[Breast cancer metastases in the iris: does treatment modifies natural history of the illness?]. / Metástasis en iris de un carcinoma de mama: ¿modifica el tratamiento la historia natural de la enfermedad?

The 4-5% of the breast cancer patients have metastases in the eye. We present the case of a 30-year-old woman with an infiltrant duct carcinoma of the breast pT2N2M0 HER2 positive. Six months after primary radical treatment she had a systemic relapse with multiples metastatic sites, so several treatment with trastuzumab in combination with chemotherapy were started. After 4 years patient presented multiple white-coloured micronodules in the iris of the right eye. Only a 3-7.8% of ocular metastases are located in the iris. With mantenaince therapy with trastuzumab natural history of the illness has changed. Several studies had analyzed if metastases in the brain during treatment with trastuzumab have increased in comparison with the pretrastuzumab era. The infrequent presentation of metastases in the anterior uveal makes difficult to establish if it is an spontaneous fact or if it is favoured by trastuzumab treatment.

Metástasis en iris de un carcinoma de mama: ¿modifica el tratamiento la historia natural de la enfermedad? / Breast cancer metastases in the iris: does treatment modifies natural history of the illness?

El 4-5% de las pacientes con cáncer de mama presentan metástasis oculares. Presentamos a una mujer de 30 años con un carcinoma ductal infiltrante de mama pT2N2M0 HER2 positivo. A los seis meses de finalizar el tratamiento presentó una recaída sistémica con múltiples localizaciones metástaticas por lo que inició tratamientos combinados de trastuzumab mantenido y quimioterapia. Tras 4 años con trastuzumab de mantenimiento presenta en iris de ojo derecho multiples micronódulos blanquecinos. Solo un 3-7.8% de las metástasis oculares se localizan en el iris. Con la terapia mantenida con trastuzumab la historia natural de la enfermedad avanzada ha cambiado, diversos estudios analizaron si existe mayor frecuencia de metástasis cerebrales en pacientes tratados con trastuzumab que en la era pretrastuzumab. La infrecuente aparición de metástasis en úvea anterior hace difícil establecer si es un hecho espontáneo o si está favorecido por el tratamiento con trastuzumab

The 4-5% of the breast cancer patients have metastases in the eye. We present the case of a 30-year-old woman with an infiltrant duct carcinoma of the breast pT2N2M0 HER2 positive. Six months after primary radical treatment she had a systemic relapse with multiples metastaticsites, so several treatment with trastuzumab in combination with chemotherapy were started. After 4 years patient presented multiple white-coloured micronodules in the iris of the right eye. Only a 3-7.8% of ocular metastases are located in the iris. With mantenaince therapy with trastuzumab natural history of the illness has changed. Several studies had analyzed if metastases in the brain during treatment with trastuzumab have increased in comparison with the pretrastuzumab era.The infrequent presentation of metastases in the anterior uveal makes difficult to establish if it is an spontaneous fact or if it is favoured by trastuzumab treatment

[Fitting hearing aids in early childhood based on auditory evoked potentials in steady states]. / La adaptación audioprotésica pediátrica precoz a partir de registros de potenciales evocados auditivos de estado estable.

The purpose of the Newborn Hearing Screening Program is to achieve early. Identification and appropriate intervention for hearing loss. Hearing aids are the most frequent intervention for deafness. Paediatric specific clinical protocols for fitting hearing aids always recommend accurate characterisation of hearing thresholds in newborns. In this sense, electrophysiological procedures are specially indicated in determined hearing sensibility from the first age of life since it is an objective and reliable procedure. 20 normal hearing subject and 17 hearing loss subjects participated in this study. Auditory Steady State Responses (ASSR) were obtained from all of them. Hearing aid fitting was established from the electrophysiological responses. Dynamic range, gain, compression ratio and maximum output of the hearing aid were obtained from the intensity amplitude function of the ASSR. The procedure discussed in this study is specially indicated in newborns and very young children in which other test are not suitable.

La adaptación audioprotésica pediátrica precoz a partir de registros de potenciales evocados auditivos de estado estable / Fitting hearing aids in newborns from auditory steady state responses

La detección temprana del defecto auditivo tiene sentido en la medida que puede conllevar la intervención precoz mediante sistemas de corrección auditiva. La prótesis auditiva es el procedimiento de habilitación sonora más frecuente. Los protocolos de adaptación audioprotésicos específicamente pediátricos exigen la caracterización de la sensibilidad auditiva de la forma más precisa posible. Las técnicas de registro electrofisiológico están especialmente indicadas en la determinación del umbral auditivo desde los primeros meses de la vida por su objetividad, fiabilidad y validez. En este estudio participaron 20 participantes normoyentes y 17 hipoacúsicos de corta edad. Se obtuvieron registros de Potenciales Evocados Auditivos de Estado Estable (PEAee) en ambos grupos. A partir de estos registros se estimaron los parámetros de ajuste y reglaje de las adaptaciones audioprotésicas llevadas a cabo en el grupo de niños hipoacúsicos. Los resultados de este estudio sugieren que los parámetros de ajuste de las adaptaciones audioprotésicas pueden determinarse directamente a partir de respuestas electrofisiológicas. La relación entre la intensidad de estimulación y la amplitud de los PEAee permite establecer el rango dinámico, ganancia, compresión y limitación de salida de la prótesis auditiva. Este procedimiento está especialmente indicado en recién nacidos y niños de corta edad en el que otro tipo de pruebas no pueden ser llevadas acabo

