Pediatric tinea faciei in southern Spain: a 30-year survey.

Tinea faciei (TF) is a common clinical form of tinea in children that is frequently misdiagnosed and treated with corticosteroids. No large case series of TF focusing on children have been published. The aim of this study was to analyze the main epidemiologic, clinical, and microbiologic features of TF in children over a period of 30 years and compare these features with those of other tineas. We undertook a retrospective study of 818 cases of tinea in children at a referral hospital in southern Spain, diagnosed between 1977 and 2006, concentrating for this study on TF. Of the 73 cases of TF diagnosed, 50.7% were in girls. Most children (46.6%) were 4 to 9 years old. At the time of diagnosis, 29.2% of the cases had been treated with topical steroids. The most frequently isolated dermatophyte was Trichophyton mentagrophytes, which was isolated significantly more frequently in TF than in the other tineas. Cases of TF in children were not extremely unusual, emphasizing that TF must be considered in children with inflammatory facial eruptions. This consideration and the more-frequent use of mycologic tests can help achieve the correct diagnosis, when present.

Childhood discoid lupus in identical twins.

We report the exceptional case of 11-year-old identical male twins who both developed discoid lupus erythematosus lesions. Although systemic lupus erythematosus has often been reported in identical twins, discoid lupus erythematosus has only occasionally been described, with only one other case in twin children, as far as we are aware.

Temporary localized hypertrichosis after henna pseudotattoo.

We report the case of a 5-year-old boy who had a temporary dragon-shaped henna pseudotattoo, reinforced 4 days later. Two weeks later, as the pseudotattoo began to disappear, hypertrichosis developed in the area corresponding to the previous psuedotattoo. Skin biopsy showed an increase in vellus hair follicles, with slight peripheral fibrosis. After 4 months, the hypertrichosis resolved spontaneously.

Rotavirus gastroenteritis among children under five years of age in Valencia, Spain.

The population-based incidence of rotavirus gastroenteritis in children <5 years of age in Valencia, Spain, over a 1-year period (December 1, 2003, to November 30, 2004) was determined.A total of 553 episodes of gastroenteritis in children <5 years of age (mean age, 22.8 +/- 14.5 months) were recorded (annual incidence of 138 per 1,000). A positive enzyme-linked immunoadsorbant assay result for rotavirus antigen was obtained in 15% of the samples. The incidence of rotavirus gastroenteritis was 15 per 1,000 children <5 years of age, being the highest incidence in children

Electron probe X-ray microanalysis of cisplatin-induced cell death in rat pheochromocytoma PC12 cells.

Several lines of evidence suggest that cisplatin-induced cell death is not always the result of apoptosis. A distinctive feature between apoptosis and necrosis is the alteration in cell volume regulation and ion homeostasis. Here we analyzed the changes in intracellular element content during cell death induced by exposure to therapeutic concentrations of cisplatin in the PC12 cell line. To quantitate Na, Cl and K content, electron probe X-ray microanalysis (EPXMA) was performed in whole freeze-dried cells. We also traced the alterations in morphological features with fluorescence and transmission electron microscopy. EPXMA demonstrated progressive derangement of the absolute intracellular Na, Cl and K contents. Cisplatin-treated cells showed two microanalytical patterns: 1) cells with alterations in elemental content typical of apoptosis, i.e., an increase in intracellular Na and a decrease in intracellular Cl and K, and 2) cells characterized by an increase in Na content and a decrease in K content, with no changes in Cl content. This intracellular profile for Na, Cl, and K was not typical of necrosis or apoptosis. Morphological analysis revealed two cellular phenotypes: 1) cells characterized by a phenotype typical of apoptosis, and 2) cells characterized by a hybrid phenotype combining variable features of apoptosis and necrosis. Taken together, our findings suggest that therapeutic concentrations of cisplatin may cause a hybrid type of cell death characterized by concurrent apoptosis and necrosis in the same individual PC12 cell.

[Spindle-cell carcinoma in situ treated with 5% imiquimod]. / Carcinoma espinocelular in situ tratado con imiquimod al 5 %

We present the case of a 70-year-old woman with no personal history of interest who presented to her physician with a plaque in the right infraumbilical region whose largest diameter measured nine centimeters. The clinical and histological diagnosis was Bowen's disease. She was treated with 5 % imiquimod cream, once a day, four times a week, for eight weeks, with an excellent response. One year after treatment, no new lesions have appeared in the treated area.

