Vibrational signatures of dynamic excess proton storage between primary amine and carboxylic acid groups.

Ammonium and carboxylic moieties play a central role in proton-mediated processes of molecular recognition, charge transfer or chemical change in (bio)materials. Whereas both chemical groups constitute acid-base pairs in organic salt-bridge structures, they may as well host excess protons in acidic environments. The binding of excess protons often precedes proton transfer reactions and it is therefore of fundamental interest, though challenging from a quantum chemical perspective. As a benchmark for this process, we investigate proton storage in the amphoteric compound 5-aminovaleric acid (AV), within an intramolecular proton bond shared by its primary amine and carboxylic acid terminal groups. Infrared ion spectroscopy is combined with ab initio Molecular Dynamics (AIMD) calculations to expose and rationalize the spectral signatures of protonated AV and its deuterated isotopologues. The dynamic character of the proton bond confers a fluxional structure to the molecular framework, leading to wide-ranging bands in the vibrational spectrum. These features are reproduced with remarkable accuracy by AIMD computations, which serves to lay out microscopic insights into the excess proton binding scenario.

Inelastic Collisions of O2 with He at Low Temperatures.

Rotationally inelastic collisions of O2 with He in the 10-34 K thermal range are investigated by means of an experimental procedure based on supersonic gas jets probed by Raman spectroscopy. The procedure employs a kinetic master equation (MEQ) that describes the time evolution of the rotational populations of O2 along supersonic jets of O2 and He mixtures. The MEQ is expressed in terms of experimental quantities (number density and rotational populations) measured here, and state-to-state rate coefficients for the O2:He inelastic collisions calculated here, plus those for O2:O2 collisions from the literature. An agreement with the experiments is accomplished for temperatures between 10 and 34 K. Within this thermal range, the role of the fine structure due to electron spin in the collision dynamics of O2 is discussed.

Second-trimester fetal aberrant right subclavian artery: original study, systematic review and meta-analysis of performance in detection of Down syndrome.

OBJECTIVES: First, to estimate the prevalence of fetal aberrant right subclavian artery (ARSA) in our population and its association with Down syndrome. Second, to determine the feasibility of ultrasound to visualize ARSA in the three planes. Finally, to carry out a systematic review of the literature on the performance of second-trimester ARSA to identify fetuses with Down syndrome. METHODS: ARSA was assessed by ultrasound in the axial plane and confirmed in the longitudinal and coronal planes during the second half of pregnancy in women attending our unit (from February 2011 to December 2012). A search of diagnostic tests for the assessment of ARSA was carried out in international databases. Relevant studies were subjected to a critical reading, and meta-analysis was performed with Meta-DiSc. RESULTS: Of the 8781 fetuses in our population (mean gestational age: 24 ± 5.4 weeks), 22 had Down syndrome. ARSA was detected in the axial view in 60 cases (0.7%) and confirmed in the coronal view in 96.7% and in the longitudinal view in 6.7% (P < 0.001). Seven cases with ARSA had Down syndrome and all were in the non-isolated-ARSA group. The estimates of positive likelihood ratio (LR) were 0 for isolated ARSA and 199 (95% CI, 88.9-445.2) for non-isolated ARSA. In the systematic review, six studies were selected for quantitative synthesis. The pooled estimates of positive and negative LRs for global ARSA were, respectively, 35.3 (95% CI, 24.4-51.1) and 0.75 (95% CI, 0.64-0.87). For isolated ARSA, the positive and negative LRs were 0 (95% CI, 0.0-14.7) and 0.98 (95% CI, 0.94-1.02), respectively. CONCLUSIONS: The prevalence of ARSA seems close to 1%. The coronal plane is the most suitable for its confirmation after detection in the axial plane. Detection of isolated or non-isolated ARSA should guide decisions about karyotyping given that isolated ARSA shows a weak association with Down syndrome.

Prenatal diagnosis of Potocki-Lupski syndrome in a fetus with hypoplastic left heart and aberrant right subclavian artery.

