Comparison of procedural success between two radial sheaths : Comparison of the 6-Fr Glidesheath Slender to 6-Fr standard sheath.

BACKGROUND: The most common cause of procedural failure in cardiac catheterization using the transradial approach is radial artery spasm. The aim of this study was to compare the procedural success rate of the 6­Fr Glidesheath Slender with the 6­Fr standard sheath in transradial coronary angiography and intervention. METHODS: Patients who underwent percutaneous coronary angiography via the transradial approach through placement of a 6-Fr Glidesheath Slender or a 6-Fr standard sheath for primary radial access were prospectively enrolled in the study. RESULTS: The study included 200 cases: 76 patients undergoing percutaneous coronary angiography with the Glidesheath Slender and 124 patients with the standard sheath. Failed procedures were recorded for 19 patients (9.5%), defined as inability to complete the procedure via the primary access. There was no difference in the percentage of failed cases between the Glidesheath Slender and standard sheath groups (10.5% vs. 8.9%, OR = 1.21, p = 0.8). More cases of spasm were observed in the Glidesheath Slender group compared with the standard sheath group, which was not statistically significant (7.9% vs. 5.7%, OR = 1.43, p = 0.56). Smoking, hyperlipidemia, and age influenced the procedural outcome in the Glidesheath Slender group, while body mass index, sex, and smoking impacted the procedural outcome in the standard sheath group. CONCLUSION: There is no difference in procedural success rates, as defined by the ability to complete the procedure via primary radial access, between the 6­Fr Glidesheath Slender and the 6­Fr standard sheath. Our study suggests that the patient characteristics that elevate the risk of procedural failure for Glidesheath Slender may differ from those for the standard sheath.

Tumoración abdominal intermitente secundaria a ectopia renal cruzada sin fusión / Intermittent abdominal tumor secondary to crossed nonfused renal ectopia

La ectopia renal cruzada, sin fusión, es excepcional. Ensus diferentes formas clínicas de presentación, la aparición como una masa abdominal intermitente no la hemos observado en la revisión bibliográfica realizada. Presentamos a un varón con historia de dolor y tumoración intermitente de repetición, en hipogastrio, que en diferentes pruebas se observó que correspondía a una ectopia al derecha, cruzada, sin fusión, debida a una hidronefrosis secundaria, intermitente, por una posición anómala de la unión pieloureteral. Se practicó una plastia tipo Anderson-Hynes, no habiendo complicaciones en el postoperatorio. El estudio de la función renal fue normal. Debido a que se suele acompañar de múltiples anomalías, es preciso realizar un estudio exhaustivo. Como conclusión, consideramos que en el diagnóstico diferencial de las masas abdominales intermitentes se debe incluir la posibilidad de la hidronefrosis intermitente debida a ectopia renal con anomalía en la unión pieloureteral. Asimismo, existen complicaciones a largo plazo, por lo que estos pacientes se deben controlar de por vida (AU)

Crossed renal ectopia without fusion is a rare form. Among its different variations in clinical presentation, the appearance as an intermittent abdominal mass have not been ascertained reviewing literature. In this case, we present a male patient with a history of a hypogastric periodic repetitive pain and mass, which is later observed corresponding to a right crossed renal ectopia, without fusion, and due to secondary intermittent hydronephrosis by an abnormal ureteropelvic junctional position. A pyeloplasty of Anderson—Hynes type was performed without any postoperative complications. Renal functional study was normal. A thorough study is required due to it commonly being accompanied by multiple abnormalities. In conclusion, we believe that the differential diagnosis of intermittent abdominal masses should include the possibility of intermittent hydronephrosis due to renal ectopia with ureteropelvic junction abnormality. Furthermore, these patients should be monitored throughout their lives due to lifelong complications (AU)

Benchmarking en la identificación de pacientes: una oportunidad para aprender / Benchmarking in patient identification: an opportunity to learn

