Beta radiation excited thermoluminescence of solid-state synthesized SrZrO3 phosphors.

In this work, we report on the solid-state reaction synthesis of SrZrO3 phosphors, and their beta particle irradiation excited thermoluminescence (TL) characterization. X-ray diffraction data confirmed the obtention of the orthorhombic phase of SrZrO3. Through computational glow curve deconvolution, the whole glow curve was resolved into six individual first order kinetics peaks. This is the first report concerning the usefulness of SrZrO3 as TL dosimeter. The synthesized phosphors exhibit TL emission from below 100 °C up to above 300 °C, being the most intense TL between 200 and 300 °C, as well as a remarkable reproducibility of the TL response in repeated irradiation-TL readout cycles.

Beta radiation excited thermoluminescence of SrB4O7 phosphors synthesized through solid state reaction.

In this work, the synthesis of SrB4O7 through solid state reaction and its beta particle excited thermoluminescence (TL) are reported. The glow curves show maxima around 200 and 300 -considered suitable for TL dosimetry-, and a remarkable reproducibility in successive irradiation - TL readout cycles. The integrated TL exhibits a linear dependence upon the irradiation dose in the tested dose range (from 1.0 up to 8.0 Gy). The lower detection limit and the sensitivity relative to the TLD-100 dosimeter are 88 mGy and 0.49, respectively. From the results here presented, we conclude that SrB4O7 synthesized through solid state reaction can be considered a phosphor material interesting to develop TL dosimeters.

Synthesis and thermoluminescence characterization of self-agglomerating CaSO4 exposed to beta radiation.

The synthesis and thermoluminescence (TL) characterization of self-agglomerating pellet-shaped CaSO4 phosphors, through a low cost and environmentally friendly method is reported. In order to investigate their TL features, some samples were exposed to beta particle irradiation in the dose range from 0.07 to 10 Gy. Characteristic TL glow curve consists of a single main maximum located at 216 °C, which is considered stable, hence, suitable for dosimetry applications. The dose-response was remarkable linear. Moreover, the lower detection limit was determined to be 6.0 µGy, and the relative TL sensitivity twice the one from the commercial TLD-100 dosimeter.

RUNX1 amplification in AML with myelodysplasia-related changes and ring 21 chromosomes.

Ring 21 is an unstable structural abnormality of chromosome 21 that can lead to RUNX1 gene amplification. We present a unique case with a carrier patient of a constitutional ring chromosome 21 (partial monosomy and trisomy 21) with dysmorphic features and congenital malformations phenotype, who developed acute myeloid leukaemia with myelodysplasia-related changes and two ring 21 chromosomes with RUNX1 amplification. The patient's constitutional ring 21 chromosome showed alterations in tumour suppressor genes, and oncogenes, but not in RUNX1. RUNX1 gene expression at acute myeloid leukaemia diagnosis, showed no upregulation, so other genes may also be the genetic amplification targets in this patient. Copyright © 2016 John Wiley & Sons, Ltd.

Phenotype and Polyfunctional Deregulation Involving Interleukin 6 (IL-6)- and IL-10-Producing Monocytes in HIV-Infected Patients Receiving Combination Antiretroviral Therapy Differ From Those in Healthy Older Individuals.

BACKGROUND: Despite the relevance of monocytes as promoters of the inflammatory response, whether human immunodeficiency virus (HIV) infection induces premature age-related changes to the phenotype and function of monocytes or whether these alterations are different and/or specifically driven by HIV remains to be mechanistically determined. METHODS: We assayed the activation phenotype and the responsiveness in vitro to Toll-like receptor (TLR) agonists in classical, intermediate, and nonclassical subsets of monocytes by assessing intracellular interleukin 1α (IL-1α), IL-1ß, interleukin 6 (IL-6), interleukin 8, tumor necrosis factor α, and interleukin 10 (IL-10) production in 20 HIV-infected patients receiving combination antiretroviral therapy (cART) and 2 groups of uninfected controls (20 age-matched young individuals and 20 older individuals aged >65 years). RESULTS: HIV-infected patients showed a more activated phenotype of monocytes than older controls. Regarding functionality, under unstimulated conditions HIV-infected patients showed a higher percentage of classical monocytes producing IL-6 and IL-10 than control subjects. The percentage of cells with production of multiple cytokines (polyfunctionality), including IL-10, in response to TLR agonists was greater among HIV-infected patients than among control subjects. CONCLUSIONS: Inflammatory alterations associated with monocytes during HIV infection are different from those in aging individuals. This monocyte dysfunction, mainly characterized by high levels of IL-6- and IL-10-producing monocytes, may have clinical implications in HIV-infected patients that are different from those in aging individuals.