Potocki-Lupski syndrome (PTLS) is a rare genetic disorder associated with neurodevelopmental delay and heart defects. We report the first case of prenatal diagnosis of PTLS in a fetus with hypoplastic left heart and aberrant right subclavian artery. Detection of a fetal heart defect should be followed by chromosomal and genetic studies in order to rule out fetal aneuploidy and/or associated genetic syndromes with significant implications for the treatment of children with PTLS.

Microwave spectroscopy and quantum chemical investigation of nine low energy conformers of the 15-crown-5 ether.

Crown ether macrocyles constitute a central class of selective substrates in Supramolecular Chemistry. The backbone of crown ethers is particularly flexible which makes the spectroscopic and computational investigations challenging. In this work, we present a systematic investigation of the low energy conformational landscape of the benchmark macrocycle 15-crown-5 ether (15c5) under isolated conditions. Molecular beam Fourier transform microwave spectroscopy is employed to measure a broad ensemble of rotational transitions within the range of 4-11 GHz. The recorded spectra allow us to determine the rotational constants of eight individual 15c5 rotamers which are identified among the nine lowest energy conformers predicted by ab initio MP2 computations. The study illustrates well the variety of conformers of prolate and oblate character that the 15c5 molecule displays within a narrow range of energies. Implications for the supramolecular behavior of 15c5 are discussed.

High-Resolution Rotational Spectroscopy of a Cyclic Ether.

The conformational landscape of crown ethers has constituted a central topic in the development of host-guest supramolecular chemistry. We report a high-resolution rotational study of a crown ether, 1,4,7,10,13-pentaoxacyclopentadecane (15-crown-5), by means of molecular beam Fourier transform microwave spectroscopy. The considerable size and the broad range of conformations allowed by the flexibility of the cyclic backbone of this ether pose important challenges to spectroscopy approaches. In this investigation, three stable rotamers of the 15-crown-5 ether have been identified and characterized through their rotational constants and centrifugal distortion coefficients. Ab initio quantum calculations at the MP2 level predict these conformers as the most stable ones for the title system and reproduce accurately their distinct structural features. The results pave the ground for an extensive survey of the conformational landscape of the 15-crown-5 and related cyclic ethers in the near term.

Crown ether complexes with H3O⁺ and NH4⁺: proton localization and proton bridge formation.

The complexes formed by crown ethers with hydronium and ammonium cations are of key relevance for the understanding of their supramolecular behavior in protic solvents. In this work, the complexes of the 15-crown-5 (15c5) and 18-crown-6 (18c6) ethers with H3O⁺ and NH4⁺ and their deuterated variants are investigated under isolated conditions. The study employs infrared multiple photon dissociation (IRMPD) vibrational spectroscopy and DFT B3LYP/6-31++G(d,p) calculations for conformational assignment. The 18c6 ether provides two energetically nearby C(3v) conformations with commensurate linear O-H···O and N-H···O bonds. The 15c5 ether ring adopts partially folded asymmetric pyramidal geometries, yielding one shorter linear H bond and two longer non-linear H bonds. Remarkably, an appreciable broadening of the IRMPD vibrational bands is observed for the 15c5-H3O⁺/D3O⁺ complexes. This can be interpreted as a signature for partial sharing of the proton (or deuteron) between the water and the crown ether along the linear O-H···O intermolecular H bond, which is indeed particularly short for this complex.

