The Ginkgo biloba extract (GbE) protects the kidney from damage produced by a single and low dose of carbon tetrachloride in adult male rats.

Gingko biloba leaves have been used as herbal medicine in China for 5000 years, and the standardized leaf extract (GB-STE) has some beneficial effects in the treatment of age-related, cardiovascular, and neurological diseases. The aim of this study was to investigate the renoprotective effects of the Gingko biloba extract (GbE) against the toxicity of a single and relatively low dose of carbon tetrachloride (CCl4). In male adult Wistar rats, we determined the urine flux, the concentration of total proteins in urine, the concentration of glucose in urine, and the concentration of malondialdehyde (MDA) in renal cortex as well as two markers of renal function (clearance of inulin and p-aminohippurate); we also compared the histological lesions caused by CCl4. Carbon tetrachloride increased the urinary concentration of total proteins, and the renal concentration of MDA; however, it did not modify the urine flux, urinary concentration of glucose, nor the inuline or the p-aminohipurate clearances. Morphologically, CCl4 generated some tubular damage that was more intense in the inner cortex of kidneys. The GbE extract counteracted the effects of CCl4 on the concentration of total proteins in urine, the concentration of renal MDA, and the renal histological changes. In conclusion the main toxic effects produced by CCl4 were prevented by the GbE, probably due to their antioxidant properties and the inhibition of the main P450 isoenzyme (CYP2E1) that metabolize CCl4.

[Pure neural leprosy. Diagnostic aspects of a clinical case]. / Lepra neural pura. Aspectos diagnosticos en un caso clinico.

INTRODUCTION: Leprosy is an infectious disease caused by the bacteria Mycobacterium leprae. It is particularly prone to affect the skin and the nerve trunks and, in fact, both are compromised in most infected patients. It is transmitted by exposure to those with the disease and sometimes by reactivation. One uncommon possibility is pure neural leprosy, which is characterised by neuropathy, but without skin lesions. We report the case of a patient with pure neural leprosy and review the diagnostic aspects. CASE REPORT: A 40-year-old male, an immigrant who was diagnosed and treated for leprosy 20 earlier. The patient visited due to painful paraesthesias and dysesthesias in the hands and legs without the presence of any skin lesions. Acute multiple mononeuritis with mainly ulnar involvement was observed. The disease, typified as paucibacillary/tuberculoid, was treated and in a few weeks there was a clear improvement. CONCLUSIONS: In this case of pure neural leprosy due to reactivation, early diagnosis allowed timely treatment to be established. Evaluation of neuropathy together with clinical, electrophysiological and ultrasound criteria is recommended. By so doing, a high degree of sensitivity is achieved as well as allowing early diagnosis and treatment, and therefore a better functional recovery.

TITLE: Lepra neural pura. Aspectos diagnosticos en un caso clinico.Introduccion. La lepra es una enfermedad infecciosa causada por la bacteria Mycobacterium leprae. Presenta especial avidez por la piel y los troncos nerviosos, y, de hecho, ambos se afectan en la mayor parte de los infectados. Se trasmite por exposicion con enfermos y en ocasiones por reactivacion. Una posibilidad inhabitual es la lepra neural pura, caracterizada por neuropatia, pero sin lesiones en la piel. Se describe un paciente con lepra neural pura y se revisan los aspectos diagnosticos. Caso clinico. Varon de 40 años, inmigrante, diagnosticado y tratado de lepra 20 años antes. Acudio por parestesias y disestesias dolorosas en las manos y las piernas sin lesiones en la piel. Se demostro mononeuritis multiple aguda con principal afectacion de cubitales. La enfermedad, tipificada como tuberculoide paucibacilar, se trato y en pocas semanas la mejoria fue evidente. Conclusiones. En este caso de lepra neural pura por reactivacion, el diagnostico temprano permitio un rapido tratamiento. Es recomendable la evaluacion de la neuropatia integrada con criterios clinicos, electrofisiologicos y ecograficos. De este modo se consigue una alta sensibilidad y especialmente una precocidad en el diagnostico y la instauracion del tratamiento, y por consecuencia una mejor recuperacion funcional.