NUP98-HOXA9 bearing therapy-related myeloid neoplasm involves myeloid-committed cell and induces HOXA5, EVI1, FLT3, and MEIS1 expression.

INTRODUCTION: Chromosomal rearrangements involving NUP98 gene have been associated with human leukemias such as de novo AML, therapy-related AML (t-AML), myelodysplastic syndrome (MDS), and chronic myeloid leukemia (CML). Genetic fusion NUP98-HOXA9, caused by t(7;11)(p15;p15), is a recurrent cytogenetic alteration in de novo acute myeloid leukemia (AML) usually found in young Asian patients and its description in therapy-related myeloid neoplasms (t-MN) is rare. Only one Asian case with molecular demonstration of the NUP98-HOXA9 fusion has been reported in therapy-related leukemia. NUP98-HOXA9 leukemogenic mechanism is derived from the transcription factor activity of the chimeric protein, which enhances the expression of genes related to cellular differentiation arrest and proliferation. PATIENTS AND METHODS: We studied a Caucasian woman with a therapy-related acute myeloid leukemia after Ewing's sarcoma. Molecular demonstration of the genetic fusion NUP98-HOXA9 was performed by RT-PCR, and gene expression was analyzed by real-time PCR, including four AML patients with MLL rearrangements for comparative analysis. Cytologic and flow cytometric analysis was also carried out. RESULTS: After cytologic and flow cytometric analysis diagnostics was therapy-related myeloid neoplasm (t-MN). The major component of blasts in the acute leukemia was with neutrophilic differentiation, but 13% erythroid lineage blasts were also found. Cytogenetic and FISH analysis revealed t(7;11)(p15;p15) and NUP98-HOXA9 fusion gene was demonstrated. Gene expression analysis showed upregulation of EVI1 and MEIS1 in the index patient, both of them previously related to a worst outcome. CONCLUSION: In this work, we include a detailed molecular, clinical, cytological, and cytometric study of the second t-AML bearing NUP98-HOXA9 genetic fusion.

A review of sarcocystosis in camels and redescription of Sarcocystis cameli and Sarcocystis ippeni sarcocysts from the one-humped camel (Camelus dromedarius).

There is considerable confusion concerning Sarcocystis species in camels. Five species: Sarcocystis cameli, Sarcocystis ippeni, Sarcocystis camelicanis, Sarcocystis camelocanis and Sarcocystis miescheri were named with inadequate descriptions and no type specimens. Here, we review literature on sarcocystosis in camels worldwide and redescribe structure of S. cameli and S. ippeni sarcocysts by light- and transmission electron microscopy (LM and TEM). Eight sarcocysts from the oesophagi of two camels (Camelus dromedarius) from Egypt were studied. By LM, all sarcocysts were thin-walled with barely visible projections on the cyst walls. By TEM, two structurally distinct sarcocysts were recognized by unique villar protrusions (vp) not found in sarcocysts from any other host. Sarcocysts of S. cameli had vp of type 9 j. The sarcocyst wall had upright slender vp, up to 3.0 µM long and 0.5 µM wide; the total thickness of the sarcocyst wall with ground substance (gs) layer was 3.5 µM. On each vp, there were rows of knob-like protrusions that appeared to be interconnected. The vp had microtubules that originated at midpoint of the gs and continued up to the tip; microtubules were smooth, without any granules or dense areas. Bradyzoites were approximately 14-15 × 3-4 µM in size with typical organelles. Sarcocystis ippeni sarcocysts had type 32 sarcocyst wall characterized by conical vp with an electron dense knob. The total thickness of the sarcocyst wall (from the base of gs to vp tip) was 2.3-3.0 µM. The vp were up to 1.2 µM wide at the base and 0.25 µM at the tip. Microtubules in vp originated at midpoint of gs and continued up to tip; microtubules were criss-crossed, smooth and without granules or dense areas. Bradyzoites were 12.0-13.5 × 2.0-3.0 µM in size. Sarcocystis camelicanis, S. camelocanis and S. miescheri are considered invalid.

