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El mundo tuberculoso de Maxence Van der Meersch
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Duarte G., Ignacio

Revista chilena de infectología

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Jun 2021, Volume 38 Nº 3 Páginas 432 - 437

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Maxence Van der Meersch (1907-1951) was a French writer whose novels encompassed social inequities of the time. Among them, those related to tuberculosis are of special interest. This was a common disease that affected his family members and ultimately caused his death. In his narrations, the author refers to the various signs of the illness, the diagnostic methods, the patients’ behaviour, their environment, how it affected their employment situation, the economic difficulties, treatment resources and complications. As the novels’ plots are developed throughout the so called “sanatorial age of tuberculosis”, the author describes the events occurring in a public sanatorium. The similitude among the situations lived by the writer and his wife, and those of the imaginary couples in the novels are highlighted. During his last years, Van der Meersch's success declined due to the complications of his illness, and because of the harsh criticism towards some of his writings. Particularly, the critiques posed by the medical professionals of the time, who rejected the raw language, inaccurate technical descriptions, and, above all, the promotion of an objected anti-tuberculosis regime.

Resumen Maxence Van der Meersch (1907-1951) fue un escritor francés cuyas novelas exponían las desigualdades sociales de la época. Entre ellas se destacan las asociadas con la tuberculosis, enfermedad frecuente, que aquejó a miembros de su familia y causó la muerte del autor. Las narraciones refieren las formas de presentación del mal, los métodos de diagnóstico, las actitudes de los pacientes y de su entorno, cómo afectaba a su situación laboral, los medios de subsistencia familiar y los recursos y complicaciones de los tratamientos. Al desarrollarse el argumento durante la llamada “era sanatorial de la tuberculosis” se retrata el acaecer en un sanatorio público. Se destaca la similitud de sucesos de la vida real del escritor y su esposa con los que se describen en parejas imaginadas en las novelas. El éxito de Van der Meersch fue opacado en sus últimos años por el agravamiento de su enfermedad y por críticas formuladas a algunos escritos. Resaltan las del cuerpo médico de esos años, que objetaron la crudeza del lenguaje, la inexactitud en la descripción de técnicas y, principalmente, por promover un objetado régimen antituberculoso.

520 downloads

Colitis de Crohn: resultados del tratamiento quirúrgico y evolución alejada
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Imigo G., Felipe

; Molina P., María-Elena

; Álvarez-Lobos, Manuel

; Quintana V., Carlos

; Klaassen L., Julieta

; Torres M., Javiera

; Duarte G., Ignacio

; Bellolio R., Felipe

; Zúñiga D., Álvaro

Revista médica de Chile

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Fev 2018, Volume 146 Nº 2 Páginas 183 - 189

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Exclusive involvement of the colon or rectum in Crohn's disease, called Crohn's colitis, (CC) occurs in about 25% of these patients. Aim: To analyze early surgical results and long-term outcomes of patients undergoing surgery for CC. Material and Methods: Review of a prospective database, identifying patients with Crohn's disease operated between 2003 and 2015 and excluding those with ileocecal disease. We analyzed demographic data, pre and postoperative pharmacological treatment, operations, morbidity and the need for a second bowel resection at follow-up. Results: We reviewed data from 28 patients aged 17 to 72 years (15 men). Twenty-seven (96.4%) had previous pharmacological treatment, 11 received monoclonal antibodies. The most common indications for surgical treatment were failure of medical treatment in 15 cases, acute severe colitis in 12 and anemia/malnutrition in eight. Total colectomy was performed in 17 (61%) patients, proctocolectomy in 8 (29%) and segmental colectomies in 3 (11%). Sixteen (57%) were operated laparoscopically. Major postoperative complications were observed in 5 (18%). Four needed a reintervention. There was no operative mortality. During a 55 months median follow-up of 27 patients, seven (26%) required a second bowel resection, one of them for recurrence. Nineteen (70%) patients had an ostomy, which was permanent in 11. Fifteen patients are without medical treatment. Conclusions: Most of the reviewed patients required total colectomy for the control of the disease with a low surgical morbidity. Two-thirds required an ileostomy, which became permanent in half of them.

