Cannabinoids induce cell death in leukaemic cells through Parthanatos and PARP-related metabolic disruptions.

BACKGROUND: Several studies have described a potential anti-tumour effect of cannabinoids (CNB). CNB receptor 2 (CB2) is mostly present in hematopoietic stem cells (HSC). The present study evaluates the anti-leukaemic effect of CNB. METHODS: Cell lines and primary cells from acute myeloid leukaemia (AML) patients were used and the effect of the CNB derivative WIN-55 was evaluated in vitro, ex vivo and in vivo. RESULTS: We demonstrate a potent antileukemic effect of WIN-55 which is abolished with CB antagonists. WIN-treated mice, xenografted with AML cells, had better survival as compared to vehicle or cytarabine. DNA damage-related genes were affected upon exposure to WIN. Co-incubation with the PARP inhibitor Olaparib prevented WIN-induced cell death, suggesting PARP-mediated apoptosis which was further confirmed with the translocation of AIF to the nucleus observed in WIN-treated cells. Nicotinamide prevented WIN-related apoptosis, indicating NAD+ depletion. Finally, WIN altered glycolytic enzymes levels as well as the activity of G6PDH. These effects are reversed through PARP1 inhibition. CONCLUSIONS: WIN-55 exerts an antileukemic effect through Parthanatos, leading to translocation of AIF to the nucleus and depletion of NAD+, which are reversed through PARP1 inhibition. It also induces metabolic disruptions. These effects are not observed in normal HSC.

[Incidence of alarm criteria and attitude towards patients with headache attended in emergency departments]. / Incidencia de criterios de alarma y actitud frente a los pacientes con cefalea atendidos en urgencias.

INTRODUCTION: Alarm criteria make it possible to identify persons who visit emergency services because of severe secondary headaches. AIMS: To determine the socio-demographic characteristics of the patients who visit emergency departments due to headache, the incidence of alarm criteria, treatment and the diagnosis after one year's follow-up. PATIENTS AND METHODS: We conducted a retrospective observational cross-sectional study of the persons attended in the emergency department of the Arnau de Vilanova Hospital between June 2014 and May 2015 due to headache. RESULTS: A total of 303 persons were identified, of whom 165 were finally included in the study. There was a predominance of women (66.7%). The mean age was 41.2 ± 15.9 years. Only 16.4% were referred from primary care and 52 (31.5%) presented alarm criteria. A computerised tomography head scan was performed in half of these cases, and lumbar puncture was carried out in four of them (7.7%). A serious cause of headache was found in four cases (2.4%). After one year of follow-up, three patients who did not initially visit because of alarm criteria were diagnosed with severe diseases of the central nervous system, and 23 (13.9%) returned to the emergency department for the same reason. CONCLUSIONS: Only one out of every two patients meets the alarm criteria. The proportion of severe secondary headache is really low. The multidisciplinary management of headache needs to be improved in our setting to prevent people visiting the emergency department due to primary headaches without any alarm criteria.

TITLE: Incidencia de criterios de alarma y actitud frente a los pacientes con cefalea atendidos en urgencias.Introduccion. Los criterios de alarma permiten identificar a las personas que consultan por cefaleas secundarias graves en los servicios de urgencias. Objetivo. Determinar las caracteristicas sociodemograficas de los pacientes que acuden a urgencias por cefalea, la incidencia de criterios de alarma, el tratamiento y el diagnostico tras un año de seguimiento. Pacientes y metodos. Estudio transversal retrospectivo y observacional de personas atendidas en el servicio de urgencias del Hospital Arnau de Vilanova entre junio de 2014 y mayo de 2015 por cefalea. Resultados. Se identifico a un total de 303 personas, de las cuales 165 se incluyeron finalmente en el estudio. Hubo un predomino de mujeres (66,7%). La edad media fue de 41,2 ± 15,9 años. Solo un 16,4% fue derivado desde atencion primaria y 52 (31,5%) presentaban criterios de alarma. En la mitad de estos casos se realizo una tomografia computarizada craneal, y en 4 (7,7%), una puncion lumbar. Se identifico una causa grave de la cefalea en 4 casos (2,4%). Tras un año de seguimiento, tres pacientes que inicialmente no consultaron por criterios de alarma fueron diagnosticados de enfermedades graves del sistema nervioso central, y 23 (13,9%) volvieron a urgencias por el mismo motivo. Conclusiones. Solo uno de cada dos pacientes cumple criterios de alarma. La proporcion de cefalea secundaria grave es realmente baja. Es necesario mejorar el abordaje multidisciplinar de la cefalea en nuestro ambito para evitar la consulta a urgencias por cefaleas primarias sin criterios de alarma.