Experimental transmission of Cystoisospora felis-like coccidium from bobcat (Lynx rufus) to the domestic cat (Felis catus).

Cystoisospora felis is an ubiquitous coccidian of cats. The domestic cat (Felis catus) is its definitive host and several mammalian and avian species are its optional intermediate/transport hosts. Nothing is known if it is transmissible to wild felids. In the present study C. felis-like oocysts were found in two naturally infected bobcats (Lynx rufus) from Pennsylvania. To study transmission of C. felis-like parasite from bobcats to domestic cats, sporulated oocysts of C. felis-like from one bobcat were orally inoculated into interferon gamma gene knockout (KO) mice, and 56 days later tissues of KO mice were fed to two coccidian-free cats; two littermate cats were uninoculated controls. The inoculated cats and controls were euthanized five and seven days later, and their small intestines were studied histologically. One inoculated cat excreted C. felis-like oocysts seven days post inoculation (p.i.) and was immediately euthanized. Mature schizonts, mature male and female gamonts, and unsporulated oocysts were found in the lamina propria of small intestine; these stages were morphologically similar to C. felis of domestic cats. No parasites were seen in histological sections of small intestines of the remaining three cats. The experiment was terminated at seven days p.i. (minimum prepatent period for C. felis) to minimize spread of this highly infectious parasite to other cats. Although oocysts of the parasite in bobcats were morphologically similar to C. felis of domestic cats, the endogenous stages differed in their location of development. The bobcat derived parasite was located in the lamina propria of ileum whereas all endogenous stages of C. felis of domestic cats are always located in enterocytes of intestinal epithelium. Characterization of DNA isolated from C. felis-like oocysts from the donor bobcat revealed that sequences of the ITS1 region was only 87% similar to the ITS1 region of C. felis from domestic cats. These results indicate that the parasite in bobcat is likely different than C. felis of cats.

Redescription of Sarcocystis fusiformis sarcocysts from the water buffalo (Bubalus bubalis).

Four valid species of Sarcocystis have been reported from the water buffalo (Bubalus bubalis): Sarcocystis fusiformis, Sarcocystis buffalonis, Sarcocystis levinei and Sarcocystis dubeyi. Here, we redescribe structure of S. fusiformis sarcocysts by scanning and transmission electron microscopy (SEM, TEM). Twenty-one macroscopic sarcocysts from oesophagus of the water buffalo in Egypt were examined by light microscopy, SEM and TEM. The sarcocyst wall was up to 9 µm thick, depending on the section and the technique. In 5 µm paraffin-embedded sections, the sarcocyst wall was indistinct, 2-5 µm thick and appeared smooth. In 1 µm plastic-embedded sections stained with toluidine blue, the sarcocyst wall was 2.5-5.2 µm thick and had branched villar protrusions (vp)-like branches of a dead tree. By SEM, the sarcocyst wall had a mesh-like structure with irregularly shaped vp that were folded over the sarcocyst wall. On each vp there were uniform papillomatous structures that were 100 nm wide. By TEM, vp were up to 6 µm long and contained filamentous tubular structures, most of which were parallel to the long axis of the projections; granules were absent from these tubules. By TEM, bradyzoites within the same cyst varied from 11.2 to 16.8 µm in length. By TEM, bradyzoites had a very long (10 µm) convoluted mitochondrion, up to 12 dense granules, but only 2 rhoptries. This redescription should help to differentiate the sarcocysts of S. fusiformis from similar sarcocysts in domestic and wild ruminants.