Objetivo. Realizar benchmarking sobre la identificación segura de los pacientes en los hospitales integrantes del Club de las 3 «C» (calidez, calidad y cuidados) y elaboración de una ficha común del proceso. Material y métodos. Se trata de un estudio descriptivo de las actividades llevadas a cabo en el proceso de identificación de pacientes en 5 hospitales de media estancia en las unidades de cuidados paliativos y de ictus. Se han seguido las siguientes etapas: recogida de datos en cada hospital, organización y análisis de los datos y elaboración de una ficha común de proceso. Resultados. Los datos obtenidos para el proceso de ictus, del total de pacientes identificados de forma segura fueron: hospital n.° 1 (93%), hospital n.° 2 (93,1%), hospital n.° 3 (100%) y hospital n.° 5 (93,4%). Para el proceso de cuidados paliativos: hospital n.° 1 (93%), hospital n.° 2 (92,3%), hospital n.° 3 (92%), hospital n.° 4 (98,3%) y hospital n.° 5 (85,2%). Conclusiones. El objetivo del trabajo se ha cumplido satisfactoriamente. Se han desarrollado las actividades de benchmarking y compartido conocimientos sobre el proceso de identificación de pacientes. Todos los hospitales han tenido buenos resultados. El hospital n.° 3 destaca en la identificación del proceso de ictus. La identificación de un benchmark es difícil, pero entre los 5hospitales se ha identificado una ficha común útil que recoge las mejores prácticas. Es importante incorporar a la sistemática de las organizaciones la práctica del benchmarking (AU)

Objective. To perform a benchmarking on the safe identification of hospital patients involved in 'Club de las tres C' (Calidez, Calidad y Cuidados) in order to prepare a common procedure for this process. Material and methods. A descriptive study was conducted on the patient identification process in palliative care and stroke units in 5medium-stay hospitals. The following steps were carried out: Data collection from each hospital; organisation and data analysis, and preparation of a common procedure for this process. Results. The data obtained for the safe identification of all stroke patients were: hospital 1 (93%), hospital 2 (93.1%), hospital 3 (100%), and hospital 5 (93.4%), and for the palliative care process: hospital 1 (93%), hospital 2 (92.3%), hospital 3 (92%), hospital 4 (98.3%), and hospital 5 (85.2%). Conclusions. The aim of the study has been accomplished successfully. Benchmarking activities have been developed and knowledge on the patient identification process has been shared. All hospitals had good results. The hospital 3 was best in the ictus identification process. The benchmarking identification is difficult, but, a useful common procedure that collects the best practices has been identified among the 5 hospitals (AU)

[Benchmarking in patient identification: An opportunity to learn]. / Benchmarking en la identificación de pacientes: una oportunidad para aprender.

OBJECTIVE: To perform a benchmarking on the safe identification of hospital patients involved in "Club de las tres C" (Calidez, Calidad y Cuidados) in order to prepare a common procedure for this process. MATERIAL AND METHODS: A descriptive study was conducted on the patient identification process in palliative care and stroke units in 5medium-stay hospitals. The following steps were carried out: Data collection from each hospital; organisation and data analysis, and preparation of a common procedure for this process. RESULTS: The data obtained for the safe identification of all stroke patients were: hospital 1 (93%), hospital 2 (93.1%), hospital 3 (100%), and hospital 5 (93.4%), and for the palliative care process: hospital 1 (93%), hospital 2 (92.3%), hospital 3 (92%), hospital 4 (98.3%), and hospital 5 (85.2%). CONCLUSIONS: The aim of the study has been accomplished successfully. Benchmarking activities have been developed and knowledge on the patient identification process has been shared. All hospitals had good results. The hospital 3 was best in the ictus identification process. The benchmarking identification is difficult, but, a useful common procedure that collects the best practices has been identified among the 5 hospitals.

Effect of geraniol on rat cardiomyocytes and its potential use as a cardioprotective natural compound.

AIMS: Reactive oxygen species (ROS) are generated in the ischaemic myocardium especially during early reperfusion and affect myocardial function and viability. Monoterpenes have been proposed to play beneficial roles in diverse physiological systems; however, the mechanisms of action remain largely unknown. This study aims to assess the effect of monoterpene geraniol (GOH) on neonatal rat ventricular cardiomyocytes (NRVCs) subjected to oxidative stress. MAIN METHODS: We used an in vitro model of hypoxia-reoxygenation. Cardioprotective (AMPK) and cardiotoxic (ERK1/2, ROS) signaling indicators were measured. Assays were performed by fluorogenic probes, MTT assays and Western-blots. KEY FINDINGS: We determined that the addition of GOH (5-200µM) to cultured normoxic and hypoxic-NRVCs diminished the endogenous production of ROS in stressed cardiomyocytes. We observed that GOH treatment increased pAMPK levels and decreased pERK1/2 levels in cultured NRVCs. SIGNIFICANCE: This report suggests that GOH is a candidate cardioprotective natural compound that operates by blunting the oxidative stress signaling that is normally induced by hypoxia-reoxygenation.

