Mammography correlates to better survival rates in breast cancer patients: a 20-year experience in a University health institution.

Breast cancer (BC) is the most common malignancy in women. We retrieved medical records from >2,000 Chilean BC patients over the 1997-2018 period. The objective was to assess changes in clinical presentation or prognosis of our patients throughout these 20 years of practice. Although most variables did not display significant variations, we observed a progressive increase in stage IV BC over this period. Our data showed that tumour stage III/IV or HER2-enriched subtype tumours were associated with poorer prognosis. In contrast, we found that patients diagnosed by mammography had better overall survival. We speculate that better screenings and more sensitive imaging could explain the unexpected rise in stage IV cases. Our results support mammography screenings as an effective measure to reduce BC-related mortality.

Glomerulopatía colapsante con insuficiencia renal terminal de rápida progresión / Collapsing glomerulopathy with rapid progression to terminal renal failure

La glomerulopatía colapsante (GC) constituye una variedad de la glomeruloesclerosis focal y segmentaria. Afecta tanto a la población adulta (40%) como a la infantil (20%); presentándose con mayor frecuencia en hombres jóvenes y afrodescendientes. Clínicamente se presenta como un síndrome nefrótico, con niveles elevados de úrea y creatinina. Se presenta el caso de paciente femenino de 22 años, quien acude por presentar fiebre, edema matutino en miembros inferiores, e intolerancia oral de 9 días de evolución. Al examen físico: Hipertensión arterial y ascitis. La GC es una entidad poco diagnosticada, que progresa rápidamente a insuficiencia renal terminal a pesar de recibir cualquier tratamiento sistémico descrito hasta la actualidad, por lo que amerita mayor investigación en el ámbito terapéutico(AU)

Collapsing glomerulopathy (GC) is a variety of focal segmental glomerulosclerosis. It affects both adult population (40%) and children (20%); it occurs most often in young people, male and of African descent. Clinically it is presented as a nephrotic syndrome, with high levels of urea and creatinine serum. There is insufficient evidence regarding the treatment of this entity, so that steroids and immunosuppressants are used at high doses. We present the case of a 22-year old female, who presented fever, edema in the lower limbs and oral intolerance of 9 days of evolution. Physical examination showed: high blood pressure and ascitis. This nephropathy is an underdiagnosed entity rapidly progressing to kidney failure despite receiving any systemic treatment described until now, so it merits further research in the therapeutic field(AU)

Augmented reality and dynamic infrared thermography for perforator mapping in the anterolateral thigh.

Dynamic infrared thermography (DIRT) has been used for the preoperative mapping of cutaneous perforators. This technique has shown a positive correlation with intraoperative findings. Our aim was to evaluate the accuracy of perforator mapping with DIRT and augmented reality using a portable projector. For this purpose, three volunteers had both of their anterolateral thighs assessed for the presence and location of cutaneous perforators using DIRT. The obtained image of these "hotspots" was projected back onto the thigh and the presence of Doppler signals within a 10-cm diameter from the midpoint between the lateral patella and the anterior superior iliac spine was assessed using a handheld Doppler device. Hotspots were identified in all six anterolateral thighs and were successfully projected onto the skin. The median number of perforators identified within the area of interest was 5 (range, 3-8) and the median time needed to identify them was 3.5 minutes (range, 3.3-4.0 minutes). Every hotspot was correlated to a Doppler sound signal. In conclusion, augmented reality can be a reliable method for transferring the location of perforators identified by DIRT onto the thigh, facilitating its assessment and yielding a reliable map of potential perforators for flap raising.

