Massive right hemothorax due to idiopathic spontaneous rupture of a phrenic artery following cardiac surgery. / Hemotórax masivo derecho por rotura espontánea idiopática de una arteria frénica tras cirugía cardiaca.

We report a case of a 35-years-old man who presented a massive haemothorax and hypovolemic shock following cardiac surgery, from spontaneous rupture of a phrenic artery. A quick diagnosis and immediate intervention is crucial to manage the patient.

Cost-Effectiveness and Cost-Utility Analysis of Ingenol Mebutate Versus Diclofenac 3% and Imiquimod 5% in the Treatment of Actinic Keratosis in Spain. / Análisis de coste-efectividad y coste-utilidad de ingenol mebutato versus diclofenaco 3% e imiquimod 5% en el tratamiento de la queratosis actínica en España.

OBJECTIVE: To perform a cost-effectiveness and cost-utility analysis of ingenol mebutate in the treatment of actinic keratosis in Spain. METHODS: We used an adapted Markov model to simulate outcomes in a cohort of patients (mean age, 73 years) with actinic keratosis over a 5-year period. The comparators were diclofenac 3% and imiquimod 5%. The analysis was performed from the perspective of the Spanish National Health System based on direct costs (2015 retail price plus value added tax less the mandatory discount). A panel of experts estimated resources, taking unit costs from national databases. An annual discount rate of 3% was applied. Deterministic and probabilistic sensitivity analyses were performed. RESULTS: The effectiveness of ingenol mebutate-with 0.192 and 0.129 more clearances gained in treatments for face and scalp lesions and trunk and extremity lesions, respectively-was superior to diclofenac's. The total costs of treatment with ingenol mebutate were lower at € 551.50 (face and scalp) and € 622.27 (trunk and extremities) than the respective costs with diclofenac (€ 849.11 and € 844.93). The incremental cost-effectiveness and cost-utility ratios showed that ingenol mebutate was a dominant strategy vs diclofenac. Ingenol mebutate also proved to be more effective than imiquimod, based on 0.535 and 0.503 additional clearances, and total costs of € 551.50 and € 527.89 for the two drugs, respectively. The resulting incremental cost-effectiveness ratio was € 728.64 per clearance gained with ingenol mebutate vs imiquimod. CONCLUSIONS: Ingenol mebutate was a dominant treatment option vs diclofenac and was efficient vs imiquimod (i.e., more effective at a higher cost, achieving an incremental cost-utility ratio of<€30000/quality-adjusted life-years).

Genetic variability of the marine mussel Mytilus galloprovincialis assessed using two-dimensional electrophoresis.

Two-dimensional electrophoresis (2-DE) has been used to measure the degree of genetic variability of the marine mussel Mytilus galloprovincialis. Genetic polymorphisms were detected in 33 of a total of 86 polypeptides scored among the most abundant proteins from foot samples in 38 individuals. Estimates of average heterozygosity were 0.101+/-0.018 and 0.114+/-0.021 in a natural and a cultured population, respectively, from the NW of the Iberian Peninsula. These are the highest estimates of average heterozygosity reported by 2-DE in an animal species to date. We consider that these data throw open the question of the level of genetic variability detectable by two-dimensional electrophoresis. Multilocus genotype data were used to infer haplotypic frequencies by means of the EM algorithm in order to detect linkage disequilibrium between loci coding abundant proteins. Significant associations were found in 22.7% of the 406 two-locus pairs analysed. Also, clusters of loci in which all pairwise combinations exhibit statistically significant associations were detected and physical linkage between some of these loci is postulated from the linkage disequilibrium data.

Anemia hipocromica como forma de presentacion de las gastroduodenitis. A proposito de seis casos. / Hypochromic anemia as a form of presentation of gastroduodenitis. Apropos of 6 cases

La anemia hipocromica como forma de presentacion de la patologia del sector gastroduodenal, es en pediatria, un hecho frecuente. En este trabajo se presentan seis casos de anemia hipocromica y gastroduodenitis en pacientes de edad escolar pertenecientes al Servicio A (Prof. Dr. Jose Ma. Portillo) del hospital "Dr. Pedro Visca", en el periodo comprendido entre 1977 y 1979. Los seis casos se diagnosticaron con estudios hematologicos,radiologicos y endoscopicos, tratandose desde el punto de vista hematologico, digestivo y psiquiatrico siendo la evolucion favorable en todos los casos

Estudio de la incidencia de la carencia de hierro en ninos menores de 2 anos.(Comunicacion preliminar). / Occurrence of iron deficiency in children less than two years old. (Preliminary communication)

La carencia de hierro aparece actualmente como la segunda enfermedad nutricional asociada al subdesarrollo y a todo objeto de multiples estudios a nivel mundial. En Uruguay no existen estudios oficiales. En el presente trabajo se estudian desde este punto de vista, 100 ninos de consulta externa del hospital "Dr. Pedro Visca", Montevideo. Se estudiaron a traves del examen clinico y la valoracion de los examenes de sangre periferica y de los depositos de hierro. Esto ultimo determinando la ferritina serica por IRMA (radio inmunoensayo). Se encontraron valores inferiores a los tomados como limite de la normalidad, en el 72% de los casos para la ferritina, en el 65% para la sideremia y en el 59% para la hemoglobina

Eritema polimorfo severo tipo Stevens-Johnson asociado a drogas. Estudios clinico-inmunologicos. / Severe multiform erythema type Stevens-Johnson associated with drugs. Clinical-immunologic studies

Se presentan tres casos de sindrome de Stevens-Johnson o eritema polimorfo mayor, estudiados en la Catedra de Pediatria del hospital "Dr. Pedro Visca" entre los meses de febrero y julio de 1979. En todos los pacientes existio el antecedente de administracion de drogas entre los 7 y 20 dias previos al inicio del cuadro clinico. Se realizo en ellos un estudio inmunologico "in vitro" para determinar la sensibilizacion medicamentosa por la tecnica de M.I.F. (prueba de inhibicion de la migracion leucocitaria). En los tres pacientes fue posible demostrar dicha sensibilizacion: en dos de ellos a la hidantoina y en el restante al acido acetisalicilico. Como una conclusion tentativa, se sugiere que la prueba de inhibicion de la migracion leucocitaria se aplique rutinariamente a todos los pacientes con sindrome de Stevens-Johnson, usando en cada caso la o las drogas mas sospechosas. Al identificar asi el agente causal, se podran evitar futuros accidentes de sensibilizacion