Prevalence of myocardial bridges in the Mexican population: A morphometric and histological analysis.

BACKGROUND: Myocardial bridge (MB) is described as an abnormal band of myocardium covering a variable portion of any coronary artery. METHODS: The current study explores the presence of MB throughout the coronary arterial system and provides a morphometric description through instrumented dissection of a sample of 100 human hearts. The study shows a higher prevalence of MB in the Mexican population than in previous reports. RESULTS: In the total sample (n=100), MB was identified in 96% of it. A total of 421 MBs were observed, with a mean of 4.38mm (±0.28) per dissected heart. The most frequently affected vessel is the anterior interventricular artery where a total of 52 MBs were found, of the total sample studied. DISCUSSION: The high prevalence of MB among Mexican patients could be the result of a genetic association for this population or the neoformation of MB after birth due to lifestyle-associated factors. Further studies are required to better understand the high prevalence of MB among Mexican subjects.

La deportividad organizacional, una norma de comportamiento y una norma de juicio / Organizational sportsmanship, a norm of behavior, and a norm of judgment

Los comportamientos de ciudadanía organizacional (CCO) suelen considerarse como comportamientos extra-rol, transversales a diferentes puestos de trabajo, aunque, en ocasiones, son considerados parte del rol habitual; manteniéndose sí la elasticidad de su definición a raíz de la existencia de conceptos que, aunque en competencia, remiten a modelos similares (comportamientos organizacionales sociales, desempeño contextual, etc.). Con todo, parece haberse formado un consenso en torno a sus dimensiones constituyentes: altruismo, cortesía, civismo, profesionalismo y deportividad. Es esta última dimensión la que nos interesa aquí. Según Gangloff (2016), la deportividad tendría un carácter normativo. Sin embargo, es posible distinguir dos tipos de normas: normas de comportamiento y normas de juicio (Dubois, 1994). El presente estudio plantea la posibilidad de transformar la deportividad organizacional en una norma de juicio. 120 empleados del sector privado (60 hombres y 60 mujeres) han respondido a preguntas que corresponden a cuatro ítems de deportividad distribuidos al azar entre 24 ítems a ser completados. Dos de estos ítems fueron extraídos de un cuestionario clásico de CCO -y están formulados en forma de comportamientos-, mientras que los otros dos fueron construidos ad hoc y formulados en forma de juicios. Los resultados obtenidos van en el sentido de la hipótesis planteada (AU)

Organizational citizenship behaviors (OCB) are usually considered as extra-role behaviors, transversal to diffe-rent jobs, although sometimes they are considered part of the usual role; maintaining the elasticity of its definition as a result of the existence of concepts that, although in competition, refer to similar models (social organizational behaviors, contextual performance, etc.). Still, it seems to have formed a consensus around its constituent dimensions: altruism, courtesy, civility, professionalism, and sportsmanship. It is this last dimension that interests us here. Accor-ding to Gangloff (2016), sportsmanship would have a normative character. However, it is possible to distinguish two types of norms: norms of behavior and norms of judgment (Dubois, 1994). The present study raises the possibility of transforming organizational sportsmanship into a standard of judgment. 120 private sector employees (60 men and 60 women) have answered questions that correspond to four sportsmanship items randomly distributed among 24 items to be completed. Two of these items were extracted from a classic OCB questionnaire - and are formulated in the form of behaviors - while the other two were constructed ad hoc and formulated in the form of judgments. The results obtained are in the sense of the hypothesis raised (AU)

Liver damage in bleomycin-induced pulmonary fibrosis in mice.