TNF-α levels in HIV-infected patients after long-term suppressive cART persist as high as in elderly, HIV-uninfected subjects.

BACKGROUND: Chronic and systemic inflammatory alterations occur in HIV-infected patients and elderly uninfected subjects and in both scenarios these alterations are associated with the development of chronic morbidities and mortality. However, whether the levels of inflammatory alterations in untreated HIV-infected patients and elderly individuals are similar is unknown. Moreover, whether long-term antiretroviral therapy normalizes inflammatory alterations compared with HIV-uninfected persons of different age is not known. METHODS: We analysed soluble inflammatory levels [high-sensitivity C-reactive protein, interferon (IFN)-γ, tumour necrosis factor (TNF)-α, interleukin (IL)-1ß, IL-6, IL-8 and IL-17] in a cohort of viraemic HIV-infected patients compared with (i) age-matched, (ii) elderly and (iii) non-survivor elderly, uninfected healthy controls. We longitudinally analysed the effect of long-term 48 and 96 week suppressive combined antiretroviral therapy (cART) on the soluble inflammatory levels compared with those found in control subjects. RESULTS: Baseline IL-6 and IL-8 levels were at similar or lower concentrations in untreated patients compared with healthy elderly individuals. However, TNF-α and IFN-γ levels broadly exceeded those found in survivors and non-survivor elderly individuals. Long-term suppressive cART normalized most of the inflammatory markers, with the exception of TNF-α levels, which persisted as high as those in elderly non-survivor controls. CONCLUSIONS: Chronic inflammatory alterations associated with HIV infection are maintained at a different level from those of ageing. The persistent alteration of TNF-α levels in HIV-infected patients might cause tissue damage and have implications for developing non-AIDS-defining illnesses, even when HIV replication is long-term controlled by cART.

Toxoplasma gondii infection in llama (Llama glama): acute visceral disseminated lesions, diagnosis, and development of tissue cysts.

Clinical toxoplasmosis has been reported in many species of warm-blooded animals but is rare in camelids. Here we report acute fatal systemic toxoplasmosis involving heart, thyroid gland, stomach, intestine, diaphragm, kidneys, adrenal glands, and liver of a 13-mo-old llama (Llama glama). Many Toxoplasma gondii tachyzoites were associated with tissue necrosis in multiple organs. Death was attributed to severe myocarditis. Ulcers associated with numerous tachyzoites were present in the C3 compartment of the stomach. Tissue cyst development was followed using bradyzoite-specific T. gondii antibodies. Individual intracellular, and groups of 2 or more, bradyzoites were identified in hepatocytes, biliary epithelium, myocardiocytes, lung, diaphragm, thyroid gland, spleen, and stomach. Lesions in the brain were a few microglial nodules and very early tissue cysts containing 1-3 bradyzoites. These observations suggest that the animal had acquired toxoplasmosis recently. Diagnosis was confirmed immunohistochemically by reaction with T. gondii -specific polyclonal rabbit serum but not with antibodies to the related protozoan Neospora caninum . Genetic typing using the DNA extracted from paraffin-embedded myocardium of llama and 10 PCR-restriction fragment length polymorphism (RFLP) markers revealed a type II allele at the SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, PK1 L358, and Apico loci; therefore, this isolate belongs to the ToxoDB PCR-RFLP genotype #1, which is most common in North America and Europe.

Differential cytogenetic profile in advanced chronic myeloid leukemia with sequential lymphoblastic and myeloblastic blast crisis.

Frequency of additional chromosomal abnormalities in chronic myeloid leukemia (CML) is estimated to be 7% in chronic phase and increases to 40-70% in advanced disease. Progression of CML from chronic phase to accelerated phase or blast crisis is often associated with secondary chromosomal aberrations. We report an exceptional case of CML as debut in lymphoblastic blast crisis and a subsequent progression in myeloblastic blast crisis with rare cytogenetic abnormalities.

