Primary hepatic pleomorphic liposarcoma: Case report and literature review.

Primary hepatic liposarcoma is an extremely rare malignant tumour derived from adipocytes and is part of the group of mesenchymal tumours. We present the case of a 43-year-old Hispanic male patient with a pleomorphic hepatic liposarcoma and absence of MDM2 gene amplification. Two years and six months after surgery, the patient is asymptomatic. The present case is the first report of this entity with positive immunohistochemical testing for p16, p53, S100, vimentin and absence of MDM2 gene amplification.

Melanocytic nevus of the anal canal and granular cell tumor of the cecum: a case report and literature review of 2 coincidentally co-occurring neurocristopathies.

Granular cell tumors are predominantly benign soft tissue tumors originating from Schwann cells, whereas melanocytic nevi are benign proliferations of melanocytes. We present the case of a patient with the presence of both entities located in the cecum and anal canal, respectively, constituting an extremely rare coincidental finding. A 43-year-old woman was evaluated by colonoscopy for iron-deficiency microcytic anemia that had lasted for 1 year. Colonoscopy demonstrated a macular lesion of 0.3 cm with a melanocytic appearance in the anal canal; at the cecum level, a subepithelial, yellowish, and partially mobile firm nodular lesion measuring 1.3 cm was observed. A histopathological study showed a melanocytic nevus in the anal canal and a granular cell tumor in the cecum. This is the first reported case of a patient with the extremely rare coincidental-incidental finding of these 2 entities at the same time.

Laparoscopic enucleation of an esophageal leiomyoma.

BACKGROUND: Leiomyoma is the most common benign esophageal tumor that originates in the muscular layer, with the most common site located in the distal third of the esophagus. Its growth causes symptoms due to partial obstruction of the esophageal lumen, leading to the diagnosis and subsequent treatment. Today, due to modern minimally invasive surgical techniques, complete removal of these tumors can be accomplished with minimal morbidity and excellent results. CASE REPORT: We report the case of a 49-year-old female with a history of dysphagia, epigastric pain, and halitosis. She was diagnosed with a benign tumor originating from the muscular layer of the distal esophagus. Multiple biopsies had previously been taken, without histological confirmation. The patient underwent surgery where complete tumor enucleation was done laparoscopically. CONCLUSIONS: Preoperative diagnosis of these tumors should be based on clinical history and studies such as esophagoscopy and endoscopic ultrasound. Laparoscopic enucleation is the treatment of choice for leiomyomas of the esophagogastric junction. Biopsy specimens should be avoided because histology is not always possible. Furthermore, they are related to rupture of the esophageal mucosa during surgical treatment. After enucleation in selected patients, anti-reflux procedure should be carried out in order to protect the area of surgical resection and prevent complications from weakening the lower esophageal sphincter, as well as to resolve reflux symptoms.

Perfil epidemiológico de la mortalidad por influenza humana A (H1N1) en México / Epidemiological profile of mortality due to human influenza A (H1N1) in Mexico

OBJETIVO: Efectuar el análisis epidemiológico de 122 defunciones por influenza A (H1N1) confirmadas por laboratorio y contribuir a mejorar el diagnóstico y atención oportuna de casos. MATERIAL Y MÉTODOS: Se Analizaron 122 expedientes de pacientes fallecidos por influenza A (H1N1). RESULTADOS: Una proporción de 51 por ciento correspondió a mujeres y 49 por ciento a varones. Hasta 45.1 por ciento ocurrió entre los 20 y 39 años. La letalidad general fue de 2.2 por ciento y varió entre 0.3 por ciento en el grupo de 10 a 19 años y 6.3 por ciento en el de 50 a 59. Una cifra de 43 por ciento de las defunciones se concentró en dos de las 32 entidades federativas y 5l por ciento se atendió en instituciones de seguridad social. Sólo 17 por ciento recibió atención hospitalaria en las primeras 72 horas y 42 por ciento falleció en las primeras 72 horas de hospitalización. En 58.2 por ciento de los fallecidos había algún padecimiento asociado. DISCUSIÓN: El Nuevo virus A (H1N1) produce mayor mortalidad en personas jóvenes, al contrario de lo que sucede con la influenza estacional que muestra un mayor impacto en niños pequeños y personas de edad avanzada. El retraso de la atención médica y la morbilidad asociada fueron factores relevantes del fallecimiento.

OBJECTIVE: To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases. MATERIAL AND METHODS: A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died. RESULTS: Fifty-one percent of patients were female and 49 percent were male. A total of 45.l percent who died were between 20 and 39 years old. Overall fatality was 2.2 percent and ranged between 0.3 percent for the l0 to l9 year-old group to 6.3 percent for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l percent received medical attention in social security institutions. Only l7 percent received hospital attention within 72 hours and 42 percent died within 72 hours of hospital attention. DISCUSSION: Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.

Glaucoma primario de ángulo abierto: un problema de salud en el municipio Las Tunas / Primary open angle glaucoma: a health problem in Las Tunas municipality

Se realizó un estudio longitudinal retrospectivo a través de una pesquisa de glaucoma en la población del municipio de Las Tunas, que incluyó todos los grupos de edades, en el período comprendido desde enero de 2003 hasta diciembre de 2004, con la finalidad de precisar la incidencia y los principales factores de riesgo del glaucoma primario de ángulo abierto. Se examinaron 3 789 pacientes. La enfermedad se presentó con una incidencia de 1, 97 para todos los grupos de edades. Los factores de riesgo identificados fueron la edad, la hipertensión arterial y la hipertensión ocular

Educación médica por computadora / Medical education by computer

Contenido: Introducción. 1) Generalidades. 2) El proceso cognitivo. 3) Metacognición y estrategias de aprendizaje. 4) Preferencias de aprendizaje y modalidades pedagógicas. 5) Presentación electrónica de informacióny el medio virtual. 6) Aprendizaje basado en problemas. 7) Medicina basada en evidencias. 8) Recursos pedagógicos en internet. 9) Educación a distancia, telemedicina e internet2. Glosario

Prevalencia de cancer gástrico Solca, Quito-Ecuador

Se realiza un estudio de los pacientes portadores de cáncer gástrico en 18 meses (Enero/94-Junio/95). Se registran 114 casos cuyo promedio de edad es de 58.5 años. El 92 por ciento tuvo cáncer gástrico avanzado y sólo el 8 por ciento fue temprano. El 53 por ciento se encontraba en EIV. El 26 por ciento pudo acceder a una cirugía curativa.