Pulmonary fibrosis is an emerging disease with a poor prognosis and high mortality rate that is even surpassing some types of cancer. This disease has been linked to the concomitant appearance of liver cirrhosis. Bleomycin-induced pulmonary fibrosis is a widely used mouse model that mimics the histopathological and biochemical features of human systemic sclerosis, an autoimmune disease that is associated with inflammation and expressed in several corporal systems as fibrosis or other alterations. To determine the effects on proliferation, redox and inflammation protein expression markers were analyzed by immunohistochemistry. Analyses showed a significant increase in protein oxidation levels by lipoperoxidation bio-products and in proliferation and inflammation processes. These phenomena were associated with the induction of the redox status in mice subjected to 100 U/kg bleomycin. These findings clearly show that the bleomycin model induces histopathological alterations in the liver and partially reproduces the complexity of systemic sclerosis. Our results using the bleomycin-induced pulmonary fibrosis model provide a protocol to investigate the mechanism underlying the molecular alteration found in the liver linked to systemic sclerosis.

[Invasive Haemophilus influenzae type B infections in infancy (1981-1990)]. / Infecciones invasivas por Haemophilus influenzae tipo B en la infancia (1981-1990).

We report the epidemiology of invasive Haemophilus influenzae type B infections. The study is based on 58 children and was carried out during the years from 1981 to 1990. Sixty-three percent of the patients had meningitis, 10.3% had arthritis, 10.3% had epiglottitis, 8.6% had cellulitis and 6.9% had pneumonia. Thirteen percent of the cases were children who were less than 6 months old, 34.4% were less than 12 months old, 70.6% were less than 24 months of age and 93% were less than 4 years old. Among the latter, 90% of the children with epiglottis or pneumonia were 24 months or older compared with 16% of the patients with meningitis, arthritis or cellulitis (p < 0.001). Sixty-three percent of the isolated strains of Haemophilus influenzae type B were resistant to ampicillin and 19.2% of the strains were resistant to ampicillin and chloramphenicol.

La biopsia endoscópica en cáncer gástrico

Con el fin de comparor lo déscrito en la literatura mundial sobre numero y sitio de la toma de la biopsia en lesiones gástricas sospechosas de malignidad realizamos en 41 pacientes un estudio prospéctivo,abierto,a los cuales se les tomaron 9 fragmentos,analizados en grupos de tres.Con la información obtenida se clasificaron los apacientes y se establecio que la sensibilidad de la biopsia gástrica aumenta en la medida que se toma un mayor número de fragmentos del area sospechosa

Enfermedad de Gaucher: presentación de dos hermanos

La enfermedad de Gaucher es un desorden hereditario en el metabolismo de los glucocerebrósidos (glucosil ceramidas). Es causada por la deficiencia de glucocerebridasa lisosomal que cataliza la liberación de glucosa de la glucosil ceramida. El exceso de este glucocerebrósido se acumula en las células reticuloendoteliales, las cuales toman su apariencia característica. Masas de estas células de Gaucher infiltran y hacen crecer órganos como el bazo, hígado, nodos linfáticos y alternan la estructura y función de otros órganos como huesos y pulmones. Se han reconocido variantes de esta enfermedad, las cuales parecen ser debidas a diferentes mutaciones, afectando el mismo locus genético o un similar. Se presentan dos casos de esta enfermedad en dos hermanos de raza negra, procedentes de Buenaventura (Valle). El mayor se sexo masculino tiene 18 años, y la hermana 16 años. No hay otros casos en la familia. Se presentan con hepatoesplenomegalia gigante, retardo en el desarrollo físico y sexual y uno de ellos con convulsiones. Se hace el diagnóstico por medio de aspirado y biopsia de medula osea

Colitis colágena: una buena razón para tomar biopsias de recto en pacientes con diarrea crónica

