Conocimiento de las tendencias de ataques rivales en el bloqueo de voleibol / Knowledge of Opposition Attacking Tendencies on Volleyball Blocking

El objetivo del estudio fue investigar los efectos de proporcionar información probabilística, obtenida del análisis en vídeo de las tendencias de pase de las colocadoras oponentes, sobre el rendimiento en el bloqueo de una jugadora de alto nivel de voleibol. Se analizó su tiempo de reacción, toma de decisión y calidad de ejecución durante 1117 acciones de bloqueo realizadas en 18 partidos de competición, antes y después de recibir esa información contextual de los ataques rivales. Los resultados revelaron que la bloqueadora reaccionó antes (p < .001) en aquellos partidos que recibió información sobre las tendencias de pase de las colocadoras oponentes. En cambio, esta información contextual no tuvo influencia sobre sus decisiones, ni en la calidad de ejecución de sus movimientos. Estos resultados refuerzan el uso de información probabilística como una estrategia competitiva para iniciar antes una respuesta preparatoria a la acción de bloqueo en voleibol de alto nivel. (AU)

The aim of the study was to investigate the effects of providing probabilistic information, obtained from video-performance analytics on passing direction tendencies in opposing volleyball setters, on blocking performance in a high skilled female volleyballer. Data on reaction times, decision-making and quality of movement execution of the skilled blocker were analyzed during 1117 blocking actions in 18 competitive matches, before and after receiving information from the passing tendencies of opposition setters. Results revealed that the blocker reacted significantly earlier in those matches when she received information about opposition pass direction tendencies. No effects of contextual information were found for the blocker´s decisions and quality of movement execution. These results reinforced the use of probabilistic information as a competitive strategy for initiating an early preparatory response to the blocking action in high-skill levels of volleyball. (AU)

Paronychia argentea Lam. protects renal endothelial cells against oxidative injury.

ETHNOPHARMACOLOGICAL RELEVANCE: Paronychia argentea Lam. (Arabic tea), a species spontaneously growing in the Mediterranean area, has been used in folk medicine for renal diseases. AIM OF THE STUDY: To assess the antioxidant and protective potentials of different extracts from P. argentea in the renal endothelial NRK-52E cell line by several in vitro models, including a H2O2-induced oxidative stress model. MATERIAL AND METHODS: Aerial parts of P. argentea were collected in Algeria and ethanolic, chloroform and aqueous-chloroform extracts were obtained from dried plant. The antioxidant capacity was first evaluated by the Oxygen Radical Absorbance Capacity (ORAC) and the free radical scavenging activity (DPPH) methods. Cellular viability was assessed by MTT method assay after 24 h pretreatment with each extract concentration in order to measure protection from H2O2 in NRK-52E cells. Furthermore, the intracellular ROS formation (DCFH-DA method), was determined. RESULTS: P. argentea showed in vitro antioxidant activity as evidenced by the ORAC and DPPH assays. No cell toxicity was observed for concentrations ranging from 0.1 to 100 µg/mL of each extract. These extracts also exerted a protective effect on renal endothelial cells simultaneously treated with 1 mM H2O2. Chemical composition for the aqueous-chloroform extract was assessed by HPLC, as it showed the strongest antioxidant ability, revealing three quercetin derivatives as the main phenolic compounds. CONCLUSION: P. argentea is endorsed with antioxidant activity and protects renal endothelial cells against oxidative damage which indicate this plant constitutes a potential treatment for renal diseases.

Influencia de la perspectiva de visionado en el comportamiento motor de tenistas noveles / Influência da perspectiva de visualização no comportamento motor de jogadores novatos / The influence of the viewing perspective on the novel tennis players´ motor behavior

El objetivo del estudio fue analizar la influencia de la perspectiva de visionado (egocéntrica o alocéntrica) sobre el comportamiento motor de una muestra reducida de tenistas noveles cuando percibieron servicios de tenis video-proyectados en laboratorio. Específicamente, un grupo de tenistas (n=6) percibió la secuencia de ensayos con una perspectiva egocéntrica. En cambio, el otro grupo de tenistas (n=6) percibió la misma secuencia de servicios con una perspectiva alocéntrica. Los participantes debían de iniciar su movimiento, rápida y precisamente, cuando identificaran la dirección final la pelota. Los resultados mostraron que los tenistas que percibieron los servicios con una perspectiva alocéntrica consiguieron tiempos de reacción significativamente menores y una precisión de la respuesta mayor en relación a la perspectiva egocéntrica. Se recomienda incluir proyecciones alocéntricas de visionado en el diseño de los entrenamientos perceptivos en el deporte ya que favorecen el rendimiento de los deportistas en la tarea, mediante la producción de inicios rápidos y precisos de la respuesta (AU)