Short- and long-term effects of nicotine and the histone deacetylase inhibitor phenylbutyrate on novel object recognition in zebrafish.

RATIONALE: Zebrafish have a sophisticated color- and shape-sensitive visual system, so we examined color cue-based novel object recognition in zebrafish. We evaluated preference in the absence or presence of drugs that affect attention and memory retention in rodents: nicotine and the histone deacetylase inhibitor (HDACi) phenylbutyrate (PhB). OBJECTIVES: The objective of this study was to evaluate whether nicotine and PhB affect innate preferences of zebrafish for familiar and novel objects after short- and long-retention intervals. METHODS: We developed modified object recognition (OR) tasks using neutral novel and familiar objects in different colors. We also tested objects which differed with respect to the exploratory behavior they elicited from naïve zebrafish. RESULTS: Zebrafish showed an innate preference for exploring red or green objects rather than yellow or blue objects. Zebrafish were better at discriminating color changes than changes in object shape or size. Nicotine significantly enhanced or changed short-term innate novel object preference whereas PhB had similar effects when preference was assessed 24 h after training. Analysis of other zebrafish behaviors corroborated these results. CONCLUSIONS: Zebrafish were innately reluctant or prone to explore colored novel objects, so drug effects on innate preference for objects can be evaluated changing the color of objects with a simple geometry. Zebrafish exhibited recognition memory for novel objects with similar innate significance. Interestingly, nicotine and PhB significantly modified innate object preference.

Eficacia de intervenciones educativas en la adherencia terapéutica de pacientes hipertensos / Effectiveness of educational interventions on the therapeutic adherence of hypertension patients / Eficácia das intervenções educativas na adesão terapêutica de pacientes hipertensos

Este estudio exploratorio con abordaje cualitativo fenomenológico busca identificar la eficacia de intervenciones educativas en \r\nla adherencia terapéutica de un grupo de pacientes hipertensos, seleccionados de un barrio con alto grado de vulnerabilidad \r\ndel municipio de Toluviejo, Sucre, a quienes se invitó a participar en la investigación. Para recolectar la información socioeco\r\n-\r\nnómica de los participantes, se construyó una ficha de caracterización; para determinar el grado de adherencia al tratamiento \r\nfarmacológico prescrito para la hipertensión, se utilizó el test de Morisky-Green antes y después de la intervención con estrategias \r\neducativas, tales como charlas grupales, grupos focales con pacientes y cuidadores, y jornadas lúdicas.\r\nComo resultado se logró establecer que los pacientes modificaron significativamente su respuesta al seguimiento del tratamiento, \r\ncon un aumento del 26,70% de los pacientes con respuestas indicativas de adherencia, comparado con los resultados iniciales. Se \r\nconcluye que la intervención educativa pudo tener alguna incidencia de manera directa y efectiva sobre el grupo en estudio, lo \r\ncual influyó en los resultados obtenidos.

An exploratory study was performed using a phenomenolo-\r\ngical qualitative approach, aimed at identifying the effective\r\n-\r\nness of educational mediation on the therapeutic adherence \r\nof hypertensive patients in the high-vulnerability municipality \r\nof Toluviejo, Sucre. Socioeconomic information was collected \r\nthrough a characterization chart; A Morisky-Green Test was \r\nused before and after the mediation in order to determine the \r\nadherence to the hypertension treatment. Educational strate\r\n-\r\ngies, such as group discussions, focus groups with patients and \r\ncaregivers, and recreational days were used.\r\nResults showed a significant improvement of treatment \r\nresponse with an increased adherence of 26.70% in comparison \r\nto previous results. We conclude that educational mediation \r\ncould have had some direct and effective impact on the study \r\ngroup, contributing to the results obtained

