Ictus en una mujer joven afecta de migraña sin aura / Stroke in a young woman suffering migraine without aura

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Tumores infantiles en el área de salud del Bierzo: 1989-2003 / No disponible

Objetivo: conocer la incidencia de cáncer infantil y las características epidemiológicas, clínicas y administrativas de los casos diagnosticados en el área de salud del Bierzo durante el período comprendido entre 1989 y 2003. Material y métodos: se diseñó un estudio descriptivo retrospectivo con recogida de datos de los niños menores de 15 años diagnosticados de cualquier tipo de cáncer durante el período referido. Resultados: se diagnosticaron 22 casos, con una incidencia anual de 7 por 100.000. Pertenecieron al grupo hematológico un 50%, siguiendo los del sistema nervioso central (27%) y los tumores óseos (14%). Destaca la ausencia de diagnóstico en 1990, 1996 y 1997, con un má- ximo de cinco diagnósticos durante 1998. Existe un predominio en varones (60%) y el 64% pertenece al grupo de edad menor de 5 años, lo que supone un aumento de incidencia estadísticamente significativo. El 82% de los casos se diagnosticó antes de las 48 horas de ingreso. Se trasladaron a otros hospitales el 100% de los casos. Sólo en el 22% de los casos se remitió desde el hospital de nivel 3 el informe clínico. Conclusiones: la incidencia anual de cáncer en la población infantil del área de salud del Bierzo es de 7 por 100.000. La incidencia anual en los niños menores de 5 años es de 19 por 100.000. Existe un predominio de varones y edades tempranas; este último es estadísticamente significativo. La estirpe predominante es la hematológica. Se trasladan el 100% de los procesos tumorales a distintos hospitales de referencia. La comunicación reglada mediante documento escrito con el hospital de referencia es unidireccional en el 78% de los casos (AU)

Objective: the objective of this study is to gain an awareness of the incidence of childhood cancer, the epidemiological, clinical and administrative features of the diagnosed cases in the Bierzo health area during the period 1989-2003. Material and methods: we designed a retrospective descriptive study by collecting information from diagnosed cancer cases amongst children under 15 years of age over the aforementioned period. Results: twenty-two cases were diagnosed, with an annual incidence of 7 in 100,000. Of these diagnosed cases, 50% belonged to the haematological group, whilst central nervous system cases accounted for 27% and bone tumours made up 14% of the total. The fact that no tumours were diagnosed in 1990, 1996 and 1997 is particularly noteworthy, and a maximum of five cases registered in 1998. There is a predominance of male patients (60%) and 64% of children in this group were under 5 years of age, representing a significant statistical increase. Eighty-two percent of the cases were diagnosed within 48 hours after admission. All cases were subsequently transferred to a higher level hospital. The level 3 hospital sent back the clinical report in only 22% of the cases. Conclusions: the annual incidence of cancer amongst children in the Bierzo health area is 7 in 100,000. The annual incidence amongst children under the age of 5 is 19 in 100,000. Males predominated, and amongst this group, there is a high incidence of younger members. Haematological cancer is the most frequently encountered type. All procedures involving tumours were transferred. The official written report with the hospital reference is unidirectional in 78% of the cases (AU)

[Extragonadal germ cell tumor in HIV+ female]. / Tumor de células germinales extragonadal en mujer VIH+.

Extragodanal germ cell tumors (EGCT) are not common, especially among women. Although there is no evidence of relationship between this sort of tumor and HIV infection they can appear at the same time in a patient, because in both cases the maximum incidence occurs in patients in the same age group. We present the case of a 27 years old woman, poly-drug user, with a recently diagnosis of HIV infection, who was admitted to clinic because of infection and shortage of breath, and develops during her hospitalization diarrhoea, generalized tonic-clonic seizure and left hemiparesis. Complementary tests showed us diffuse interstitial pulmonary pattern, mediastinal mass with intrathoracic adenopathies, cerebral tumor and diffuse intestinal enlargement. The breath infection got better with a wide-ranging antibiotic treatment, which included cotrimoxazol and levofloxacin, but the brain tumor didnt get better with the antitoxoplasma treatment. The clinical presentation simulated in the beginning a disseminated lymphoma, in a HIV+ patient; nevertheless, after receiving the result of the biopsy of a supraclavicular adenopathy and a b-HCG, an extragodanal germ cell tumor was diagnosed. We haven't found any case of EGCT in young women infected with HIV in our bibliographical review (MEDLINE).

