Quiste Vallecular: Caso clínico de estridor agudo / Vallecular cyst: clinical case of acute stridor

El enfrentamiento de estridor en el Servicio de Urgencias puede ser un desafío para el clínico. La mayoría de los pacientes responderán a medidas estándar de anafilaxia, no obstante, ante pacientes refractarios a tratamiento se deben sospechar otras patologías. Presentamos el caso clínico de una paciente refractaria a manejo de anafilaxia. Se realiza videolaringoscopía que identifica quiste de vallécula y se maneja mediante protección de vía aérea con intubación orotraqueal. Se decide escisión quirúrgica, en la cual se identifica estenosis subglótica que requiere instalación de traqueostomía. La paciente evoluciona favorablemente y es dada de alta.

Coping with stridor in the Emergency Department can challenge the clinician. Most patients respond to standard anaphylaxis measures. The clinician should suspect other differential diagnoses when patients are refractory to treatment. We present the clinical case of a patient refractory to standard anaphylaxis management. A video laryngoscopy was performed, identifying a vallecula cyst. We secured the airway through orotracheal intubation. The surgical team of our hospital performed a surgical excision of the cyst and identified subglottic stenosis, which required the installation of a tracheostomy. The patient evolved favorably in the postoperative period and was discharged.

Stress-Charge Nonlinear Physical Description and Tensor Symmetries for Piezoelectric Materials.

Nonlinear piezoelectric materials are raised as a great replacement for devices that require low power consumption, high sensitivity, and accurate transduction, fitting with the demanding requirements of new technologies such as the Fifth-Generation of telecommunications (5G), the Internet of Things (IoT), and modern radio frequency (RF) applications. In this work, the state equations that correctly predict the nonlinear piezoelectric phenomena observed experimentally are presented. Furthermore, we developed a fast methodology to implement the state equations in the main FEM simulation software, allowing an easy design and characterization of this type of device, as the symmetry structures for high-order tensors are shown and explained. The operation regime of each high-order tensor is discussed and connected with the main nonlinear phenomena reported in the literature. Finally, to demonstrate our theoretical deductions, we used the experimental measurements, which presented the nonlinear effects, which were reproduced through simulations, obtaining maximum percent errors for the effective elasticity constants, relative effective permittivity, and resonance frequencies of 0.79%, 2.9%, and 0.3%, respectively, giving a proof of the potential of the nonlinear state equations presented for the unifying of all nonlinear phenomena observed in the piezoelectric devices.

SAFETY AND EFFICACY OF THYMIC PEPTIDES IN THE TREATMENT OF HOSPITALIZED COVID-19 PATIENTS IN HONDURAS.

Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.

Clinical effectiveness of Lactobacillus reuteri in the treatment of peri-implant diseases: a systematic review and meta-analysis.

In the last decades, the presence of peri-implant diseases (PD) has increased. One of the therapies currently used is probiotics with Lactobacillus reuteri (LR). The aim of this article is to determinate, through a systematic review and meta-analysis, the clinical effectiveness of LR in the treatment of PD. We searched the literature until January 2021, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, Scopus, SIGLE, LILACS, Google Scholar and Cochrane Central Registry of Clinical Trials. The selection criteria of the studies were: randomized controlled clinical trials, without language and time restriction, reporting the clinical effects (depth to probing, plaque index and bleeding index) of the LR in the PD treatment. The risk of study bias was analyzed through the Cochrane tool for randomized studies using Review Manager software. The search strategy resulted in 6 articles of which four investigated peri-implantitis and three peri-implant mucositis. All studies reported that there was a difference in the depth of the probing in the treatment of PD, in favor of the group using LR, though not always achieving significance. The use of LR can be clinically effective in terms of pocket depth reduction in the treatment of PD.

Neurobiology of anesthetic-surgical stress and induced behavioral changes in dogs and cats: A review.

