Apendicitis aguda y teratoma: ¿causalidad o consecuencia? / Acute appendicitis and teratoma: causality or consequence?

La enfermedad ginecológica puede cursar con gran variedad de manifestaciones clínicas. La coexistencia de teratoma y apendicitis aguda supone un porcentaje inusual de enfermedad abdominal en mujeres jóvenes, aunque no de forma exclusiva. Apenas hay revisiones o casos documentados en la literatura, por lo que se desconoce si existe causalidad entre ambas o simplemente es una coincidencia. Exponemos el caso de una paciente joven cuyo síntoma guía fue un dolor abdominal difuso con gran discordancia clinicorradiológica, que precisó intervención quirúrgica y confirmó la presencia de ambas entidades tras el estudio anatomopatológico.(AU)

Gynaecological disorders can have a wide variety of clinical manifestations.The coexistence of teratoma and acute appendicitis accounts for unusual, but not exclusive, percentage of abdominal pathology in young women. There are virtually no reviews or documented cases in the literature, so it is unknown whether there is causality between the 2or simply a coincidence.The case is presented of a young patient whose main symptom was diffuse abdominal pain with great clinical and radiological discordance. Surgical intervention was required to confirm the presence of both pathologies after the completion of the histopathology study.(AU)

Síndrome neuroléptico maligno y síndrome serotoninérgico: a propósito de dos casos / Malignant neuroleptic syndrome and serotoninergic syndrome: two cases

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[Acute-phase reactants and markers of inflammation in venous thromboembolic disease: correlation with clinical and evolution parameters]. / Reactantes de fase aguda y marcadores de inflamación en pacientes con enfermedad tromboembólica venosa: correlación con parámetros clínicos y evolutivos.

OBJECTIVE: To asses the association of acute reactants and interleukin 6 and 8 (IL-6 & IL-8) at diagnosis of venous thromboembolic disease (VTD) and clinical outcome. METHODS: 100 patients were diagnosed of VTD by image tests. Acute reactants (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen), D-dimer and IL-6 and IL-8 we measured at the moment of diagnosis. We made a 12 month follow-up of these patients to notice any clinical evolution outcomes (recurrences, bleeding, post-phlebitic syndrome, death). RESULTS: IL-6 was increased in 9 patients and IL-8 in 3. The risk factors, time to diagnosis and pulmonary embolism rate were similar in both interleukin groups (normal and high levels). Fibrinogen levels were significantly increased in high IL-6 group (585 +/- 179 vs. 485 +/- 154 mgr/dl; p = 0.05). During follow-up there were 5 deaths, 3 recurrences, 11 bleedings and 43 postphlebitic syndromes. Normal ESR level was associated to postphlebitic syndrome (17.8 +/- 14.5 vs. 31.4 +/- 27.4 mm/1st h; p = 0.016). Patients who had high levels of IL-6 had worse survival than these with normal levels (p = 0.015). CONCLUSION: IL-6, ESR, and CPR at diagnosis of VTD could be useful to identified patients with higher risks of death and postphlebitic syndrome during the first year after diagnosis.

Los nuevos antidiabéticos orales para el tratamiento de la diabetes mellitus tipo 2

La diabetes tipo 2 es una enfermedad de alta prevalencia y con graves complicaciones si no se lleva un control estricto de los niveles de glucemia, por lo que están apareciendo nuevos antidiabéticos orales que mejoran el control y la morbimortalidad de estos pacientes. En este artículo se pretende realizar una revisión de estos nuevos hipoglucemiantes como son las glinidas, glitazonas y el miglitol (AU)