Hiperplasia de células neuroendocrinas: reporte de caso / Neuroendocrine cell hyperplasia: case report

A clinical case of Neuroendocrine Cell Hyperplasia is presented with a bibliographic review. An infant patient with respiratory distress syndrome, characterized by nasal flaring, retractions, and tachypnea with temporary resolution with the use of bronchodilators. However, the patient requires oxygen. With complementary examinations (negative viral panel twice) and epidemiology it is classified as a viral Bronchiolitis. Without improvement, extrapulmonar pathologies were suspected, discarding hearth disease, epilepsy, pathological gastroesophageal reflux. New tests were performed to rule out other pathologies, including immunological disorders. Those results were normal, so a high-resolution chest tomography was done which allowed the diagnosis of Neuroendocrine Cell Hyperplasia. During the follow up the child had improved and required oxygen until he was two years old. Neuroendocrine Cell Hyperplasia belongs to a huge group of less common interstitial disorders, which diagnosis is clinical and radiological. It can easily be confused with common respiratory disorders. For this reason, it is important to know about this disease to make an early diagnosis. Most of the cases had a gradual (months to years) improvement.

Se presenta un caso clínico de Hiperplasia de Células Neuroendocrinas y la revisión de la literatura. Paciente lactante menor con cuadro de dificultad respiratoria, caracterizado por aleteo nasal, retracciones y taquipnea persistente acompañada de desaturación. Sin adecuada respuesta al uso de broncodilatadores. Por exámenes complementarios, panel viral negativo en dos ocasiones y epidemiología, se le diagnostica una bronquiolitis viral. Por no presentar mejoría se completan estudios, descartándose neumonía atípica, cardiopatía, epilepsia, reflujo gastroesofágico patológico y compromiso inmunológico. El diagnóstico fue determinado en base a la clínica, junto con imágenes en vidrio esmerilado característicos en lóbulo medio y língula. En su seguimiento mejora paulatinamente, requiriendo soporte de oxígeno hasta los dos años. La Hiperplasia de Células Neuroendocrinas es una patología intersticial pulmonar poco frecuente, cuyo diagnóstico es clínico y radiológico. Puede ser fácilmente confundida con desórdenes respiratorios comunes, por lo que es importante sospecharla para realizar un diagnóstico precoz. La mayor parte de los casos evolucionan con declinación de los síntomas, mejorando espontáneamente en meses o en los primeros años de vida.

Mini-Mental State Examination: standardization and validation for the elderly Slovenian population.

For more than two decades Mini-Mental State Examination (MMSE) has been adapted to the Slovenian language as 'Kratek preizkus spoznavnih sposobnosti' (KPSS). In this study, we evaluated the influences of age and education on the KPSS score, looking for the cut-off point with the optimal ratio of sensitivity (SE) and specificity (SP) to support the use of the KPSS as a screening tool. During the years 2000-03 we examined 258 Slovenian volunteers. Volunteers were divided in two groups based on clinical criteria. A total of 189 were healthy, aged from 45 to 96 years, 69 were demented patients aged from 46 to 91 years, of both sexes, all different levels of education and different degrees of dementia. Median value, SE, SP, positive predictive power and negative predictive power were calculated at cut-off points 23/24, 24/25, 25/26 and 26/27. Younger age and higher education (at least 10 years of education) were each associated with higher KPSS scores. The Slovenian modification of the MMSE demonstrates an optimal cut-off score at 25/26 points for screening dementia in the Slovenian population, due to the best SP (75%)/SE (73%) ratio. The cut-off level 26/27 is recommended for screening highly educated persons.

Syntactic comprehension, verbal memory, and calculation abilities in Spanish-English bilinguals.

This article analyzes the interfering effect of the second language (L2) on the first language (L1) in native Spanish speakers living in the United States. We examined 3 linguistic aspects: (a) syntactic comprehension, (b) verbal memory, and (c) calculation abilities. We carried out 2 different studies. In the 1st study, we studied syntactic understanding in 50 Spanish-English bilinguals. For all participants, L1 was Spanish and L2 was English, and all learned English early in life and had attended English schools. Results for the Spanish Syntactic Comprehension Test (Marcos & Ostrosky, 1995) were compared with the normative results obtained with 40 Spanish monolingual participants. We observed that the closer to the English syntax the sentences were, the easier it was for the participants to understand them. Participants who had been exposed to English between the ages of 5 and 12 outperformed participants exposed to English before 5 years of age. Language preference correlated with syntactic comprehension. Women outperformed men. In the 2nd study, verbal memory and calculation abilities were examined in L1 and L2 in a group of 85 Spanish-English bilinguals. Parallel versions of the different tests were administered in Spanish and English. The results indicated some significant differences between the 2 languages in several verbal learning and calculation ability subtests. Most of the verbal memory subtests were better performed in L1. Scores on tasks measuring speed and calculation accuracy were higher in the participant's native language. Best spoken language proved to be a significant variable in some verbal memory subtests performed in English but not in Spanish. We analyze implications of bilingualism in neuropsychological testing. We also present some suggestions to minimize the bilingualism effect.

Cual es la eficacia del componente de rehidratacion oral en el municipio de Medina en el mes de febrero de 1984 / Which is efficacy of the oral rehidratation component in Municipio de Medina during the month of february 1984

Durante 1983 la EDA fue la primera causa de consulta en el Hospital Local de Medina por lo cual se considero importante evaluar el componente de rehidratacion oral del programa de salud materno-infantil implantado recientemente, desde el punto de vista de su eficacia en el sentido de su impacto sobre la comunidad en terminos de satisfaccion, mantenimiento o modificacion de la situacion inicial y los indices de recuperacion de los ninos y satisfaccion de las madres. Los datos presentados se refieren a 11 casos en los cuales pudo hacerse el seguimiento completo. El mayor indice de recuperacion se logro en los ninos de 1-4 anos, siguientes a las sales hidratantes mantuvieron satisfactoriamente el nivel de hidratacion inical mientras que el grupo de menores de 1 ano este objetivo solamente se logro en el 25% . En terminos de satisfaccion de las madres el 73% se mostro satisfecho con el programa aun cuando se describen algunas conductas del peronal de salud que deben corregirse en provecho de la poblacion. Se recomienda incrementar las actividades de educacion a la comunidad involucrando nuevos metodos de ensenanza y establecer estrategias para lograr mayor asistencia de las madres a las controles, asi como continuar las evaluaciones del programa..