The anesthetic-surgical stress response consists of metabolic, neuroendocrine, hemodynamic, immunological, and behavioral adaptations through chemical mediators such as the adrenocorticotropic hormone, growth hormone, antidiuretic hormone, cortisol, aldosterone, angiotensin II, thyroid-stimulating hormone, thyroxine, triiodothyronine, follicle-stimulating hormone, luteinizing hormone, catecholamines, insulin, interleukin (IL)-1, IL-6, tumor necrosis factor-alpha, and prostaglandin E-2. Behavioral changes include adopting the so-called prayer posture, altered facial expressions, hyporexia or anorexia, drowsiness, sleep disorders, restriction of movement, licking or biting the injured area, and vocalizations. Overall, these changes are essential mechanisms to counteract harmful stimuli. However, if uncontrolled surgical stress persists, recovery time may be prolonged, along with increased susceptibility to infections in the post-operative period. This review discusses the neurobiology and most relevant organic responses to pain and anesthetic-surgical stress in dogs and cats. It highlights the role of stress biomarkers and their influence on autonomous and demeanor aspects and emphasizes the importance of understanding and correlating all factors to provide a more accurate assessment of pain and animal welfare in dogs and cats throughout the surgical process.

Nociceptive pain and anxiety in equines: Physiological and behavioral alterations.

Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxiety, since prolonged exposure to situations that cause stress and pain generates such physiological changes as tachycardia, tachypnea, hypertension, hyperthermia, and heart rate variability (HRV), often accompanied by altered emotional states, deficient rest, and even aggressiveness. In the long term, animals may show deficiencies in their ability to deal with changes in the environment due to alterations in the functioning of their immune, nervous, and endocrinologic systems. In conclusion, pain and anxiety directly impact the homeostasis of organisms, so it is necessary to conduct objective evaluations of both sensations using behavioral scales, like the horse grimace scale, complemented by assessments of blood biomarkers to analyze their correlation with physiological parameters: Heart rate, respiratory rate, HRV, theparasympathetic tone activity index, lactate and glucose levels, and temperature. Additional tools - infrared thermography, for example - can also be used in these efforts to improve the quality of life and welfare of horses.

Motoric Cognitive Risk Syndrome: Prevalence and Risk of Cognitive Impairment in a Population Studied in the Mexican Health and Aging Study 2012-2015.

OBJECTIVES: The aim of this study was to determine the prevalence of Motoric Cognitive Risk (MCR) syndrome, describe associated risk factors and to determine the risk of progression to cognitive impairment after three years of follow-up, in a sample of Mexican older adults. DESIGN: A prospective panel study of health and aging in Mexico. SETTING AND PARTICIPANTS: Baseline and follow-up information was obtained from the Mexican Health and Aging Study's 2012 and 2015 waves. A total of 726 subjects aged 60 years or older with normal cognition at baseline were classified into 4 groups: 1) with MCR, 2) with memory complaint only, 3) with slow gait speed only and, 4) without MCR. Cox regression analysis controlling for confounder factors was performed to determine the risk of progression to cognitive impairment in the MCR group. MEASURES: Data such as gait speed, functional status and cognitive performance (standardized by age and sex in Mexican population) was collected. RESULTS: MCR prevalence was 14.3%. When compared with non-MCR subjects, the presence of MCR was associated with older age (p<0.01), lower educational status (p=0.05), having two or more comorbidities (p<0.05) and diabetes mellitus diagnosis (p<0.05). At follow-up and after adjusting for confounders, MCR was associated with a 2.4-fold increased risk (95% CI: 1.28-4.26, p=.000) of cognitive impairment. CONCLUSIONS: MCR syndrome increases the risk of cognitive impairment in Mexican older adults. Simple measurements such as gait evaluation in subjects with memory complaints could allow early identification of those at risk of developing cognitive impairment.

Expression of Toll-like receptors 2 and 4 and its association with matrix metalloproteinases in symptomatic and asymptomatic apical periodontitis.

