Hipertensión arterial pulmonar presentada en el puerperio. Reporte de caso / Pulmonary arterial hypertension presented at the puerperium. Case report

La hipertensión pulmonar es una enfermedad compleja, grave y de baja incidencia. Es un estado hemodinámicamente patológico con una presión de arteria pulmonar que supera los 25 mmHg. La presencia de hipertensión pulmonar en el puerperio es poco frecuente y conlleva un alto riesgo para la madre. Se presenta el caso de una mujer de 31 años en puerperio mediato patológico post parto eutócico con datos de bajo gasto cardiaco. El ecocardiograma demostró la presión de la arteria pulmonar que iguala a la sistémica. La angiotomografía helicoidal de tórax descarta tromboembolismo pulmonar, y se realiza diagnóstico de hipertensión de la arteria pulmonar de etiología desconocida

Pulmonary hypertension is a complex, serious and low incidence disease. It is a haemodynamically pathological state with a pulmonary artery pressure that exceeds 25 mmHg. The presence of pulmonary hypertension in the puerperium is rare, and carries a high risk to the mother. The case is presented of a 31 year-old female in the subacute postpartum period of a normal delivery with data of low cardiac output. The echocardiogram showed that the pressure of the pulmonary artery was equal to the systemic. A thoracic helical angio-tomography ruled out pulmonary thromboembolism, making a diagnosis of pulmonary artery hypertension of unknown aetiology

Fetal lung interstitial tumor: Prenatal presentation of a rare fetal malignancy.

Fetal lung interstitial tumor (FLIT) is a rare fetal malignancy that is typically diagnosed in the postnatal period, or, if recognized prenatally can mimic a benign lesion such as congenital pulmonary airway malformation. We present the earliest case of a FLIT tumor described by ultrasound and MRI at 26 weeks of gestation. Our case highlights features suggestive of FLIT including presentation later in gestation in combination with findings on fetal MRI such as a solid appearance with radiating curved bands of high signal within and along the periphery of the lesion (not as intensely high signal as the typical CPAM), possibly detailing a radiographic signature for these tumors. The role of betamethasone for these tumors is not known.

Impact of prenatal diagnosis of fetus-in-fetu.

Fetus in fetu (FIF) is an extremely rare condition (1/500,000 live births) in which a fetiform structure is incorporated into the body of its twin. FIF can be a diagnostic dilemma due to its similarity to a teratoma, but identification of FIF is important for subsequent medical and surgical management. We compare two cases of fetal masses diagnosed on prenatal imaging that were later identified as FIF through further radiological, surgical, and pathologic evaluation. We use these cases to illustrate key pre- and postnatal features of FIF and highlight the benefits of prenatal detection and follow-up for postnatal management.

[Effects of an intensive thalassotherapy and aquatic therapy program in stroke patients. A pilot study]. / Efectos de un programa intensivo de talasoterapia y terapia acuatica en pacientes con ictus. Estudio piloto.

INTRODUCTION: Stroke remains the leading cause of acquired disability. Health and social planning and management may vary and although prevention is crucial, having better treatments and strategies to reduce disability is needed. AIM: To determine the effect of an intensive program of thalassotherapy and aquatic therapy in stroke patients, valuing clinical parameters and functional validated scales. PATIENTS AND METHODS: A quasi-experimental prospective study consisting of a specific program assessed pre- and post- 3 weeks treatment to 26 stroke patients with a mild-moderate disability. The outcomes measured were: Berg Balance scale, Timed Up and Go test, 10-meter walking test, 6-minute walking test and pain Visual Analogue Scale. RESULTS: After intervention, participants had a significant improvement in all outcomes measured. CONCLUSIONS: Our results suggest that an intensive program of thalassotherapy and aquatic therapy could be useful during stroke rehabilitation to improve balance, gait and pain.