El motivo de presentar esta paciente es hacer consciencia entre el cuerpo médico de la existencia de esta entidad, de la cual hay muy pocos casos reportados en la literatura y sólo informe reciente en nuestro país. La colitis colágena es una entidad de etiología no aclarada que se caracteriza histológicamente por la presencia de una banda de colágeno mayor de 7 micras a nivel subepitelial de la mucosa colorrectal y clínicamente por diarrea crónica acuosa profusa, que puede asociarse con dolor abdominal tipo cólico, y estudios tanto de laboratorio como endoscópicos negativos. Se presenta un caso de esta entidad manejado recientemente en el Hospital Universitario del Valle, en quien se tomaron las biopsias aún en presencia de cambios endoscópicos. La respuesta terapéutica a la sulfasalazina y esteroides ha sido aceptable. Finalmente, sugerimos como recomendación que en pacientes con diarrea crónica no explicada, deben tomarse biopsias de colon y recto, a pesar de no presentar cambios endoscópicos

Tuberculosis ano rectal: presentación de 2 casos

Se presentan dos casos de tuberculosis rectal: en uno de ellos habia además lesiones de la piel perianal, cuyas biopsias fueron positivas para Bacilo de Koch. Ambos casos presentaban compromiso pulmonar. Se hace asi mismo una breve revisión de la literatura

Esofagitis secundaria a medicamentos

Se presentan dos casos de esofagitis aguda severa relacionada con la ingestión de doxiciclina y se lleva a cabo una revisión breve de la literatura, hacindo énfasis en algunas recomendaciones para evitar esta entidad severa

Carcinoma Primario del Duodeno: Informe de 4 Casos

El cáncer primario del duodeno es un tumor muy raro. La fibroendoscopia gastrointestinal alta de uso incrementado en los últimos anos, puede contribuir al diagnóstico temprano. Se presentan en esta publicacion cuatro casos de carcinoma primario del duodeno estudiados en el Hospital Universitario del Valle entre 1958 y 1986, analizándose sus características clínicas y comparandolas con otros casos presentados en diferentes poblaciones

Defective thyroidal iodine concentration in protein-calorie malnutrition.

Although protein-calorie malnutrition (PCM) is known to result in various abnormalities of thyroid function, the exact relationship between the two is not clearly understood. Therefore, the thyroid function of 10 men, 13-55 yr of age, with severe PCM was studied in a clinical research ward before and 3-4 months after protein-calorie repletion. Before repletion, all subjects had low serum T4 (mean +/- SEM, 5.1 +/- 0.5 micrograms/dl) and T3 (74 +/- 6 ng/dl) concentrations. Eight subjects were chemically euthyroid, and their free T4 (1.5 +/- 0.1 ng/dl) and serum TSH (2.9 +/- 1.4 microU/ml) values were normal. Two subjects were chemically hypothyroid, with low free T4 values and high serum TSH values. After repletion, the 8 euthyroid subjects had significant increases in serum T4 (P less than 0.01) and T3 (P less than 0.005), but TSH did not change. Serum T4 and T3 were still lower (P less than 0.05-0.001) and TSH higher (P less than 0.01) than in 28 normal men of comparable age coming from the same area. After repletion, values remained unchanged in the 2 hypothyroid subjects, except for moderate increases in serum T3 and slight decreases in TSH. In all PCM subjects, values of thyroidal exchangeable iodine (23.1 +/- 7 vs. 42.9 +/- 8 mg; P less than 0.02), estimated thyroidal I per g wet wt (1.05 +/- 0.3 vs. 1.99 +/- 0.36 mg; P less than 0.02), and thyroidal iodide clearance (13.8 +/- 1.6 vs. 19.4 +/- 1.3 ml/min; P less than 0.002) were lower before repletion than after; the protein-bound 131I level (72 h; 0.27% vs. 0.08 dose/liter; P less than 0.05) was higher, but thyroid hormone secretion rates (200 +/- 49 vs. 153 +/- 25 micrograms/day) were not significantly different. Thyroid iodide clearance was lower even though plasma inorganic iodine (6.3 +/- vs. 12.5 +/- 3 micrograms/liter; P less than 0.05) and daily urinary iodine excretion (158 +/- 43 vs. 395 +/- 62 micrograms; P less than 0.01) were lower before than after repletion. In 2 PCM euthyroid subjects, baseline thyroid 131I uptake was lower before than after repletion, and the magnitude of the increase after TSH (10 U, im) stimulation was greater when the malnourished state improved. TSH increased concentrations of serum T4 and T3 both before and after protein repletion. After repletion, one hypothyroid patient failed to respond to TSH; the other had a small increase in 131I uptake but not in serum T4 or T3. The results indicate defective thyroid iodine concentration in human PCM, but adequate hormone secretion. This situation leads to depletion of thyroid iodine stores. This alteration, if extreme, might result in hypothyroidism. Adequate protein-calorie intake tends to reverse these abnormalities.

