Intraneural microcystic lymphatic malformation of the ulnar nerve at the Guyon canal: Unusual cause of ulnar pain in a child.

We present a case of an unusual cause of ulnar pain on a 9-year-old patient. The patient had pain on the ulnar side of the wrist after a fall. MRI showed a poorly defined lesion on the ulnar nerve at Guyon's canal. The initial diagnosis was traumatic neuropathy. Following conservative treatment of symptoms for one year, the pain started again. Therefore, a new MRI was performed where progression of the lesion was observed. Excision of the lesion was performed and the specimen sent for pathologic analysis. The diagnosis was of microcystic lymphatic malformation. The patient had a satisfactory evolution, with complete resolution. This is the first description of a microcystic lymphatic malformation in an intraneuronal location.

Síndrome del folículo vacío genuino: a propósito de un caso / Genuine empty follicle syndrome: Apropos of a case

El síndrome del folículo vacío es una situación en la cual, repetidamente, no se recuperan ovocitos durante la punción-aspiración folicular. Existen 2 tipos de síndrome del folículo vacío: el falso y el genuino. Se presenta el caso clínico de una paciente de 38 años con esterilidad primaria de un año de evolución. Ante un estudio básico de esterilidad normal, se realizaron 4 ciclos de IAC, que resultaron fallidos. Se decidió realizar FIV-ICSI, llevándose a cabo un total de 3 ciclos; el primero, protocolo de estimulación con análogo largo, y los ciclos restantes, protocolo de estimulación con antagonista. En todos los casos se constató la ausencia de errores en la medicación y unos niveles de gonadotropina coriónica humana óptimos. Se llega al diagnóstico de síndrome del folículo vacío genuino, pues a pesar de obtener un desarrollo folicular y niveles adecuados de gonadotropina coriónica humana prepunción, no se obtienen ovocitos durante la misma. La ovodonación actualmente es la mejor alternativa

Empty follicle syndrome is a situation in which there is repeated failure to retrieve oocytes during follicular puncture-aspiration. There are 2 types of empty follicle syndrome: false and genuine. We report the case of a 38-year-old woman with a one-year history of primary sterility. After basic study of normal sterility, the patient underwent 4 unsuccessful artificial insemination cycles. We decided to carry out IVF-ICSI, and the patient underwent a total of 3 cycles. A long-agonist protocol was used in the first stimulation and an antagonist protocol in the remaining 2. In all stimulations, we confirmed the absence of medication errors and optimal levels of human chorionic gonadotropin. A diagnosis of genuine empty follicle syndrome was made because no oocytes were obtained during aspiration despite obtaining follicular development and appropriate levels of human chorionic gonadotropin pre-puncture. Oocyte donation is currently the best alternative

Galectins: major signaling modulators inside and outside the cell.

Galectins control cell behavior by acting on different signaling pathways. Most of the biological activities ascribed to these molecules rely upon recognition of extracellular glycoconjugates and establishment of multivalente interactions, which trigger adaptive biological responses. However, galectins are also detected within the cell in different compartments, where their regulatory functions still remain poorly understood. A deeper understanding of the entire galectin signalosome and its impact in cell behavior is therefore essential in order to delineate new strategies to specifically manipulate both galectin expression and function. This review summarizes our current knowledge of the signaling pathways activated by galectins, their glycan dependence and the cellular compartment where they become activated and are biologically relevant.

Hemorragia subaracnoidea y embarazo / Subarachnoid hemorrhage and pregnancy

La incidencia de hemorragia subaracnoidea (HSA) parece aumentar durante el embarazo y origina un amplio grupo de problemas a resolver tales como la realización de pruebas de imagen con protección radiológica, la viabilidad del feto, la finalización del parto, el manejo neuroanestésico, los fármacos a utilizar y la decisión de intervención neuroquirúrgica. El diagnóstico y el tratamiento precoz de la HSA es fundamental para obtener buenos resultados tanto para la madre como para el feto y evitar complicaciones. Se exponen 3 casos de hemorragia intracraneal de aparición espontánea durante el embarazo que se registraron en el Hospital Virgen de las Nieves de Granada durante los años 2008-2010 (AU)