TITLE: Efectos de un programa intensivo de talasoterapia y terapia acuatica en pacientes con ictus. Estudio piloto.Introduccion. El ictus es la principal causa de discapacidad adquirida. Su planificacion y gestion (sanitaria y social) varia y, aunque la prevencion resulta crucial, no es menos importante disponer de mejores tratamientos y estrategias para reducir la discapacidad. Objetivo. Analizar la eficacia de un programa intensivo de talasoterapia y terapia acuatica en pacientes con ictus, valorando parametros clinicos y escalas funcionales validadas. Pacientes y metodos. Se realizo un estudio prospectivo cuasi experimental con 26 pacientes con discapacidad leve-moderada postictus. Los pacientes fueron evaluados con las siguientes escalas: equilibrio de Berg, equilibrio dinamico/Timed Up and Go, marcha de 10 metros, seis minutos de marcha y escala visual analogica del dolor, antes y despues de realizar tres semanas de tratamiento. Resultados. Finalizado el tratamiento programado, se obtuvieron diferencias significativas para todas las variables estudiadas. Conclusion. Un programa intensivo de talasoterapia y terapia acuatica contribuye a mejorar el equilibrio, la marcha y la percepcion del dolor en estos pacientes.

Ectasia dural y dolor lumbar en pacientes con síndrome de Marfan / Ectasia and lumbar pain associated with marfan syndrome

Objetivo: Evaluar clínica y radiológicamente si la presencia y el volumen de la ectasia dural (ED) se asocia con dolor lumbar en pacientes con Síndrome de Marfan (SM). Material y Método: 92 pacientes diagnosticados de SM según los criterios de Gante fueron estudiados de forma prospectiva durante un año. Se les realizó una historia clínica, pruebas de imagen, incluyendo una resonancia magnética de columna lumbar volumétrica y se les entregaron 3 cuestionarios: SRS 22 (Scoliosis Research Society) y SF 36 v- 2 e Índice de discapacidad de Oswestry en función del que subdividimos la muestra en grupo I (pacientes con dolor lumbar moderado o grave) y grupo II (pacientes sin dolor lumbar). Resultados: Se realizó análisis multivariante de las variables relacionadas con el dolor lumbar, alcanzando la ED significación estadística. Estaba presente en el 75,9% de los pacientes del grupo I, y en el 49,2% del grupo II. La presencia de la ED se asocian con dolor lumbar en pacientes con SM (p= 0,016) y con la presencia de deformidad vertebral (p <0,001). Conclusiones: La presencia y el tamaño de la ED se asocian de forma significativa con dolor lumbar en el SM pero el scalloping no influye en la mayor intensidad del dolor (AU)

Objetive: Evaluate clinically and radiographically whether the presence and size of dural ectasia (ED) is associated with low back pain in patients with Marfan syndrome (MS). Material and method: 92 patients diagnosed with MS according to Ghent criteria were studied prospectively for one year. Underwent a medical history, imaging tests, including a lumbar spine MRI volumetric and 3 questionnaires were given: SRS 22 (Scoliosis Research Society) and SF 36 v-2 and Oswestry Disability Index subdivided according to the sample in group I (patients with moderate lower back pain and / or severe) and group II (patients without pain). Results: Multivariate analysis of variables related to low back pain, the ED reached statistical significance. ED was present in 75.9% of patients in group I, and 49.2% in group II. The presence of ED is associated with low back pain in patients with MS with an OR of 3.24 (1.21 to 8.68) p = 0.016 and the presence of vertebral deformity (scalloping) with an OR of 129, 83 (16.1 to 1047.74) p <0.001. Conclusion: The presence and size of ED was significantly associated with LBP in the SM but the «scalloping» does not affect the increased intensity of pain (AU)

Ectasia dural y dolor lumbar en el síndrome de Marfan / Dural ectasia and lumbar pain associated with Marfan syndrome

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La calidad de la atención de Enfermería a los pacientes de un Hospital Regional del ISSSTE, en México D. F: Un estudio basado en el grado de satisfacción de los usuarios / The quality of nursing care patients of a Regional Hospital ISSSTE in Mexico D. F: A study based on the degree of user satisfaction

