Úlceras dolorosas en la lengua / Painful Tongue Ulcers

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Rotura uterina por placenta percreta. Un caso clínico en útero bicorne unicollis / Uterine rupture due to placenta percreta. A case in uterus bicornis unicollis

Se expone el caso de una gestante de 27 semanasde amenorrea, diagnosticada de útero bicorneunicollisy portadora de cerclaje cervical, queacude a urgencias por dolor abdominal. No seobserva dinámica. Tras empeoramiento general yprogresivo en 4 h, se retiró el cerclaje y se indicócesárea urgente por shock hipovolémico ysospecha de desprendimiento prematuro deplacenta normalmente inserta. En la laparotomíase observó hemoperitoneo 2 l, útero bicorne,acretismo placentario con perforación de 3 cmen fondo del hemiútero gestante. Nació un fetomujer vivo de 1.030 g, que evolucionósatisfactoriamente

A woman in the 27th week of gestation, with aprior diagnosis of uterus bicornis unicollis and acervical cerclage in situ, presented to theemergency department with severe abdominal pain.No uterine dynamics were observed. The patientrapidly deteriorated shortly after admission,warranting removal of the cervical cerclage andemergency cesarean section delivery with theworking diagnoses of hypovolemic shock andabruptio placentae. Laparotomy showed free bloodin the peritoneum (2 liters) as well as a placentaaccreta with a 3-cm perforation in the uterinefundus. A female infant, weighing 1030 g, wasdelivered and progressed satisfactorilyshockwav

Safety of long-term treatment with cyclosporin A in resistant chronic plaque psoriasis: a retrospective case series.

BACKGROUND: An intermittent short course of cyclosporin A (CyA) therapy is a good choice in the treatment of severe psoriasis. Nevertheless, some severe or resistant patients might benefit from long-term treatment. Adverse effects of long-term use of CyA are investigated and the results are compared with the literature. PATIENTS AND METHODS: A retrospective study of adverse effects of CyA treatment in a group of 53 patients suffering from psoriasis. The mean treatment time was 31.4 +/- 23.2 months with a minimum of 4 months to a maximum of 95 months, with very few short interruptions of treatment (from 2 to 5 months in five patients). RESULTS: The group consisted of 29 women and 24 men, ranging in age from 18 to 65 years, with an average age of 44.49 years. Arterial hypertension appeared in 45.3% of patients during treatment. Pharmacological treatment was required in 32% of these patients to control the condition. Serum creatinine levels were transiently elevated in 11.3% of the cases, but withdrawal of treatment was required in none of them. DISCUSSION: Long-term CyA treatment might be necessary in some patients and this study shows that it could be sustained with a close follow-up. This involves regular visits depending on each patient, as well as common test protocol and clinical evaluation. In conclusion, this retrospective study seems to confirm the relative safety of long-term CyA treatment when patients are adequately monitored.

Tratamiento del carcinoma basocelular con radiaciones ionizantes / Ionizing radiation treatment of basal cell carcinoma

El conocimiento y correcto empleo de las diferentes técnicas de radioterapia suponen una gran ayuda en el manejo de los pacientes con carcinomas basocelulares. En nuestro Servicio continuamos empleando la técnica de radioterapia de contacto para estas neoplasias en un número elevado de enfermos. Hemos recogido los datos referentes a los tumores tratados durante los años 1997, 1998 y 1999, un total de 279, y hemos analizado los datos epidemiológicos de la muestra, edad, sexo y fototipo, así como tamaño, tipo clínico, localización, cicatrización y recidivas de los tumores. Empleamos una técnica desarrollada por nuestro equipo, consistente en tres sesiones de 10 Gy, hasta un total de 30 Gy, lo cual supone un buen balance entre la comodidad del enfermo y los resultados médicos en tasas de curación y resultado estético de las cicatrices. Los pacientes tratados fueron en su mayoría de pelo oscuro en la edad adulta y ojos claros. Hemos tratado lesiones de 0,5 a 3,5 cm de diámetro con un 5% de recidivas y un 22,3% de cicatrices imperceptibles (AU)

Instantaneous Ramanography of a turbulent diffusion flame.

The first reported instantaneous two-dimensional map of the fuel-gas concentration in a turbulent diffusion flame using quantitative Ramanography is described. Details of the experimental configuration are presented, along with data obtained in both cold flows and turbulent reacting flows.