Análisis de un programa de teleoftalmología para el cribado de retinopatía diabética en área rural tras cinco años / Five-year experience of tele-ophthalmology for diabetic retinopathy screening in a rural population

OBJETIVO: Estudiar la prevalencia de retinopatía diabética (RD) y los factores de riesgo asociados en la población incluida en un programa de teleoftalmología en área rural. Evaluar la capacidad diagnóstica de RD de los médicos de atención primaria (MAP) y su correcta coordinación con los oftalmólogos, cuantificando el ahorro generado. MATERIAL Y MÉTODOS: Estudio observacional transversal de una muestra aleatoria de 394 pacientes incluidos en el programa de teleoftalmología desde enero de 2010 a enero de 2015. Analizamos características clínicas, hallazgos de RD en las retinografías y la correcta derivación de imágenes por los MAP al servicio de oftalmología según los criterios establecidos: RD moderada o severa, baja agudeza visual (AV), mala calidad de imagen y presión intraocular (PIO) > 22 mmHg. Análisis estadístico con SPSS. Pruebas t de Student y χ 2. RESULTADOS: La prevalencia de RD fue del 12,1%. Los pacientes con hemoglobina glucosilada > 7,68% o tratados con combinación de antidiabéticos orales e insulina presentaron mayor riesgo de RD (p < 0,05). El 43,3% de los pacientes derivados correctamente a oftalmología presentaban retinopatía moderada o severa. Los pacientes no derivados a oftalmología de forma correcta pasaron de un 91,7% en 2010 a un 98,6% en 2014. Estimamos un ahorro global de 152.550,45€. CONCLUSIONES: El programa de teleoftalmología resulta útil como cribado de RD. Los MAP son capaces de discriminar los pacientes que requieren valoración oftalmológica, evitando consultas presenciales y generando ahorro

OBJECTIVE: To identify the prevalence and risk factors of diabetic retinopathy (DR) among rural inhabitants included in a tele-ophthalmology program. To analyse diagnostic accuracy among primary care physicians, concordance with ophthalmologists, and financial savings. MATERIAL AND METHODS: An observational randomised study was conducted on 394 patients included in a tele-ophthalmology program (from January 2010 to January 2015). An analysis was performed on the clinical characteristics, DR findings in retinography images, and correspondence between the request for a second interpretation by an ophthalmologist, and previously established criteria for it: presence of moderate to severe DR, vision loss, poor image quality and/or intraocular pressure > 22 mmHg. Statistical analysis was performed using the SPSS program (Student t and χ 2 tests). RESULTS: DR prevalence was 12.1%. Patients with glycosylated haemoglobin values > 7.68% or those treated with a combination of insulin and oral antidiabetic drugs showed a higher risk of DR (P < .05). 43.3% of patients correctly referred to ophthalmologists showed moderate to severe DR. Unnecessary referrals to specialists were improved from 91.7% in 2010 to 98.6% in 2014. It is estimated that the program has made a total saving of €152,550.45. CONCLUSIONS: Tele-ophthalmology programs are a useful tool in DR screening. Primary care physicians are able to distinguish patients who need specialist care, avoiding unnecessary referrals to ophthalmologists, and saving costs

Five-year experience of tele-ophthalmology for diabetic retinopathy screening in a rural population. / Análisis de un programa de teleoftalmología para el cribado de retinopatía diabética en área rural tras cinco años.

OBJECTIVE: To identify the prevalence and risk factors of diabetic retinopathy (DR) among rural inhabitants included in a tele-ophthalmology program. To analyse diagnostic accuracy among primary care physicians, concordance with ophthalmologists, and financial savings. MATERIAL AND METHODS: An observational randomised study was conducted on 394 patients included in a tele-ophthalmology program (from January 2010 to January 2015). An analysis was performed on the clinical characteristics, DR findings in retinography images, and correspondence between the request for a second interpretation by an ophthalmologist, and previously established criteria for it: presence of moderate to severe DR, vision loss, poor image quality and/or intraocular pressure >22mmHg. Statistical analysis was performed using the SPSS program (Student t and χ(2) tests). RESULTS: DR prevalence was 12.1%. Patients with glycosylated haemoglobin values >7.68% or those treated with a combination of insulin and oral antidiabetic drugs showed a higher risk of DR (P<.05). 43.3% of patients correctly referred to ophthalmologists showed moderate to severe DR. Unnecessary referrals to specialists were improved from 91.7% in 2010 to 98.6% in 2014. It is estimated that the program has made a total saving of €152,550.45. CONCLUSIONS: Tele-ophthalmology programs are a useful tool in DR screening. Primary care physicians are able to distinguish patients who need specialist care, avoiding unnecessary referrals to ophthalmologists, and saving costs.