El objeto de esta investigación es conocer cual es la calidad de la atención que proporciona Enfermería en el Hospital Regional 1º de Octubre del ISSSTE, en México, D.F con base en el grado de satisfacción de los usuarios. La variable medida fue la calidad de la atención. El tipo de investigación fue descriptivo, diagnóstico, analítico, transversal y observacional. La población estuvo constituida por 445 pacientes del Hospital Regional 1º de Octubre del ISSSTE, internados en los cuatro servicios básicos como son: Cirugía, Pediatría, Gineco - Obstetricia y Medicina Interna. La muestra total es de 198 pacientes. La investigación fue realizada en el año 1999. Se midió la variable Calidad de Atención de Enfermería con base en la teoría de Avedis Donabedian de clasificar las modalidades de: estructuras, proceso y resultados. De cada modalidad se establecieron indicadores. Se comprobó la hipótesis de trabajo que califica de alta calidad, la atención que Enfermería proporciona a los pacientes. Se disprueba la hipótesis nula al considerar que los usuarios se sienten satisfechos con la atención que Enfermería les proporciona y la calidad de atención que reciben.

This research aims to know what the attention quality delivered by Nursing in the Regional ISSSTE Hospital 1o. de Octubre in Mexico City is, based on the users satisfaction level. The measured variable was attention quality. The research type was descriptive, diagnostic, analytical, transversal, and observational. Population consisted of 445 patients from the Regional ISSSTE Hospital 1o. de Octubre, who were interned in the four basic services: Surgery, Pediatrics, Gyneco-Obstetrics, and Internal Medicine. The total sample had 198 patients. The research was carried out during 1999. Nursing attention quality variable was measured based on the Avedis Donabedian's theory, which classifies the structures, process, and result modalities. Indicators were set for each modality. The work hypothesis that qualifies the high quality of attention delivered by nursing to the patients was checked. The null hypothesis was proven off when considering that users feel satisfied with the attention nursing is providing then and with the attention quality they are receiving.

Dengue 2 genotypes in the state of Oaxaca, Mexico.

To genetically characterize dengue 2 (DEN-2) viruses in Oaxaca, Mexico, the C protein, and a portion of the prM protein genes of 8 isolates from the 2001 DEN epidemic were sequenced. The sequences were compared to those of prototype DEN-2 viruses from various parts of the world. Phylogenetic analysis suggested that the 2001 isolates of DEN-2 were of the American/Asian genotype and were most similar to the Jamaica and Venezuelan isolates MARA3, LARD1996 and LARD1910. Molecular analyses confirmed the origin of the isolates. This study indicates that DEN-2 strains of American/Asian genotype probably from Southeast Asian are circulating in Oaxaca.

Chromosome banding in Amphibia. XXVIII. Homomorphic XY sex chromosomes and a derived Y-autosome translocation in Eleutherodactylus riveroi (Anura, Leptodactylidae).

Extensive cytogenetic analyses on a population of the leptodactylid frog Eleutherodactylus riveroi in northern Venezuela revealed the existence of multiple XXAA male/XYAA female/XAA(Y) female sex chromosomes. The XAA(Y) karyotype originated by a centric (Robertsonian) fusion between the original, free Y chromosome and an autosome. 46.2% of the male individuals in this population are carriers of this Y-autosome fusion. In male meiosis the XAA(Y) sex chromosomes pair in the expected trivalent configuration. In the same population 53.8% of the male animals still possess the original, free XY sex chromosomes. E. riveroi is only the second vertebrate species discovered in which a derived Y-autosome fusion coexists with the ancestral free XY sex chromosomes. The free XY sex chromosomes, as well as the multiple XA(Y) sex chromosomes are still in a very primitive (homomorphic) stage of differentiation. With no banding technique applied it is possible to distinguish the Y from the X. Various banding techniques and in situ hybridizations have been carried out to characterize the karyotypes. DNA flow cytometric measurements show that the genome size of E. riveroi resembles that of other Eleutherodactylus species. The cytogenetic data obtained in E. riveroi are compared with those of the sole other vertebrate known to possess the extremely rare, multiple XXAA male/XYAA female/XAA(Y) female sex chromosomes. Surprisingly enough, this vertebrate again is a frog belonging to the genus Eleutherodactylus [E. ((maussi) biporcatus] which lives exactly in the same habitat in northern Venezuela as does E. riveroi.

