this pathology are discussed.

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Detection of anti-hepatitis C virus (anti-HCV) antibodies may yield a high frequency of false-positive results in people at low risk. To date, no clinical rule had been developed to predict viremia in HCV-seropositive patients. Therefore, we aimed to generate a prediction rule on the basis of clinical and serologic data, which can be used in outpatient care. We selected 114 seropositive patients without antiviral treatment or hepatitis B coinfection. Subsequently we identified independent predictors of the hepatitis C viremia by logistic regression and selected the quantitative value of the screening test for anti-HCV antibodies with the best performance in detecting viremia. Then, we combined clinical and serologic data to generate different prediction rules. Ratio of immunoassay signal strength of the sample to cut-off (S/CO) >15 had accuracy, positive predictive value (PPV) and positive likelihood ratio (LR+) of 84%, 83%, and 3.7; respectively. The rule compounded of the antecedent of blood transfusion before 1993 and S/CO >15 performed the best in prediction of viremia in all patients, with accuracy, PPV and LR+ of 71%, 88%, and 5.6; respectively. In the group of asymptomatic patients this rule improved in efficacy of prediction, with accuracy, PPV and LR+ of 79%, 91% and 12.8; respectively. In conclusion, a clinical rule is better than S/CO alone in prediction of the hepatitis C viremia. In a patient that meet the rule the probability of having viremia is high, therefore, it can be indicated directly an assay for viral load instead of other supplemental tests, thus, saving time and economic resources.

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Se estableció un ensayo con el objeto de evaluar el efecto de dos tipos de estiércol, sobre la producción de un cultivo de frutilla en un ambiente protegido y bajo riego por goteo. Los tratamientos T1, T2 y T0 consistieron en el uso de estiércol bovino (40 Tn/Ha), estiércol cuy (15 TN/Ha), y un testigo sin incorporación de estiércol. El ensayo se realizó en la localidad de Mallco Rancho, ubicada en la provincia de Quillacollo del departamento de Cochabamba, a 24 Km. de la misma; geográficamente está ubicada entre los meridianos de 66º 27' de longitud Oeste y entre los paralelos 17º 21' y 66º 27'longitud Sur, a una altitud de 2400 - 2600 msnm. Se usaron plantas previamente vernalizadas. El diseño experimental usado fue Completamente al azar (CAA), con dos repeticiones. Se realizó la evaluación de dos cosechas en las variable: número de hojas, altura de planta, número de flores, número de frutos, diámetro de fruto y rendimiento. El análisis de varianza mostró respuestas diferenciales en el número de flores que fue mayor para el tratamiento T1, asi también se evidenció significancia en el número de frutos, lo que finalmente reflejó un mayor rendimiento para el tratamiento T1, durante las dos primeras cosechas con valores de 6.4 Tn/ha y 15.2 Tn/ha respectivamente con relación a los otros tratamientos (T2 y T0). El análisis económico efectuado, mostró que el abono bovino es el que mejores resultados muestra en cuanto a beneficio respecta.

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Los autores presentan un caso inusitado de prurito y urticaria asociado al hipertiroidismo tomando como base los hallazgos clínicos, de laboratorio, falla a la terapéutica tradicional y respuesta dramática al uso del propanolol y propiltiouracilo (AU)

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Los autores presentan un caso inusitado de prurito y urticaria asociado al hipertiroidismo tomando como base los hallazgos clínicos, de laboratorio, falla a la terapéutica tradicional y respuesta dramática al uso del propanolol y propiltiouracilo

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