To determine Toll-like receptors (TLR)2 and TLR4 expression levels and associate them with matrix metalloproteinases (MMPs) in asymptomatic apical periodontitis (AAP), symptomatic apical periodontitis (SAP), and healthy controls. Apical tissue/lesion samples were obtained from chronic AAP (n = 35) and SAP (n = 29), and healthy periodontal ligament (HPL, n = 10) with indication of tooth extraction, respectively. mRNA expression levels of TLR2, TLR4, MMP-1, MMP-2, MMP-8, and MMP-13 were determined by real-time reverse-transcription polymerase chain reaction. The data were analyzed with Kruskal-Wallis and Dunn's pot hoc test (p < 0.05). The correlation coefficient was obtained using the Spearman correlation (p < 0.05). TLR2, MMP-1, MMP-2, and MMP-13 mRNA levels were the highest in SAP followed by AAP and controls (p < 0.05). TLR4 and MMP-8 were over expressed in AAP and SAP compared to HPL (p < 0.05). TLR2 positively correlated with TLR4, MMP-1, MMP-8, and MMP-13 in SAP (p < 0.05). TLR2 and TLR4 are overexpressed in apical lesions versus healthy periodontal ligament and correlate with collagenolytic MMPs. Particularly, TLR2 is overexpressed in SAP in association with MMP-1, MMP-8, and MMP-13. Our results suggest that the activation of TLR2 along with MMP overexpression might contribute to SAP clinical presentation and progression. TLRs, MMPs, and their interaction can explain the clinical presentations and evolution of apical periodontitis and might represent key targets for new diagnostic and treatment approaches.

Scar sarcoidosis: A rare entity found by 18F-FDG-PET/CT.

18F-labeled fluoro-2-positron deoxyglucose emission tomography/computed tomography has been widely used in malignancy assessment, however, is not tumor-specific and may be taken up by non-malignant conditions such as sarcoidosis. Sarcoidosis is a systemic inflammatory disorder and scar sarcoidosis is a rare manifestation of the disease. A 60-year-old man with a past medical history of synchronous colon adenocarcinoma and clear cell renal cell carcinoma with clinical suspicion of tumor recurrence. 18F-labeled fluoro-2-positron deoxyglucose emission tomography/computed tomography scan demonstrated lesions with increased fluorodeoxyglucose uptake in mediastinal and left supraclavicular lymph nodes, along with hypermetabolic cutaneous foci that corresponded with previous surgical scars. Skin biopsy was suggestive of sarcoidosis.

[Errors in prescriptions and their preparation at the outpatient pharmacy of a regional hospital]. / Errores en las recetas médicas y en la preparación de estas en farmacia de pacientes ambulatorios: El caso del Hospital de Nueva Imperial.

BACKGROUND: Adverse effects of medications are an important cause of morbidity and hospital admissions. Errors in prescription or preparation of medications by pharmacy personnel are a factor that may influence these occurrence of the adverse effects Aim: To assess the frequency and type of errors in prescriptions and in their preparation at the pharmacy unit of a regional public hospital. MATERIAL AND METHODS: Prescriptions received by ambulatory patients and those being discharged from the hospital, were reviewed using a 12-item checklist. The preparation of such prescriptions at the pharmacy unit was also reviewed using a seven item checklist. RESULTS: Seventy two percent of prescriptions had at least one error. The most common mistake was the impossibility of determining the concentration of the prescribed drug. Prescriptions for patients being discharged from the hospital had the higher number of errors. When a prescription had more than two drugs, the risk of error increased 2.4 times. Twenty four percent of prescription preparations had at least one error. The most common mistake was the labeling of drugs with incomplete medical indications. When a preparation included more than three drugs, the risk of preparation error increased 1.8 times. CONCLUSIONS: Prescription and preparation of medication delivered to patients had frequent errors. The most important risk factor for errors was the number of drugs prescribed.

