Fundus autofluorescence: applications and perspectives.

PURPOSE: To describe the findings of the study of autofluorescence of the different retinal diseases included in the study. To determine in which diseases autofluorescence may be more, or just as, useful as fluorescein angiography (FAG) in terms of diagnostic information. MATERIAL AND METHODS: We studied the retinal autofluorescence of 123 eyes of 93 patients, including various diseases of the eye fundus. In all cases we explored the fundus, retinal autofluorescence, and, if indicated, FAG was performed. Analysis of the autofluorescence was performed using the Heidelberg Retina angiography Angiograph 2 (HRA2) Heidelberg Engineering (Germany). RESULTS: The autofluorescence information provided was equal or better (than FAG) in: 68.18% of cases of macular edema, 50% of pigment epithelium detachments, 100% of pigment epithelium atrophies, 100% of central serous chorioretinopathy; 55.55% of choroidal neovascularization, 100% of retinal dystrophies with deposition of lipofuscin, 100% of hard exudates and pre-retinal hemorrhages. CONCLUSIONS: Autofluorescence is a quick and non-invasive examination method, comfortable for both patient and examiner, and with a very short learning curve. It provides diagnostic information about many eye fundus diseases. While more studies and more experience with its use are needed, its interest lies in the possibility of avoiding the performing of angiography in patients with these diseases, and in the additional information autofluorescence provides about the functional situation of cells and retinal pigments.

Autofluorescencia retiniana: aplicaciones y perspectivas / Fundus autofluorescence: applications and perspectives

Objetivos: Describir los hallazgos en el estudio de la autofluorescencia de las distintas enfermedades retinianas incluidas en el estudio. Estudiar en qué enfermedades la autofluorescencia puede ser igual o superior a la angiografía fluoresceínica (AGF) en cuanto a información diagnóstica. Material y métodos: Se estudió la autofluorescencia retiniana de 123 ojos y pacientes, incluyendo diversas enfermedades del fondo de ojo. En todos los casos se exploró el fondo de ojo, la autofluorescencia retiniana, y, en caso de estar indicado, se realizó AGF. La exploración de la autofluorescencia fue llevada a cabo usando el angiógrafo Heidelberg Retina Angiograph 2 (HRA2) de Heidelberg Engeneering (Alemania). Resultados: La autofluorescencia aportó una información igual o mejor (que la AGF) en: 68,18% de casos de edema macular; 50% de desprendimientos del epitelio pigmenario; 100% de atrofias del epitelio pigmentario; 100% de coriorretinopatías centrales serosas; 55,55% de neovascularizaciones coroideas; 100% de las distrofias retinianas con depósito de lipofucsina; 100% de los exudados duros y hemorragias prerretinianas. Conclusiones: La autofluorescencia es un método de exploración rápido, cómodo para el paciente y explorador, no invasivo y con una curva de aprendizaje muy corta, que aporta información para el diagnóstico de múltiples enfermedades con afectación del fondo de ojo. Si bien son precisos más estudios y más experiencia con su uso, su interés radica en la posibilidad de evitar la realización de angiografías en pacientes con estas enfermedades y en la información adicional que nos aporta sobre la situación funcional de las células y pigmentos retinianos(AU)

Purpose: To describe the findings of the study of autofluorescence of the different retinal diseases included in the study. To determine in which diseases autofluorescence may be more, or just as, useful as fluorescein angiography (FAG) in terms of diagnostic information. Material and methods: We studied the retinal autofluorescence of 123 eyes of 93 patients, including various diseases of the eye fundus. In all cases we explored the fundus, retinal autofluorescence, and, if indicated, FAG was performed. Analysis of the autofluorescence was performed using the Heidelberg Retina angiography Angiograph 2 (HRA2) Heidelberg Engineering (Germany) .Results: The autofluorescence information provided was equal or better (than FAG) in: 68.18% of cases of macular edema, 50% of pigment epithelium detachments, 100% of pigment epithelium atrophies, 100% of central serous chorioretinopathy; 55.55% of choroidal neovascularization, 100% of retinal dystrophies with deposition of lipofuscin, 100% of hard exudates and pre-retinal hemorrhages. Conclusions: Autofluorescence is a quick and non-invasive examination method, comfortable for both patient and examiner, and with a very short learning curve. It provides diagnostic information about many eye fundus diseases. While more studies and more experience with its use are needed, its interest lies in the possibility of avoiding the performing of angiography in patients with these diseases, and in the additional information autofluorescence provides about the functional situation of cells and retinal pigments(AU)