Vejiga neurógena no neurogénica congénita (VNNN C): estudio evolutivo / Congenital non-neurogenic neurogenic bladder: evolutionary study

Introducción. Dentro de los trastornos funcionales vesicales de vaciado o disfunciones miccionales, uno de los más conocidos es el síndrome de Allen-Hinman, considerado como un proceso adquirido. Recientemente, se han descrito varios casos de aparición congénita, por lo que es una patología muy poco conocida, originando graves errores diagnósticos y terapéuticos. Caso clínico. Niña de 15 años de edad, controlada desde el nacimiento por presentar una gran distensión abdominal, evacuando 400 ml de orina; siendo los estudios realizados compatibles con vejiga neurógena no neurogénica congénita mediante el tratamiento médico y sondajes vesicales intermitentes, se ha conseguido que no exista afectación renal. Conclusiones. Consideramos que la VNNN congénita es excepcional. Gracias al tratamiento seguido, se ha logrado que no exista afectación renal, y ninguna complicación. Desde hace unos 5 años, a veces, presenta deseos de micción, que no se acompaña de la misma, por lo que debemos seguir realizando un control evolutivo preciso (AU)

Introduction. The Allen-Hinman syndrome, considered being a adquired process, is one of the best known within functional disorders of emptying, or voiding dysfunctions. Recently, several cases describing a congenital appearance has been seen. It is a very little-known pathology, resulting in serious diagnostical and therapeutical errors. Clinical case. A 15 year old girl, known since birth to present a great abdominal distension, removing 400 ml of urine; realizing through studies a compatibility with congenital non-neurogenic neurogenic bladder. Medical treatment and intermittent catheterization has come to show no renal involvement or any complications with the treatment. Conclusions. We consider that congenital VNNN is exceptional. Thanks to continued treatment, We have come to conclude there being no renal involvement as well as any complications with the treatment. During the last five years she has occasionally presented the desire to urinate, both by day time and night time, without urination following. Not knowing if it can be a future-related bladder, we have to secure a evolutionary control (AU)

"Raking-in Technique:" Removal Of Brachiocephalic Vein Thrombus Using AngioVac® Device Within A Stented Venous Segment.

INTRODUCTION: A case is reported of left brachiocephalic vein thrombus removal using the Angiovac device within a stented venous segment via a through-and-through access technique. REPORT: This novel technique involves obtaining through-and-through access from the left basilic vein to the right femoral vein, which then facilitates the advancement of the Angiovac device to successfully remove in a stepwise fashion the thrombus present within a stented region of the left brachiocephalic vein. DISCUSSION: The Angiovac device has been shown to be very useful and effective at removing large amounts of thrombus, tumor, and foreign bodies within arterial and venous systems successfully. This novel technique uses the through-and-through venous access approach to allow for this device to remain close to the targeted area of thrombus burden and prevent damage of the already existing stents in this region.

Vasculitis retiniana / No disponible

No disponible

[Ureteral triplication]. / Triplicidad ureteral.

INTRODUCTION: Ureteral triplication is considered a rare anomaly and its association with ectopic ureterocele, is unusual. CLINICAL CASE: We report a male with a history of recurrent urinary tract infections, who showed left vesicoureteral reflux associated with apparent ureteral duplication in multiple test performed, and only during the vesicostomy was discovered a third ureter ending in a ectopic ureterocele corresponding with the upper pole ectopic kidney. CONCLUSIONS: Being a very unusual and complex pathology, and despite all the tests made, it is very difficult to make an accurate presurgical diagnosis, therefore the diagnosis sometimes is only performed during the surgical treatment, which must be individualized according to fthe unctional stage of each renal portion and the termination of each ureter.

Role of laser atherectomy for the management of in-stent restenosis in the peripheral arteries.

The prevalence of PAD is expected to increase as the population ages and the treatment for chronic disease becomes more sophisticated. The safety, efficacy, and lower cost of endovascular treatment for peripheral vascular disease of the lower extremities when compared with surgical revascularization are well known. Despite the clinical improvements and advances in endovascular techniques over the past decade, in-stent restenosis of peripheral arteries remains a challenge for the endovascular specialist. The use of excimer laser atherectomy has been shown to be safe and effective for the revascularization of complex, critical de novo peripheral lesions and offers promise in the treatment and prevention of in-stent restenosis.