Errores en las recetas médicas y en la preparación de estas en farmacia de pacientes ambulatorios: El caso del Hospital de Nueva Imperial / Errors in prescriptions and their preparation at the outpatient pharmacy of a regional hospital

Background: Adverse effects of medications are an important cause of morbidity and hospital admissions. Errors in prescription or preparation of medications by pharmacy personnel are a factor that may influence these occurrence of the adverse effects Aim: To assess the frequency and type of errors in prescriptions and in their preparation at the pharmacy unit of a regional public hospital. Material and Methods: Prescriptions received by ambulatory patients and those being discharged from the hospital, were reviewed using a 12-item checklist. The preparation of such prescriptions at the pharmacy unit was also reviewed using a seven item checklist. Results: Seventy two percent of prescriptions had at least one error. The most common mistake was the impossibility of determining the concentration of the prescribed drug. Prescriptions for patients being discharged from the hospital had the higher number of errors. When a prescription had more than two drugs, the risk of error increased 2.4 times. Twenty four percent of prescription preparations had at least one error. The most common mistake was the labeling of drugs with incomplete medical indications. When a preparation included more than three drugs, the risk of preparation error increased 1.8 times. Conclusions: Prescription and preparation of medication delivered to patients had frequent errors. The most important risk factor for errors was the number of drugs prescribed.

Factors associated with mixed dementia vs Alzheimer disease in elderly Mexican adults. / Factores asociados a la demencia mixta en comparación con demencia tipo Alzheimer en adultos mayores mexicanos.

INTRODUCTION: Mixed dementia (DMix) refers to dementia resulting from Alzheimer disease in addition to cerebrovascular disease. The study objectives were to determine the clinical and imaging factors associated with Dmix and compare them to those associated with Alzheimer disease. MATERIAL AND METHODS: Cross-sectional study including 225 subjects aged 65 years and over from a memory clinic in a tertiary hospital in Mexico City. All patients underwent clinical, neuropsychological, and brain imaging studies. We included patients diagnosed with DMix or Alzheimer disease (AD). A multivariate analysis was used to determine factors associated with DMix. RESULTS: We studied 137 subjects diagnosed with Dmix. Compared to patients with AD, Dmix patients were older and more likely to present diabetes, hypertension, dyslipidaemia, and history of cerebrovascular disease (P<.05). The multivariate analysis showed that hypertension (OR 1.92, CI 1.62-28.82; P=.009), white matter disease (OR 3.61, CI 8.55-159.80; P<.001), and lacunar infarcts (OR 3.35, CI 1.97-412.34; P=.014) were associated with Dmix, whereas a history of successfully treated depression showed an inverse association (OR 0.11, CI 0.02-0-47; P=.004) CONCLUSIONS: DMix may be more frequent than AD. Risk factors such as advanced age and other potentially modifiable factors were associated with this type of dementia. Clinicians should understand and be able to define Dmix.

[Myomectomy and uterine desarterialization as conservative treatment for uterine fibroids: Review of clinic case]. / Miomectomía y desarterialización uterina como tratamiento conservador de la miomatosis de grandes elementos: reporte de un caso.

BACKGROUND: Uterine fibroids are the most common gynecological tumors; the prevalence increases with age. They can cause symptoms (20-50%). Myomectomy is an alternative for women who wish to preserve their fertility, increased risk of blood loss and longer operative time. Since 2000, a significant number of surgeons have performed occlusion of uterine arteries prior to myomectomy successfully. CASE REPORT: We report the case of a 24-year-old patient, with a history of premature birth; and starts her condition after obstetric event with abnormal uterine bleeding and postcoital bleeding, accompanied by intense, oppressive and stabbing abdominal pain and increased ab-dominal volume. At physical examination an enlarged abdominal wall by a tumor involving, abdominal pain on palpation, at the gynecological examination: frankly enlarged uterus, about 25 x 20 cm, painful and tenderness. Prior to myomectomy, uterine externalization takes place and proceeds to dearterialization of uterine arteries under the García-González technique, removing the tumor without complications, with an estimated 100 cc bleeding. The bilateral uterine artery ligation, is one of the methods used to re-duce intraoperative blood loss. It is a quick, simple technique, whose theoretical basis is that 90% of the irrigation of the uterus comes from the uterine arteries.

[Salpingectomy in ovarian cancer prevention: Evidence behind the hypothesis and surgical implications]. / Salpingectomía como opción de reducción de riesgo de cáncer de ovario.