[Linear Darier disease]. / Enfermedad de Darier lineal.

Darier disease is a genodermatosis with a pattern of autosomal dominant inheritance, which occasionally presents by following a linear or segmental pattern. We present the case of a 22-year-old woman who had presented for three years with small, linearly distributed, yellowish-brown papules on the right lower extremity, with no other skin, mucous membrane or appendage involvement. She had no personal or family history of any interest. Histologically, suprabasal acantholysis and abundant dyskeratotic cells were seen. All of this data led to the diagnosis of linear Darier disease.

Protocolo Cask en pacientes con infarto agudo de miocardio, estudio descriptivo de un grupo de pacientes, período 1999-2001 / Cask protocol in patients with acute myocardial infarction, descriptive study of a group of patients, period 1999-2001

Tipo de estudio: descriptivo, clínico, transversal, prospectivo. Objetivo: Usar terapéuticamente el protocolo CASK (Captopril, ácido acetilsalicílico, trombolisis con estreptoquinasa SK), en todo paciente con diagnóstico de infarto de miocardio trasmural. Métodos: Estudio de cohorte con seguimiento de 2 años de pacientes ingresados por infarto agudo de miocardio en los años 1999, 2000 y 2001 en la Unidad de Cuidados Intensivos del hospital Dr. Teodoro Maldonado Carbo de la ciudad de Guayaquil, Ecuador. Se analizó el tiempo trascurrido del evento coronario agudo, infarto de miocardio y su periodo óptimo de inicio de la fibrinólisis con estreptoquinasa SK, criterios de reperfusión e índice de morbimortalidad del evento coronario. Resultados: Un universo de 263 pacientes, con infarto de miocardio ingresados: 86% fueron tratados con el protocolo Cask, durante las primeras 6 horas del evento coronario, Captopril 6.25mg vo stat, BID, ácido acetilsalicílico tab. 100mg ,150mg vo stat, día, y fibrinólisis con estreptoquinasa SK, 15000.000ui iv en 100cc de dextrosa al 5% pasar en una hora, período óptimo alcanzado como lo recomienda el Colegio Americano de Cardiología. El resto 14%, no recibieron fibrinólisis por ser tardíos, de 12-24 horas, debutan con infarto de miocardio subendocárdico, por no tener elevación del segmento ST, contraindicación 2%, retraso prehospitalario, > 24 horas, u otras causas 3%; los pacientes tratados presentaban los factores de riesgo cardiaco mayores, el retraso medio de administrar el fibrinolítico SK, fue de 270 minutos, en cuarto lugar en relación al estudio PRÍAMHO.

Study type: descriptive, clinical, transversal, prospective. Objectives: The therapeutic use of the CASK protocol, Captopril, acetylsalicylic acid, trombolysis with streptoquinasa SK, in all patients with diagnosis of trasmural myocardial infarct. Methods: Cohort study with a 2 year follow up of patients admitted with acute myocardial infarction in the years 1999, 2000, 2001 to the Intensive Care Unit of the Teodoro Maldonado Carbo Hospital of Guayaquil, Ecuador. The time of the acute coronary event, myocardial infarction, and its optimal period for beginning of fibrinolysis with streptoquinasa SK, reperfusion criteria and index of morbimortality were analyzed. Results: An universe of 263 patients, admitted with myocardial infarct: 86% were treated with the Cask protocol, during the initial 6 hours of the coronary event, Captopril 6.25mg vo stat, BID, acetylsalicylic acid tab.100mg, 150mg vo stat, day, and fibrinolysis with streptoquinasa SK, 15000.000ui iv in 100 dextrose cc to 5% passed in 1 hour, period optimal as recommended by the American School of Cardiology. Resting 14% did not receive fibrinolysis, for being late, of 12-24 hours, debut with subendocardic myocardial infarct, for not having elevation of the ST segment, contraindication 2%, prehospitalarian delay, >24 hours, or other causes 3%, treated patients presented the highest cardiac risk factors, median delay of administering the fibrinolytic SK, was of 270 minutes, in 4th place in relation to the PRÍAMHO study.