Sexual bother and function after radical prostatectomy: predictors of sexual bother recovery in men despite persistent post-operative sexual dysfunction.

Changes in sexual bother (SB) following radical prostatectomy (RP) negatively affect health-related quality of life (HRQoL) of prostate cancer survivors. However, post-operative SB tends to be neglected whereas sexual function (SF) is thoroughly assessed in clinical practice and few studies have focused on and evaluated patients' SB. We retrospectively reviewed 2 345 consecutive patients who underwent RP between 2001 and 2009 at a single institution. SF and SB were assessed using Expanded Prostate Cancer Index Composite (EPIC) questionnaires. We stratified our cohort by SB recovery and post-operative SF status, including a subset of men who recovered SB despite persistent post-RP sexual dysfunction. Multivariable logistic regression analyses were conducted to identify factors for men who have SB recovery. Of 319 eligible patients, 133 (41.7%) recovered their SB at a mean of 20 months after RP. Among the 133 men who demonstrated SB recovery, 109 had post-operative sexual dysfunction. Patients with SB recovery despite post-RP sexual dysfunction were more likely to be old (p = 0.004), to have higher clinical T stage (p < 0.001), to have more non-nerve-sparing RP (p < 0.001), to have lower pre-operative EPIC-SF/SB scores (p < 0.001), to have more extracapsular extension (p = 0.031) and to be PDE5i non-users after surgery (p < 0.001). In multivariable analysis, predictors for this subset were lower comorbidity (OR 0.62, p = 0.043), higher clinical cancer stage (OR 2.35, p = 0.026), worse pre-operative SF (OR 0.98, p = 0.010), SB (OR 0.98, p < 0.010) and no PDE5i use (OR 0.37, p = 0.002); age was not related (OR 0.99, p = 0.555). As SB can influence patients' overall HRQoL, expectations of SB recovery should be provided to patients in the same way that SF recovery is presented. This study may help clinicians to discuss SB with patients and assess their potential for SB recovery following RP.

Gangrena de Fournier: experiencia en el Hospital Barros Luco / Fournier-s Gangrene: Barros Luco Hospital experience

La gangrena perineal (enfermedad de Fournier) corresponde a una fasceítis infecciosa necrotizante de la región perineal, genital y/o perianal, de evolución fulminante y progresiva, asociada a una alta mortalidad. Se realizó una revisión retrospectiva de los pacientes atendidos en nuestro hospital con diagnóstico de egreso de gangrena perineal o enfermedad de Fournier, entre los años 2005 y 2008. De un total de 18 pacientes (100 por ciento hombres), la edad promedio fue de 55 años (rango de 34 a 81). En 15 casos (84 por ciento) fue posible determinar el foco, de éstos 6 (40 por ciento) fueron urológicos, 8 (53 por ciento) colorrectales, 1 (7 por ciento) dermatológico. Las condiciones predisponentes más frecuentes fueron diabetes mellitus (50 por ciento) y alcoholismo (33 por ciento). El germen más aislado en urocultivos fue E coli (75 por ciento) y en cultivos de secreción el S aureus (21 por ciento), en el contexto de cultivos con flora polimicrobiana. Sólo se logró aislar anaerobios en 2 casos. El promedio de días cama fue de 24 días (rango de 7 a 98). Se realizó un total de 59 intervenciones quirúrgicas con un promedio de 3,5 cirugías por paciente. La mortalidad en esta serie fue de 6 pacientes (33 por ciento). La enfermedad de Fournier continúa siendo una patología relevante en nuestro medio con una alta mortalidad, a pesar de un diagnóstico y tratamiento precoz y agresivo.

