Necesidad de cribado de enfermedad de Chagas y de infestación por Strongyloides previo a inicio de terapia biológica en países no endémicos / Need to screen for Chagas disease and Strongyloides infestation in non-endemic countries prior to treatment with biologics

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Relapsing bullous amyloidosis of the oral mucosa and acquired cutis laxa in a patient with multiple myeloma: a rare triple association.

It is well known that primary systemic amyloidosis [light chain (AL) amyloidosis] is associated with hidden dyscrasia or multiple myeloma. Acquired cutis laxa (cutis laxa acquisita; CLA) has also been described in patients with plasma cell dyscrasias, including multiple myeloma. We report a case in which haemorrhagic oral bullae were the first sign of an undiagnosed primary systemic amyloidosis related to multiple myeloma IgG-λ and previously diagnosed CLA. There is only one report in literature of this rare triple association; however, in that case the patient did not have oral mucosal involvement or bullous amyloidosis.

The Most Common HLA Antigens Found in Patients With Renal Transplants at the Specialties Hospital of "La Raza" Medical Center, Mexico.

BACKGROUND: The knowledge to understand transplant acceptance or rejection derives directly from knowing its genetic material and the major histocompatibility complex involved in immune response, so it is essential to identify the most common alleles in the Mexican population. METHODS: In the northern areas of the Federal District (DF), Hidalgo, and Mexico State, we performed an analysis of HLA class I (A and B) and HLA class II (DRß1 and DQß1) with the use of the PCR-SSP process (Invitrogen). We performed measures of central tendency and percentages of common alleles in the study population. RESULTS: We analyzed 718 results of patients before renal transplantation: 313 pairs of recipients and living donors and 92 patients receiving cadaveric donation. HLA allele A 02 536 (37.32%) was the most common allele found. In HLA B, the most common allele corresponded to 35, in 321 (22.35%), which was the most polymorphic. In HLA DRß1 the most common was 04, in 447 (31.12%), which was the least polymorphic; the most common was 03, in 777 (54.10%). CONCLUSIONS: We corroborated the frequency of alleles found in the considered population, which corresponds to the northern part of Mexico City as well as the states of Mexico and Hidalgo. It was determined that there is no risk allele for developing chronic kidney disease.

Two cases of overlap severe cutaneous adverse reactions to benznidazole treatment for asymptomatic Chagas disease in a nonendemic country.

Chagas disease is a parasitosis endemic to South America. It is normally treated with benznidazole as first choice, which has been associated with numerous cutaneous reactions. However, very few benznidazole-associated severe cutaneous adverse reactions have been reported to date. The rise of Chagas disease in nonendemic countries represents a growing public health challenge. We report two patients who met the criteria for drug reaction with eosinophilia and systemic symptoms syndrome and Stevens-Johnson syndrome/toxic epidermal necrolysis according to the RegiSCAR scoring systems. They were thus deemed overlapping cases, with a lymphocyte transformation test positive for benznidazole. Both required intensive care unit admission and both survived. Considering the rising application of this drug for trypanosomiasis in immigrant populations, clinicians should be aware of this newly reported, potentially life-threatening risk.

Infestación cutánea diseminada por larva migrans / Disseminated cutaneous larva migrans infestation

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Linfoma gástrico de tejido linfoide asociado a mucosa en un paciente con psoriasis grave en tratamiento con ustekinumab / Gastric Mucosa-Associated Lymphoid Tissue Lymphoma in a Patient With Severe Psoriasis Receiving Ustekinumab

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Psoriasis ungueal / Nail psoriasis

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Expansión posterior con resortes y avance fronto-orbitario simultáneo en craneosinostosis sindrómicas / Spring-assisted posterior expansion and simultaneous fronto-orbitary expansion in syndromic cranyosinostosis

Las craneoestenosis sindrómicas son anomalías congénitas de difícil resolución y requieren generalmente varios procedimientos quirúrgicos. La expansión posterior de la calota permite disminuir la hipertensión endocraneana y sus efectos sobre el cerebro. La utilización de resortes para la expansión posterior ha demostrado ser un método efectivo y estable, disminuyendo la morbilidad de los procedimientos tradicionales. La combinación de la expansión posterior con resortes y el avance frontoorbitario en una sola etapa, antes del año de vida, disminuye el número de intervenciones necesarias obteniéndose una buena remodelación de la bóveda craneana. Presentamos nuestra experiencia en 3 casos de craneoestenosis sindrómica mediante la realización simultánea de ambos procedimientos con buenos resultados estéticos y funcionales (AU)