The aim of the study was to address the influence of the viewing perspective (egocentric or alocentric one) in the motor behavior of a reduced sample of novel tennis players when they perceived video-projected services in a laboratory setting. Specifically, a group of tennis players (n = 6) perceived the sequence of rallies with an egocentric perspective. In contrast, another group of players (n = 6) perceived the same sequence with an alocentric perspective. Participants were required to initiate the movement, quickly and precisely, when they identify the final direction of the ball. The results showed that the players, who perceived the rallies with an alocentric viewing, achieved significantly lower reaction times and higher response accuracy than an egocentric perspective. It is recommended to include alocentric viewing projections in the design of perceptual trainings in the sport as they enhance the performance of athletes in the task by producing fast movements and accurate responses (AU)

O objetivo do estudo foi analise a influência da perspectiva de (egocêntrico ou alocêntrica) de visão sobre o comportamento motor de uma pequena amostra de jogadores novatos quando perceberam serviços de vídeo de tênis projetado por laboratório. Especificamente, um grupo de jogadores (n = 6), viu a sequência do ensaio com uma perspectiva autocentrada. Em vez disso, outro grupo de jogadores (n = 6), viu a mesma sequência de serviços com uma perspectiva alocêntrica. Os participantes foram obrigados a iniciar o movimento, de forma rápida e identificar com precisão quando a direcção final da bola. Os resultados mostraram que os jogadores que perceberam uma alocêntrica perspectiva serviços alcançado significativamente menores tempos de reação e precisão do maior resposta em relação à perspectiva egocêntrica. Recomenda-se incluem projeções alocêntrica visualização no projeto de formação perceptual no esporte uma vez que aumentam o desempenho dos atletas na tarefa de produzir resposta inicial rápida e precisa (AU)

Analysis of disease activity and response to treatment in a large Spanish cohort of patients with systemic lupus erythematosus.

OBJECTIVES: The objectives of this paper are to study the impact of disease activity in a large cohort of patients with systemic lupus erythematosus (SLE) and estimate the rate of response to therapies. METHODS: We conducted a nationwide, retrospective, multicenter, cross-sectional cohort study of 3658 SLE patients. Data on demographics, disease characteristics: activity (SELENA-SLEDAI), damage, severity, hospitalizations and therapies were collected. Factors associated with refractory disease were identified by logistic regression. RESULTS: A total of 3658 patients (90% female; median SLE duration (interquartile range): 10.4 years (5.3-17.1)) were included. At the time of their last evaluation, 14.7% of the patients had moderate-severe SLE (SELENA-SLEDAI score ≥6). There were 1954 (53.4%) patients who were hospitalized for activity at least once over the course of the disease. At some stage, 84.6% and 78.8% of the patients received glucocorticoids and antimalarials, respectively, and 51.3% of the patients received at least one immunosuppressant. Owing to either toxicity or ineffectiveness, cyclophosphamide was withdrawn in 21.5% of the cases, mycophenolate mofetil in 24.9%, azathioprine in 40.2% and methotrexate in 46.8%. At some stage, 7.3% of the patients received at least one biologic. A total of 898 (24.5%) patients had refractory SLE at some stage. Renal, neuropsychiatric, vasculitic, hematological and musculoskeletal involvement, a younger age at diagnosis and male gender were associated with refractory disease. CONCLUSIONS: A significant percentage of patients have moderately-to-severely active SLE at some stage. Disease activity has a big impact in terms of need for treatment and cause of hospitalization. The effectiveness of the standard therapies for reducing disease activity is clearly insufficient. Some clinical features are associated with refractory SLE.

Creutzfeldt-Jakob disease cluster in the health area of Meixoeiro Hospital.