Background: Over the last decade, evidence suggests the fallopian tubes are the origin of most of the high grade ovarian serous carcinomas. This type of carcinoma represents at least 50% of all the cases of epithelial ovarian cancer. Salpingectomy may lower the risk of high grade serous carcinoma. Removing the two fallopian tubes should be considered a strategy for risk reduction in patients who decide tubal sterilization or in patients with hysterectomy for benign disease. There are ongoing protocols that evaluate the ovarian hormonal production impact after prophilactic salpingectomy. In patients with BRCA1 and BRCA2 mutations, salpingo-oophorectomy is recommended usually between 35 to 40 years of age for BRCA 1 and between 40 and 45 years of age for BRCA 2. The oopherectomy done whithin these decades has the consequences and side effects of premature menopause, some physicians have suggested doing a two step procedure: perform a salpingectomy as soon as the patient has decided to have permanent birth control, and doing the ophoorectomy at the onset of menopause. The oncological safety of this approach is still under evaluation and is not recommended outside a protocol.

Effects of water deficit on radicle apex elongation and solute accumulation in Zea mays L.

In this study, we examined the effects of water deficit on the elongation of radicles of maize seedlings and on the accumulation of solutes in the radicle apices of two maize varieties: VS-22 (tolerant) and AMCCG-2 (susceptible). Sections of radicle corresponding to the first 2 mm of the primary roots were marked with black ink, and the seedlings were allowed to grow for 24, 48, and 72 h in polyvinyl chloride (PVC) tubes filled with vermiculite at three different water potentials (Ψ(w), -0.03, -1.0, and -1.5 MPa). The radicle elongation, sugar accumulation, and proline accumulation were determined after each of the growth periods specified above. The Ψ(w) of the substrate affected the dynamics of primary root elongation in both varieties. In particular, the lowest Ψ(w) (-1.5 MPa) inhibited root development by 72% and 90% for the VS-22 and AMCCG-2 varieties, respectively. The osmotic potential (Ψ(o)) was reduced substantially in both varieties to maintain root turgor; however, VS-22 had a higher root turgor (0.67 MPa) than AMCCG-2 (0.2 MPa). These results suggest that both varieties possess a capacity for osmotic adjustment. Sugar began to accumulate within the first 24 h of radicle apex growth. The sugar concentration was higher in VS-22 root apices compared to AMCCG-2, and the amount of sugar accumulation increased with a decrease in Ψ(w). Significant amounts of trehalose accumulated in VS-22 and AMCCG-2 (29.8 µmol/g fresh weight [FW] and 5.24 µmol/g FW, respectively). Starch accumulation in the root apices of these two maize varieties also differed significantly, with a lower level in VS-22. In both varieties, the proline concentration also increased as a consequence of the water deficit. At 72 h, the proline concentration in VS-22 (16.2 µmol/g FW) was almost 3 times greater than that in AMCCG-2 (5.19 µmol/g FW). Trehalose also showed a 3-fold increase in the tolerant variety. Accumulation of these solutes in the root growth zone may indicate an osmotic adjustment (OA) to maintain turgor pressure.

Adaptación y validación de instrumentos para medir errores en las recetas médicas y en el proceso de preparación de medicamentos en farmacia de pacientes ambulatorios / Adaptation and validation of checklists to detect medication prescription and dispensing errors

Background: Adverse effects of medications are an important source of morbidity. Prescription and dispensing errors are an important cause of these adverse effects. Aim: To adapt and validate two checklists, one to measure errors in handwritten prescriptions and other to detected errors in the medication dispensing process of hospital pharmacies for outpatient care. Material and Methods: The study was conducted in three stages. First, checklists for medication errors developed elsewhere were adapted. Afterwards, the checklists were reviewed by experts. Finally, the inter and intra-observer reliability of each checklist was assessed, testing them in 32 occasions by two independent observers. Results: The checklists for medication prescription and dispensing were composed by 12 and seven items, respectively. They were corrected according to experts’ opinions. The intraclass correlations of the results of each tester were 0.68 and 0.82 for the prescription and dispensing error checklists, respectively. Conclusions: The developed checklists for the detection of errors in prescription and dispensing of medications are reliable en can be applied in future studies.