Este estudo exploratório, com abordagem qualitativa feno\r\n-\r\nmenológica teve como objetivo identificar a eficácia das \r\nintervenções educativas sobre a adesão terapêutica de um \r\ngrupo de pacientes hipertensos, selecionados a partir de um \r\nbairro com um alto grau de vulnerabilidade, do município de \r\nToluviejo, Sucre, os quais foram convidados a participar da \r\ninvestigação. Para a coleta de informações socioeconômicas \r\ndos participantes, uma ficha de caracterização foi construída; \r\ne para determinar o grau de adesão ao tratamento farmaco\r\n-\r\nlógico prescrito para hipertensão, o teste de Morisky-Green foi \r\nutilizado antes e após a intervenção com estratégias educa\r\n-\r\ncionais, tais como discussões em grupo, grupos focais com \r\npacientes e cuidadores, e atividades recreativas.\r\nComo resultado, ficou estabelecido que os pacientes modifi\r\n-\r\ncaram significativamente a sua resposta à monitorização do \r\ntratamento, com um aumento de 26,70% dos pacientes com \r\nrespostas indicativas de adesão, em comparação com os resul\r\n-\r\ntados iniciais. Concluímos que a intervenção educativa pode \r\nter impactado direta e efetivamente o grupo em estudo, o que \r\ninfluenciou nos resultados obtidos.

Individual factors and school-based policies related to adherence to physical activity recommendations in Spanish adolescents.

Our objective was to identify individual- and school-level contextual factors related to adherence to the recommendations for physical activity in adolescents. The study used a representative sample of 15,902 students from 328 schools aged 11-18 years participating in the Spanish Health Behaviour in School-aged Children (HBSC) survey 2006. In addition to the student questionnaire, the school management board completed a questionnaire about school-based policies related to physical activity. Adherence to the recommendations was defined as "having carried out moderate and/or vigorous physical activity for at least 60 min a day on five or more days during the last week". Analysis was undertaken using multilevel logistic regression models. Individual factors associated in a statistically significant way with a higher non-compliance were: being female; being older; immigrants; tobacco smoking; being overweight or obese; low consumption of fruit and vegetables; low level of satisfaction with life; not having a high level of academic achievement; and spending a lot of time studying. The family variables were: not undertaking sports activities with the family; low socioeconomic status; and a low level of satisfaction with family relationships. Compared with schools that have a low level of policies to promote physical activities, those with a high level of promotion had an odds ratio of 0.76 (CI 95 %, 0.61-0.94). In summary, irrespective of personal and family factors, students from schools with better policies of promotion of physical activity showed a higher compliance with the recommendations.

[Intravenous infusion of adult adipose tissue stem cells for repairing spinal cord ischaemic lesions. An experimental study on animals]. / Infusión intravenosa de células madre adultas procedentes del tejido adiposo para la reparación de lesiones medulares isquémicas. Estudio experimental en conejos.

OBJECTIVE: To assess if a peripheral intravenous infusion of adipose tissue stem cells (ATSC), after an ischemic spinal cord injury can promote selective cell migration and cell survival in the damaged neural tissue. ANIMALS AND METHOD: An ischaemic spinal cord injury was provoked by trapping the abdominal aorta for 20 minutes in 11 male New Zealand rabbits (2.5±0.5kg). They were randomised into two groups: one group (n=5) received an intravenous transfusion of 10±2×10(6) ATSC at 24 hours from the injury, and the control group (n=6) were only given the vehicle. The functional status was assessed, using the Tarlov scale at 24h, and 7 and 14 days. The animals were sacrificed at 14 days and a histological and immunohistochemical study was performed. RESULTS: Complete paraplegia was achieved in both groups. There were no significant differences as regards neurological recovery, which was nil in both cases. In the histological and immunohistochemical study, it was tested to see if there was any bromodeoxyuridine-marked ATSC in the area of the lesion, but there was only a small amount. CONCLUSION: ATSC are able to migrate and survive in the injured spinal cord after aortic ischaemia after they have been administered intravenously. Intravenous infusion is a harmless procedure with no side effect. No neurological recovery was achieved.

[Prevalence of vascular risk factors among Spanish populations aged 70 years and over, as reported in door-to-door studies on neurological diseases]. / Prevalencia de factores de riesgo vascular en poblaciones españolas de 70 años y más en estudios puerta a puerta de enfermedades neurológicas.