Intestinal function and morphology in strongyloidiasis.

Divergent available information on the capability of Strongyloides stercoralis to cause malabsorption prompted a long-term observation in which the nutritional state of the subjects was carefully defined. In spite of moderate to severe symptoms, well nourished patients, even with segmental jejunitis, did not show malabsorption. All patients presenting this parasitic infection with concomitant malnutrition showed absorptive defects. Abnormal absorption persisted in spite of parasitic cure when malnutrition was not immediately corrected, and disappeared with correction of the malnutrition even if parasitic infection was allowed to continue. The present experience indicates that the malabsorption syndrome seen in some cases of S. stercoralis infection is secondary to the concomitant malnutrition and not to the parasite per se.

Enterobacteriaceae in the jejunal microflora prevalence and relationship to biochemical and histological evaluations in healthy Colombian men.

When 23 healthy native Southwestern Colombian men were studied to determine the prevalence of Enterobacteriaceae in the jejunal microflora in a sample of thoroughly evaluated tropical inhabitants who were normal by physical examination, chest x-ray, and medical history, 14 of the 23 proved to be Enterobacteriaceae-positive, with counts of 10(3) to 10(9) per milliliter of jejunal aspirate. Thirteen had Escherichia coli, and the fourteenth had Klebsiella pneumoniae. Four had a second species of Enterobacteriaceae associated with E. coli: three were K. pneumoniae, and one was Proteus morganii. Laboratory studies routinely done on all subjects disclosed a total of 18 low biochemical values, 17 of which were associated with 12 of the 14 Enterobacteriaceae-positive subjects: six were low in serum cholesterol, four low in serum vitamin B12, four low in D-xylose excretion, and three low in creatinine coefficient; whereas, the Enterobacteriaceae-negative subjects had normal values for all biochemical tests except for serum vitamin B12 in one case. Nitrogen balance means were significantly different for the two groups: 3.39 g for the Enterobacteriaceae-positive subjects and 1.94 g for the Enterobacteriaceae-negative. No relationship was evident when the histology of the jejunal biopsies was compared with the microbiological or laboratory findings. When the 23 subjects were grouped into those (N = 19) with significant microbial recoveries of any type and those (N = 4) without, the data yielded no meaningful relationships.

Enteropathy in adult protein malnutrition: a review of the Cali experience.

Since 1964, 41 patients with strictly defined, severe primary (dietetic) protein malnutrition have been studied under metabolic ward conditions during prolonged periods, initially on a low (20 g) and later on a high (100 g) protein diet. Clinical, nutritional, hematological, intestinal absorptive and histological studies were performed in the malnourished state, during and after protein repletion. Classical signs and symptoms of malnutrition, lasting for at least 4 months, were present in most patients. Mild diarrhea was frequent. All were normoblastically anemic, hypoproteinemic, and hypocholesterolemic; serum folate values were normal or low but serum B12 values were normal or high. Liver biopsy showed fatty liver in the cases where it was performed. Mild malabsorption was detected in over one-half of the patients, with moderate intestinal radiological abnormalities. Malabsorption was independent of concomitant folate deficiency. All the clinical, absorptive and histological abnormalities reversed with treatment consisting only of a high protein diet. In addition to protein lack, another factor has to be invoked in the pathogenesis of the intestinal abnormalities present in severely malnourished adults from rural areas in the tropics.