Syndromic craniosynostosis is a difficult-to-resolve congenital anomaly generally requiring several surgical procedures. Expansion of the posterior cranial vault diminishes intracranial hypertension and its deleterious effect on the brain. The use of spring-assisted distraction for posterior vault expansion showed to be an effective and stable method with lower morbidity than that seen intraditional procedures. The combination of spring-assisted posterior vault expansion and fronto-orbital advancement in a single stage before one year of life decreases the number of surgical interventions necessary and leads to adequate remodeling of the cranial vault. Here we present 3 cases of syndromic craniosynostosis who simultaneously underwent both procedures with good esthetic and functional results (AU)

[Prevention secondary to ischemic cardiopathy at the lipid level in primary care in Aragon. PRECIAR study 1]. / Prevención secundaria de cardiopatía isquémica a nivel lipídico en atención primaria Aragón. Estudio PRECIAR 1.

BACKGROUND: Despite the existing evidence of the effectiveness of secondary prevention by modifying lifestyles or using the different drugs which have shown themselves to be clinically beneficial for heart patients, there is little, not highly accurate information available regarding the handling of the treatment of these patients within the scope of primary care in our country. The purpose of this study is that of ascertaining the current status of secondary prevention of heart disease as far as lipid control is concerned. METHODS: A review was made of the clinical records of all of the patients diagnosed at some point in time of their life as having ischemic heart disease, including those under the heading of acute myocardial infarction and angina pectoris within the 11 groups of patients assigned to three urban Health Care Centers in Area II in Zaragoza. The population in question totaled 19,692 patients, 388 cases of ischemic heart disease having been found in the record files data. RESULTS: Based on a study of the lipid control data, 60.8% of the cases analyzed in this study showed a complete lipid profile for the last year. Solely 4.7% of these patients had LDL < 100, the control objective having to be limited to c-LDL < 130 to find a 31.3% of patients with a lower than optimum control of this parameter. CONCLUSIONS: The results of our study reveal that the diagnosis of dyslipemias as well as the control of all other heart disease risk factors in secondary care have not been in keeping, for the most part, with the quality criteria of this health care procedure and therefore reveal the existence of a major degree of room for improvement.

Prevención secundaria de cardiopatia isquémica a nivel lipídico en atención primaria Aragón. Estudio PRECIAR 1. Prevención secundaria de cardiopatia isquémica a nivel lipídico / Secondary prevention of ischemic heart disease at the Lipid-related level in primary care in Aragon. Study PRECIAR I

Fundamento: A pesar de la evidencia existente sobre la eficacia de la prevención secundaria, modificando los estilos de vida o utilizando los diversos fármacos que han mostrado su beneficio clínico en pacientes coronarios, la información disponible sobre el manejo terapéutico de estos pacientes en el ámbito de la atención primaria en nuestro país es escasa y poco precisa. El objetivo de este estudio es conocer el estado de la prevención secundaria de la enfermedad coronaria desde el punto de vista del control de los lípidos. Métodos: Se revisaron las historias clínicas de todas las personas diagnosticadas en algún momento de su vida de patología cardiovascular isquémica; incluyéndose en este apartado el infarto agudo de miocardio y el ángor, dentro de 11 cupos de 3 Centros de Salud urbanos del área II de Zaragoza. La población global era de 19.692 pacientes, encontrándose 388 casos de cardiopatía isquémica, de los datos recogidos de las historias. Resultados: Estudiando los datos sobre el control lipídico, el 60.8 por ciento de los casos analizados en este estudio presentaba un perfil lipídico completo en el último año. De estos 236 pacientes solamente el 4,7 por ciento tenía el LDL < 100, teniendo que limitar a un c-LDL < 130 el objetivo de control para encontrar un 31,3 por ciento de pacientes con un control subóptimo de este parámetro. Conclusiones: Los resultados de nuestro estudio revelan que el diagnóstico de las dislipemias, así como el control del resto de factores de riesgo cardiovascular en prevención secundaria no se han adecuado en gran medida a los criterios de calidad de este proceso asistencial y señalan, en consecuencia, la existencia de un amplio margen de mejora (AU)

Accumulation of Poly (beta-Hydroxybutyrate) by Halobacteria.

Some species of extremely halophilic archaebacteria, Halobacteriaceae, have been shown to accumulate large amounts of poly (beta-hydroxybutyrate) under conditions of nitrogen limitation and abundant carbon source. The production of poly (beta-hydroxybutyrate), at least in large quantities, was restricted to two carbohydrate-utilizing species, Halobacterium mediterranei and H. volcanii. In addition to the nutrients in the media, the salt concentration also influenced poly (beta-hydroxybutyrate) accumulation, which was greater at lower salt concentrations. The possible application of these microorganisms for the production of biodegradable plastics is discussed.