Comparación de la ingesta de energía y nutrientes en adolescentes mujeres con sobrepeso y obesidad / Comparison of energy and nutrients intake in female adolescents with overweight and obesity

Introducción: El sobrepeso y la obesidad son consecuencia de una modificación de los patrones dietarios y de una actitud cada vez más sedentaria. Objetivos: Comparar la ingesta de energía y nutrientes de adolescentes mujeres con sobrepeso y obesidad. Diseño: Estudio transversal, observacional y analítico. Lugar: Centro Educativo de la zona urbana de Lima. Participantes: Adolescentes entre 10 a 18 años. Intervención: Se estudió 100 adolescentes con sobrepeso y 87 con obesidad. El diagnóstico se hizo mediante el índice de masa corporal (IMC), con la población de referencia de la Organización Mundial de la Salud (OMS) y con los niveles de corte entre 85 y 95 percentil para sobrepeso y más de 95 para obesidad. La evaluación de la cantidad de energía y de nutrientes se realizó mediante un cuestionario de frecuencia semicuantitativo, utilizando la Tabla Peruana de Composición de Alimentos y la del Departamento de Agricultura de los EE UU. Para el porcentaje de adecuación de la energía y para la identificación cuantitativa de la ingesta de vitaminas y mineral se utilizó las recomendaciones de la FAO. El análisis estadístico se hizo con la prueba t-Student para comparación de medias. Principales medidas de resultados: Energía ingerida, adecuación de los nutrientes, cantidad de vitaminas y minerales ingeridos, de acuerdo a los grupos estudiados. Resultados: No hubo diferencia de la ingesta de energía entre los grupos estudiados, y estos valores fueron menores que los requerimientos. La adecuación porcentual mostró que el consumo de las grasas estuvo por debajo del requerimiento; lo mismo sucedió con las grasas saturadas, monoinsaturadas y poliinsaturadas; sin embargo, lo que más se consumió fue la grasa saturada. En cuanto a las vitaminas y minerales, fueron ingeridas en cantidades que cubrían los requerimientos, a excepción de los folatos. La ingesta de fibra fue muy pobre. Conclusiones: Se puede afirmar que el consumo de energía en ambos grupos fue por debajo de su requerimiento, por lo que se podría asumir que la causa de la presencia de estas enfermedades responda a una muy poca actividad física. Por otro lado, el principal problema en la alimentación de este grupo fue la deficiencia en la ingesta de fibra dietaria, de grasa y de folatos.

Introduction: Overweight and obesity result from change in dietary patterns and increasingly sedentary attitude. Objectives: To compare the energy and nutrient intake in female adolescents with overweight and obesity. Design: Cross-sectional, observational and analytical study. Location: Lima’s urban area Education Center. Participants: Adolescents aged 10 to 18 years. Interventions: One hundred overweight adolescents and 87 obese adolescents were studied. Diagnosis was done by body mass index (BMI) with the World Health Organization (WHO) reference population and cutoff levels between 85 and 95 percentile for overweight and over 95 for obesity. Amount of energy and nutrients was determined by a semi quantitative food frequency questionnaire using the Peruvian Table for Food Composition and the Table of the USA Department of Agriculture. FAO recommendations were used to determine the adequate percentage of energy and the quantitative identification of vitamin and mineral intake. Statistical analysis used Student t-test to compare measures. Main outcome measures: Energy intake, ingested nutrients, vitamins and minerals adequacy according to the study groups. Results: There was no difference in energy intake between the groups studied, and these values were lower than requirements. Adequacy of fat consumption, saturated, monounsaturated and polyunsaturated fats was below requirements; however saturated fat was more consumed. The amount of vitamins and minerals ingested covered requirements except for folates. Fiber intake was very poor. Conclusions: Neither group exceeded energy requirements, so it could be assumed that cause of these conditions was very little physical activity. On the other hand the main problem was dietary fiber, fat and folate intake deficiency.