Retinopatía diabética / No disponible

No disponible

Triplicidad ureteral / Ureteral triplication

Introducción. La triplicidad ureteral se considera una anomalía muy poco frecuente y su asociación a ureterocele ectópico, no es habitual. Caso clínico. Presentamos a un varón con historia de infecciones urnarias de repetición, a quien en las múltiples pruebas realizas se observa un reflujo vesicoureteral izquierdo asociado a una aparente duplicidad ureteral, y sólo durante la vesicostomía se descubrió un tercer uréter que terminaba en un ureterocele ectópico correspondiente al riñón del pielon superior. Conclusiones. Al ser una patología tan poco frecuente y compleja y a pesar de todas las pruebas realizadas, es muy difícil efectuar un diagnóstico exacto previo a la intervención, por lo que el diagnóstico, a veces, sólo se realiza durante el tratamiento quirúrgico, el cual debe ser individualizado, según el grado de función de cada porción renal y la terminación de cada uréter

Introduction. Ureteral triplication is considered a rare anomaly and its association with ectopic ureterocele, is unusual. Clinical case. We report a male with a history of recurrent urinary tract infections, who showed left vesicoureteral reflux associated with apparent ureteral duplication in multiple test performed, and only during the vesicostomy was discovered a third ureter ending in a ectopic ureterocele corresponding with the upper pole ectopic kidney. Conclusions. Being a very unusual and complex pathology, and despite all the tests made, it is very difficult to make an accurate presurgical diagnosis, therefore the diagnosis sometimes is only performed during the surgical treatment, which must be individualized according to the unctional stage of each renal portion and the termination of each ureter

Retinosquisis juvenile ligada al cromosoma X. Historia y actualidad / X-Linked juvenile retinoschisis history and present

La Retinosquisis Juvenil Ligada al cromosoma X (RJLX) es una degeneración macular que puede conducir a degeneración vitreorretiniana; presenta patrón de transmisión recesivo y es casi exclusivamente de hombres. Frecuentemente se diagnostica durante la edad escolar por disminución de agudeza visual o por hemorragia vítrea abrupta. RS1 es el gen asociado a la enfermedad, el cual codifica Retinosquina, una proteína secretada a partir de células de la retina que se une a la superficie de los fotorreceptores y células bipolares, contribuyendo a mantener la integridad de la retina. Los rasgos característicos de la enfermedad incluyen, disminución de la agudeza visual, estrías radiales que surgen de la Retinosquisis foveal, división de las capas interna y periférica de la retina, Electrorretinograma negativo dado por una disminución marcada de la onda b. En la actualidad la OCT con dominio espectral, es la técnica diagnostica más importante, la cual demuestra la Retinosquisis característica del área macular, mas allá del patrón radial del fondo de ojo. El tratamiento se basa principalmente en la mejoría de la agudeza visual. Los inhibidores de la anhidrasa carbónica han sido utilizados con éxito en la reducción de la Retinosquisis del polo posterior. Recientemente se ha involucrado la terapia génica mediante vectores no virales de nanopartículas sólidas lipidícas, para la RJLX, con resultados prometedores en un futuro. Realizamos una revisión bibliográfica sobre la patogenia y las opciones para el diagnostico y tratamiento actual de la RJLX (AU)

The linked juvenile retinoschisis X (XLRS) is a macular degeneration which can lead to vitreoretinal degeneration; presents recessive transmission pattern is almost exclusively men. It is often diagnosed at school age by decreased visual acuity or vitreous hemorrhage, abruptly. RS1 is the disease-associated gene, which encodes Retinosquina, a secreted protein from cells of the retina that binds to the surface of the photoreceptors and bipolar cells, helping to maintain the integrity of the retina. The characteristic features of the disease include, visual acuity reduction, radial grooves arising from the foveal retinoschisis, division of the peripheral and inner layers of the retina, given negative Electroretinograms a marked decrease in the b-wave. Today with spectral domain OCT is the most important diagnostic technique, which demonstrates the characteristic Retinoschisis macular area, beyond the radial pattern of the fundus. The treatment is based primarily on visual acuity improvement. The carbonic anhydrase inhibitors have been used with success in reducing the posterior pole retinoschisis. Recently, gene therapy has involved using nonviral vectors of solid lipid nanoparticles, for RJLX with promising results in the future. A literature review on the pathogenesis and options for diagnosis and current treatment XLRS (AU)

Determination of biofilm production by Candida tropicalis isolated from hospitalized patients and its relation to cellular surface hydrophobicity, plastic adherence and filamentation ability.

