Utility of artificial intelligence for detection of pneumothorax on chest radiopgraphs done after transthoracic percutaneous transthoracic biopsy guided by computed tomography.

OBJETIVE: To assess the ability of an artificial intelligence software to detect pneumothorax in chest radiographs done after percutaneous transthoracic biopsy. MATERIAL AND METHODS: We included retrospectively in our study adult patients who underwent CT-guided percutaneous transthoracic biopsies from lung, pleural or mediastinal lesions from June 2019 to June 2020, and who had a follow-up chest radiograph after the procedure. These chest radiographs were read to search the presence of pneumothorax independently by an expert thoracic radiologist and a radiodiagnosis resident, whose unified lecture was defined as the gold standard, and the result of each radiograph after interpretation by the artificial intelligence software was documented for posterior comparison with the gold standard. RESULTS: A total of 284 chest radiographs were included in the study and the incidence of pneumothorax was 14.4%. There were no discrepancies between the two readers' interpretation of any of the postbiopsy chest radiographs. The artificial intelligence software was able to detect 41/41 of the present pneumothorax, implying a sensitivity of 100% and a negative predictive value of 100%, with a specificity of 79.4% and a positive predictive value of 45%. The accuracy was 82.4%, indicating that there is a high probability that an individual will be adequately classified by the software. It has also been documented that the presence of Port-a-cath is the cause of 8 of the 50 of false positives by the software. CONCLUSIONS: The software has detected 100% of cases of pneumothorax in the postbiopsy chest radiographs. A potential use of this software could be as a prioritisation tool, allowing radiologists not to read immediately (or even not to read) chest radiographs classified as non-pathological by the software, with the confidence that there are no pathological cases.

Nanocatalytic performance of pectinase immobilized over in situ prepared magnetic nanoparticles.

Immobilization of enzymes is one of the protein engineering methods used to improve their thermal and long-term stabilities. Immobilized pectinase has become an essential biocatalyst for optimization in the food processing industry. Herein, nanostructured magnetic nanoparticles were prepared in situ for use as supports to immobilize pectinase. The structural, morphological, optical and magnetic features and the chemical compositions of the nanoparticles were characterized. Nanoparticle agglomeration and low porosity were observed due to the synthetic conditions. These nanoparticles exhibited superparamagnetic behavior, which is desirable for biotechnological applications. The maximum retention rate for the enzyme was observed at pH 4.5 with a value of 1179.3 U/mgNP (units per milligram of nanoparticle), which was equivalent to a 65.6% efficiency. The free and immobilized pectinase were affected by the pH and temperature. The long-term instability caused 40% and 32% decreases in the specific activities of the free and immobilized pectinase, respectively. The effects of immobilization were analyzed with kinetic and thermodynamic studies. These results indicated a significant affinity for the substrate, a decreased reaction rate, and improved thermal stability of the immobilized pectinase. The reusability of the immobilized pectinase was preserved effectively during cycling, with only a 21.2% decrease in activity observed from the first to the last use. Therefore, alternative magnetic nanoparticles are presented for immobilizing and maintaining the thermostability of pectinase.

Synthesis of ZnAl2O4 and Evaluation of the Response in Propane Atmospheres of Pellets and Thick Films Manufactured with Powders of the Oxide.

ZnAl2O4 nanoparticles were synthesized employing a colloidal method. The oxide powders were obtained at 300 °C, and their crystalline phase was corroborated by X-ray diffraction. The composition and chemical structure of the ZnAl2O4 was carried out by X-ray and photoelectron spectroscopy (XPS). The optical properties were studied by UV-vis spectroscopy, confirming that the ZnAl2O4 nanoparticles had a direct transition with bandgap energy of 3.2 eV. The oxide's microstructures were microbars of ~18.2 nm in size (on average), as analyzed by scanning (SEM) and transmission (TEM) electron microscopies. Dynamic and stationary gas detection tests were performed in controlled propane atmospheres, obtaining variations concerning the concentration of the test gas and the operating temperature. The optimum temperatures for detecting propane concentrations were 200 and 300 °C. In the static test results, the ZnAl2O4 showed increases in propane response since changes in the material's electrical conductance were recorded (conductance = 1/electrical resistance, Ω). The increases were ~2.8 at 200 °C and ~7.8 at 300 °C. The yield shown by the ZnAl2O4 nanoparticles for detecting propane concentrations was optimal compared to other similar oxides categorized as potential gas sensors.