Liposucción con diodo láser 980-nm (LSDL 980-nm): optimización de protocolo seguro en cirugía de contorno corporal / Body contouring using laser diode 980-nm (LSDL 980-nm) assisted lipolysis: a safe procedure

La disponibilidad en el mercado de una gran gama de equipos de láser de diferentes potencias y longitudes de onda para su aplicación en el tejido graso, así como la existencia de diversos trabajos científicos sobre el tema con resultados opuestos, han causado gran confusión y dudas sobre la técnica de láser-lipolisis entre los cirujanos plásticos. Presentamos un protocolo quirúrgico de liposucción condiodo-láser de 980-nm (LSDL 980-nm) aplicado en 240 pacientes. Evaluamos la seguridad de la técnica según el índice de complicaciones sufrido, así como la evolución en el post-operatorio de los pacientes tratados. Empleamos un equipo diodo-láser-980 nm (ORlight ®), cuya energía llevamos a través de una fibra de 600 µm. Esto se traduce en la aplicación de 99 J por cada cm2de área tratada, con un espesor de hasta 4 cm de tejido adiposo subcutáneo. No tuvimos complicaciones mayores, tipo quemaduras y entre las complicaciones menores, que fueron de un 48.33%(116 pacientes), encontramos equímosis mínimas (menos del 2% de superficie corporal). El tiempo que los pacientes requirieron para controlar el dolor postoperatorio fue de entre 1 y 2 días. Consideramos importante la incorporación de la LSDL-980 nm por ser una técnica menos traumática y con bajo índice de complicaciones, que reduce el periodo de recuperación de los pacientes, provoca una importante retracción de la piel y disminuye el dolor postoperatorio (AU)

The availability of multiple laser systems on the market with different power and wavelengths and the existence of several scientific papers with contradictory presents, have created great confusion and doubts among plastic surgeons with regard to the laser lipolysis technique. We report a surgical protocol for liposuction diodelaser-980 nm (LSDL-980 nm) applied to 240 patients. We evaluate the security of the technique according to the complication rate and the postoperative development of patients submitted to the technique We use a diode laser-980 nm (ORlight®), transporting its energy through a 600 µm fiber. This concludes in the aplication of 99 J per cm2of treated area with a width of until 4 cm of subcutaneous adipose tissue. All the complications were considered minor or nonexistent. Within the minor complications that were 48.33% (116 patients)most cases presented minimum echymosis (less than 2%of the body surface). The time required to control pain was between 1 and 2 days, depending on the procedure. We consider important to incorporate the LSDL 980-nm in clinical practice because it is a less traumatic technique with a low rate of minor complications, significant skin retraction, short recuperation period and less postoperative pain (AU)

Multiple infection with resistant and sensitive M. tuberculosis strains during treatment of pulmonary tuberculosis patients.

OBJECTIVE: To identify multiple infection events during anti-tuberculosis treatment in a cohort of pulmonary tuberculosis (PTB) patients in a local hospital in Callao, Peru. DESIGN: We evaluated 10 patients with smear-positive PTB who had two or more different isolates available during DOTS treatment. We determined drug susceptibility to rifampicin, isoniazid, ethambutol and streptomycin, and performed molecular sub-typing by restriction fragment length polymorphism (RFLP) and PCR. RESULTS: Drug susceptibility patterns changed from sensitive to resistant in the first and subsequent isolate of three of 10 patients. This change coincided with a dramatic alteration of their DNA fingerprint profile. We ruled out the possibility of cross-contamination or potential labelling errors. CONCLUSION: We found multiple infections with sensitive and resistant strains of Mycobacterium tuberculosis throughout the same treatment scheme in three patients with PTB. Further studies are needed to determine the frequency of exogenous re-infection and simultaneous/ mixed infection and their impact on TB control in Peru.

Down the tube: pollinators, predators, and the evolution of flower shape in the alpine skypilot, Polemonium viscosum.

We address how a conflict between pollinator attraction and avoidance of flower predation influences the evolution of flower shape in Polemonium viscosum. Flower shape in P. viscosum is the product of an isometric relationship between genetically correlated (rA = 0.70) corolla flare and length. Bumblebee pollinators preferentially visit flowers that are more flared and have longer tubes, selecting for a funnel-shaped corolla. However, flower shape also influences nectar-foraging ants that sever the style at its point of attachment to the ovary. Surveys of ant damage show that plants having flowers with flared, short corollas are most vulnerable to ant predation. Consistent with this result, the ratio of corolla length to flare is significantly greater in a krummholz (high predation risk) population than in a tundra (low predation risk) population. To explicitly test whether the evolution of a better defended flower would exact a cost in pollination, we created tubular flowers by constricting the corolla during development. Performance of tubular flowers and natural controls was compared for defensive and attractive functions. In choice trials, ants entered control flowers significantly more often than tubular ones, confirming that the evolution of tubular flowers would reduce the risk of predation. However, in a bumblebee-pollinated population, tubular flowers received significantly less pollen and set fewer seeds than controls. A fitness model incorporating these data predicts that in the absence of the genetic correlation between corolla length and flare, intermittent selection for defense could allow tubular flowers to spread in the krummholz population. However, in the tundra, where bumblebees account for nearly all pollination, the model predicts that tubular flowers should always confer a fitness disadvantage.