INTRODUCTION: The aim of this study was to re-analyze door-to-door studies on neurological diseases among the elderly, in which vascular risk factors (VRF) were studied, describing methodological characteristics and prevalence of VRF. METHODS: The surveys were identified in two phases. They were aimed at ascertaining prevalence of stroke, dementias or Parkinsonisms and, at the time of individual screening, had collected data on at least three of the following VRF: arterial hypertension (AHT), smoking habit, diabetes mellitus and hypercholesterolemia. A questionnaire was drawn up to collect the data reported in each study, and a database was constructed. VRF prevalences were quantified and analyzed using logistic regression. RESULTS: The total of the re-analyzed population was 12,510 persons aged 70 years and over, residents in seven geographic areas during the period 1994-2002. Information available on VRF was essentially self-reported. The prevalence of self-reported AHT was 25.7 % in men and 44.2 % in women, and that of measured AHT was 61 % and 71.9 %, respectively. Populations with arterial pressure obtained by direct measurement registered 138 higher risks (OR: 1.74; 95 % CI: 1.51-2.01, and OR: 1.48; 95% CI: 1.33-1.64). Reported prevalence of diabetes, hypercholesterolemia and smoking habit were 14.3 %, 23.3% and 8.5 %, respectively. CONCLUSIONS: There was a high prevalence of VRF among the Spanish elderly population. However, its relationship with dementia, Parkinsonisms and cerebrovascular disease could not be studied due to the poor quality of the VRF data. The differences between measured and self-reported arterial pressure suggest the existence of undetected AHT and wide scope for prevention.

Familial Alzheimer disease in Latinos: interaction between APOE, stroke, and estrogen replacement.

BACKGROUND: Factors that modify risk related to APOE variants have been examined primarily in unrelated patients and controls, but seldom in family-based studies. Stroke, vascular risk factors, estrogen replacement therapy (ERT), head injury (HI), and smoking have been reported to influence risk of sporadic but not familial Alzheimer disease (AD). OBJECTIVES: To examine the potential relationship between these risk factors and APOE, the authors used a family study design in a population in which the APOE-epsilon4 variant is strongly associated with risk of AD. METHODS: Latino families primarily from the Caribbean Islands in which two or more living relatives had dementia were identified in the New York City metropolitan area, the Dominican Republic, and Puerto Rico. A total of 1,498 participants from 350 families underwent a clinical interview, medical and neurologic examinations, neuropsychological testing, and APOE genotyping. Diagnosis was made by consensus using research criteria for AD. RESULTS: APOE-epsilon4 was associated with a nearly twofold increased risk of AD. A history of stroke was also associated with a fourfold increased risk. A statistical interaction between APOE-epsilon4 and stroke was observed. Women with an APOE-epsilon4 who took ERT did not have an increased risk of AD, but in women with a history of stroke ERT was a deleterious effect modifier. CONCLUSIONS: APOE-epsilon4 and stroke independently increase risk of familial Alzheimer disease (AD) among Latinos, and may interact to further increase AD risk. Among women, the risk of AD associated with APOE-epsilon4 may be attenuated by a history of ERT.

[Cardiovascular risk factors in Spanish population: metaanalysis of cross-sectional studies]. / Factores de riesgo cardiovascular en la población española: metaanálisis de estudios transversales.

BACKGROUND AND OBJECTIVE: To review published studies on the prevalence of the main vascular risk factors -hypertension, hypercholesterolemia, diabetes mellitus, obesity and tobacco smoking- in Spain, and to combine their results in an estimate for the Spanish population. MATERIAL AND METHOD: After a bibliographic search, the studies fulfilling the following inclusion criteria were selected: cross-sectional design, sampling on Spanish population, results including prevalence data of at least one of the above mentioned risk factors, and objective [corrected] (not self-referred) determination of arterial blood pressure, total serum cholesterol, basal glucose, weight, size and body mass index. The combined prevalence was obtained by means of the random effects model, including weight for the proportion that the studied population supposes on the total Spanish population. RESULTS: Forty-eight studies were identified including a total of 130.945 subjects. According to these studies, the most frequent vascular risk factors were hypertension in the elderly (66.7%, CI 59-74%), overweight/obesity in adult women (48,3%, CI 41-55%) and smoking among men (41.1%, CI 38-44%). In the Spanish population as a whole, 23% showed total cholesterol levels above 250 mg/dl; 33% were smokers (41,1% in men and 24% in women); 34% suffered hypertension; 20% were obese (18% in men and 23% in women); and diabetes affected 8% women and 12% men. CONCLUSION: Cardiovascular risk in Spain is high. Monitoring the vascular risk factors at a population level is basic for preventive and health care measures.

Preoperatively irradiated rectal carcinoma: analysis of the histopathologic response and predictive value of proliferating cell nuclear antigen immunostaining.