Chromosome banding in Amphibia. XXII. Atypical y chromosomes in Gastrotheca walkeri and Gastrotheca ovifera (Anura, Hylidae).

The chromosomes of the rare South American marsupial frogs Gastrotheca walkeri and G. ovifera were extensively reexamined with various banding techniques. The karyotypes of both species are distinguished by a new category of XY female symbol /XX male symbol female sex chromosomes. The unusual Y chromosomes are characterized by containing the least amount of constitutive heterochromatin in the karyotypes. This is in contrast to all previously known amphibian Y chromosomes and does not fit the evolutionary model of early XY differentiation in vertebrates. In male meiosis, the heteromorphic XY chromosomes of both species still exhibit the same pairing configurations as the autosomes. DNA flow cytometric measurements show the nuclear DNA amount of G. walkeri to be 10.90 pg. The significance of the XY/XX sex chromosomes of these marsupial frogs, the various classes of constitutive heterochromatin detected, and the data obtained from meiotic analyses are discussed in detail.

Influencia de las epidemias de poliomielitis sobre la rehabilitación en España (1949-1969) / Influence of poliomyelitis epidemics on rehabilitation in Spain (1949-1969)

La aparición de las epidemias de poliomielitis en España durante la década de los años cincuenta y principios de los sesenta, facilitó que se desarrollaran técnicas diagnósticas, terapéuticas y evaluadoras específicas de Rehabilitación. De otro lado, también surgió una nueva organización e institucionalización en torno a los cuidados de estos pacientes, se fomentó la formación del personal especializado en este ámbito y se creó una infraestructura tanto de recursos humanos como de instalaciones relacionadas con la especialidad de Rehabilitación. Además se favoreció que un colectivo de médicos se dedicara específicamente a los cuidados de reeducación y readaptación de los niños, constituyendo el germen de lo que actualmente comienza a conocerse como una supraespecialidad: la Rehabilitación infantil (AU)

X chromosomes of American marsupials contain minimal amounts of euchromatin.

The karyotypes of four South American didelphid marsupials, representing diploid numbers of 2n = 14 and 18, have been analyzed by a variety of banding techniques. The 2n = 14 karyotypes display a high degree of homoeology, but there also exist distinct similarities between the 2n = 14 and 2n = 18 karyotypes. The interspecific differences found are due to centric fissions, pericentric inversions, and variations in the amount and composition of the constitutive heterochromatin. Contrary to the evolutionary conservation of the banding patterns in all autosomal arms, there are multiple differences in the number and chromosomal location of the nucleolus organizer regions. In species with X-linked nucleolus organizers, the 18S + 28S ribosomal RNA genes escape inactivation in female cells. Measurements on the X chromosomes of Marmosa fuscata and Micoureus demerarae unexpectedly reveal the lowest quantities of euchromatin so far determined in the X chromosomes of mammals: 1.5% and 1.8%, respectively, of their haploid female genomes. This is significantly less than the amount of euchromatin in the basic X chromosomes of other marsupials (3%) or eutherians (5%).

Chromosome banding in Amphibia. XXVI. Coexistence of homomorphic XY sex chromosomes and a derived Y-autosome translocation in Eleutherodactylus maussi (Anura, Leptodactylidae).

A 15-year cytogenetic survey on one population of the leaf litter frog Eleutherodactylus maussi in northern Venezuela confirmed the existence of multiple XXAA male symbol /XAA(Y) female symbol sex chromosomes which originated by a centric (Robertsonian) fusion between the original Y chromosome and an autosome. 95% of the male individuals in this population are carriers of this Y-autosome fusion. In male meiosis the XAA(Y) sex chromosomes pair in the expected trivalent configuration. In the same population, 5% of the male animals still possess the original, free XY sex chromosomes. In a second population of E. maussi analyzed, all male specimens are characterized by these ancestral XY chromosomes which form normal bivalents in meiosis. E. maussi apparently represents the first vertebrate species discovered in which a derived Y-autosome fusion still coexists with the ancestral free XY sex chromosomes. The free XY sex chromosomes, as well as the multiple XA(Y) sex chromosomes are still in a very primitive (homomorphic) stage of differentiation. With no banding technique applied it is possible to distinguish the Y from the X. DNA flow cytometric measurements show that the genome of E. maussi is among the largest in the anuran family Leptodactylidae. The present study also supplies further data on differential chromosome banding and fluorescence in situ hybridization experiments in this amphibian species.