Candida tropicalis is an emerging virulent species. The aim of this study is to determine the biofilm-forming ability of 29 strains of C. tropicalis isolated from inpatients, and to examine its relation with other virulence factors such as cellular surface hydrophobicity (CSH), immediate (15 min, IA) and late (24 h, LA) plastic adherence and filamentation ability. The study was performed in parallel using two incubation temperatures - 37 and 22 °C - to determine the effect of growth temperature variations on these pathogenic attributes of C. tropicalis. Biofilm formation (BF) was measured by optical density (OD) and by XTT reduction (XTT); Slime index (SI), which includes growth as a correction factor in BF, was calculated in both methods. All strains were hydrophobic and adherent - at 15 min and 24 h - at both temperatures, with higher values for 22 °C; the adhered basal yeast layer appears to be necessary to achieve subsequent development of biofilm. Filamentation ability varied from 76.2% of strains at 37 °C to 26.6% at 22 °C. All C. tropicalis strains were biofilm producers, with similar results obtained using OD determination and XTT measurement to evaluation methods; SI is useful when good growth is not presented. BF at 37 °C was similar at 24 h and 96 h incubation; conversely, at 22 °C, the highest number of biofilm-producing strains was detected at 96 h. CSH is an important pathogenic factor which is involved in adherence, is influenced by the filamentation of yeast, and plays a critical role in BF.

Hipertensión intracraneana benigna (pseudotumor cerebri) y sus manifestaciones oftalmológicas / Benign intracranial hypertension (pseudotumorcerebri) and ophthalmological manifestations

Caso Clinico. Presentamos el caso clínico de una paciente de 22 años con antecedentes de leucemia mieloblástica aguda diagnosticada hace dos años, quien al mes de estar hospitalizada por trasplante alogénico de donante no emparentado, comienza concefalea bifrontal que aumentaba con las maniobras de valsalva y diplopía binocular, con posterior diagnóstico de hipertensión intracraneana benigna. Discusion. La hipertensión intracraneana benigna o pseudotumorcerebrí es un síndrome de elevación de la presión intracraneal de causa desconocida que ocurre principalmente en mujeres jóvenes en edad fértil y obesas. El diagnóstico es de exclusión y se hace descartando otras causas de HTI con historia clínica, pruebas de imagen y análisis del líquido cefalorraquídeo (LCR).Es importante su diagnóstico oportuno ya que uno de los principales signos que produce es el papiledema que puede causar perdida visual progresiva y atrofia del nervio óptico si no es tratado de forma oportuna (AU)

Clinical Case. We are presenting the case of a 22 years old female patient with an acute myelogenous leukemia background diagnosed two years ago. Within two months of being hospitalized after an allogeneic transplant from an unrelated donor, begins with headache and binocular double vision, followed by a subsequent diagnosis of benign intracranial hypertension. Discussion. Benign intracranial hypertension or pseudotumorcerebri is a syndrome implying an increase of intracranial pressure with an unknown cause and mainly common in young obese, fertile females. The diagnosis is of exclusion and it is performed ruling out other causes of HTI with a clinical record, image tests and Cerebrospinal fluid analysis (LCR). A timely diagnosis is important given that one of the main signs that produces is the papilledema, which may lead to progressive visual loss and optic nerve atrophy if it is not treated in a timely manner (AU)

Acumulación de neonatos con malformación anorrectal en 2011. ¿Solo azar? / Increase of newborns with anorectal malformation in 2011. Is it just by chance?