OBJECTIVES: To investigate the relationship between the histopathologic effects of preoperative chemoradiotherapy in rectal cancer and the proteins, proliferating cell nuclear antigen (PCNA) and p53. METHODS: Samples from 73 tumors were examined. The histopathologic effects observed in the resected specimens induced by preoperative chemoradiotherapy were correlated with the inmunohistochemical expression of PCNA and p53 in biopsies obtained by rectoscopy before chemoradiotherapy. RESULTS: Thirty-five tumors showed a high PCNA index (48%). Nuclear accumulation of p53 protein was detected in 53 tumors (72%). Specimens were assigned one of four grades based on the amount of residual viable tumor. Three neoplasms (4%) showed complete regression; 8 other carcinomas (11%) showed only small numbers of tumor cells scattered within the field of stromal reaction. In these cases, it was considered that the tumor had responded significantly to radiotherapy. Tumors with a high PCNA index responded to chemoradiotherapy more frequently (8/35; 72%) than tumors with a low index (3/38; 43%) (p = 0.07). p53-negative tumors responded more frequently (4/20; 20%) than positive tumors (7/53; 13.2%) (p = 0.50). When pathologic and immunohistochemical characteristics of the tumors were included in a logistic regression model, only high PCNA index (odds ratio 5.35, 95% confidence interval 1.07-26.7) (p = 0.04) was significantly associated with the histologic response to preoperative chemoradiotherapy. CONCLUSION: High proliferative activity of rectal cancer, as determined by PCNA immunostaining, is predictive of the response to preoperative chemoradiotherapy.

High prevalence of RET tyrosine kinase activation in Mexican patients with papillary thyroid carcinomas.

RET/PTC oncogene expression is restricted to papillary thyroid carcinomas (PTC). At least three forms of this oncogene have been described. These are generated by the rearrangement of the 5'-terminal region of different expressed genes with the tyrosine-kinase (TK) domain of the ret proto-oncogene. Several studies showing the correlation between the expression of this oncogene, clinical outcome, and histological subtypes have been published. Thirty-five paraffin-embedded PTC samples from patients without a history of radiation exposure were studied. Immunohistochemistry (IHC) and in situ hybridization (ISH) were used to determine a possible correlation between RET activation, clinical outcome, and tumor subtype. Almost half of the studied cases presented with tumoral extension or metastases. Ret gene transcripts and protein were found in all PTC variants as well as in their corresponding metastases. In contrast, none of the follicular adenomas, goiters, or normal follicular cells from the thyroid gland showed evidence of ret activation. We observed a high frequency of ret expression in PTCs, suggesting that ret activation is a common event in nonradiation-related PTC from Mexican patients.

Influence of tumor localization on the prognostic value of P53 protein in colorectal adenocarcinomas.

BACKGROUND: The prevalence of genetic alterations is different in primary carcinomas from the proximal colon when compared with carcinomas from the distal colorectum. The objective of this work was to explore the existence of possible differences in the informative weight of the risk of tumor recurrence provided by p53 immunostaining depending on the localization of the neoplasm. PATIENTS AND METHODS: Nuclear immunohistochemical expression of p53 protein was determined in formalin-fixed paraffin-embedded archival tumor tissue samples from 190 primary colorectal adenocarcinomas. The relative prognostic importance on the risk of recurrence of each variable was assessed in a Cox's proportional hazard regression analysis. Multiplicative interaction terms between p53 and tumor site were included in the multivariate models in order to test their joint effect on survival. RESULTS: One hundred and one patients (53.1%) manifested nuclear accumulation of the protein. P53 overexpression was more frequent in distal than in proximal tumors (58.5% ve s 41.7%) (p = 0.03). Disease-free survival was lower in p53-positive cases (75% versus 38%) (p = 0.006), but significance of the association varied according to the localization of the tumor (p = 0.004 in proximal carcinomas and p = 0.049 in distal carcinomas). Multivariate analysis identified p53 positivity and distal tumor localization as the factors significantly associated with a high risk of recurrence Interaction between p53 expression and localization was present. P53 exhibited different prognostic value in distal and proximal colon. While adjusted hazard ratio for positive p53 was 1.99 in distal cancers, it was 8.04 for proximal tumors. CONCLUSION: The prognostic with value of tumor recurrence associated overexpression of p53 protein is influenced by the location of the tumor. The negative predictive weight is significantly higher in proximal than in distal cancers.

P53 protein expression in gastric adenocarcinoma. Negative predictor of survival after postoperative adjuvant chemotherapy.