Effective antimicrobial activity of ZnO and Yb-doped ZnO nanoparticles against Staphylococcus aureus and Escherichia coli.

Nanostructured Zn1-xYbxO (0.0 ≤ x ≤ 0.1) powders were prepared by the solution method using polyvinyl alcohol (PVA) and sucrose. The effect of the ytterbium doping content on the structural, morphological, optical and antimicrobial properties was analyzed. X-ray diffraction (XRD) analysis revealed that the hexagonal wurtzite structure was retained, and no secondary phases due to doping were observed. The crystallite size was under 20 nm for all the Zn1-xYbxO (0.0 ≤ x ≤ 0.1) powders. The optical band gap was calculated, and the results revealed that this value increased with the ytterbium content, and the Eg values varied from 3.06 to 3.10 eV. The surface chemistry of the powders was analyzed using X-ray photoelectron spectroscopy (XPS), and the results confirmed the oxidation state of ytterbium as 3+ for all the samples. Zn1-xYbxO (0.0 ≤ x ≤ 0.1) nanoparticles were tested as antimicrobial agents against Staphylococcus aureus and Escherichia coli, resulting in a potential antimicrobial effect at most of the tested concentrations. These results were used in an artificial neural network (ANN). The results showed that it is possible to generate a model capable of forecasting the absorbance with good precision (error of 1-2%).

Ultra-dry air plasma treatment for enhancing the dielectric properties of Al2O3-GPTMS-PMMA hybrid dielectric gate layers in a-IGZO TFT applications.

We assessed the effects of ultra dry-air plasma surface treatments on the properties of Al2O3-GPTMS-PMMA hybrid dielectric layers for applications to high-performance amorphous Indium Gallium Zinc Oxide (a-IGZO) thin film transistors (TFTs). The hybrid layers were deposited by an easy dip coating sol-gel process at low temperature and then treated with dry-air plasma at 1, 2 and 3 consecutive cycles. Their properties were analyzed as a function of the number of plasma cycles and contrasted with those of the untreated ones. The dielectric characteristics of the hybrid layers were determined from I-V and C-f measurements performed on metal-insulator-metal and metal-insulator-semiconductor devices. The results show that the plasma treatments increase the surface energy and wettability of the hybrid films. There is also a reduction of the OH groups and oxygen vacancies in the hybrid network improving the dielectric properties. The incorporation of nitrogen into the hybrid films surface is also observed. The plasma-treated hybrid dielectric layers were applied as dielectric gate in the fabrication of a-IGZO TFTs. The best electrical performance of the fabricated TFTs was achieved with the 3 cycles plasma-treated hybrid dielectric gate, showing high mobility, 29.3 cm2 V-1 s-1, low threshold voltage, 2.9 V, high I ON/OFF current ratio, 106, and low subthreshold swing of 0.42 V dec-1.

Prevalencia de la lactancia materna en el sector de salud del Hospital «Son LLàtzer» de Palma de Mallorca / Prevalence of breastfeeding in the health sector Hospital Son Llàtzer (Palma de Mallorca)