OBJECTIVE: Galicia is the Spanish region in which most bovine spongiform encephalopathy cases have been registered. Meixoeiro Hospital is included in the Galician Health Service (SERGAS). The aim of the study was to analyze the clinical and epidemiological characteristics of Creutzfeldt-Jakob disease (CJD) in the health area of Meixoeiro Hospital and to identify possible specific risk factors to the general public. METHODS: All incident cases of CJD were identified in the health area of Meixoeiro Hospital (187,877 inhabitants) over a 14-year period, 1997-2010, and classified according to WHO diagnostic criteria. We obtained clinical detail and epidemiological information on all cases. Crude and age-specific incidence rates were calculated. A review of surgical or invasive medical procedures was undertaken. RESULTS: We diagnosed 12 patients with CJD, 10 sporadic CJD (sCJD), and two genetic CJD (gCJD). No iatrogenic or variant CJD was detected. According to Poisson distribution, 3.9 CJD cases would be expected for our area over the 14 years researched. The average yearly mortality rate from CJD was 4.6 cases per million (3.8 from sCJD and 0.8 from gCJD). Eight patients (67%) underwent at least one surgical or invasive medical procedure. Sixteen of twenty-seven (59%) of these procedures were undertaken in Meixoeiro Hospital. CONCLUSIONS: The incidence of CJD in the health area of Meixoeiro Hospital is three times higher than expected. The hypothesis that at least some cases of sCJD are apparently because of covert transmission or zoonosis events should not be formally refuted and might explain the high rate found.

A comparative study of two histological techniques for the identification of cytomegalovirus infection in colorectal biopsies from patients with chronic inflammatory bowel disease.

BACKGROUND: the role that cytomegalovirus (CMV) plays in inflammatory bowel disease (IBD) is controversial. The diagnosis of CMV infection in IBD depends on viral identification with hematoxylin-eosin (HE) or immunohistochemistry (IHC). Our aim was to compare the sensitivity of HE and IHC for this diagnosis in IBD patients. PATIENTS AND METHODS: a case-control study. Our database was searched for IBD patients with HE- or IHC-based CMV-positivity from 1997 to 2007. Controls were selected among IBD inpatients matched for age and year of diagnosis with CMV. Their clinical characteristics were analyzed. HE and IHC were performed on biopsies from cases and controls at 6 months before and after inclusion in the study. In the statistical analysis, p values below 0.05 were considered significant. RESULTS: ten IBD patients with CMV infection were identified. IBD-CMV patients were more steroid-resistant or steroid-dependent (p = 0.03), and underwent a higher number of colonic biopsies (p = 0.03). From 97 biopsies analyzed, 12 were HE-negative and IHC-positive, and 3 showed reversed results. The sensitivity of HE was 58.6%, 95% CI (38.9-78.3), and that of IHC was 89.7%, 95% CI (76.8-100). We did not find a good level of agreement between both techniques: kappa value 0.55, 95% CI (0.36-0.75). CMV positivity with IHC was associated with the use of more than one immunosuppressant drug, OR 13.5, 95%CI (1.2-152.2). Antiviral treatment was useful for CMV patients with steroid-dependent and steroid-refractory IBD. CONCLUSIONS: IHC shows a 30% higher sensitivity than HE for the diagnosis of CMV infection in IBD patients. There is no good level of agreement between both histological techniques.

[Prognostic value of the ultrasound and diuretic renogram in the evolution of ureteropelvic junction obstruction]. / Valor pronóstico de la ecografía y el renograma diurético en la evolución de la estenosis pieloureteral.

INTRODUCTION: The congenital obstruction of the pieloureteral junction (UPJ) is the most frequent cause of hydronephrosis in children. Sometimes, establishing the convenience of a surgical procedure is difficult, mainly if we consider the literature published on the spontaneous resolution of the slight, moderate and even severe hydronephrosis in newborns. OBJECTIVE: To determine the prognostic value of ultrasound in the evolution of the unilateral hydronephrosis, by assesing the size of the contralateral kidney. To verify if the "supranormal" renal function (SRF) is real or an artefact. PATIENTS AND METHODS: We have performed a descriptive observational study over a 10 years period (1995-2005). The study included all patients with the only diagnosis of obstructive unilateral hydronephrosis that underwent pieloplasty, and were controlled for 1 year period after the surgical treatment. RESULTS: Of the 66 patients in the study, 42 were boys (63.6%) and 24 girls (36.4%). After the first diuretic renogram (DR), in 57 of the patients (86.4%) the clearance half-time (T1/2) was over 20 minutes, in 6 cases (9.1%) it was 10-20 minutes and only in 3 cases it was shorter than 10 minutes. A similar differential renal function (FRD) was observed in the moderate and severe hydronephrosis. Supranormal function (FRD > 52%) was detected on DR in 11 patients, predominating in left hidronefrosis, and in more than 50% of the cases this value it did not agree with the renal function measured by dimercapto-succinic acid (DMSA), Pearson's correlation coefficient: 0.19. These kidneys experienced a greater reduction of the postoperative renal function. CONCLUSIONS: In the unilateral obstructive hydronephrosis, the healthy contralateral kidney experiences hypertrophy detectable by ultrasound, but these ecographic diameters are within the band of individual confidence of the healthy children of reference. The supranormal function exists, but in most cases it is an artefact.