https://doi.org/10.4067/s0034-98872018000200183 1064 downloads

Historia de la escrófula: de la discrasia humoral a la consunción
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Duarte G, Ignacio

; Chuaqui F, Claudia

Revista médica de Chile

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Abr 2016, Volume 144 Nº 4 Páginas 503 - 507

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

The term “scrofula” was used for a long time to designate a chronic swelling of cervical lymph nodes. This paper outlines the prevalent ideas on the nature, pathogenesis and the treatment of this disorder, from classical Greek medicine up to the 18th century. A Hippocratic treatise regarded scrofula as produced by an accumulation of phlegm, with a consequent imbalance or dyscrasia of the body humors. It was believed that it could heal spontaneously; but it could also soften, open through the skin and have an obstinate course. The treatment consisted mainly on local applications, incision to evacuate the soft content, or extirpation of the abnormal mass. In France and England, crowds of scrofulous patients were touched by the kings who were supposed to have a hereditary miraculous power to cure the disease. A Medieval text mentioned that scrofula could also affect other parts of the body. In the 17th century, scrofula was reputed as a frequent condition and was attributed to blood acrimony which coagulated in spongy organs. It was associated to phthisis or consumption due to the lethal outcome in some patients and to a cheese-like appearance of the pulmonary and the scrofulous lesions.

1742 downloads

CARCINOMA DE CÉLULAS ESCAMOSAS PRIMARIO DEL PÁNCREAS
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Gabrielli N, Mauricio

; Achurra T, Pablo

; León F, Felipe

; Leiva S, Lissette

; Martínez R, Santiago

; Duarte G, Ignacio

; Guerra C, Juan F

; Martínez C, Jorge

; Jarufe C, Nicolás

; Guzmán B, Sergio

Revista chilena de cirugía

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Dez 2014, Volume 66 Nº 6 Páginas 577 - 582

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Squamous cells are usually not present in the pancreas. Therefore, primary squamous cell carcinoma of the pancreas (SCCP) is an extremely rare tumor. Case report: We report two cases of SCCP. Case 1: A 77 years-old woman was admitted for upper gastrointestinal bleeding. MDCT scan and endoscopic biopsy showed a carcinoma of the pancreatic head. She underwent a Whipple procedure and definitive biopsy revealed a SCCP. She died 9 years after surgery due to an unrelated disease. To our knowledge, this is the longest survival reported. Case 2: A 63 years-old man was admitted for jaundice. Work-up revealed a pancreatic head mass and liver metastasis. He underwent a palliative double bypass surgery and chemotherapy. Intraoperative biopsy revealed a SCCP. The patient is still alive at 8 months follow-up. Conclusion: Differential diagnoses of pancreatic cancer include SCCP. Long-term survival can be achieved if an early diagnosis and treatment are performed.

Introducción: Las células escamosas habitualmente no están presentes en el páncreas. Por lo tanto, el carcinoma de células escamosas primario del páncreas (CCEP) es un tumor extremadamente raro. Caso clínico: Presentamos dos casos de CCEP. Caso 1 : Una paciente de 77 años consulta por hemorragia digestiva alta. El estudio con tomografía computada de abdomen y biopsias endoscópicas revelaron un carcinoma de la cabeza pancreática. Se realiza operación de Whipple con intención curativa y la biopsia definitiva fue diagnóstica de un CCEP. La paciente fallece 9 años después de la cirugía debido a una enfermedad no relacionada, siendo actualmente la mayor sobrevida reportada en la literatura. Caso 2: Un hombre de 63 años consulta por ictericia y dolor abdominal. El estudio con imágenes revela una masa en la cabeza pancreática en conjunto con múltiples metástasis hepáticas. Se realiza una doble derivación biliar y digestiva con intención paliativa, junto con quimioterapia. Las biopsias intraoperatorias revelaron un CCEP. El paciente permanece vivo a los 8 meses de seguimiento. Conclusiones: El diagnóstico diferencial del cáncer pancreático incluye el CCEP. Es posible lograr sobrevida a largo plazo en caso de diagnóstico y tratamiento en forma oportuna.

5794 downloads

Placental hydroxymethylation vsmethylation at the imprinting control region 2 on chromosome 11p15.5
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Magalhães, H.R.

; Leite, S.B.P.

