Silicosis crónica complicada, hallazgo en un paciente asintomático / Complicated Chronic Silicosis: Findings in Asymptomatic Patient

La silicosis es producida por la inhalación mantenida de dióxido de silicio (SiO2). Los trabajos en canteras e industrias de roca ornamental, granito y pizarra, y marmolerías son las exposiciones clásicamente descriptas, junto al pulido con chorro de arena. El arenado de jeans, producción de mesadas de cocinas y baños han surgido más recientemente. Las presentaciones clínicas pueden clasificarse en silicosis crónica (sim ple, complicada y fibrosis pulmonar), silicosis acelerada y silicosis aguda, según los años de exposición y factores individuales. Se presenta un caso clínico de un paciente masculino de 78 años con silicosis crónica complicada, asintomático, diagnosticado en contexto de un examen prequirúrgico.

Silicosis is caused by sustained inhalation of silicon dioxide (SiO2). Work in quarries and industries of ornamental rock, granite and slate, and marble work, are the typi cally described types of exposure, together with sandblasting. Denim sandblasting and the production of kitchen and bathroom countertops have emerged more recently. Clinical presentations can be classified into chronic silicosis (simple, complicated, and pulmonary fibrosis), accelerated silicosis, and acute silicosis, depending on years of exposure and individual factors. We present a clinical case of a 78-year-old male pa tient with complicated chronic silicosis, asymptomatic, diagnosed in the context of a pre-surgical examination.

Síndrome de la Cimitarra / Scimitar Syndrome

Se presenta una paciente femenina de 48 años de edad, tabaquista severa (30 p/y) que se realizó una radiografía de tórax en contexto de un cuadro de tos con expectoración clara y leve disnea de 3 días de evolución, observando una opacidad paracardíaca derecha de bordes netos con clara relación con estructuras vasculares (Figura 1). Se solicitó una Tomografía computada (TC) de tórax con y sin contraste endovenoso obteniendo como resultado una imagen radiopaca densa de bordes netos, que en los cortes de reconstrucción desciende en forma curva y se ensancha en su parte inferior, compatible con un drenaje anómalo de las venas pulmonares derechas hacia la vena cava inferior (Figuras 2 y 3). Se realizó un ecocardiograma dopler no observando alteraciones de sus estructuras. Recibió tratamiento antibiótico y broncodilatadores, encontrándose en el control posterior asintomática, luego discontinuó controles médicos

Lymphoid progenitor cells from childhood acute lymphoblastic leukemia are functionally deficient and express high levels of the transcriptional repressor Gfi-1.

Acute lymphoblastic leukemia (ALL) is the most frequent malignancy of childhood. Substantial progress on understanding the cell hierarchy within ALL bone marrow (BM) has been recorded in the last few years, suggesting that both primitive cell fractions and committed lymphoid blasts with immature stem cell-like properties contain leukemia-initiating cells. Nevertheless, the biology of the early progenitors that initiate the lymphoid program remains elusive. The aim of the present study was to investigate the ability of lymphoid progenitors from B-cell precursor ALL BM to proliferate and undergo multilineage differentiation. By phenotype analyses, in vitro proliferation assays, and controlled culture systems, the lymphoid differentiation potentials were evaluated in BM primitive populations from B-cell precursor ALL pediatric patients. When compared to their normal counterparts, functional stem and progenitor cell contents were substantially reduced in ALL BM. Moreover, neither B nor NK or dendritic lymphoid-cell populations developed recurrently from highly purified ALL-lymphoid progenitors, and their proliferation and cell cycle status revealed limited proliferative capacity. Interestingly, a number of quiescence-associated transcription factors were elevated, including the transcriptional repressor Gfi-1, which was highly expressed in primitive CD34⁺ cells. Together, our findings reveal major functional defects in the primitive hematopoietic component of ALL BM. A possible contribution of high levels of Gfi-1 expression in the regulation of the stem/progenitor cell biology is suggested.