Tumor de células germinales extragonadal en mujer VIH+ / Extragonadal germ cell tumor in HIV+ female

Los tumores de células germinales extragondales (TCGE) son poco frecuentes, sobre todo en mujeres. Aunque no existe evidencia de asociación entre este tipo de tumor y la infección por VIH, pueden coincidir en el mismo paciente debido a que, en ambos, la máxima incidencia se da en el mismo segmento de edad. Presentamos el caso de una mujer de 27 años, politoxicómana, con infección por VIH de reciente diagnóstico, que ingresa por clínica de infección e insuficiencia respiratoria y desarrolla durante su hospitalización, diarrea, crisis tónico-clónica generalizada y hemiparesia izquierda. En las pruebas complementarias practicadas se evidencia patrón intersticial pulmonar difuso, masa mediastínica con adenopatías intratorácicas, lesión ocupante de espacio (LOE) cerebral y engrosamiento intestinal difuso. La infección respiratoria mejoró con tratamiento antibiótico de amplio espectro que incluía cotrimoxazol y levofloxacino, pero la LOE cerebral no mejoró con tratamiento antitoxoplasma. La presentación clínica inicialmente simulaba la de un linfoma diseminado, en una paciente VIH +, sin embargo, tras recibir el resultado de la biopsia de una adenopatía supraclavicular y de b-HCG se realizó el diagnóstico de tumor de células germinales extragonadal. En la revisión bibliográfica realizada (MEDLINE) no hemos encontrado ningún caso de TCGE en mujeres jóvenes con infección por VIH (AU)

Afasia: ¿Síntoma de comienzo de encefalitis? / Aphasia: a presenting symptom of encephalitis?

Aphasia: a presenting symptom of encephalitis? (AU)

Surface changes of ram spermatozoa by adsorption of homologous and heterologous seminal plasma proteins revealed by partition in an aqueous two-phase system.

Ram spermatozoa freed from seminal plasma by a dextran 'swim-up' procedure were incubated with Tween 20 and fractionated into motile (PEG-rich) and stationary (dextran-rich) fractions by centrifugal countercurrent distribution (CCCD) in an aqueous dextran-Ficoll-polyethylene glycol (PEG) two-phase system. Increasing concentrations of Tween 20 resulted in greater amounts of extracted protein and lower cell viability. Addition of bull seminal plasma increased the proportion of live cells, whereas ram seminal plasma increased the proportion of stationary cells. Proteins isolated from each type of seminal plasma restored the CCCD profile of treated spermatozoa to the right, this effect being reduced when proteins were thermally denatured. Bovine serum albumin induced a slight displacement to the left. No restoration of profile was achieved when ram spermatozoa were exposed to proteins from bull seminal plasma in the presence of protein-free ram seminal plasma. Adsorption of seminal plasma proteins by spermatozoa previously stripped of surface proteins by exposure to detergent reversed the detergent effect on motility. The findings are consistent with the concept that ram seminal plasma contains a factor that interferes with protein adsorption on the cell surface and prevents the protective effect of seminal plasma proteins on maintenance of cell viability.

Reversion of thermic-shock effect on ram spermatozoa by adsorption of seminal plasma proteins revealed by partition in aqueous two-phase systems.

Centrifugal counter-current distribution (CCCD) in a dextran, Ficoll, poly(ethylene glycol) two-phase system was used to study the effect of seminal plasma proteins on the partition behaviour of ram spermatozoa exposed to thermal shock. Ram spermatozoa freed from seminal plasma by a 'swim-up' procedure were submitted to thermal shock and fractionated by CCCD. Cell viability decreased from 68% to 18% after the treatment, showing a slight displacement of the cells from the right (where a higher enrichment of live cells is found) to the centre of the profile. A change of the distribution profile was shown in the presence of either ram or bull seminal plasma. Bull seminal plasma was able to move the profile to the right, whereas ram seminal plasma increased the proportion of cells with enhanced affinity for the lower dextran-rich phase. Plasma proteins isolated from both seminal plasmas moved the profile to the right. In addition, cell viability rose to 48% after the CCCD run in the presence of ram plasma proteins. This restoring effect was lost when ram plasma proteins were thermally denatured. Bovine serum albumin was not only unable to move the profile to the right but even promoted displacement of the profile to the left. This negative effect was also observed when proteins from bull seminal plasma were in the presence of protein-free ram seminal plasma. However, proteins isolated from ram seminal plasma still restored the profile in the presence of bull seminal plasma freed from proteins. The results presented here strongly suggest that seminal plasma proteins are adsorbed by a spermatozoal surface previously exposed to thermic shock. These proteins would exert a highly specific protective effect on ram spermatozoa. In addition, in the ram seminal plasma there must be some factor which avoids this adsorption.