Complicaciones postoperatorias de la estrategia CHIVA para el tratamiento de la insufi ciencia venosa crónica / Postoperative complications of CHIVA technique for the treatment of chronic venous

Introducción. La técnica más utilizada para la cirugía de varices es la safenectomía, sin embargo,la cirugía CHIVA está experimentando en la última década en nuestro país un crecimientoimportante debido a su buena recuperación postoperatoria y a sus escasas complicaciones.Objetivo. Describir y cuantifi car cuáles son las complicaciones postoperatorias de la cirugíaCHIVA en nuestra experiencia y las refl ejadas en la bibliografía.Material y métodos. Estudio descriptivo retrospectivo de 269 extremidades intervenidas pornuestro grupo y el análisis de 2.793 extremidades intervenidas descritas en la literatura.Resultados. Complicaciones propias: 17 casos en 269 extremidades (6,33 %), distribuidas de laforma siguiente: 11 trombosis de safena sintomáticas, dos parestesias temporales, dos hematomasinguinales, una infección de herida quirúrgica y una cefalea postpunción raquídea. Lascomplicaciones refl ejadas en la literatura fueron: 208 casos en 2.793 extremidades (7,44 %),distribuidas de la forma siguiente: 82 trombosis safenianas sintomáticas, 70 neuritis y parestesias,25 infecciones cutáneas menores, 9 hematomas, 7 infecciones inguinales, 6 linforreas inguinales,4 trombosis venosas profundas y una hemorragia inguinal. No se han descrito muertesni complicaciones mayores relacionadas con el procedimiento.Conclusiones. La cirugía CHIVA por insufi ciencia venosa crónica se acompaña de una recuperaciónrápida y activa con alrededor de un 7 % de complicaciones, que cursan de una forma benignay no entorpecen dicha recuperación. La trombosis safeniana sintomática es la complicaciónmás frecuente tras una cirugía CHIVA por varices(AU)

Introduction. The most commonly used technique for varicose vein surgery is saphenectomy,although haemodynamic surgery (CHIVA) has been becoming increasing popular in the lastdecade in our country, probably, due to its good postoperative recovery and fewercomplications.Objective. To describe and quantify postoperative complications of CHIVA technique in ourexperience as well as that reported in the literature.Methods. Retrospective descriptive study of 269 limbs operated on by our group and analysis of2,793 audited limbs described in the literature.Results. The main complications in our patients were: 17 cases in 269 limbs (6.33 %), distributedas follows: 11 symptomatic saphenous vein thrombosis, two temporary paresthesias, two groinhaematomas, one wound infection, and one headache after spinal anaesthesia. Complicationsreported in the literature: 208 cases in 2,793 limbs (7.44 %), distributed as follows:82 symptomatic saphenous vein thrombosis, 70 neuritis and paresthesias, 25 minor skininfections, 9 haematomas, 7 groin infections, 6 lymphatic groin leakages, 4 deep vein thrombosis,and one groin haemorrhage. There is no mortality or major complications associated with thisprocedure.Conclusions. CHIVA surgical approach to chronic venous insuffi ciency is accompanied by a rapidrecovery and active life with a 7 % complication rate, which are mostly benign and do nothinder recovery. Symptomatic saphenous vein thrombosis is the most common complicationafter surgery for varicose veins using this technique(AU)

Fetal thymus size in uncomplicated twin and singleton pregnancies.

OBJECTIVES: The main objective of this study was to determine whether fetal thymic measurements could be obtained in twins, with a secondary goal to determine whether thymic measurements from uncomplicated singleton and twin pregnancies are comparable. METHODS: The transverse diameter and perimeter of the fetal thymus were measured prospectively in 678 singleton and 56 twin pregnancies, and their relationships with gestational age were determined and compared between groups. RESULTS: Thymic measurements were possible in 757 (95.8%) of the 790 fetuses. Measurements were not possible in 19 of 678 singletons (2.8%) and in 14 of the 112 (12.5%) twins (P < 0.001). After construction of nomograms for the transverse diameter and perimeter of the fetal thymus, similar measurements were noted for singletons and twins. CONCLUSIONS: These results suggest that sonographic measurements of the thymus are feasible in twin pregnancies and that, in uncomplicated pregnancies, these measurements are similar to those noted for singletons. These findings pave the way for future studies aimed at determining the clinical utility of thymic measurements in complicated singleton and twin pregnancies.