Objetivo: Conocer la incidencia y la prevalencia de la lactancia materna (LM) en los 6 primeros meses de vida, y relacionarla con las variables que predisponen al inicio de la lactancia y su mantenimiento, las dificultades más frecuentes y los motivos de abandono y/o la introducción temprana de otros alimentos. Se pretende comparar las prácticas hospitalarias recomendadas por la Organización Mundial de la Salud y la prevalencia de lactancia materna al inicio. Material y método: Estudio descriptivo transversal con recogida de datos retrospectivos, mediante encuesta telefónica a madres de bebés de 15, 30, 90 y 180 días, y los registros de enfermería de la maternidad sobre alimentación de los recién nacidos. Resultados: La prevalencia de la decisión de lactancia materna en el momento del parto es del 81,2%, y al alta del hospital del 76%. Va descendiendo progresivamente, y a los 15 días de vida es del 73,6%, al mes del 72,5%, a los 3 meses del 56,9%, y a los 6 meses del 37,8%. Las madres que han hecho «piel con piel» después del parto y han iniciado la lactancia precoz en la primera hora tienen una mayor prevalencia de lactancia materna completa frente a lactancia parcial a los 15 días (un 86,6 y un 86,3%, frente un 56,3 y un 55%, respectivamente). La asociación desaparece a partir del primer mes, y tampoco se observa ninguna relación entre la práctica de «piel con piel» y la lactancia materna en la primera hora, con el abandono precoz de la lactancia. La edad de la madre no se asocia al tipo de la lactancia, según los datos obtenidos. El 79,3% de las madres con estudios universitarios mantiene la lactancia hasta los 3 meses, frente al 62,2% de las madres con otros estudios; a los 6 meses, todas lo hacen de forma similar. Los momentos críticos de abandono se presentan alrededor del primer mes, y entre el cuarto y quinto mes de vida. Los motivos de lactancia parcial durante el primer mes son principalmente (75,64%) el llanto, el hambre, la poca ganancia de peso y la leche insuficiente. Los motivos de lactancia parcial entre los 3 y 6 meses son la recomendación profesional (60,6%), motivos de trabajo o estudios (18,2%), y leche insuficiente, llanto o hambre (18,2%). Conclusiones: Las tasas de lactancia materna en el sector de salud del Hospital «Son Llàtzer» son similares a las obtenidas en otros estudios y a las de la Encuesta Nacional de Salud de 2006. Las prácticas hospitalarias adecuadas mejoran la prevalencia de la lactancia al inicio; después son muchos los factores que intervienen. Para mejorar la prevalencia de la lactancia los meses posteriores, se debe mejorar la atención sanitaria tras la hospitalización y las medidas institucionales que la protejan (AU)

Objective: To know the incidence and importance of breastfeeding during the first six months of life, and to relate it to the variables that predispose to the beginning of breastfeeding and maintenance, the most frequent difficulties and the motives for abandoning it and/or introducing other kind of food early. We aim to compare hospital practice recommended by the World Health Organization and the importance of breastfeeding at the beginning. Material and method: Transversal descriptive study with retrospective data gathering, telephonically surveying to mothers of babies 15, 30, 90 and 180 days old and maternity infirmary registries about newborns feeding. Results: 81.2% decide to breastfeed at the moment of birth, 76% after hospital leave. It descends progressively 73.6% after 15 days of life, 72.5% after one month, 56.9% after three months, 37.8% after 6 months. Mothers that hare "touched skin to skin" right after birth and hare initiated breastfeeding during the first hour hare a higher prevalence of full breastfeeding against partial breastfeeding after 15 days is a 86.6 and a 86.3%, against 56.3 and 55%, respectively. The association disappears after the first month, and there is no direct relation between the practice of getting in contact of "skin with skin" during de first hour and the early cessation of breastfeeding. The age of the mother is not associated with the type of lactation according to the gathered data. 79.3% of women who are university students keep on breastfeeding for 3 months, compared to 62.2% in other studies, after 6 months they all do it in a similar way. The critical moments of abandonment are around first month, and between the 4th and 5th month of life. The reasons for partial breastfeeding during the first month are primarily 75.64% crying, hunger, puts on little weight, insufficient milk. The reasons for partial breastfeeding between 3 and 6 months is a 60.6% professional recommendation, a 18.2% because of working or studying and 18.2% insufficient milk, crying or hunger. Conclusions: Rates of breastfeeding in the Hospital Son Llàtzer health sector are similar to those obtained in other studies and those of the 2006 National Health Survey. Appropriate hospital practices improve the prevalence of breastfeeding in the beginning, after that there are a lot of other factors involved. To improve the prevalence of breastfeeding during the subsequent months, health care and measures that protect it should be improved (AU)

[Joint position statement of the Mexican College of Orthopedics and Traumatology: prophylaxis for venous thromboembolic disease in high-risk orthopedic surgery]. / Declaración de posición conjunta del Colegio Mexicano de Ortopedia y Traumatología: profilaxis de la enfermedad tromboembólica venosa en cirugía ortopédica de alto riesgo.