BACKGROUND: The aim of the present study was to evaluate the influence of p53 protein on the survival of patients undergoing radical gastrectomy and postoperative adjuvant chemotherapy for gastric cancer. PATIENTS AND METHODS: It was a retrospective study of 46 patients with gastric adenocarcinoma (Stage II and III of the Japanese staging system). Alypatients were treated by curative radical gastrectomy with regional lymphadenectomy plus adjuvant chemotherapy. This regime included Mitomycin (20 mg one hour before surgery, followed by 10 mg the day after) and Fluorinated Pyrimidine (UFT) (400 mg/m2/day orally) (started four weeks after operation, and continued for one year). Immunohistochemical expression of p53 protein was determined on tumor samples from the removed specimens. The influence of p53 on survival was assessed in a Cox's proportional hazard regression analysis. RESULTS: Sixteen tumors (34.7%) manifested nuclear overexpression of p53 protein. Patients with p53-negative tumors showed higher cumulative survival at 4 years follow-up than patients with p53-positive tumors (82% versus 45%) (p < 0.01). Multivariate analysis identified p53 overexpression as a negative independent predictive factor (hazard ratio: 11.15) (95% CI: 1.93-64.42). Multivariate analysis performed on patients with Stage III tumors, separately, confirmed the predictive effect of p53 overexpression. CONCLUSION: The results suggest that postoperative adjuvant chemotherapy acted differently in p53-positive than in p53-negative gastric tumors. Absence of p53 overexpression is associated to longer survival when adjuvant therapy is administered.

Subconjunctival infection with Dirofilaria repens: serological confirmation of cure following surgery.

Cases of zoonotic dirofilariasis infection, caused by Dirofilaria repens, occur widely throughout European, African, Middle Eastern, and Asian countries. The reports of this infection in humans in Spain are limited, and we herein report the case of a 43-year-old man from Elche (Alicante), Spain, who was seen with acute hyperemic reactivity of the temporal limbus of the right eye. A large nematode was visualized on examination and the intact worm was surgically removed. The parasite was identified as a mature but infertile female D repens. The level of serum antibodies against D repens was monitored for 6 months after surgery using immunoenzymatic assays. Serological results confirmed, as expected, the presence of a single worm and the parasitological cure after the surgical removal of the parasite. To our knowledge, this is the fourth autochthonous case of D repens infecting humans in Spain and also the first autochthonous case of subconjunctival localization.

Presence of the 918 mutation in the RET proto-oncogene in a Mexican patient with multiple endocrine neoplasia type 2B.

The dominantly inherited Multiple Endocrine Neoplasia cancer syndrome type 2B (MEN2B) is characterized by the presence of medullary thyroid carcinoma (MTC), phaechromocytoma (PHAEO), mucosal neuromas, ganglioneuromas of the intestinal tract, skeletal and ophthalmic abnormalities. MEN2B has been associated with a specific point mutation in the tyrosine kinase domain of the RET proto-oncogene (918RET mutation). We investigated a Mexican patient MEN2B for the presence of the 918RET mutation using the polymerase chain reaction followed by restriction endonuclease digestion. We have detected this mutation in DNA from the patient's MTC, PHAEO, and peripheral blood cells, but not in DNA from the patient's mother, suggesting that this mutation arose de novo. Our results are in agreement with the suggestion that the 918RET mutation is present in a vast majority of MEN2B cases around the world.

[Lymphangioleiomyoma with retroperitoneal and thoracic involvement]. / Linfangioleiomioma con afectación retroperitoneal y torácica.

We report a new case of lymphangioleiomyoma in a 29 years old woman, with antecedents of recurrent spontaneous pneumothorax; she was diagnosed 2 years previously of retroperitoneal hemangiopericytoma, and she has admitted to the hospital because pneumothorax, chilotorax and honeycomb lung pattern, which induce to review the previous retroperitoneal biopsy and confirm to answer with lymphangioleiomyoma. The literature is reviewed.

Morbilidad en esterilización quirúrgica femenina por minilaparotomía en el subcentro de Tamayo

Se realizó un estudio prospectivo de morbilidad con 139 pacientes a las que se les practicó esterilización con minilaparotomía de Pomeroy en el subcentro de salud de Tamayo, República Dominicana, durante el período enero 1986-enero 1987. Se empleó anestesia infiltrativa en 83 pacientes; 40 casos se aplicó anestesia general y raquianestesia en 16 casos. En 67 pacientes se realizó miniparotomía puerperal de las cuales se presentaron 9 casos (6.48%) de morbilidad post operatoria y en 72 casos minilaparatomía de intervalo donde hubo 15 casos (10.79%) de morbilidad post-operatoria. De las pacientes intervenidas 2 volvieron a embarazarse, para una tasa de fracaso de 1.44%