Piomiositis tropical, un gran simulador de diagnóstico infrecuente / Tropical pyomyositis, a great simulator of uncommon diagnosis

La piomiositis tropical es una infección que afecta al músculo estriado, principalmente de región pélvica y proximal de muslos. Lo excepcional radica en la colonización del músculo estriado, evidenciándose la práctica de ejercicio extenuante como factor predisponente. El Staphylococcus aureus es el principal agente etiológico. La presentación se caracteriza por fiebre, mialgia y limitación funcional. El tratamiento contempla antibioticoterapia y drenaje quirúrgico. Se trata de escolar masculino, 11 años, quien presenta dolor en región inguinal izquierda, aumento de volumen en muslo ipsilateral, fiebre, limitación funcional. Práctica interdiaria de béisbol. Posición antálgica de muslo izquierdo, signos de flogosis en región inguinal y glútea ipsilateral. Paraclínicos: Leucocitosis, neutrofilia, proteína C reactiva elevada. Resonancia magnética nuclear demuestra colección en músculos pelvitrocantéricos. Se indicó antibioticoterapia con Clindamicina y Cefotaxime. Presenta evolución satisfactoria.

Tropical pyomyositis is an infection that affects the striated muscle, mainly of the pelvic and proximal thighs. Seen more frequently in immunocompetent males between 2-10 years. The uncommon fact is the colonization of striated muscle, with the practice of extenuating exercise, as a predisposing factor. Staphylococcus aureus is the main etiological agent. Clinical presentation is characterized by fever, myalgia and functional limitation. Treatment includes antibiotic therapy and surgical drainage. Clinical case: An 11 year old boy, who presents with pain in the left inguinal region, increased volume of the ipsilateral thigh, fever and functional limitation. The patient usually practiced baseball every other day. Physical examination: Antalgic position of the left thigh, phlogosis in inguinal and gluteal ipsilateral regions. Paraclinics: Leukocytosis, neutrophilia, elevated C-reactive protein. Nuclear magnetic resonance demonstrates collection in pelvitrocanteric muscles. Antibiotic therapy with Clindamycin and Cefotaxime were prescribed with a satisfactory evolution.

Epilepsia occipital / Occipital lobe epilepsy

Se han hecho innumerables intentos para lograr una definición que incluya toda la semiología y fisiología que envuelve la epilepsia, y tratar de hacerlo ha sido una tarea que ha tomado muchos años. Aunado a ello se ha propuesto una clasificación en diferentes grupos según su inicio y desencadenamiento, como lo son focales y generalizadas. La presente revisión versará acerca de la epilepsia occipital, clasificada antes dentro de las crisis parciales, en las que se han identificado un curso y un pronóstico favorables en el transcurso del tiempo, y que tienen en común un inicio en la edad temprana. Ha sido descrito que algunos de estos trastornos pudieran tener una base genética hereditaria o bien esporádica en otros, lo cual requiere una investigación exhaustiva. Por lo anterior se hace necesaria una revisión completa acerca de la epilepsia occipital, con el fin de dar claridad conceptual, clínica y diagnóstica de este desorden, así como para hacer aportes al conocimiento de la misma en pro de mejorar la calidad de vida y el tratamiento en la práctica clínica de pacientes que se encuentren dentro del espectro de esta enfermedad.

Epilepsy and its overall semiology and physiology have been subject to Innumerable definition attempts which have taken many years of effort. Likewise, a proposal for an epilepsy classification based on onset and precipitating factors was developed dividing seizures into focal and generalized seizures. This article reviews occipital lobe epilepsy which was formerly classified in the partial seizures group characterized by a favorable course and prognosis over time and by onset during early childhood. A possible genetic hereditary origin and that they may be sporadic has been described for some of these problems and still require a thorough investigation. Thus, it is necessary to conduct an extensive review on occipital lobe epilepsy for obtaining conceptual, clinical and diagnostic clarity as well as, to enhance knowledge on this illness for improving quality of life and clinical treatment in patients experiencing this spectrum of disorders.