La asistencia rehabilitadora en España durante el período previo a su reconocimiento oficial (1949-1969) / Rehabilitating care in Spain during the period prior to its official recognition (1964-1969)

El período previo a la existencia oficial de una especialidad médica es un momento relevante en su historia porque es cuando se delimitan sus contenidos científicos y el ámbito de actuación de los profesionales de la nueva disciplina. Fue durante las décadas de los años cincuenta y sesenta cuando se impulsó esta actividad asistencial rehabilitadora, reconociéndose el 6 de Junio de 1969 la especialidad por el Ministerio de Educación y Ciencia (AU)

El desarrollo de la Rehabilitación en España (1949-1969) / The development of Rehabilitation in Spain (1949-1969)

La vida oficial de la especialidad médica de Rehabilitación en nuestro país es corta, se remonta tan sólo a treinta años. Durante las décadas de los años cincuenta y sesenta se desarrollaron una serie de contingencias que propiciaron la consolidación de la Rehabilitación como una nueva actividad médica especializada. En este trabajo vamos a situar y describir cómo era entendida la Rehabilitación, a quién iba dirigida, cómo se organizó esta actividad especializada y por qué se consideraba necesaria una nueva división de la labor médica en España durante las dos décadas previas a su reconocimiento oficial (AU)

Dietary fatty acids effects on sucrose-induced cardiovascular syndrome in rats.

Cardiovascular disease is one of the leading causes of morbidity and mortality in Mexico. We investigated the effects of omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids on the metabolic syndrome associated with cardiovascular disease in a high-sucrose-fed rat model. The metabolic syndrome-induced rats showed a significant increase in systolic blood pressure, serum insulin, nonfasting serum triglyceride and serum cholesterol levels. Experimental high-sucrose-fed animals received either a n-3 or n-6 enriched diet or a control diet during 6 weeks. Animals fed the n-3 enriched diet had a significant reduction in blood pressure and serum insulin and triglyceride levels. Serum triglyceride levels were also significantly reduced in the n-6-rich diet animals.

[Cardiac arrhythmias induced by short-time maximal dynamic exercise (sprint): a study in greyhounds]. / Arritmias cardíacas inducidas por el ejercicio dinámico máximo de corta duración (sprint): estudio en el galgo greyhound.

INTRODUCTION AND OBJECTIVES: Physical exercise causes a significant increase in the incidence of cardiac arrhythmias in athletes, basically when maximal capacity is approached and during the period of early recovery. In this study the incidence of cardiac arrhythmias consecutive to maximal exercise (sprint) was studied using racing greyhounds as a biomodel. METHODS: The study was done on 399 greyhounds taking part in programmed speed races at a greyhound track. For each animals two electrocardiograms where taken: the first before the race and the second between 90 and 150 seconds after finishing it. RESULTS: 112 cases of abnormal arrhythmias were found, 32 before racing, and 80 afterwards. Of these 80 post-effort cases, 80% did not present any abnormalities in cardiac rhythm before racing. Only cases of electrical alternans, electrical alternans + sinus tachycardia, ventricular extrasystoles, sinus tachycardia and ventricular tachycardia were due to non-random phenomena. CONCLUSIONS: Maximal physical exercise (sprint) provokes a significant increase (150%) in the incidence of abnormal cardiac arrhythmias during the period of early recovery: mainly electrical alternans, ventricular extrasystoles, sinus tachycardia and ventricular tachycardia. The class, sex, age, weight of greyhound and distance covered do not have a significant influence on the presentation of arrhythmias, except in cases of sinus tachycardia and distance.