Venous thromboembolic disease (VTED) is a public health problem worldwide. In the United States it causes 2 million annual cases. Its annual incidence is 1-2 cases per 1,000 individuals in the general population. It is a disease frequently associated with life threatening complications and its mortality rate is 1-5% of cases. Due to its high complication rate, its slow recovery, and the need for prolonged disability, it is considered as a high-cost disease. VTED may occur in both surgical and medical patients; the known associated risk factors include prolonged rest, active cancer, congestive heart failure, atrial fibrillation, and stroke, among the major medical conditions. Orthopedic surgery represents the main surgical risk factor for VTED, including mainly hip and knee replacements, as well as polytraumatized patients with severe spinal lesions, and major fractures. VTED may be prevented with the appropriate use of antithrombotics. The participants in this consensus defined thromboprophylaxis as the strategy and actions undertaken to reduce the risk of VTED in patients undergoing high risk orthopedic surgery. The position of the Mexican College of Orthopedics and Traumatology regarding the prevention of VTED in orthopedic surgery is described herein.

Prevalencia del tabaquismo y perfil del fumador en los escolares adolescentes de la provincial de Castellón / Smoking prevalence and smoker profile in the adolescents scholars in the province of Castellon

Objetivo analizar la prevalencia del tabaquismo en los escolares adolescents de la provincial de Castellón. Pacientes y métodos: estudio epidemiológico realizado en institutos de educación secundaria (curso 2006-2007); se recogió información sobre hábitos tóxicos, entornos familiar y social del adolescente, el estado de salud general y los síntomas respiratorios, el grado de adición y dependencia y la motivación para la cesación tabáquica. Resultados: participaron 1.088 adolescentes de edad media 15,94 años (46,69% chicas y 53,31% chicos). El 25,82% eran fumadores (27,36% chicas, 24,48% chicos). La edad media de inicio del consumo de tabaco fue de 13,46 años, empezando a fumar antes las chicas (13,08 años) que los chicos (13,85 años), y antes enter 10-14 años (12,38 años) que entre 15-19 años (13,57 años). El porcentaje de familiares y amigos fumadores fue mayor entre los adolescentes fumadores. Al aumentar el grado de dependencia física y/o psíquica/social/gestual a la nicotina, el grado de motivación para dejar de fumar fue menor y la actitud ante el abandono fue peor. Conclusiones: el inicio del consumo de tabaco se da cada vez a edades más tempranas y antes en las chicas que en los chicos, detectándose una asociación entre el entorno familiar y el social y el inicio y mantenimiento del hábito tabáquico (AU)

Objective: to analyze the prevalence of smoking in the adolescents scholars in the province of Castellon. Patients and methods: epidemiologic study carried out in secondary schools, with the help of a questionnaire where in addition to the toxic habits, information on familiar and social environment, global health status and respiratory symptoms; addiction and dependence degree and smoking cessation motivation was collected. Results: 1.088 adolescents with a mean age of 15.94 years participated (46.69% girls and 53.31% boys). The 25.82% were smokers (27.36% girls and 24.48% boys). The mean age of starting smoking was 13.46 years, starting to smoke earlier the girls (13.08 years) than the boys (13.85 years), and earlier between 10-14 years (12.38 years) than between 15-19 years (13.57 years). Higher percentage of familiar and friends smokers was seen within adolescent smokers. As the physic and/or psychic/social/gestural dependence degree to nicotine increases, the motivation degree to stop smoking was smaller and the attitude about cessation was worst. Conclusions: smoking starting is every time at a younger age and earlier in girls than boys, being and association detected between familiar and social environment and the star and maintenance of smoking (AU)