Perineal gangrene (Fournier’s disease) is an infective necrotizing fasciitis of the perineal, genital and/or perianal regions, with a progressive and fulminant evolution, and high mortality risk. We reviewed the record of the patients seen at our hospital with discharge diagnosis of perineal gangrene or Fournier´s disease, between years 2005 to 2008 and we found 18 patients (100 percent males). Average age was 55 years (range 34 to 81 ). In 15 cases (84 percent) we could find the source of infection, 6 (40percent) was urogenital, 8 (53 percent) anorectal, 1 (7 percent) cutaneous. The most common association was diabetes Mellitus (50 percent) and smoking (55 percent). The most frequently isolated germ in urine cultures was E coli (75 percent).From polymicrobial secretions culture, S aureus was the most frequently isolated (21percent).Only in two cases it was possible isolate anaerobic bacteria. The average of hospitalization was 24 days (range 7 to 98 ). A total of 59 surgical procedures were performed, with an average of 3,5 per patient. The mortality in this review was 6 patients (33 percent).Key words: Perineal gangrene, Fournier’s disease, perineal necrotizing fasciitis.

Histopathology of trichinellosis in wild boar.

Histopathological study of Trichinella constitutes an important knowledge base to understand the pathogenesis of this disease. This study analyses cell response and macroscopic lesions in wild boar for the two species of Trichinella present in Spain: Trichinella spiralis and T. britovi. We carried out both trichinelloscopy and artificial digestion to calculate the parasitic load and relate this to the macroscopic lesions. The results obtained prove a lesser adaptation of T. britovi in wild boar. From a histological point of view, the organic region that was most affected was the skeletal muscle, where inflammatory infiltrates were observed around the larvae, and they were most abundant in calcified cysts.

Hernia interna de divertículo de Meckel como causa de obstrucción intestinal en un senescente / Internal hernia of Meckel diverticulum in elderly patient

Meckel Diverticulum is the most frequent gastrointestinal congenital anomaly. General population incidence is 2 percent. Complications develop in 4 to 30 percent of the cases, where over 50 percent present during the first decade. This high incidence progressively decreases to cero in elderly patients, as some authors propose. Bowel obstruction, the most prevalent complication in adults, occurs by different mechanisms; however there is no available publication that mentions an internal hernia of Meckel Diverticulum through colonic mesentery. Meckel Diverticulum complications are rare in elderly patients; moreover an internal hernia generating bowel obstruction is even more infrequent. We present a 75-year-old male patient with bowel obstruction produced by a Meckel Diverticulum herniated through colonic mesentery.

El divertículo de Meckel (DM), es la anomalía congénita mßs frecuente del tracto gastrointestinal. Su incidencia en población general es de 2 por ciento. Las complicaciones se presentan entre 4-30 por ciento de casos. Más de 50 por ciento ocurren en la primera década de vida, disminuyendo drásticamente con la edad, llegando a cero en adultos mayores (AM) según algunos autores. La obstrucción intestinal (Oí), complicación más frecuente en adultos, tiene distintos mecanismos patogénicos; sin embargo, no hay literatura disponible que mencione la hernia interna del DM en el mesenterio colonice La complicación del DM es infrecuente en el AM, siendo más infrecuente aún, la hernia del DM en el mesenterio colónico como causa de una Oí. Presentamos un paciente masculino, 75 años con obstrucción intestinal secundaria a un DM herniado en mesenterio del colon ascendente.

[Paraneoplastic limbic encephalitis: a difficult-to-diagnose condition]. / Encefalitis límbica paraneoplásica: una entidad de difícil diagnóstico.

INTRODUCTION: Paraneoplastic syndromes can be defined as manifestations in distant places of tumors or metastasis, which are not related with tumoral growth. Most of these syndromes are caused by substances secreted by the tumor, that mimic natural hormones, or interfere with plasma proteins. DEVELOPMENT: The rate of paraneoplastic syndromes with neurological manifestations is less than 0.5/100,000 per year, and affect about 0.01% of cancer patients. The pathogenesis of neurological paraneoplastic syndromes is attributed to humoral autoimmunity, due to the existence of a great variety of antibodies in relationship with the neurological alterations associated. Nevertheless, the absence of antibodies does not exclude a neurological paraneoplastic syndromes, just as antibodies may be found without a neurological paraneoplastic syndrome. The characteristic symptoms of paraneoplastic limbic encephalitis are confusion of acute onset, mood changes, hallucinations, loss of short term memory, and seizures; these symptoms generally develop in days or weeks, but may present suddenly. Image studies, cerebral spinal fluid evaluation, and serologic tests are the most useful in diagnosing a neurological paraneoplastic syndrome. The treatment requires two different approaches. The first one is through the suppression of the immune response generated by neurological damage. The second, is by removing the tumor as the source of the antigen. The latter is often the only effective treatment. CONCLUSIONS: The paraneoplastic limbic encephalitis is an unusual and hard to diagnose entity, which can easily be confused with psychiatric problems. An early diagnosis and treatment is very important to avoid nonreversible neuronal damage.