Diagnóstico prenatal de un hemangioma occipital de rápida involución / Prenatal diagnosis of a occipital rapidly involuting hemangioma

El hemangioma occipital es, tras los linfangiomas, el tipode tumoración más frecuente en cabeza y cuello. Su diagnósticoecográfico suele establecerse en el tercer trimestre o finalesdel segundo trimestre siendo útil la resonancia magnética(RM) prenatal para la confirmación del mismo. Posnatalmente,la gran mayoría de los casos regresan espontáneamente si bienpueden persistir y complicarse requiriendo exéresis quirúrgica.Presentamos el caso del hemangioma fetal de involuciónrápida (RICH, Rapidly Involuting Congenital Hemangioma) anivel occipital diagnosticado por ecografía en el tercer trimestrede gestación así como una revisión de la literaturadestacando los puntos clave para su diagnóstico diferencial,manejo prenatal, conducta obstétrica y tratamiento posnatal(AU)

Occipital hemangioma is one of the most frequentfetal head and neck tumors, second only to lymphangiomas.Diagnose is usually established in the third or inthe late second trimester of pregnancy. Prenatal MRIallowsdiagnosis confirmation. Vast majority of fetal hemangiomasregress spontaneously in the first year afterdelivery. However, persistence is a possibility, and theymight present complications, such as bleeding or ulcerations,in which case surgical treatment is warranted.We report a case of rapidly involuting congenitalhemangioma (RICH) in the occipital region of fetal craniumdiagnosed on a routine third timester fetal ultrasoundscan. We also present a review of available literature,outlining the key points to differential diagnosis,prenatal, obstetric and postnatal management(AU)

Influence of the displacement out of the center of mass and nonaxiality of the dipole on the thermodynamics of liquids composed of linear dipole molecules.

We present results for organic liquids modeled as linear rods with an embedded point dipole shifted from the geometrical center. Previously, we have obtained results for the vapor-liquid equilibrium (VLE) of similar systems with centered point dipoles. Our results included both models and applications to real systems. Results presented here are based on a previous work ( Phys. Rev. E 2003, 68, 021201) on the structural properties of these systems where relevant results about the appearance of dimers were found. Now, we have also performed systematic simulations on these systems to calculate the VLE of models with different aspect ratios, dipole shifts, and dipole strengths using the Gibbs ensemble Monte Carlo (GEMC) to calculate equilibrium densities and vapor pressure at each temperature. The applications considered here include some important substances such as 1-amines, acetonitrile, and 1-alcohols whose intermolecular parameters were fitted from our model simulations. Furthermore, we have used quantum chemistry calculations to obtain a reliable charge distribution, and we have applied our model to predict the vapor pressure of alpha,omega-diols where experimental results are rather scarce. Our results show a general improvement of the agreement between experiment and models compared to centered dipole models previously used. Results for amines are particularly remarkable.

Abdomen agudo como forma atípica de presentación de una agenesia de la vena cava inferior: a propósito de un caso / Acute abdomen as an unusual presenting symptom of agenesis of the inferior vena cava: a case report

Introducción. La agenesia de la vena cava inferior (VCI) es una malformación congénita muy rara. Suele descubrirseen el estudio etiológico de un paciente con trombosis venosa profunda (TVP) unilateral con o sin factores deriesgo o de trombosis de la VCI. Caso clínico. Varón de 15 años de edad con un único antecedente de obesidad moderada,que fue intervenido por cirugía general por un cuadro de abdomen agudo con pruebas complementarias preoperatoriasno concluyentes. En la laparotomía exploradora sólo se observó la trombosis de la vena gonadal izquierda hipertrofiada.Se decidió su resección y en el estudio anatomopatológico se informó como un cavernoma venoso. A las 12 horasdel postoperatorio comenzó con una clínica de TVP del miembro inferior izquierdo. El estudio ecográfico confirmó laTVP ilíaca; en la tomografía axial computarizada no se identificó la VCI, por lo que se realizó una iliocavografía porla vía femoral derecha que confirmó una agenesia de la VCI infrarrenal y del segmento retrohepático con desarrollode la vena ácigos y venas paravertebrales. Se instauró un tratamiento compresivo y de anticoagulación con heparina debajo peso molecular y luego dicumarínicos con una buena evolución clínica. Se realizó un cribado familiar sin hallarseotros miembros con malformación. Conclusión. La agenesia de cava suele diagnosticarse en el contexto de una TVP.Otras formas de presentación como el abdomen agudo son anecdóticas