The purpose of the Newborn Hearing Screening Program is to achieve early. Identification and appropriate intervention for hearing loss. Hearing aids are the most frequent intervention for deafness. Paediatric specific clinical protocols for fitting hearing aids always recommend accurate characterisation of hearing thresholds in newborns. In this sense, electrophysiological procedures are specially indicated in determined hearing sensibility from the first age of life since it is an objective and reliable procedure. 20 normal hearing subject and 17 hearing loss subjects participated in this study. Auditory Steady State Responses (ASSR) were obtained from all of them. Hearing aid fitting was established from the electrophysiological responses. Dynamic range, gain, compression ratio and maximum output of the hearing aid were obtained from the intensity amplitude function of the ASSR. The procedure discussed in this study is specially indicated in newborns and very young children in which other test are not suitable

In vitro percutaneous penetration of acyclovir from solvent systems and Carbopol 971-P hydrogels: influence of propylene glycol.

The mechanism underlying propylene glycol (PG) effects on acyclovir (ACV) penetration through human epidermis were studied. Solvent systems and Carbopol gels containing increasing percentage of PG (from 0% to 70%, w/w) were used. Viscosity studies of both vehicles were carried out to characterise the influence of rheological behaviour. In solvent systems skin permeation values of ACV increase as the concentration of PG increase yielding a maximum enhancement ratio (ER = 10) for 70% PG. The release rate of ACV from gels was determined. Higuchi's model was used to estimate the apparent diffusion coefficient of the drug. These values show a decrease as the content of PG in the vehicle increases; this effect could be attributed to the increase of the viscosity in the diffusional pathway. When gels are used skin permeation values of ACV were smaller than those of the solvent systems. This could be attributed to the network structure created by the polymer that increases the length of the diffusional pathway. The maximum ER (= 6.8) was for Carbopol gel containing 50% PG. Therefore, these gels can be considered candidates for further research to confirm their usefulness as delivery systems for ACV topical formulations.

Enfermedad diverticular: revisión histórica y estado actual / Diverticular disease: historical review and current situation

Introducción. La enfermedad diverticular del colon presenta una incidencia elevada en los países occidentales. El presente trabajo se propone llevar a cabo tanto una revisión histórica como del estado actual de las actuaciones diagnósticas y del tratamiento en sus diferentes estadios. Material y métodos. Para la revisión bibliográfica se ha recurrido a la búsqueda a través de Medline de las publicaciones previas. Resultados y conclusión. La enfermedad diverticular presenta una clara relación con la dieta pobre en fibra. En el diagnóstico de diverticulitis aguda no deben emplearse métodos invasivos (enema opaco, fibrocolonoscopia) por el riesgo de complicaciones que conllevan, siendo preferible los métodos de imagen (tomografía axial computarizada; ecografía abdominal). El enema opaco y la fibrocolonoscopia son útiles en el estudio de la enfermedad en fase no aguda y para el diagnóstico diferencial. El tratamiento de la diverticulitis aguda no complicada es médico en los primeros episodios y quirúrgico en los casos recidivantes, siendo preferible la cirugía programada en un solo tiempo. Los abscesos abdominales pueden tratarse mediante punción guiada por ecografía o TAC, permitiendo así realizar la cirugía en un segundo tiempo, cuando ha remitido la fase aguda. La cirugía laparoscópica puede suponer una vía de abordaje en el tratamiento de la diverticulitis aguda no complicada (AU)

Traumatic intrapericardial diaphragmatic hernia: case report and literature review.

A traumatic rupture of the diaphragm, with herniation of the abdominal viscera into the thoracic cavity, is relatively rare, being observed in approximately 3-7% of all abdominal or thoracic traumas [1]. Herniation into the pericardium is very rare [2]. We have reviewed the post-traumatic intrapericardial diaphragmatic hernias (TIPDH) published in the world literature within our reach and, as it was already stated in the review carried out by Van Loenhout et al. [3] in 1986, approximately one post-traumatic intrapericardial hernia is reported every year. The patient that we present makes case 82 of those published until October of 1999.

Evaluation of the elastic behaviour of central venous PVC, polyurethane and silicone catheters.

Eighty used and 20 new silicone, polyurethane and polyvinylchloride central venous catheters were tested to establish the Young's modulus and the bending stiffness of the catheters and their introducers. The catheters were subjected to longitudinal traction forces and their lengthening measured. Young's modulus and the geometric moment of inertia were then calculated. It is shown that polyurethane catheters show least variation in their elastic characteristics, and that silicone catheters offer least resistance to bending and do not change their elastic properties after use. All catheters were equally unlikely to cause thrombus production if this is related to excessive bending stiffness.