Albendazole therapy for neurocysticercosis: a prospective double-blind trial comparing 7 versus 14 days of treatment. Cysticercosis Working Group in Peru.

OBJECTIVE: To compare the effectiveness of two regimens of albendazole therapy for neurocysticercosis. DESIGN: Randomized, double-blind clinical trial. SETTINGS: Patients admitted to neurologic wards in Lima, Peru. PATIENTS: Adult patients with active neurocysticercosis demonstrated by CT and Western blot (immunoblot). INTERVENTION: One week (n = 25) versus 2 weeks (n = 25) of albendazole therapy. MEASUREMENTS: Decrease in the number of cysts on CT. RESULTS: Effectiveness of albendazole was 78%, with no difference between the groups when compared 3 months after therapy. Complete cure was obtained in only 38% of patients. Patients with more than 20 cysts had poorer responses to therapy. The clinical course and EEG evolution improved in most patients. Side effects were present in 38% of patients, mainly mild, transient gastrointestinal symptoms. Therapy was also associated with exacerbation of neurologic symptoms. Two patients died in the first year after therapy, both because of aggregated infections of ventricle-peritoneal shunts. One-year follow-up CT showed lesions in three of 10 patients presumed to be cured 3 months after therapy. CONCLUSIONS: Extension of albendazole therapy for more than 7 days adds no benefits for the patients.

Recovery of adrenal function after treatment of paracoccidioidomycosis.

In endemic areas, the systemic mycosis paracoccidioidomycosis (PCM) is the most frequent etiology of Addison's disease. Paracoccidioides brasiliensis, the causative agent of PCM, exhibits a high tropism for the adrenal glands, which results in a low hormone reserve and in more severe cases, in symptoms of primary adrenal insufficiency. In these cases, the hormone deficit is usually treated with replacement corticoid therapy for the rest of the patient's life. Recently, we identified three patients with disseminated PCM who had adrenal insufficiency; one of them had Addison's disease. All showed complete recovery of adrenal function after a 1-2-year period of specific therapy with ketoconazole or sulfonamides. Plasma cortisol levels were determined by radioimmunoassay of baseline blood samples, as well as those taken after the rapid stimulation test with synthetic adrenocorticotrophic hormone, and before and after the antifungal therapy.

La papaverina intracavernosa versus Doppler como métodos diagnósticos en la impotencia sexual / Intracavernous papaverine vs Doppler as a diagnosis methods in sexual impotence

Resultado del estudio de 62 pacientes con disfunción eréctil, que incluye historia clínica, examen físico y de laboratorio y registro de los resultados de la aplicación intracavernosa de 60 mg de hidrocloruro de papaverina. Se llevó anotación del inicio, intensidad y duración de la erección, las complicaciones inmediatas, los hallazgos de la cavernosografía estática, así como los resultados del Doppler; estos se correlacionaron con los datos obtenidos con el diagnóstico etiológico de la disfunción eréctil.

[A progressive case of ataxia in a family of Huntington's chorea]. / Un cas d'ataxie progressive dans une famille de chorée de Huntington.

One case of ataxic, pyramidal and demential syndrome associated with retinitis pigmentosa occurred in a family with Huntington's disease (36 patients among 7 generations). The disease started at 15 years of age. Ataxia was transiently attenuated by isoniazid. The patient died of the disease at 26 years of age.

[An evaluation of transesophageal atrial pacing for studying the use-dependence effect of anti-arrhythmia drugs]. / Evaluación de la sobreestimulación auricular transesofágica para el estudio del efecto uso-dependencia de las drogas antiarrítmicas.