Hospitales públicos y Responsablidad Social Corporativa / Public hospitals and Social Corporate Responsibility

Todos los centros hospitalarios del Sistema Nacional de Salud, son en la práctica epresas de servicios de alta calificacion científico y tecnológica, pero prestadores de uns ervicio; para optimizar y gesionar mejor todos sus recursos el Hospital General Universiario “Reina Soía” de Murcia tiene un Proyecto Institucional de Ética y Responsabilidad Social Corporativo basado en una serie de iniiativas puestas ya en fuencionamiento y en otras qu se irán agregando paulatinamente, con una clara orientación hacia los pacientes y profesionales del centro (AU)

All the hospitable centers of the national System of Health, are in the practice companies, but lending of services, of high scientific and technological qualification of a service; to optimize and to manage better all his resources the Hospital General Universitari “Reina Sofia” of Murcia has an Institutional Project of Ethics and Social Corporate Responsibility based on a series of initiatives us already in functioning and in others who will be joing gradually, with a clear orientation towards the patients and professionals of the center (AU)

¿Cómo incorporar las utilidades de los pacientes a las decisiones clínicas?. Informe SESPAS 2008 / How should patients¿ utilities be incorporated into clinical decisions? 2008 SESPAS Report

Hay muchas situaciones clínicas en las que no se puedetomar una decisión ®correcta» desde el punto de vista técnico.Ejemplo de ello sería la cirugía electiva, donde atenderlas preferencias de los pacientes resulta ineludible. Una formade incorporar dichas preferencias es la aplicación del análisisde las decisiones clínicas. En este enfoque, primero secuantifican dichas preferencias (utilidades) y después se combinancon los conocimientos técnicos del médico. Al modeloresultante de toma de decisiones se le suele denominar ®tomade decisiones compartidas». En la revisión efectuada en esteartículo se constata que: a) dicho modelo, en caso de aplicarsesistemáticamente, podría mejorar la efectividad de lostratamientos y el bienestar de los pacientes; b) la práctica clínica,no obstante, se enfrenta a restricciones en forma de tiempoy recursos disponibles que hacen difícil su aplicación; c)la incorporación de las utilidades de los pacientes a las guíasde práctica clínica podría contribuir a estrechar la distanciaque separa las preferencias de los médicos de las de los pacientes;d) aparentemente, la aplicación de este tipo de análisisen España es muy ocasional, donde, incluso, se detectandeficiencias, no ya en la participación de los pacientes enlas decisiones clínicas, sino en el ejercicio del derecho a lainformación, y e) la alternativa de las ayudas a la decisión,aun cuando conozca una creciente expansión, no está librede problemas(AU)

There are many clinical situations in which there is no “right”decision from a technical point of view. An example of this iselective surgery, in which patients’ preferences are critical. Oneway to integrate patients’ preferences within clinical practiceis the application of decision analysis.According to this approach, preferences (utilities) are assessedand are then combined with physicians’ knowledge.This combination of evidence and utilities leads to the so-calledshared decision-making (SDM) model.The overview provided in the present article indicates that:a) The SDM model, if systematically applied, could improvetreatment effectiveness and patients well being; b) clinical practice,nevertheless, faces barriers in the form of time and resourceconstraints, limiting the application of such a model;c) discrepancies between patients’ and doctors’ preferencescould be narrowed if patients’ utilities were included in clinicalpractice guidelines; d) the application of this kind of analysisseems to be scarce in Spain. Moreover, information providedto patients is probably insufficient; and e) patientdecision aids, even though their use is rapidly growing, aresubject to certain problems(AU)

Derechos y restricciones del enfermo alérgico en el ambiente laboral / Rights and restrictions of the allergic patient in the occupational environment

