Asunto(s)
Medicamentos Genéricos , Educación Médica , Hospitales , Humanos , México , Pautas de la Práctica en MedicinaRESUMEN
Cavernous hemangiomas of the tympanic membrane are extremely rare. Only 9 cases have been published in the literature. We describe a case with clinical characteristics, otoscopic image and diagnostic studies. Alternatives in treatment are discussed and a review of the literature was carried out.
Asunto(s)
Técnicas de Diagnóstico Otológico , Neoplasias del Oído/patología , Hemangioma Cavernoso/patología , Membrana Timpánica/patología , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Síndrome de Inmunodeficiencia Adquirida , Vacunas contra el SIDA , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/economía , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Síndrome de Inmunodeficiencia Adquirida/terapia , Análisis Costo-Beneficio , Costos y Análisis de Costo , Predicción , Salud Global , Reforma de la Atención de Salud , Derechos Humanos , Humanos , América Latina , México/epidemiología , Salud Pública , Calidad de la Atención de Salud , Seguridad Social , Naciones UnidasAsunto(s)
Neoplasias/prevención & control , Adolescente , Adulto , Anciano , Neoplasias de la Mama/prevención & control , Neoplasias del Sistema Digestivo/prevención & control , Femenino , Neoplasias de los Genitales Femeninos/prevención & control , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Neoplasias/genética , Factores de Riesgo , Vitaminas/uso terapéuticoRESUMEN
Malignant external otitis is a life-threatening infection occurring in aging diabetic and immunocompromised patients. The development of new antimicrobial and diagnostic aids has modified the therapy and prognosis of the disease. We describe our experience in 12 cases seen between 1982 and 1991, and review the diagnostic and therapeutic criteria during this lapse. Ten cases were males and 11 were diabetics. The most common symptoms were unilateral otalgia and otorrhea. All had edema of the external auditory channel and nine, proliferation of granulation tissue. Four had cranial nerve palsy. In ten patients Pseudomonas aeruginosa was recovered. All had axial computed tomographic scans and six sequential radionuclide scanning performed at diagnosis and follow-up. Eleven patients received combined therapy with an aminoglucoside and an anti-pseudonomas beta-lactam antibiotic; in four ambulatory treatment was continued with a quinolone. Only one patient received a quinolone as only treatment due to unavailability of other drugs in the mexican market. Presentation of granulation tissue or bone sequestrum was performed in nine patients. Only three required extensive surgical debridement procedures. We conclude that a combined antimicrobial therapy and the use of quinolones has favorably modified the prognosis and avoids extensive surgery and disminishes hospital stay.
Asunto(s)
Complicaciones de la Diabetes , Otitis Externa/complicaciones , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Otitis Externa/diagnóstico , Otitis Externa/terapia , Estudios RetrospectivosRESUMEN
A synthesis of the historical background of the councils for specialty certification in Mexico is presented. A comment is made on the role of the National Academy of Medicine and on its relation to the councils. Some statistical data are given on the councils endorsed by the Academy, which up to April 1992 grouped 29,093 physicians throughout the country. Finally, a brief comment is made on the future of these organization in Mexico and the increasing influence they will exert on the regulation of specialized medical practice.