[Experience in the treatment of multiple sclerosis with interferon beta in Galicia]. / Experiencia del tratamiento con interferón beta en la esclerosis múltiple en Galicia.

OBJECTIVE: To analyze the experience in daily clinical practice of interferon-beta (IFN-beta) treatment in relapsing-remitting (RR) and secondary progressive (SP) multiple sclerosis (MS) in Galicia (Spain). PATIENTS AND METHODS: Patients with RR-MS and SP-MS treated with IFN-beta1a and 1b between 1995 and December/2000, analyzing demographic and clinical data. RESULTS: 313 patients were included, with a mean age of 38.2 years. A total of 296 patients (94.6%) were clinically defined MS and 17 (5.4%) were laboratory supported (Poser criteria); 84.6% of the patients were RR and 15.4% were SP. The mean duration of the disease prior to treatment was 7.06 years. Betaferon was used in 52.4% patients (115 RR-MS and 47 SP-MS), Avonex in 26% and Rebif in 21.6%. Relapse rate was reduced in 68.8% for the RR-MS for Betaferon-treated patients, 73.3% for Avonex treated and 35.7% for Rebif-treated patients. Betaferon reduced relapse rate in 50% for SP-MS. The global EDSS remained stable during IFN-beta treatment. During treatment, 33% of Betaferon, 60.5% of Avonex and 54.5% of Rebif-treated patients remained relapse-free. Treatment was suspended in 12.9% of Betaferon, 6.2% of Avonex, and 3% Rebif-treated patients. The most frequent causes of treatment suspension were increase in disability and in relapse count. CONCLUSIONS: The present study supports the benefits of IFN-beta treatment in RR MS and SP MS in daily clinical practice, with reduction in relapses count and incapacity, good over-all tolerance and low incidence of serious adverse side-effects.

[Brain perfusion SPECT in the prognostic assessment of stroke]. / SPECT de perfusión cerebral en la valoracion pronóstica del ictus.

PURPOSE: To compare the diagnostic yield of CT scan and perfusion SPECT on admission and its prognostic value in clinical outcome. METHODS: 25 ischemic stroke cases were studied on admission (<24 h) and at 30-60 days by CT scan, 99mTc-HMPAO-SPECT and neurological scales. Infarct size and severity on SPECT were assessed: visually "Total Weighted Score," added value in 22 areas, and by several semiquantitative count-based indices. RESULTS: Sensitivity: the first CT scan was positive in 24% patients, initial SPECT in 75% (73% of pure subcortical infarcts and 91% of those with cortical involvement). Localization: kappa: 0.725 between SPECT findings on admission and those in control-CT at 5 days. Extent and severity: correlations between count-based and visual indices (r: >0.719), the latter correlated slightly better with clinical scales. Both predicted similarly (Rho>0.739) infarct size in CT diagnostic scan. Early Outcome: There were statistical differences between deceased and survivors in SPECT (<24h) indices and CT-infarct size (mean 5 days), but not in neurological scores on admission. Long term Outcome: Correlation of initial SPECT indices with follow-up functional scores (SNSLP, Barthel index; mean 37 days) was only significant for visual SPECT indices (Rho:0.560 to 0.620). Nevertheless the best predictor of functional status on discharge was the Barthel Index on admission. CONCLUSIONS: 1) Early SPECT has good sensitivity and accurate infarct size prediction so it can be a useful tool for deciding thrombolytic therapy; 2) Visual scores perform as well as more complex indices; 3) Infarct volume seems to be a critical determinant in vital outcome; other factors (strategic localization, etc.) might influence long term functional status.

[Developmental cysts in the presacral space in adults]. / Quistes del desarrollo en el espacio presacro en el adulto.

