[Lipoid pneumonia: presentation of a case]. / Neumonía lipoidea: a propósito de un caso.

We report a case of lipoid pneumonia treated in our Health Centre. It is a disease that occurs rarely, but is important in Primary Care. This condition has been known since 1925, when it was first described by Laughlen, who described a case of lipoid pneumonia secondary to an injection of oil in the nasopharyngeal area. Today it is a rarity, and it is most frequently associated with the use of oil-based nasal drops (which are now decreasing in use). Its aetiology may be endogenous or exogenous. Although the pathological diagnosis is generally the most important, sometimes a lesion in the chest X-ray can lead us to suspect it due to the patient's history. This was a case of acute lipoid pneumonia in a young patient, who periodically performed as a "fire eater".

[Suspected Hirayama disease. Presentation of a case and a clinical review]. / Sospecha de enfermedad de Hirayama. A propósito de un caso en Atención Primaria. Revisión clínica.

Hirayama's disease, or juvenile muscular atrophy of distal upper extremity, is a cervical myelopathy. It affects adolescent males, and is characterized by progressive muscle weakness and atrophy of the distal upper extremities, followed by slow paralysis. Although the cause remains unclear, radiological findings suggest neuropathic forward displacement of the posterior cervical dural sac during neck flexion, causing compression of the cervical cord, resulting in atrophic changes and ischemic disease of the medullar anterior horn. Since the bending of the neck was recognized as a cause of the disease, cervical orthosis, spinal fusion, and duraplasty combined with fusion, have been proposed as treatment. A solid understanding of Hirayama disease is critical as early recognition and effective treatment can stop the deterioration.

[Venous thromboembolic disease: presentation of a case]. / Enfermedad tromboembólica venosa: a propósito de un caso.

Venous thromboembolic disease in its clinical spectrum includes both deep vein thrombosis and pulmonary thromboembolism, which is usually a complication of deep vein thrombosis. It is a relatively common disease with significant morbidity and requires an accurate diagnosis. They are numerous risk factors for venous thromboembolism, and there is evidence that the risk of thromboembolic disease increases proportionally to the number of predisposing risk factors present. The primary care physician should know the risk factors and suspect the presence of venous thromboembolic disease when there is a compatible clnical picture. The treatment for this pathology is anticoagulation. We report a patient with cardiovascular risk factors who was seen with pain in the right leg and shortness of breath and referred to the hospital with suspected venous thromboembolism, atrial fibrillation and pleural effusion.

[Subphrenic abscess in the context of low back pain and reading analytics in the primary care consultations]. / Absceso subfrénico en el contexto de lumbalgia y lectura analítica en la consulta de atención primaria.

The subphrenic space is defined as the area below the diaphragm and above the transverse colon. Most abscesses are due to direct subphrenic contamination associated with, surgery, local disease, or trauma, but the cause still remain undefined or unknown. It is a disease rarely diagnosed in primary care. About 55% of subphrenic abscesses are located on the right side, with 25% on the left, and 20% are multiple. These can be extended to the thoracic cavity, which sometimes produce empyema, lung abscess, or pneumonia. The mortality of subphrenic abscess is between 11%-31%, and may be due to uncontrolled infection, malnutrition, and complications of prolonged hospitalization, such as nosocomial infections. Ultrasound or computed tomography-guided percutaneous drainage is now the preferred treatment, combined with antibiotics.

[Onset of myasthenia gravis in primary care. Presentation of a case]. / Debut de miastenia gravis en atención primaria. A propósito de un caso.

Myasthenia gravis is an autoimmune disorder of neuromuscular transmission involving the production of autoantibodies directed against skeletal muscle receptors, in most cases of acetylcholine. Clinically it is characterized by the appearance of muscle weakness after prolonged activity, which tends to recover after a period of rest, or administration of acetylcholinesterase inhibitors. It is a relatively rare disease, although the prevalence has increased by improved diagnosis and increased longevity of the population. The diagnosis can be based on evidence after it is suspected using pharmacological, immunological or electrophysiology tests. Treatment can be divided into: symptomatic, short term and long term. We report the case of a patient who complained of diplopia, this muscle weakness being the most common initial symptom of the disease.

[Zuska disease. Diagnosis and treatment in primary care]. / Enfermedad de zuska. Diagnóstico en atención primaria.

A fistula is an abnormal pathological communication which links two organs together or with the exterior. They are fibrous paths internally coated with granulation tissue, extending from an internal o primary opening to one or more openings located outside or on the skin. The recurrent mastitis that some patients suffer is due to a fistula between a lactiferous duct and the limit of the areola, and this condition is called a recurrent periareolar fistula.To incorporate this clinical condition into the proposed terminology, Zuska disease, is essential to believe in its existence, in order to to treat it from the source. The knowledge of this disease, a proper diagnosis and treatment will prevent the constant recurrence of mastitis as presented by these patients, avoiding their pilgrimage to various specialists. In this article we review this disease, methods of diagnosis and treatment.