Difference between early clinical features of swine origin A H1N1 influenza confirmed and not confirmed infection in Mexico.

INTRODUCTION: The Swine Origin A H1N1 Influenza Virus (SOIV) pandemic emerged in April 2009 affecting people and health-care systems worldwide. This study examined the differences among the early clinical features presented in confirmed SOIV cases, those who tested negative for SOIV infection, fatalities, and hospitalized cases. METHODOLOGY: We reviewed 1,024 initial medical records of patients presenting with acute respiratory symptoms who attended the respiratory emergency room of a general hospital in Mexico and had a confirmatory test for influenza AH1N1 by RT-PCR from April to December 2009. RESULTS: Out of 1,024 cases, 457 (44%) were men with a mean age of 31±17 years; however, of these, SOIV confirmed cases were younger (26±8, p=0.000). SOIV infection was confirmed in 36% of the patients. Most (%?) cases presented mild infection, 20% of the patients required hospitalization, and 0.09% patients died. Asthma was more frequent in confirmed cases (p=0.028). Presence of COPD, systemic arterial hypertension, and diabetes mellitus was significant in confirmed hospitalized cases. Pulmonary rales, wheezing, and sudden symptom onset were more frequent and statistically significant in confirmed patients. Influenza-like illness was more frequent in confirmed cases (p=0.049).  CONCLUSIONS: This study presents one of the largest series of the new SOIV infection confirmed by RT-PCR reported. This infection is frequently mild and affects mainly young adults. Sudden symptoms onset, pulmonary rales, and wheezing are early features of this infection. Asthma, COPD, systemic arterial hypertension, and diabetes mellitus should be identified to identify potentially severe and fatal cases. ILI helps distinguish SOIV infection.

[Histology of submandibular gland tumours, 10 years' experience]. / Histología de tumores de glándulas submandibulares. Experiencia de 10 años.

INTRODUCTION AND OBJECTIVES: There are few reports focused on neoplasms in the submandibular gland because they are uncommon and are frequently grouped with the other salivary glands tumours. In the classical studies, the proportion of malignancy reported in these cases is around 50%. OBJECTIVES: Determining the proportion of malignancy, the most frequent histological types, the gender distribution and average age at diagnosis in patients with submandibular gland neoplasms who were treated in our hospital from 2000 year to 2010. METHODS: A retrospective review of our department database of the patients who underwent surgery for submandibular gland neoplasm in a ten-year period was performed. RESULTS: Twenty-two patient records were included, in which 19 (86%) patients presented benign disease and 3 were of a malignant type (adenocarcinoma, well-differentiated epidermoid carcinoma, follicular lymphoma). Two of the 3 cases of malignant neoplasms were in men. CONCLUSIONS: A greater proportion of benign neoplasm was found in submandibular tumours. The most frequent benign tumour is the pleomorphic adenoma. Women are more commonly affected (76%). Benign tumours appear in younger patients than do malignant ones.

Manejo médico y quirúrgico del absceso periamigdalino: experiencia de cinco años / Medical and surgical management of peritonsillar abscess (QUINSY): five years experience

El absceso periamigdalino es una patología infecciosa grave, que frecuentemente se atiende en nuestra división. Para su manejo existen diversas opciones en la actualidad. La incisión y drenaje, acompañada de tratamiento con penicilina y clindamicina, es la elección de nuestro servicio. Se realizó una revisión de los expedientes de pacientes con diagnóstico de absceso periamigdalino del primero de enero de 1996 al 31 de diciembre del 2000, incluyéndose 117 casos en el presente estudio. Se midió la eficacia del tratamiento médico y quirúrgico, la frecuencia de complicaciones, así como la realización de amigdalectomía de intervalo. Se encontró una eficacia de 88.4 por ciento para el procedimiento de incisión y drenaje. En todos los casos el tratamiento antimicrobiano inicial fue efectivo, de los cuales 89.7 por ciento recibieron penicilina y clindamicina. La única complicación encontrada fue la persistencia del absceso en 11.6 por ciento de los casos, resuelta en todos con un segundo drenaje. Se realizó amigdalectomía de intervalo a 43.6 por ciento de los pacientes. Conclusión: La incisión y drenaje tiene una eficacia superior a otras técnicas para drenaje, el esquema antimicrobiano de penicilina y clindamicina puede considerarse de elección para el manejo del absceso periamigdalino. Un porcentaje relativamente bajo de nuestros pacientes acepta la realización de amigdalectomía, colocándolos bajo un mayor riesgo de recurrencia.