Introduction. Agenesis of the inferior vena cava (IVC) is a very rare congenital malformation. It is usuallydiscovered during the aetiological study of patients with unilateral deep vein thrombosis (DVT) with or without riskfactors or thrombosis in the IVC. Case report. A 15-year-old male, with moderate obesity as the only relevant event in hismedical history, who underwent general surgery to treat symptoms of acute abdomen with non-conclusive findings in thepreoperative complementary tests. The exploratory laparotomy only revealed thrombosis in the hypertrophied leftgonadal vein. The decision was made to excise it and the findings of the pathological study showed it to be a veincavernoma. Twelve hours into the post-operative period, the patient began to display clinical symptoms of DVT in theleft lower limb. Ultrasound imaging confirmed the iliac DVT; the IVC was not identified in the computerised axialtomography scan, and so iliocavography was performed via the right femoral to confirm agenesis of the infrarenal IVCand the retrohepatic segment with the development of the azygos vein and the paravertebral veins. Compressive therapywas established together with low-molecular-weight heparin anticoagulation treatment and then dicumarols; the clinicalcourse of the patient progressed favourably. Familial screening was carried out but no other relatives with malformationswere found. Conclusions. Cava agenesis is usually diagnosed within the context of DVT. Other presenting symptoms,such as acute abdomen, are anecdotal

Tratamiento endovascular de la patología arterial de los miembros inferiores / Endovascular treatment of arterial pathologies in the lower limbs

Introducción. La cirugía endovascular presenta un rápido desarrollo en todos los territorios, igualando e incluso mejorando los resultados de la cirugía convencional. Sin embargo, en los miembros inferiores todavía no se han alcanzado los niveles de seguridad y permeabilidad de otros territorios. Objetivo. Realizar una puesta al día de los procedimientos endovasculares aplicables en el sector femoral poplíteo y distal. Desarrollo. Nueve cirujanos vasculares con experiencia en terapéutica endoluminal han redactado este documento. En este trabajo se muestran desde los avances en los métodos diagnósticos, hasta los resultados y costes. Iniciamos esta guía con unas breves notas acerca de la biomecánica de la arteria femoral superficial. Cerramos esta monografía con dos capítulos dedicados al tratamiento endovascular del aneurisma poplíteo y pseudoaneurismas. Hemos intentado redactar un documento útil y práctico, siguiendo las directrices del Capítulo de Cirugía Endovascular de la Sociedad Española de Angiología y Cirugía Vascular. Al final de cada capítulo se ha incluido un apartado de recomendaciones basado en niveles de evidencia. Conclusiones. Este campo de la terapéutica vascular está teniendo un desarrollo veloz y cambiante. La intención de hacer una puesta al día sin duda queda desfasada en pocas semanas. Podría afirmarse que la mejor técnica sería la disponible ‘en nuestro medio’y según ‘nuestra experiencia, que aplicada para un ‘paciente individual’, logre la mayor duración con la menor morbimortalidad posible; y que en caso de fallo, pueda ser repetible o haya alternativas terapéuticas