Localization of primitive neoplasms the retrorectal or presacral space is rare in adults as most of these tumors are congenital. Developmental cysts are included within the group of retrorectal congenital cystic neoplasms and are slowly-progressive cystic neoplasms. Because of their localization, their manifestation is delayed, despite their congenital nature. Their form of presentation is varied and is caused by compression of the surrounding organs or infectious complications of the cyst.We describe two cases of presacral developmental cysts (one epidermoid cyst and one dermoid cyst) that presented in adulthood. Special attention is paid to the classification, and diagnostic and therapeutic problems of these tumors.

[Detection of malnutrition risk in hospitalized elderly patients]. / Detección del riesgo de malnutrición en ancianos hospitalizados.

UNLABELLED: OBJECTIVE AND SCOPE: To validate a protocol for the detection of malnutrition risk in a population of elderly patients admitted to a general hospital for non-surgical reasons. MATERIALS AND METHOD: The study involved 95 patients (34 of them male) over the age of 65 who were assessed on the third and fifth day after admission by means of a simple screening protocol (PC in its Spanish acronym) that considered recent changes in weight, serum albumin, lymphocyte concentration, food intake and diagnosis on admission, together with a more complex diagnostic protocol (PD in its Spanish acronym) including anthropometric, biochemical and immunological parameters. The PC was applied by personnel not expert in nutrition, while the PD was carried out by persons trained in nutritional assessment. The results of the PC and PD were compared, with statistical significance being considered at levels of p < 0.05. RESULTS: According to the PD, 75 patients (78.9%) suffered protein-energy malnutrition (39 slight, 31 moderate, 5 severe). The score obtained in the PC had a significant relationship with the severity of the malnutrition diagnosed using PD (p < 0.001). Furthermore, the absence or presence of nutritional risk assessed using the PC had a significant correlation with the diagnosis of malnutrition and its degree according to the PD (p < 0.01), thus indicating the validity of the PC as a method for screening of malnutrition. CONCLUSIONS: 1. In our population of geriatric patients admitted for reasons other than surgery, there was a high prevalence of protein-energy malnutrition. 2. The risk of malnutrition in an elderly population in hospital settings is appropriately assessed by means of a simple screening test effected by non-specialized personnel. 3. The score obtained in the PC is linked with the presence of malnutrition and with its severity. 4. The use of simple screening techniques in populations with a high prevalence of malnutrition may contribute to the detection and correction of this problem.

[The capacity of the rest-dobutamine gated SPECT protocol to predict contractile recovery after revascularization of myocardial dysinergic areas]. / Capacidad del protocolo de gated-SPECT reposo/dobutamina para predecir la recuperación contráctil posrevascularización de áreas miocárdicas disinérgicas.

INTRODUCTION AND AIM: Gated-SPECT is a promising method to analyze myocardial viability. We have assessed the accuracy of a new protocol of rest/Dobutamine gated-SPECT, based on the evaluation of contractile reserve induced by 10 microg/kg/min of Dobutamine, to predict contractile recovery after revascularization of dysinergic myocardial territories. PATIENTS AND METHODS: In a group of 36 patients submitted to percutaneous revascularization, we selected 40 vascular territories (21 left descending artery, 19 right coronary-circumflex) with severely depressed contractility (contrast ventriculography, center line method). Follow up evaluation at 6 months showed the absence of angiographic restenosis and control contrast ventriculography assessed the contractile changes of the selected territories, considering those with contractile restoration as viable. Before revascularization, rest/Dobutamine gated-SPECT study was applied and viability was defined as the presence of contractile reserve (positive or improvement [n = 21] and negative or impairment [n = 7]) with non viability being the absence of contractile reserve (n = 12). We analyzed the evolution of the ejection fraction in a group of 27 patients with impaired ventricular function and complete revascularization. RESULTS: Gated-SPECT showed a sensitivity of 0.96 (95% CI 0.78-0.99) and a specificity of 0.78 (95% CI 0.48-0.94) in the diagnosis of viability. The ejection fraction (median [interquartile range]) increased after revascularization: 0.42 (0.15) vs 0.55 (0.22), Z = -3.9; p < 0. 001. The diagnosis of viability by gated-SPECT (p < 0.001) and the extent of severely depressed myocardium (p = 0.04) independently predicted the increase of the ejection fraction after revascularization. CONCLUSIONS: The analysis of contractile reserve by rest/Dobutamine gated-SPECT is adequate to diagnose viability in territories with severely depressed contractility and independently predicts the increase of ejection fraction after revascularization.