Use-dependent effect is characteristic of certain antiarrhythmic drugs, mainly those included in Group I of Vaughan-Williams classification. There is an increasing interest in the study of this phenomenon in order to correlate it with the potential arrhythmogenic effect of currently used antiarrhythmic drugs. Use-dependent effect produces widening of the QRS ECG complex as the heart rate is increased. Thus, to produce the necessary changes in heart rate to clinically disclose this phenomenon, endocardial stimulation of the right ventricle is usually done both in control condition and under the effect of the tested drug. As this is an invasive method, the amount of information collected on this important aspect of the antiarrhythmic drug effects has been limited. Hence, we decided to confirm whether transesophageal cardiac pacing is a suitable method to produce controlled changes of the heart rate in order to analyse the use-dependent phenomenon. In this study we included 14 patients, 9 women and 5 men aged 47.85 +/- 13.91 years and ejection fraction of 54.64 +/- 7.19%. Transesophageal stimulation was performed up to the Wenckebach point and the previous rate producing 1:1 A-V response was considered. ECG was recorded in an ink-jet three-channel electrocardiograph at 100 mm/sec chart speed and QRS duration was measured. All patients were studied in the basal unsedated state, free of any medication and after the administration of 3.13 +/- 0.74 mg/kg of flecainide during 4.07 +/- 1.4 days. Atrial capture was obtained with pulses of 15 mA and 18 msec. Heart rate attained before treatment was 150 +/- 21.83 bpm and 144.28 +/- 19.88 bpm under the effect of flecainide (p = NS) (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluación de la sobreestimulación auricular transesofágica para el estudio del efecto uso-dependencia de las drogas antiarrítmicas. / [An evaluation of transesophageal atrial pacing for studying the use-dependence effect of anti-arrhythmia drugs]

Use-dependent effect is characteristic of certain antiarrhythmic drugs, mainly those included in Group I of Vaughan-Williams classification. There is an increasing interest in the study of this phenomenon in order to correlate it with the potential arrhythmogenic effect of currently used antiarrhythmic drugs. Use-dependent effect produces widening of the QRS ECG complex as the heart rate is increased. Thus, to produce the necessary changes in heart rate to clinically disclose this phenomenon, endocardial stimulation of the right ventricle is usually done both in control condition and under the effect of the tested drug. As this is an invasive method, the amount of information collected on this important aspect of the antiarrhythmic drug effects has been limited. Hence, we decided to confirm whether transesophageal cardiac pacing is a suitable method to produce controlled changes of the heart rate in order to analyse the use-dependent phenomenon. In this study we included 14 patients, 9 women and 5 men aged 47.85 +/- 13.91 years and ejection fraction of 54.64 +/- 7.19

. Transesophageal stimulation was performed up to the Wenckebach point and the previous rate producing 1:1 A-V response was considered. ECG was recorded in an ink-jet three-channel electrocardiograph at 100 mm/sec chart speed and QRS duration was measured. All patients were studied in the basal unsedated state, free of any medication and after the administration of 3.13 +/- 0.74 mg/kg of flecainide during 4.07 +/- 1.4 days. Atrial capture was obtained with pulses of 15 mA and 18 msec. Heart rate attained before treatment was 150 +/- 21.83 bpm and 144.28 +/- 19.88 bpm under the effect of flecainide (p = NS) (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluación de la sobreestimulación auricular transesofágica para el estudio del efecto uso-dependencia de las drogas antiarrítmicas. / [An evaluation of transesophageal atrial pacing for studying the use-dependence effect of anti-arrhythmia drugs]

Use-dependent effect is characteristic of certain antiarrhythmic drugs, mainly those included in Group I of Vaughan-Williams classification. There is an increasing interest in the study of this phenomenon in order to correlate it with the potential arrhythmogenic effect of currently used antiarrhythmic drugs. Use-dependent effect produces widening of the QRS ECG complex as the heart rate is increased. Thus, to produce the necessary changes in heart rate to clinically disclose this phenomenon, endocardial stimulation of the right ventricle is usually done both in control condition and under the effect of the tested drug. As this is an invasive method, the amount of information collected on this important aspect of the antiarrhythmic drug effects has been limited. Hence, we decided to confirm whether transesophageal cardiac pacing is a suitable method to produce controlled changes of the heart rate in order to analyse the use-dependent phenomenon. In this study we included 14 patients, 9 women and 5 men aged 47.85 +/- 13.91 years and ejection fraction of 54.64 +/- 7.19