Los procesos alérgicos son frecuentes en el ambiente laboral, a menudo como consecuencia de las condiciones del lugar de trabajo o de los materiales y sustancias empleadas. La Ley de Prevención de Riesgos Laborales persigue la protección de la salud de los trabajadores, imponiendo la realización de una serie de medidas preventivas y correctoras. No obstante, se plantean las cuestiones de la idoneidad individual para la realización de una tarea laboral específica y de los derechos que protegen a quien resulta no apto para ese trabajo, por causa de su alergia. Mediante los exámenes de salud se puede detectar esta problemática, haciéndose imprescindibles medidas correctoras del medio laboral, así como otras de protección individual. Efectuado todo esto, y ante la persistencia de la patología alérgica, surgen dudas: ¿Podría ser alguien rechazado por esa causa?, ¿Debe el trabajador informar sobre sus limitaciones, con carácter previo?, ¿Se atenta contra su privacidad, interrogándole al respecto?, ¿Qué deben hacer el médico del trabajo y el empresario? Entendemos que la Ley otorga adecuada respuesta a esos interrogantes, garantizando los derechos de todos, a la vez que exige veracidad por parte del empleado y confidencialidad por parte del equipo médico que le examina (AU)

Allergic processes are rather frequent in the occupational environment, ofter as a consequence of the workplace conditions or of the materials and substances used. The Law for Prevention of Occupational Risks (in Spain, Ley de Prevención de Riesgos Laborales) aims at protecting the labourers’ health, by imposing a number of preventive and corrective measures. However, questions arise regarding the individual adequacy for performing a specific occupational task and also regarding the rights protecting that individual who is not apt or adequate for that particular task because of his (her) allergic condition. Health surveys may detect this particular problem, and render indispensable measures for correction of the occupational environment, as well as further ones for individual protection. However, once all this has been carried out and when the allergic disease persists, a number of doubts arise: May anyone be rejected for this cause? Should the worker previously report his ‘limitations’? Does asking him about this infringe his right to privacy? What should the occupational physician and the employer do? We do consider that the Law gives adequate answer and response to all these questions and guarantees the rights of all those involved, as well as demanding truthfulness on the side of the employee and confidentiality on the side of the examining medical team (AU)

Un enfoque del estudio de la cultura organizacional

Información sobre cultura nacional, perspectiva cultural, los científicos sociales y la cultura, estructura, procesos y cultura organizacional, y una propuesta para el estudio de la cultura organizacional.

[Adenocarcinoma in Barrett's esophagus. A retrospective study of 46 patients followed during 3.5 years]. / Adenocarcinoma en esófago de Barrett. Estudio retrospectivo de 46 pacientes seguidos durante 3,5 años.

OBJECTIVE: To determine the incidence of adenocarcinoma in patients with Barrett's esophagus and to study the characteristics in these patients. METHODS: Between January 1988 and June 1997 was diagnosed 46 patients with Barrett's esophagus. In all tem was analyzed the age, the follow-up period, the chief presenting symptoms leading to endoscopy, endoscopy esophagitis and complications of Barrett's esophagus. RESULTS: The mean age at the time of Barrett's diagnosis was 58 years. The mean follow-up period was 43 months. Presenting symptoms were heartburn in 35 (76%) patients, dysphagia in 3 (6.5%), thoracic pain 3 (6.5%), hemorrhage 2 (4.5%) and others in 3 (6.5%). Endoscopic esophagitis was present in 24 (52%) patients during the follow-up. Complications developed was stricture, ulceration or haemorrhage in 14 (30.4%) patients, two (4.3%) have adenocarcinoma and one dysplasia. Incidence of adenocarcinoma was 1/82 patient-years of follow-up. All three patients with adenocarcinoma or dysplasia was males. Two of the three presented with heartburn and the mean follow-up until development of dysplasia or cancer was 63 months. CONCLUSIONS: Heartburn and endoscopic esophagitis is frequent in these patients. The risk of development of and adenocarcinoma or others complications is high.