Clinical and economic impact of a pharmacist-intervention to promote sequential intravenous to oral clindamycin conversion.

A multicentre, prospective, controlled study compared the clinical efficacy, safety and economic impact of a pharmacist intervention to promote sequential intravenous to oral clindamycin conversion. A total of 473 patients receiving intravenous clindamycin for at least 72 hours were included in the study. Two groups were established: an intervention group (204 patients) in which an informative sheet recommending the sequential treatment was provided, and a control group (269 patients). Clindamycin was prescribed for respiratory infections in 38.9% and for prophylaxis in surgery in 25.4% of the patients (71% were contaminated surgery). No difference between groups regarding sex, infection severity, health status or clinical progress was observed. Both the step-down treatments after 72 hours of intravenous clindamycin and the change to the oral route later on, were significantly increased with the intervention (p < 0.001, p < 0.001 respectively). No significant differences between both groups were found in the number of patients with adverse effects associated with the i.v. therapy, although the incidence tended to be lower in the intervention group (49/204 intervention versus 85/269 control, p = 0.07). Compliance with the recommended clindamycin dosing regimen was significantly higher in the intervention group, in which 1.3 days reduction of intravenous therapy provided an average cost savings of PTA5246 (95% CI 2556-7935) per treatment. A higher reduction of 1.7 days was achieved in those patients candidates for switch therapy on the third day of intravenous clindamycin. A sequential program with clindamycin may provide a cost-effective alternative to conventional therapy and the introduction of an information sheet is a cost-effective strategy to promote it.

[Validation of the three-dimensional method of sestamibi gated-SPECT in the calculation of the left ventricular ejection fraction in patients with ischemic heart disease. Comparison with contrast ventriculography]. / Validación del modelo tridimensional de gated-SPECT con sestamibi para el cálculo de la fracción de eyección ventricular izquierda en pacientes con cardiopatía isquémica. Comparación con la ventriculografía de contraste.

INTRODUCTION AND OBJECTIVE: Tomography with acquisition synchronized with electrocardiography, gated-tomography, allows the assessment of left ventricular contractile function. The accuracy of a new method of gated-tomography, based on the three dimensional representation of the left ventricle to calculate the ejection fraction was validated by means of comparison with contrast ventriculography. METHODS: We studied 85 patients with ischemic cardiopathy, and ejection fraction was calculated by contrast ventriculography and sestamibi-gated-tomography, at rest and throughout 10 micrograms/kg/min of dobutamine. Furthermore, we assessed the extent of perfusion defect, as well as the number of segments with activity below 50% of the total 13 segments in which the tomographic slices were divided. RESULTS: Gated-tomography was significantly correlated to contrast ventriculography in the calculation of ejection fraction, both with acquisition at rest (r = 0.80) and throughout Dobutamine (r = 0.82). The average underestimation of gated-tomography calculation of ejection fraction was significantly greater for the rest study (-0.12 [IC 95% 0.04, -0.30]) than the dobutamine study (-0.07 [IC 95% 0.09, -0.24]). Patients with greater perfusion defects (4 o more segments) had no differences in underestimation of ejection fraction (-0.13 [IC 95% 0.03, -0.30] versus -0.11 [IC 95% 0.07, -0.29]). CONCLUSIONS: The three-dimensional method of gated-tomography accurately assesses the ejection fraction. The underestimation determined by this method was lower in the study done with viable doses of dobutamine. The extent of perfusion defect had no deleterious effect on gated-tomography in the calculation of ejection fraction.

[Benign coloduodenal fistula caused by inflammatory pseudotumor of the colon]. / Fístula coloduodenal benigna por pseudotumor inflamatorio del colon.

We present a case of benign coloduodenal fistula, due to an inflammatory pseudotumor of the hepatic flexure of the colon, that was found included in a calcified hepatic cavity, presumably hydatic, that opened through a large fistulous orifice into the second duodenal portion. A barium enema satisfactorily demonstrated the colonic lesion and a fistulous tract. Although the preoperative diagnosis was of colonic neoplasm fistulized into the duodenum, the histopathological study of the surgical specimen did not demonstrate malignancy.