Disección aórtica, urgencia cardiológica y su relación con hiperhomocistinemia, marcador sérico. Hospital Dr. Teodoro Maldonado Carbo, Guayaquil 1999-2000 / Aortic dissection, cardiological emergency and its Relation with hyperhomocysteinemia serum marker at the Dr. Teodoro Maldonado Carbo Hospital in Guayaquil 1999-2000

Diseño: Estudio cerrado realizado en el área de emergencia del hospital ¡§Dr. Teodoro Maldonado Carbo¡¨ del Instituto Ecuatoriano de Seguridad Social, con estigmas de dolor torácico o falla cardiaca, cuyo antecedente fue la hipertensión arterial, en quienes se analizó muestras sanguíneas para detectar homocisteina en ayunas, durante las primeras 24 horas de su ingreso.Objetivo: Evaluar prospectivamente, el riesgo de disección aórtica asociada a niveles plasmáticos elevados de homocisteina.Universo: 120 pacientes, raza mestiza, grupo etario comprendido entre los 28 y 71 años; edad promedio 65 años, predominio masculino, sin infarto de miocardio previo; 25 pacientes desarrollaron urgencias hipertensivas, edema agudo de pulmón; 61 pacientes síndrome coronario agudo, angina de clase III de Brauwald, y 34 pacientes se complicaron con disección aórtica.Medición del estudio: En quienes con hipertensión arterial, se relacionaban con hiperhomocistinemia y el desarrollo de disección aórtica.Propósito: Diagnóstico precoz de disección, algoritmo, protocolo específico ante esta patología con el uso de vasodilatadores, beta bloqueadores, cofactores enzimáticos, vitamina B6, ácido fólico, acetilcisteina, hasta su estabilización hemodinámica.

Design: Study of a population that went to the emergency room of the Dr. Teodoro Maldonado Carbo Hospital of the Ecuadorian Social Security Institute, with thoracic pain or heart failure who have a clinical history of hypertension in which we determined homocystein levels in the blood, during the first 24 hrs of the patients¡¦ arrival to the emergency room.Objective: A prospective study of the association of aortic dissection risk with the high blood levels of homocystein.Universe: 120 patients of racially mixed race, among the ages of 28-71 years being the average of 65 year of age being predominantly male, without a clinical history of myocardial infraction, 25 patients developed hypertensive emergencies and acute pulmonary edema, 61 patients developed acute coronary syndrome, class III Angina of the Brauwald, and 34 patients got complicated with aortic dissection.Measurement of the study: The relationship that exists in patients who have hypertension and development of hyperhomocysteinemia and aortic dissection. Purpose: „XTo be able to diagnose early an aortic dissection.„XTo have a specific protocol in the use of vasodilatators, beta blockers, enzymatic cofactors vitamin b6, folic Acid, acetilcystein until the patient is hemodinamically stable. Results: The homocystein levels were higher in patients with aortic dissection, 56% plasmatic level than 15umol/ml, the other patients that developed acute pulmonary edema were treated with the conventional therapy

Síndrome de Sneddon, estenosis pulmonar, como manifestación de síndrome antifosfolipídico primario, válvuloplastia: presentación de caso clínico / Sneddon Syndrome, pulmonar stenosis, as manifestation of primary antiphospholipid syndrome, valvuloplasty: case report

Presentamos el caso de una paciente, raza mestiza procedencia urbana, edad 27 años, APP sin factores de riesgos cardiovasculares mayores, hábitos negativos, alergias-antecedentes gineco-obstétricos (AGO)=G=3 P=1,A=2,C=1 con estenosis pulmonar severa y estigmas de insuficiencia cardiaca congestiva clase III NYHA, razón por la cual fue sometida a estudio hemodinámico, cateterismo cardiaco, válvuloplastia pulmonar percutánea, técnica de Kan y col., y bajo visión fluroscópica, y de ecocardiografía trastorácica, se procedió a dilatar la válvula pulmonar, se utilizó catéter Masfield de 25 mmx3cm, utilizando insuflaciones manuales de 5seg. se realizaron 5 dilataciones sucesivas con buena tolerancia de la paciente, determinándose el gradiente sistólico...