Introduction. Endovascular surgery is developing quickly in all territories and the results being achieved are similar to, or even better than, those offered by conventional surgery. Yet, the levels of safety and patency of other territories have still not been attained in the lower limbs. Aim. To update our knowledge of the endovascular procedures that can be applied in the popliteal and distal femoral segment. Development. This article has been written by nine vascular surgeons with experience in endoluminal therapy and covers aspects ranging from the advances in the diagnostic methods to the outcomes and costs. We begin this guide with a few brief words about the biomechanics of the superficial femoral artery. The monograph ends with two chapters devoted to the endovascular treatment of popliteal aneurysms and pseudoaneurysms. We have tried to draw up a document that is both useful and practical, following the guidelines of the Endovascular Surgery Chapter of the Spanish Society of Angiology and Vascular Surgery. At the end of each chapter we have included a section offering recommendations based on levels of evidence. Conclusions. This field of vascular therapy is developing in a changeable and very swift manner. What we intend to offer as an update will undoubtedly become somewhat obsolete in a few weeks. As a final conclusion we could say that the best technique is the one that we have available ‘in our area’ and which, according our experience, when applied to an ‘individual patient’ achieves the greatest durability with the lowest possible morbidity and mortality rates: at the same time, in case of failure, it can be repeated or there exist therapeutic alternatives

Tratamiento endovascular de estenosis venosas del acceso vascular para hemodiálisis / Endovascular treatment of venous stenoses in vascular accesses for haemodialysis

Objetivo. Evaluar los resultados obtenidos en la terapéutica endovascular de estenosis venosas del miembro del acceso vascular para hemodiálisis. Pacientes y métodos. Entre noviembre de 2001 y noviembre de 2005 se han realizado 13 procedimientos endovasculares en 11 pacientes, 46% hombres y 54% mujeres, con una edad media de 51,38 años. Las indicaciones fueron trombosis previa (38,5%), disfunción (23,1%) y primoimplante (38,5%), con clínica de edema del miembro en dos pacientes. La fístula problemática más frecuente fue humerocefálica (53,8%), y el sector tratado predominante, la vena subclavia (53,8%), seguido de la ilíaca (3) el tronco innominado (1), la humeral (1) y sólo una vena superficial (cefálica). Resultados. El éxito técnico fue del 92,3%, y el éxito funcional, del 76,9%, con una ganancia media de flujo de 112,5 mL/min en global (48,5 mL/min excluyendo primoimplantes) y un flujo medio postratamiento de 220 mL/min. Se colocó un stent en el 90,9% de las lesiones del sistema venoso central de 10 mm de diámetro medio (rango: 8-12 mm). A fecha de corte permanecen permeables el 25% de las fístulas arteriovenosas (485 días de supervivencia media postratamiento) y el 66,7% de los procedimientos endovasculares (tres fueron exitus estando permeables), con 877 días de permeabilidad media. Conclusiones. Tal como recomienda la bibliografía consultada, el tratamiento endovascular de las lesiones venosas es eficaz para aumentar la supervivencia de los accesos vasculares para hemodiálisis con una indicación adecuada. El uso de endoprótesis está indicado en grandes troncos venosos centrales, con una permeabilidad superior respecto a la angioplastia transluminal percutánea

Aim. To evaluate the results obtained in endovascular therapy of venous stenoses of the limb used for vascular access in dialysis. Patients and methods. Between November 2001 and November 2005, a total of 13 endovascular procedures were performed in 11 patients, 46% males and 54% females, with a mean age of 51.38 years. Indications were previous thrombosis (38.5%), dysfunction (23.1%) and first implant (38.5%), and two of the patients had a clinical picture of oedema in the limb. The most frequent problematic fistula was brachicephalic (53.8%) and the predominant sector treated was the subclavian vein (53.8%), followed by the iliac (3), the innominate artery (1), brachial (1) and only one superficial vein (cephalic). Results. Technical success rate was 92.3% and functional success was 76.9%, with a mean flow gain of 112.5 mL/min overall (48.5 mL/min excluding first implants) and a mean post-treatment flow of 220 mL/min. In 90.9% of the lesions in the central venous system a stent with a mean diameter of 10 mm was placed (range: 8-12 mm). At the cutoff date, 25% of the arteriovenous fistulas remained patent (average of 485 days’ survival after treatment) and 66.7% of the endovascular procedures (three died while being patent), with 877 days of average patency. Conclusions. As recommended in the literature that was consulted, the endovascular treatment of venous lesions is effective in increasing survival of vascular accesses for haemodialysis with an appropriate indication. The use of stents is indicated in large central venous trunks, with a patency that is higher than that of percutaneous transluminal angioplasty

Ultrasonographic measurement of fetal nasal bone in a low-risk population at 19-22 gestational weeks.