[Local recurrence after non-small cell lung cancer surgery: prognosis variables]. / Recidiva local tras la cirugía del cáncer de pulmón no microcrítico: factores pronósticos.

OBJECTIVES: Retrospectively to analyse the influence of clinical and histo-pathological characteristics in the local recurrence after non-small cell lung cancer surgery. METHOD: 146 patients were included and studied during a minimum of two years. The free survival of disease function (FSD) was constructed according to the Kaplan-Meier method. The univariant comparison of the FSD by Mantel-Haenszel means of logarithmic ranks test and the multivariant analysis by Cox regression model. RESULTS: In the univariant analysis 20 months of FSD and the following predicting factors of a smaller FSD: Radiological contact of the tumour with the pleura (p=0.005), peritumoral margin affectation (p=0.001), pleural affectation (p=0.006), T stratification factor (p=0.04) and N factor (p=0.002). Other factors like age, initial symptoms, second neoplasias, radiological spiculations or cavitations, transtoracic puncion, type of surgery, peribronquial affectation, so large margin tumorlike and histological type, did not show statistically significant differences in the FSD. In the multivariant study they maintain its value prognosis the pleural affectation (p=0.0014), ganglionary affectation (p=0.02) and degree of differentiation (p=0.03). CONCLUSIONS: The most important prognosis factor of local recurrence after surgery in these patients were the infiltration of the pleura, followed of the hilio-mediastinic ganglionary affectation and the degree of histological differentiation.

Mycoplasma pneumoniae: infección vía aérea superior / Mycoplasma pneumoniae: infection of the upper air way

Introducción. Las infecciones agudas de la vía aérea alta (IRAs) son un problema común de consulta médica. Su clínica inicial es inespecífica, dificultando la determinación de un agente etiológico. Estudios revelan predominio etiológico viral, sin embargo, investigaciones recientes demuestran que bacterias atípicas, principalmente Mycoplasma pneumoniae, tienen importante rol como causa de IRAs. El diagnóstico de infección por M pneumoniae se realiza por métodos directos (cultivo y/o RCP) o indirectos (serología). Objetivos. Demostrar incidencia de M pneumoniae como causa de IRA alta. Reconocer características clínicas de la infección por M pneumoniae en IRA alta. Material y método. Estudio descriptivo transversal. Once pacientes ingresados con sintomatología respiratoria alta en Clínica Indisa, durante Octubre 2003 y Septiembre 2005. Se estudiaron las manifestaciones clínicas, radiológicas y detección serológica de M pneumoniae por medio del método ELISA rápido. Se clasificaron según si cumplían o no criterios de faringitis. Resultados. Siete pacientes (63 por ciento) con IRA alta y 4 con faringitis. Detección M pneumoniae (+) en 5 niños y 2 adultos, todos ellos con diagnóstico de IRA alta. Las manifestaciones más frecuentes de este grupo fueron: tos, rinorrea y odinofagia. Conclusión. M pneumoniae cumple un rol importante como agente etiológico de IRA, tanto en niños como en adultos. Su principal forma de presentación clínica corresponde a IRA alta. Importante recalcar que el diagnóstico precoz y tratamiento apropiado de la infección M pneumoniae modifican su historia natural, y a la vez reducen las manifestaciones extrapulmonares y su diseminación en la comunidad.