Adenocarcinoma en esófago de Barrett: estudio retrospectivo de 46 pacientes seguidos durante 3.5 años / Adenocarcinoma in Barrett's esophagus: a retrospective study of 46 patients followed 3.5 years

Introducción: El reflujo gastroesofágico es uno de los mecanismos fisiopatológicos más importantes para el desarrollo de esófago de Barrett (EB). Los pacientes con EB presentan un riesgo elevado de desarrollar adenocarcinoma de esófago. Objetivo: 1º Estudiar las características clínicas de los pacientes con esófago de Barrett (EB) en el área de Baracaldo-Sestao. 2º Analizar el riesgo de desarrollar adenocarcinoma sobre esófago de Barrett en nuestros pacientes. Métodos: Se han analizado retrospectivamente los EB diagnosticados entre 12.000 endoscopias altas realizadas en nuestro Hospital desde 1988 a Junio de 1997. En total se han diagnosticado 46 pacientes con EB. En ellos, se ha analizado: edad y clínica al diagnóstico, presencia de esofagitis endoscópica, tiempo de seguimiento, complicaciones y desarrollo de adenocarcinoma. Resultados: La edad media fue de 58 años. 33 (72%) eran hombres y 13 (28 %) mujeres. El tiempo medio de seguimiento fue de 43 meses. La clínica de presentación fue pirosis en 35 (76%), disfagia en 3 (6,5%), dolor torácico en 3 (6,5%), hemorragia digestiva en 2 (4,5%) e inespecífica en otros 3 (6,5%) pacientes. En 24 (52%) casos hubo en algún momento de la evolución esofagitis endoscópica. Durante el seguimiento, 33 (72%) no presentaron complicaciones, 10 (22%) presentaron úlcera, estenosis o hemorragia, 2 (4,5%) degeneraron a adecarcinoma y 1 (2,25%) presentó displasia. La incidencia media fue de 0,56/46 casos/año. Los 2 pacientes que degeneraron presentaron un seguimiento mayor (87 meses frente a 41 meses del resto), todos eran hombres, la clínica fue pirosis en 1 y en otra inespecífica y la edad media de ellos fue de 63 años. Conclusiones: 1º La pirosis y la presencia de esofagitis endoscópica está presente en la mayoría de los pacientes con EB. 2º La presencia de complicaciones, así como la degeneración maligna, es relativamente frecuente en nuestro grupo de pacientes (AU)

[Hemobilia with spontaneous resolution. Sonographic diagnosis and follow-up]. / Hemobilia con resolución espontánea. Diagnóstico y evolución con ecografía.

We describe a case of hemobilia after liver biopsy, which resolved spontaneously. Clinical, analytical and sonographic monitoring were performed until the patient returned to normal. We highlight the particular characteristics of the onset and evolution in our case, as well as the role played by ultrasonography in diagnosing and monitoring. We conclude by pointing out the increasing frequency of hemobilia as a complication to invasive techniques.

Cancer del pulmón: estudio de 100 pacientes fallecidos / Lung cancer: study in 100 death patients

Se realiza un estudio que comprendió la revisión de los protocolos de necropsias y las historias clínicas de 100 pacientes fallecidos porcáncer primario del pulmón en el período comprendido desde enero de 1990 hasta diciembre de 1993, utilizando el software EPINFO 5.0 en la computación de los datos los que se resumen en porcentajes y se expresan en cuadros. El mayor número de casos estaba comprendido en el grupo de edades de 65 años, del sexo masculino y fumadores con intenso hábito. También se evidenció que la bronconeumopatía crónica es un antecedente importante y que la forma clínica de presentación más copmún fue el síndrome respiratorio; además, predominó la imagen radiológica tunoral inflamatoria asi mismo se obtuvo un alto porcentaje de negatividad en el esputo citológico por mala técnica en la recolección, y por el contrario fueron la broncoscopía con biopsia tumoral, el cepillado, lavado bronquial altamente sensible en el diagnóstico de esta enfermedad. El carcinoma epidermioide y las metástasis multiorgánicas ocuparon un lugar significativo. Además la mayor parte de los pacientes no recibieron tratamiento específico, y la supervivencia fue muy reducida (AU)