The value of repeat kidney biopsy in quiescent Argentinian lupus nephritis patients.

BACKGROUND: The duration of maintenance therapy after induction therapy for lupus nephritis has not been rigorously established. A common practice is to maintain immunosuppression for 1-2 years after complete remission, and longer for partial remission. The present work addresses whether a repeat kidney biopsy might be informative in deciding who should continue immunosuppression after complete or partial remission. METHODS: The practice in a large Buenos Aires nephrology unit is to repeat a kidney biopsy before finalizing the decision to withdraw or continue immunosuppression. This work reports on a cohort of 25 Hispanic patients that had two or more kidney biopsies, the last occurring after at least 24 months of clinically quiescent disease. RESULTS: Despite normalization of serum creatinine and reduction of proteinuria to <500 mg/d, 30% of patients still had significant activity at the last biopsy. Conversely, 60% of patients with ongoing proteinuria (500-1000 mg/d), or stable but abnormal serum creatinine, had no activity by biopsy. Univariate association analyses demonstrated that improvement in the activity index (AI) of the last biopsy was associated with choice of induction therapy (cyclophosphamide or mycophenolate), improvement in serum creatinine over the first six months of treatment, and improvement in complement component C4. By multivariate regression analyses, two AI prediction models emerged. Cyclophosphamide plus change in serum creatinine or cyclophosphamide plus change in C4 accounted for 50% of the improvement in AI. CONCLUSION: These data suggest that a repeat biopsy may be useful in making the decision to withdraw or continue maintenance immunosuppression.

UTILIDAD DE PRUEBAS CUTÁNEAS Y OTRAS PRUEBAS DE LABORATORIO EN PACIENTES CON RINITIS ALÉRGICA / Usefulness of skin tests and other laboratory tests in patients with allergic rhinitis

Antecedentes. Existen diferentes pruebas de laboratorio en las que se apoya el alergólogo dentro del abordaje de la rinitis alérgica, que varían en sus ventajas y desventajas, debiendo debiendo correlacionar su prescripción con la clínica del paciente y valorando costo-beneficio. Objetivos. Determinar la utilidad diagnóstica de IgE sérica total, eosinófilos en moco nasal, eosinófilos séricos y pruebas cutáneas para identificar a los pacientes alérgicos. Material y métodos. Se revisaron laboratorios de 400 pacientes con rinitis alérgica y de 57 con rinitis no alérgica, se describieron las variables sexo, edad, niveles séricos de IgE y eosinófilos séricos totales, la frecuencia de positividad de las diferentes pruebas, significación estadística, utilidad diagnóstica, así como correlación y concordancia de las diferentes pruebas de laboratorio y las pruebas cutáneas. Resultados. Se observó diferencia significativa en los niveles de IgE sérica total (p<0,001) y de eosinófilos séricos totales (p<0,001) entre ambos grupos; ambas pruebas muestran baja sensibilidad. Las pruebas cutáneas tienen la mayor sensibilidad y especificidad en el diagnóstico de rinitis alérgica; la correlación entre las diferentes pruebas de laboratorio y las pruebas cutáneas fue en general baja siendo con la IgE sérica total la que mostró mayor correlación 0,20 (p<0,001). Conclusiones. Debido a su baja sensibilidad y concordancia con las pruebas cutáneas, los exámenes IgE sérica total, eosinófilos séricos y eosinófilos en moco nasal no deben solicitarse como pruebas de tamizaje para identificar a pacientes alérgicos.(AU)

