[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.

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)