The incidence of subarachnoid hemorrhage increases during pregnancy and involvesa wide range of activities and issues such as the performance of imaging tests with radiological protection, assessment of fetal viability, termination of pregnancy, the patient’s anesthetic management, the drugs to be used, and neurosurgical intervention. Early diagnosis and treatment of this event are essential to obtain favorable outcomes for the mother and fetus and to avoid complications. We describe three cases of intracranial hemorrhage with spontaneous onset during pregnancy registered at the Virgen de las Nieves’ Hospital between 2008 and 2010 and provide a review of the topic (AU)

Rotura uterina en paciente con feto muerto anteparto y lupus eritematoso sistémico / Uterine rupture in a patient with intrauterine demise and systemic lupus erythematus

El Lupus Eritematoso Sistémico (LES) es una enfermedad autoinmune de causa desconocida que puede afectar a cualquier aparato o sistema del organismo ocasionando gran variedad de síntomas. Esta enfermedad es más frecuente en las mujeres en edad reproductiva. Secundigesta de 32 años diagnosticada de LES y mutación del gen del factor xii de la coagulación que recibe tratamiento con prednisona a baja dosis y heparina de bajo peso molecular. La gestación cursa sin hallazgos de interés hasta la semana 32 y 5 días, cuando la gestante nota ausencia de movimientos fetales y se evidencia óbito fetal. Se ingresa a la paciente y se inicia inducción del parto con misoprostol en dos dosis de 50 mcg separadas 4 horas; tras las que se inicia el parto. Se instaura analgesia epidural y finalmente se extrae mediante ventosa obstétrica un feto varón de 1.630 g sin anomalías aparentes. Tras el alumbramiento se produce sangrado profuso que no cesa y se evidencia rotura uterina de gran magnitud que precisa cierre laparotómico (AU)

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology that can affect any device or system in the body, causing a wide variety of symptoms. This disease is more frequent in women of reproductive age. We report the case of a 32-year-old secundigesta diagnosed with SLE and a mutation in the gene encoding coagulation factor XII, who received treatment with low-dose prednisone and low-molecular weight heparin. The pregnancy was uneventful until week 32 and 5 days, when the patient noted the absence of fetal movements and fetal death was detected. The woman was admitted to hospital for labor induction with two 50mg doses of misoprostol at a 4-hour interval. The mother received epidural analgesia and finally a 1630g boy with no anomalies was extracted through the use of an obstetric vacuum. After the birth, profuse continuous bleeding occurred and a large uterine rupture requiring laparotomic closure was detected (AU)

Clasificación radiológica y manejo de las lesiones mamarias / Radiological classification and management of breast lesions

La mamografía es el único método diagnóstico aceptado como técnica de despistaje para el cáncer de mama permitiendo su detección precoz y el único que ha demostrado una reducción de las tasas de mortalidad por cáncer de mama. El sistema Breast Imaging Reporting and Data System (BI-RADS) es un método para clasificar los hallazgos mamográficos que actualmente se considera el idioma universal en el diagnóstico de la patología mamaria. Permite estandarizar la terminología y la sistemática del informe mamográfico y categorizar las lesiones estableciendo el grado de sospecha y asignar la actitud a tomar en cada caso. En esta revisión se analizan los hallazgos mamográficos que configuran cada una de las categorías BIRADS así como las implicaciones pronósticas y forma de manejo más frecuente de cada una de ellas (AU)

Mammography is the only diagnostic method accepted as a screening technique in breast cancer, allowing early detection, and is the only method that has been shown to reduce mortality rates from breast cancer. The Breast Imaging Reporting and Data System (BI-RADS) is a method for classifying mammographic findings and is currently considered a universal language in the diagnosis of breast disease. This system allows terminology to be standardized, mammographic reports to be systematized and lesions to be categorized, thus establishing the degree of suspicion and the approach to be adopted in each case. The present review analyzes the mammographic findings that appear in each of the BI-RADS categories, as well as the prognostic implications and most frequent type of management in each category (AU)

Reversed-phase high-performance liquid chromatographic study of thimerosal stability in Cuban recombinant hepatitis B vaccine.

Non-degraded thimerosal was determined in the presence of its decomposition products by directly assaying recombinant hepatitis B vaccine using a reversed-phase liquid chromatographic method. Methanol-water-orthophosphoric acid (65:35:0.9, v/v/v) was used as the eluent. Salicylic acid was employed as an internal standard. The calibration graph was linear (r = 0.99995) up to 2.5 micrograms of thimerosal. Interference from aluminium hydroxide was eliminated by centrifugation. Good stability of thimerosal in the hepatitis B vaccine was demonstrated. The results obtained were in agreement with the recently proposed mechanism of degradation.