Epilepsia del lóbulo parietal / Parietal lobe epilepsy

La epilepsia originada en el lóbulo parietal es una entidad infrecuente, representa el tercer tipo más común, precedida por las de los lóbulos temporal y frontal, muchas veces se pasa por alto el raro origen de este tipo de crisis. Por esta razón, se presenta el caso clínico de una mujer con semiología de epilepsia del lóbulo parietal en el Hospital Infantil Universitario de San José de Bogotá, con hallazgos electroencefalográficos e imagenológicos que confirmaron su diagnóstico. Se hace una revisión del tema con las características clínicas más importantes...(AU)

Seizures beginning in the parietal lobe are rare, representing the third most common type of epilepsy after temporal and frontal lobe epilepsies. This rare type of crisis is often overlooked. Thus this clinical case is presented in a woman seen at Hospital Infantil Universitario de San José of Bogotá exhibiting parietal lobe epilepsy semiology and electroencephalographic and diagnostic imaging findings that confirmed the diagnosis. A review of the topic is conducted using the major clinical features of this condition...(AU)

Use of PCR to demonstrate presence of adenovirus species B, C, or F as well as coinfection with two adenovirus species in children with flu-like symptoms.

Adenovirus (AdV) respiratory infections have usually been associated with species B, C, and E. In this study, we detected 9.4% of AdVs by PCR in 500 nasal swabs from 319 children with influenza-like symptoms. AdV typing by PCR with specific probes showed species C, B, and F as well as coinfection with two species. Coinfection with two AdV species and the presence of species F in respiratory samples are novel findings that should be further investigated.

O comportamento agressivo de crianças do sexo masculino na escola e sua relação com a violência doméstica / Aggressive behaviors of male children in school and its relation to domestic violence

Este trabalho teve como meta estudar o comportamento agressivo de crianças do sexo masculino na escola e sua relação com a violência doméstica. Avaliaram-se 28 crianças do sexo masculino e suas respectivas mães, dentre as quais 14 crianças apresentavam comportamentos agressivos na escola (Grupo A). Estas últimas foram comparadas às 14 crianças do mesmo sexo e nível de renda que não apresentavam tais comportamentos (Grupo B). Os dados foram coletados inicialmente pelas professoras das crianças em três escolas de Ensino Básico de uma cidade do interior de São Paulo. Seguidamente, foram coletados dados com as mães das crianças em visitas domiciliares. Os resultados gerais apontam para a ocorrência de violência em ambos os grupos, porém, com maior incidência e maior severidade, no grupo de crianças agressivas. As considerações finais sinalizam a necessidade de futuros estudos para expandir a compreensão do comportamento agressivo e sua relação com a violência doméstica.

Oficina de psicologia para policiais da delegacia da mulher: um relato de experiência / Psychology workshop for officers of women's police station: an experience report

Desde março se 1998 iniciou-se um programa de atendimento a vítimas de violência na Delegacia de Defesa da Mulher (DDM) de São Carlos, por meio de um estágio supervisionado de alunos de psicologia. Na interação com tais policiais, constatou-se a queixa freqüente de que a Academia da Polícia não as havia preparado para um adequado atendimento às vítimas de violência, impedindo-as de realizar um atendimento ideal. Assim, planejou-se uma oficina inicialmente obtendo-se uma entrevista individual com cada policial. Com base nas entrevistas foi elaborado um questionário sobre crenças a respeito da violência doméstica, com 30 questões de afirmação seguidas por verdadeiro ou falso. Os objetivos da oficina foram: reconhecer o direito do ser humano e, especificamente da mulher, de não sofrer agressão, rever crenças que perpetuam a violência contra a mulher, redefinindo-as e analisar as crenças subjacentes à sua atuação na DDM. A oficina foi conduzida na Universidade em duas noites consecutivas, com um total de 8 horas de duração. Os resultados demonstraram que quatro das cinco policiais apresentaram um aumento na porcentagem de respostas corretas ao questionário. Testes futuros com um maior número de participantes poderia avaliar a aplicabilidade do instrumento