OBJECTIVE: To determine the potential value of sonographic measurement of fetal nasal bone at 19-22 weeks' gestation in screening for trisomy 21 in a low-risk population. METHODS: The fetal nasal bone was measured in a mid-sagittal view in 2035 fetuses at 19-22 weeks' gestation. A reference range was constructed and the measurements in fetuses with trisomy 21 were compared to the normal group. RESULTS: The fetal profile was successfully examined in 1913/2035 (94%) fetuses. The mean nasal bone length increased linearly with gestation from 6.2 mm at 19 weeks to 6.8 mm at 22 weeks. Nasal bone hypoplasia, defined by absence of the bone or a measurement below the 2.5th centile, was observed in 34/1899 (1.8%) chromosomally normal fetuses (1.8%), in 5/5 fetuses with trisomy 21 and in 0/9 fetuses with other chromosomal defects. CONCLUSION: At 19-22 weeks' gestation, nasal bone hypoplasia is observed in a high proportion of trisomy 21 fetuses and in less than 2% of chromosomally normal fetuses.

Lupus eritematoso sistémico y gestación / Lupus erythematosus and pregnancy

El lupas eritematoso sistémico (LES) es una enfermedad cuyas expectativas han mejorado gracias al avance en el diagnóstico y tratamiento, aunque es preciso individualizar cada caso. Describiremos el caso de una gestante afectada de LES que presentó Tombopenia severa a las 23 semanas gestacionales y RPM (rotura prematura de membranas) a las 28 semanas. Se realizó terapia con corticoides e inmunoglobulinas y se decidió extracción fetal mediante cesárea a las 30 semanas. El resultado neonatal fue óptimo y no se produjo exacerbación de la enfermedad en el puerperio (AU)

Resultados histeroscópicos en pacientes tratadas con tamoxifeno / Histeroscopical results on tamoxifen-treated patients

El tamoxifeno es la terapia coadyuvante prescrita con más frecuencia en mujeres con cáncer de mama. Objetivo: valoración de los hallazgos histeroscópicos en mujeres con cáncer de mama en tratamiento con tamoxifeno durante un tiempo superior a seis meses, cuando se ha encontrado patología endometrial en la ecografía transvaginal de screening o la paciente ha presentado síntomas. Diseño del estudio: estudio retrospectivo de 73 pacientes con cáncer de mama en tratamiento con tamoxifeno sometidas a una histeroscopia diagnóstica Resultados: La media de edad de las pacientes fue de 62,28 años; de éstas el 89 por ciento fueron postmenopáusicas. La principal indicación para realizar la histeroscopia fue la sospecha ecográfica de patología endometrial (82 por ciento), seguido de la metrorragia postmenopáusica (13,7 por ciento).El hallazgo ecográfico más frecuente fue la presencia de un endometrio engrosado (75,3 por ciento). Los hallazgos histeroscópicos por orden de frecuencia fueron: histeroscopia normal, pólipos, hiperplasia quistica y atrofia endometrial. No hubo ningún caso de adenocarcinoma (AU)

Utero doble, hemivagina ciega y agenesia renal ipsilateral / Uterus didelphys, imperforate hemivagina and ipsilateral renal agenesis

Una causa frecuente de dolor abdominal cíclico en pacientes adolescentes que todavía no han menstruado es el hematocolpos, generalmente secundario a himen imperforado. Presentamos el caso poco habitual de una adolescente con útero doble y hematocolpos que consultó por dolor abdominal cíclico con menstruaciones regulares (AU)