. Transesophageal stimulation was performed up to the Wenckebach point and the previous rate producing 1:1 A-V response was considered. ECG was recorded in an ink-jet three-channel electrocardiograph at 100 mm/sec chart speed and QRS duration was measured. All patients were studied in the basal unsedated state, free of any medication and after the administration of 3.13 +/- 0.74 mg/kg of flecainide during 4.07 +/- 1.4 days. Atrial capture was obtained with pulses of 15 mA and 18 msec. Heart rate attained before treatment was 150 +/- 21.83 bpm and 144.28 +/- 19.88 bpm under the effect of flecainide (p = NS) (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Estado de indiferencia en la disquinesia tardía (a propósito de 8 casos) / State of indiference in diskinesia tardive

La Disquinesia Tardía (D.T) es un síndrome de frecuente observación en la clínica neuropsiquiátrica, que se presenta de preferencia después de los 40 años y que se caracteriza por movimientos que toman fundamentalmente la cara, cuello y miembros superiores y afectan la marcha. Estos movimientos toman el aspecto de un síndrome coreoatetósico o parkinsoniano. El transtorno fundamental es bioquímico y se debería a una sobreactividad dopaminérgica relativa. El tratamiento consiste en suprimir el agente causal y adicionar drogas que disminuyan la actividad dopaminérgica o que estimulen los sistemas colinérgicos. Nosotros presentamos 8 observaciones en las cuales el síntoma predominante es la falta de interés, de comunicación con el personal, indiferencia con su entorno y los movimientos involuntarios. Estas manifestaciones parecen corresponder al denominado síndrome `anthymohornico' de Habid o más propiamente dicho es estado de pérdida de `automotivación psiquica' de Laplane; así quizás la patología psiquiátrica debe buscarse además con la patología del Sistema Estriado

El síndrome de Melkersson y Rosenthal / Melkersson Rosenthal Syndrome

A propósito de una paciente de 62 quien sufre, primero de una parálisis facial periférica derecha, dolorosa y con edema; pronto el síndrome se extiende al lado izquierdo. No se observó "lingua plicata", pero sí hiperreflexia osteotendinosa y en la E.M.G.: Signos de denervación de ambos faciales y de los nervios cubitales. Se recuerdan las principales teorías etiológicas y se sostiene que nuestra observación podría corresponder a la etiología neurogénica. Se revisan los síntomas fundamentales: parálisis facial periférica, recidivante o bilateral; edema, que precede, acompañan o es posterior a la PFP., y puede aparecer, aún en lugares distantes y la lengua plisada, signo inconstante. En fin, se señala la importancia de la electromiografía y de la biopsia y se piensa que ésta es una enfermedad sistémica que se expresa, entre otro, por parálisis facial periférica con edema

Computed tomography and ultrasonography of the adrenal glands in paracoccidioidomycosis. Comparison with cortisol and aldosterone responses to ACTH stimulation.

Fifteen patients with proven disseminated paracoccidioidomycosis (PCM) had computed tomography (CT) and ultrasonography (US) performed to evaluate the form, shape, density and size of their adrenal glands. Plasma and urinary cortisol were determined and adrenal reserve assessed by measuring the cortisol and aldosterone responses to synthetic ACTH. The adrenal CT showed unilateral lesions in two cases and bilateral in another four. The US study showed more frequent alterations, unilateral in seven and bilateral in three subjects. Combining both methods increased the sensitivity to 85% of the cases. All patients had normal plasma cortisol concentrations and normal or increased urinary cortisol excretion. Plasma aldosterone concentration was also normal except in one patient with hypokalemia. Seven patients showed diminished cortisol responses, five had subnormal aldosterone responses and in five plasma aldosterone concentration increased more than normally after stimulation by ACTH. There was an incidence of limited adrenal reserve in 53% of the patients on ACTH stimulation. No correlation was evident between the disorders in adrenal steroid responses to ACTH and changes in morphology revealed by CT and/or US.

Estudio de una familia con Corea de Huntington en Cañete / Study of a family with Huntington's Chorea in Cañete

De 14 familias con Corea de Huntington (C.H.) identificadas en el Valle de Cañete, se estudia una, integrada por 392 personas y en la que se encuentra 30 pacientes; 16 hombres y 14 mujeres, y 2 sospechosos. La enfermedad habría aparecido en esta familia hace 120 a 150 años. Los apellidos y los rasgos físicos corresponden todos a mestizos. Se recomienda el estudio de las tres últimas generaciones, compuestas por sujetos menores de 30 años. Se considera que a partir del Valle de Cañete se habría extendido la Corea de Huntington en el Perú. En el presente trabajo no se estudiaron los aspectos psiquiátricos de la enfermedad