[Acute aortic dissection]. / Disección aórtica aguda.

OBJECTIVE: Acute aortic dissection is a medical emergency associated with high rates of mortality. Despite recent diagnostic advances, prompt and accurate diagnosis is difficult. We present a review of the a medical emergency service experience to diagnosis, factors associated to prompt diagnosis and inhospital evolution. MATERIAL AND METHOD: We studied 86 consecutive patients who had aortic dissections, to assess the presentation, management, and outcome. RESULTS: Mean age 61.9 +/- 12.5 years, 80% male. Hypertension was the most common predisposing factor (65% of patients overall). Chest pain was the most common initial complaint (58%). The initial clinical impression was aortic dissection in 56% of patients overall. Computed tomography was diagnostic in 96% when used. 62% underwent surgery. Overall in-hospital mortality was 28%. CONCLUSIONS: Acute aortic dissection presents with a wide range of manifestations. A high clinical index of suspicion and a prompt computed tomography should to improve recognition of aortic dissection.

[Acute pancreatitis complicating primary HIV-1 infection]. / Pancreatitis aguda durante la primoinfección VIH-1.

Primary HIV infection is usually paucisymptomatic, although 30-40% of patients show a mononucleosic syndrome of variable intensity and different manifestations. An increasing number of heterosexual HIV infection in Spain, and the fact of more severe manifestations in this subset of patients make necessary a deeper understanding of this complex clinical picture. We report a case of heterosexual primary HIV infection in a female patient without any known risk factor. This care evolued in an exceptionally severe form with meningitis and pancreatitis, to the best of our knowledge, this is the first reported care of pancreatitis complicating primary HIV-1 infection.