Introducción. Durante 2011 hemos diagnosticado 9 pacientes con malformaciones anorrectales (MAR). Esto supone 13.3 casos/10.000 RN vivos, frente a la incidencia estimada de 2 casos/10.000 RN vivos. Esta acumulación de MAR puede no ser debida al azar, por lo que hemos decidido su investigación. Pacientes y Métodos. Incluimos en el estudio todos los pacientes con MAR nacidos en el 2011. En todos ellos analizamos: su área geográfica, edad y estado de salud de los padres, gestación, exposición ateratógenos (especialmente, ingesta de lorazepan), sexo, edad gestacional, peso al nacimiento, exploración abdominal y del periné, defectos congénitos asociados, estudios por imagen realizados, tratamiento y situación actual. Resultados. Todos los pacientes proceden de nuestra provincia, yla edad materna es menor de 20 años en 2, o mayor de 30 en 7; existe predominio de varones (8/1) y MAR de localización baja en 4 de los9 pacientes. El 100% de los RN presentan algún tipo de malformación asociada en los genitales, en el sistema urinario o costovertebrales. La valoración clínica y el estudio por imagen proporcionaron el diagnóstico correcto en todos los casos. Hay que destacar la ausencia de dificultades en el tratamiento quirúrgico y la evolución clínica satisfactoria en todos los niños. Conclusiones. A la acumulación de casos con MAR se suman el predominio en varones así como la alta incidencia de malformaciones asociadas y de MAR de localización alta. No hemos encontrado una explicación epidemiológica a esta concentración de pacientes con MAR. Esto nos obliga a continuar con nuestra investigación por si se detecta alguna causa, de momento no conocida (AU)

Objective. In 2011 we have diagnosed 9 anorectal malformations(MAR). This means 13.3 cases/10.000 NB versusu the estimated incidence of 2 cases/10.000 NB. This accumulation of defects can not bedue to chance, so we have decided to focus on its research. Material and Methods. The study included all the patients with anorrectal malformations born in 2011. In all of them we analyzed: geographic area, age and health status of parents, pregnancy, exposureto teratogens, especially lorazepam intake, sex, gestational age, weight at birth, exploration of the abdomen and perineum, birth defects associated, imaging studies performed, treatment and current situation. Results. All patients came from our province, and maternal age is under 20 years in (..) (AU)

Parénquima testicular ectópico en la túnica albugínea / Ectopic testicular parenchyma in albugineal tunic

Presentamos un varón, operado de criptorquidia bilateral, en el que macroscópicamente ambos testículos presentaban máculas y que en el estudio histológico se observaron grupos de túbulos seminíferos, con estroma y células de Leydig, rodeados por la albugínea, aislados del resto del parénquima testicular, siendo el diagnóstico histopatológico de "ectopia del parénquima testicular". Esta anomalía puede inducir a error y realizar laparotomías innecesarias, debido a que los túbulos seminíferos están rodeados por la albugínea, sin conexión aparente con el resto del parénquima testicular, siendo necesaria su valoración a largo plazo tanto durante la pubertad como en la edad adulta (AU)

We introduce a male patient with bilateral chryptorchidism submitted to surgery; during the intervention, macroscopically round macules were seen in the outer surface of both testes. In the round macules histological study, groups of seminiferous tubules were observed, including stroma and Leydig’s intestitial cells surrounded of tunica albuginea, isolated from the rest of testicular parenchymal tissue; the diagnosis "Ectopic testicular parenchyma tissue" was confirmed by histopathological study. Due to the seminiferous tubules are surrounded by the tunica albuginea, with no apparent connection to the rest of the testicular parenchyma, a long-term assessment is required, both during puberty aswell as in adulthood; owing to that can mislead and make unnecessary laparotomies and orchiectomies in the future (AU)

[Increase of newborns with anorectal malformation in 2011. Is it just by chance?]. / Acumulación de neonatos con malformación anorrectal en 2011. Solo azar?

OBJECTIVE: In 2011 we have diagnosed 9 anorectal malformations (MAR). This means 13.3 cases/10.000 NB versusu the estimated incidence of 2 cases/10.000 NB. This accumulation of defects can not be due to chance, so we have decided to focus on its research. MATERIAL AND METHODS: The study included all the patients with anorrectal malformations born in 2011. In all of them we analyzed: geographic area, age and health status of parents, pregnancy, exposure to teratogens, especially lorazepam intake, sex, gestational age, weight at birth, exploration of the abdomen and perineum, birth defects associated, imaging studies performed, treatment and current situation. RESULTS: All patients came from our province, and maternal age is under 20 years in 2 patientes and older than 30 in 7; male-dominated (8/1); low forms in 4 of 9 patients. 100% of newborns have some type of associated malformation, in genitals, urinary system or costovertebral. Clinical assessment and imaging study provided the right diagnosis in all the cases. It must be noted the absence of difficulties in the surgery treatment and a favorable outcome in all children. CONCLUSIONS: To this accumulation of cases with anorrectal malformation cases it is added a male predominanced, and a high incidence of associatedmalformations and high defects. We have not found an epidemiological explanation for this concentration of patients with anorrectal malformations. This forces us to continue our investigation if detected for some reason, currently not known.