Trombolisis con estreptoquinasa en disfunción protésica mitral por trombo; presentación de caso clínico / Trombolisis with estreptoquinasa in mitral protésica disfunción by trombo; presentation of clinical case

Por ser una urgencia cardiovascular; sugerimos que en disfunción protésica por trombo, el tratamiento con estreptoquinasa es una alternativa de gran utilidad al tratamiento quirúrgico, con excelentes resultados y escasos riesgos, debiéndola considerar como primera línea, tal como se utiliza en un protocolo nacional diseñado en Cuba para el manejo de esta patología. Presentamos el caso de un paciente masculino de 65 años con antecedentes de cardiopatía reumática, remplazo valvular mitral, con protesis de Bjork-Shiley en el año 1997 y secuela neurológica de ACV que desarrolla disfunción protésica por discontinuidad de terapia anticoagulante por falta de recursos económicos.

Valor nutritivo y efectos metabólicos de la reutilizació de aceites comestibles calentados y oxidados / Nutritive value and metabolic effects of the reuse of food oils heated and oxidated

Las grasas y los aceites procesados, oxidados y calentados pueden tener propiedades nutricionales diferentes de la materia prima de donde provienen; existen cambios fisico-químicos inducidos o provocados en las diferentes etapas a las que se someten durante la obtención comercial, lo que trae como consecuencia una modificación desde el punto de vista de la nutrición. Estos cambios van desde la modificación isométrica de los dobles enlaces naturales de las grasas poli insaturadas que se someten a procesos de hidrogenación, con la consiguiente formación de isómeros trans, con los efectos biológicos que éstos ocasionan al organismo humano. Por otra parte, los fenómenos de auto oxidación de las grasas produciéndose no sólo radicales libres de oxígeno...

Evaluación nutricional en un grupo escolar / Nutritional evaluation in a scholar group

Considerando que el control del crecimiento y desarrollo significa brindar al niño cuidado integral, nos planteamos realizar este trabajo con los objetivos de determinar la incidencia de mal nutrición y alteraciones del desarrollo de los alumnos de la Escuela Fiscal Juan F. Heinert. Para la evaluación se utilizaron las curvas de crecimiento de la OMS-OPS escala de Waterloo y esquemas evolutivos de la OMS. Se dictaron charlas a los Padres de familia y se entregaron antiparasitarios y vitaminas a los alumnos. De 113 niños examinados, 36 presentaron algún grado de desnutrición de los cuales 16 tenían compromiso de su talla. En el desarrollo el área más afectada fue el lenguaje. Se concluyó que la memoria de estos niños ya han sufrido el impacto socioeconómico en concordancia con la situación del país y no poseen las condiciones ambientales básicas para un buen desarrollo, en su hogar y en la escuela. De no tomarse las medidas pertinentes, el futuro de los ecuatorianos es impredecible, siendo necesario desarrollar programas en áreas de salud y educación e impulsar programas ya existentes dirigidos a la niñez.

Considering that the control of growth and development of children offer integral care, we have planned to carry out this work with the following objectives: to determine the incidence of malnutrition and development alterations of the students of the Juan F. Heinert Public School. For evaluation we used development and growth charts from the WHO and Waterloo scale. We dictated conferences to the families and gaveout antiparasites and vitamins to the students. Of 113 students examined, 36 had some degree of malnutrition, 16 had alterations of the stature. In development, the most affected area was language. We concluded that the majority of these children don´t have the basic environmental conditions that stimulate a good development.

Síndrome de Wolf-Parkinson-White, compromiso hemodinámico severo en un paciente con enfermedad de Ebstein / Syndrome of Wolf-Parkinson-White, severe hemodinámico commitment in a patient with disease of Ebstein

El síndrome de Wolf-Parkinson-White, integrante de los síndromes de preexitación, puede estar relacionado a diversas patologías como es el caso de la enfermedad de Ebstein. Reportamos un caso de paciente masculino de 59 años, sin factores de riesgo cardiacos amayores, que ingresa a la unidad de cuidados coronarios por presentar compromiso hemodinámico severo.