Parálisis facial periférica en un paciente con lesiones vesiculosas unilaterales en el rostro / Peripheral facial palsy in a patient with unilateral vesicular eruption on the face

No disponible

Morfea tras radioterapia en paciente con cáncer de mama / Morphea Following Radiation Therapy in a Patient With Breast Cancer

No disponible

Lesión anular de crecimiento centrífugo / Annular lesion of centrifugal growth

No disponible

Toxicidad cutánea por telaprevir: un nuevo fármaco que es necesario conocer / Skin Toxicity Due to Telaprevir: A New Drug We Should Be Familiar With

No disponible

Efecto de una intervención sobre prescripción de citicolina por médicos de atención primaria / Effect of an intervention about prescribing citicoline on primary care physicians

No disponible

Un paciente con eritrodermia descamativa y eosinofilia / A patient with erythroderma desquamativa and eosinophilia

No disponible

Falsa amiotrofia en los antebrazos por lipoatrofia semicircular / False amyotrophy in the forearms due to semicircular lipoatrophy

No disponible

Queilitis granulomatosa. Presentación de 6 casos y revisión de la literatura / Granulomatous Cheilitis: A Report of 6 Cases and a Review of the Literature

Introducción: La queilitis granulomatosa (QG) de Miescher representa la forma monosintomática más frecuente del síndrome de Melkersson-Rosenthal, que se caracteriza por una tumefacción labial recurrente. El objetivo de nuestro estudio fue describir las características de los pacientes con QG atendidos en nuestro servicio durante un periodo de 17 años. Material y métodos: Estudio descriptivo de los pacientes diagnosticados de QG atendidos en el Departamento de Dermatología desde enero de 1993 hasta enero de 2010. Resultados: Se recogieron un total de 6 pacientes, con un ligero predominio femenino (4 mujeres y 2 hombres), y una media de edad al diagnóstico de 49 años. Todos presentaban una tumefacción en el labio superior, persistente y recurrente, junto con afectación de otras regiones faciales en 2 casos. La media de tiempo desde la aparición de los síntomas a la consulta inicial fue de aproximadamente 16 meses. En ningún paciente se observó la presencia de parálisis facial y únicamente se objetivó lengua fisurada en un caso. Durante los años de seguimiento ningún paciente fue diagnosticado de enfermedad de Crohn ni de otra enfermedad granulomatosa. Conclusión: La QG es una entidad infrecuente. Ninguno de los pacientes evaluados ha presentado sintomatología gastrointestinal o neurológica asociada, por lo que consideramos la QG de Miescher una patología independiente dentro del grupo de las granulomatosis orofaciales, no asociada a otros síntomas o signos como forma de presentación más frecuente (AU)

Introduction: Granulomatous cheilitis (Miescher cheilitis), a condition characterized by recurrent swelling of the lips, is the most common monosymptomatic form of the Melkersson-Rosenthal syndrome. The aim of this study was to study the characteristics of patients diagnosed with granulomatous cheilitis at the dermatology department of our hospital over a period of 17 years. Material and methods: We performed a descriptive study of patients diagnosed with granulomatous cheilitis at our hospital between January 1993 and January 2010. Results: The condition was diagnosed in 6 patients (4 women and 2 men), with a mean age of 49 years at the time of diagnosis. All the patients had recurrent swelling of the upper lip and 2 also had swelling in other parts of the face. The mean time from the onset of symptoms to the initial visit was approximately 16 months. There were no cases of facial palsy, and just1 patient had a fissured tongue. None of the patients developed Crohn disease or any other granulomatous disorders during follow-up. Conclusions: Granulomatous cheilitis is a rare disease. None of the patients in our series had gastrointestinal or neurologic symptoms. Accordingly, we believe that granulomatous cheilitis is an in dependent orofacial granulomatous disease which most often presents without accompanying signs or symptoms (AU)