Background. There are different diagnosis tests in the approach of a patient suffering from allergic rhinitis; these have pros and cons, allergists should request them considering symptoms and cost-benefit. Objectives. Determine diagnosis utility from total IgE, eosinophils in nasal mucus, eosinophils-cells and skin prick test to identify allergy patients. Materials and methods. We mesured total IgE, eosinophils in nasal mucus, eosinophils-cells and skin prick test in 400 patients with allergic rhinitis and 57 with no allergic rinitis. We described sex, age, total IgE y eosinophils-cells, the positive frequency and stadistic significance, diagnostic value, correlation and concordance of different diagnosis tests. Results. Total IgE (p<0.001) and eosinophils in nasal mucus (p=0.005) showed significant difference, however both test showed low sensibility. The skin prick tests have more sensibility and specificity than others diagnosis tests, the greater concordance was between skin prick test and total IgE. The correlation between three test and skin prick test was low. Total IgE showed greater correlation 0.20 (p<0.001) than other test. Conclusions. Total IgE, eosinophils in nasal mucus, eosinophils-cells should not routilnely because have of its low sensibility and concordance.(AU)

Bilateral non-superselective embolization with particles under transient occlusion of the internal carotid artery in the management of juvenile nasopharyngeal angiofibroma: technical note.

Juvenile nasopharyngeal angiofibroma (JNA) is a rare histologically benign tumor, highly vascularized, with usually aggressive behavior, and can extend from the nasal cavity to neighboring structures. We present the case of a 14-year-old male harboring a JNA, presenting with an active severe and persistent epistaxis. Two previous surgical attempts of removal were unsuccessful, because of profuse intraoperative bleeding. Angiography showed a highly vascularized neoplasm with multiple branches arising from both internal carotid arteries, with absence of branches from the external carotid due to previous surgical ligation. Direct puncture tumor embolization was not possible because removal of nasal packing triggered major hemorrhage. The only option for embolization was a technique of non-superselective embolization with particles under transient occlusion of the internal carotid artery. The procedure was performed uneventfully from either side, the tumor was subsequently removed, and the patient had no recurrence 2 years after the initial treatment.

Violencia intrafamiliar (VIF): Quinchao, Chiloé (Chile) / Intrafamilial violence (IFV): Quinchao, Chiloe (Chile)

Objetivo: Caracterizar los nuevos episodios de VIF durante el 2008 en la Comuna de Quinchao, provincia de Chiloé. Metodología: Estudio descriptivo-retrospectivo, en el cuál se analizaron las denuncias por VIF en Carabineros y en Tribunal Mixto durante el 2008. Se utilizó información de Carabineros, y de los archivos de causas procesadas y sentencias dictadas en dicho Tribunal. Resultados: De 231 acusaciones presentadas al Tribunal de Familia, 90 correspondieron a delitos por VIF. De este número, 36 no finalizaron el proceso judicial. Treinta y ocho casos presentaron VIF psicológica, agregándose física en 16 de ellos. Destaca que 43 de las 54 acusaciones presentaron consumo de alcohol concomitante. En relación al género, la mayoría de los agresores son hombres y la mayoría de las relaciones victima-victimario son de pareja (38/54).Conclusiones: Los resultados no son comparables a los nacionales por la metodología empleada. Sin embargo pudieran entrever rasgos de la idiosincrasia local, como son patrones de violencia masculina perpetuados, en parte, por el aislamiento geográfico.

Objective: To characterize the new episodes of IFV in 2008 in the Commune of Quinchao of the Province of Chiloé. Methodology: This is a retrospective descriptive study; charges of intrafamilial violence brought to the police and to the relevant judicial court during 2008 were analyzed. We utilized official information from the local police station and from the court files on cases and verdicts. Results: Of all the 231 accusations presented to the Family Court, 90 (90/231) concerned to intra familiar violence crimes. From this number, 36 of them didn’t finish the judicial process. Thirty eight presented psychological violence and 16 also had physical violence. Notably, in 43 of the se 54 cases accusations were alcohol consumption involved. Relating to the gender, most of the aggressors were men and most of the relationships between the victim and the aggressor were a couple (38/54). Conclusions: the results are similar to the national ones, but show some noveltys: the population study idiosyncrasy presents patterns of masculine violence perpetuated, in part, by the geographic isolation of the area.