Desarrollo, salud humana y amenazas ambientales: la crisis de la sustentabilidad / Development, human health and enviromental threatenings: sustainability crisis

Contenido: Ecología, ambiente y salud. Urbanización, ambiente y calidad de vida. Contaminación y riesgo ambiental. El medio ambiente y la salud de las comunidades. Factores microambientales que producen accidentes. Provisión de agua. Efluentes domiciliarios e industriales. Contaminación de cursos de agua dulce. Los residuos sólidos urbanos y su relación con la salud. Tratamiento de residuos sólidos y peligrosos. Residuos patogénicos. Temperatura ambiente y salud. Radiaciones ionizantes. Ondas electomagnéticas. Fuegos e incendios. Ruidos y vibraciones. Vectores de enfermedad. Roedores. Sociedad, animales de compañía y zoonosis. Animales venenosos. Pesticidas y salud. Infecciones e intoxicaciones alimentarias. Accidentes de tránsito. Atención sanitaria en catástrofes.

[Commitment hierarchy of the Geneva declaration]. / Jerarquización de los compromisos de la declaración de Ginebra.

There is a revival at present in the use of the medical oath. A study of the text is necessary from the first year of study in medical school. The aim of this work was to know how medical students rank the commitments of the Geneva Declaration. One hundred seventy 1st-year students were evaluated. They were asked to enumerate the commitments in a hierarchy according to their perception of medical work. The greatest percentages of the principles for each position were obtained. The commitments placed first were respect to life (39.4%), consideration of patient health as first concern (23.5%), and non-discrimination (27.1%). Votes placed last in the ranking were related to honor and professional traditions (24.1%) and consideration of colleagues as brothers (28.8% and 44.7%). The difference among percentages was significant, mainly with regard the last commitment. Medical students located in the first places obligations with reference to ethical principles of physician-patient relationship, considering less relevant commitments with the profession and its members. It will be of interest to determine the reason for this dichotomy and to encourage reflection upon medical oaths, generating greater commitment.

Diabetes mellitus e hipertensión arterial: aspectos clínicos y epidemiológicos en la población de la La Plata / Diabetes mellitus and hypertension: clinical and epidemiological aspects in the population of La Plata

The purpose of this study was to determine socio-demographic characteristics, habits, most frequent morbid associations and degree of compliance with the control and treatment of their illness in a population of diabetic and hypertense patients of the La Plata area. A representative sample (890 people) was selected through a home survey (413 housing units). The results obtained show that diabetic and hypertense people a) are in average older than the general population and that the percentage of sedentary habits among them is also higher; b) show multiple typical symptoms of the illness but do not identify them as such and consequently diagnosis is frequently haphazardous; c) have a higher frequency of association with other risk factors, intercurrencies and hospitalization; d) are treated mainly by giving priority to drugs over changes in their detrimental habits; e) tend to ignore those indications that prescribe a change in their habits and f) control their illness at an inadequate periodicity. Consequently, it would be advisable to emphasize the incorporation of education strategies into the treatment of these patients in order to give more importance to preventive and health promoting actions. Education programmes should include not only patients and their families but also members of the health team and the community in general.

Diabetes mellitus e hipertensión arterial: aspectos clínicos y epidemiológicos en la población de la La Plata / Diabetes mellitus and hypertension: clinical and epidemiological aspects in the population of La Plata

The purpose of this study was to determine socio-demographic characteristics, habits, most frequent morbid associations and degree of compliance with the control and treatment of their illness in a population of diabetic and hypertense patients of the La Plata area. A representative sample (890 people) was selected through a home survey (413 housing units). The results obtained show that diabetic and hypertense people a) are in average older than the general population and that the percentage of sedentary habits among them is also higher; b) show multiple typical symptoms of the illness but do not identify them as such and consequently diagnosis is frequently haphazardous; c) have a higher frequency of association with other risk factors, intercurrencies and hospitalization; d) are treated mainly by giving priority to drugs over changes in their detrimental habits; e) tend to ignore those indications that prescribe a change in their habits and f) control their illness at an inadequate periodicity. Consequently, it would be advisable to emphasize the incorporation of education strategies into the treatment of these patients in order to give more importance to preventive and health promoting actions. Education programmes should include not only patients and their families but also members of the health team and the community in general.(AU)