; Paz, C.C.P. de

; Duarte, G.

; Ramos, E.S.

Brazilian Journal of Medical and Biological Research

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Out 2013, Volume 46 Nº 11 Páginas 916 - 919

Resumo: En | Texto: En | PDF: En

In addition to methylated cytosines (5-mCs), hydroxymethylcytosines (5-hmCs) are present in CpG dinucleotide-enriched regions and some transcription regulator binding sites. Unlike methylation, hydroxymethylation does not result in silencing of gene expression, and the most commonly used methods to study methylation, such as techniques based on restriction enzymatic digestion and/or bisulfite modification, are unable to distinguish between them. Genomic imprinting is a process of gene regulation where only one member of an allelic pair is expressed depending on the parental origin. Chromosome 11p15.5 has an imprinting control region (ICR2) that includes a differentially methylated region (KvDMR1) that guarantees parent-specific gene expression. The objective of the present study was to determine the presence of 5-hmC at the KvDMR1 in human placentas. We analyzed 16 third-trimester normal human placentas (chorionic villi). We compared two different methods based on real-time PCR after enzymatic digestion. The first method distinguished methylation from hydroxymethylation, while the other method did not. Unlike other methylation studies, subtle variations of methylation in ICRs could represent a drastic deregulation of the expression of imprinted genes, leading to important phenotypic consequences, and the presence of hydroxymethylation could interfere with the results of many studies. We observed agreement between the results of both methods, indicating the absence of hydroxymethylation at the KvDMR1 in third-trimester placentas. To the best of our knowledge, this is the first study describing the investigation of hydroxymethylation in human placenta using a genomic imprinting model.

https://doi.org/10.1590/1414-431X20133035 1453 downloads

Comparison of different protocols for the extraction of microbial DNA from reef corals
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Santos, H.F.

; Carmo, F.L.

; Leite, D.C.A.

; Jesus, H.E.

; De Carvalho Maalouf, P.

; Almeida, C.

; Soriano, A.U.

; Altomari, D.

; Suhett, L.

; Vólaro, V.

; Valoni, E.

; Francisco, M.

; Vieira, J.

; Rocha, R.

; Sardinha, B.L.

; Mendes, L.B.

; João, R.R.

; Lacava, B.

; Jesus, R.F.

; Sebastian, G.V.

; Pessoa, A.

; van Elsas, J.D.

; Rezende, R.P.

; Pires, D.O.

; Duarte, G.

; Castro, C.B.

; Rosado, A.S.

; Peixoto, R.S.

Brazilian Journal of Microbiology

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Jun 2012, Volume 43 Nº 2 Páginas 517 - 527

Resumo: En | Texto: En | PDF: En

This study aimed to test different protocols for the extraction of microbial DNA from the coral Mussismilia harttii. Four different commercial kits were tested, three of them based on methods for DNA extraction from soil (FastDNA SPIN Kit for soil, MP Bio, PowerSoil DNA Isolation Kit, MoBio, and ZR Soil Microbe DNA Kit, Zymo Research) and one kit for DNA extraction from plants (UltraClean Plant DNA Isolation Kit, MoBio). Five polyps of the same colony of M. harttii were macerated and aliquots were submitted to DNA extraction by the different kits. After extraction, the DNA was quantified and PCR-DGGE was used to study the molecular fingerprint of Bacteria and Eukarya. Among the four kits tested, the ZR Soil Microbe DNA Kit was the most efficient with respect to the amount of DNA extracted, yielding about three times more DNA than the other kits. Also, we observed a higher number and intensities of DGGE bands for both Bacteria and Eukarya with the same kit. Considering these results, we suggested that the ZR Soil Microbe DNA Kit is the best adapted for the study of the microbial communities of corals.

24569 downloads Citado 1 vez em SciELO

Elaboración de recubrimientos cerámicos mediante proyección térmica por combustión a partir de residuos sólidos industriales
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Restrepo, E.

; Vargas, F.

; López, M.

; Cardona, R.

; Duarte, G.

Matéria (Rio de Janeiro)

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2012, Volume 17 Nº 4 Páginas 1176 - 1185

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Ceramic coatings were elaborated onto carbon steel substrates by oxy-fuel thermal spraying process from catalysts waste used in petroleum refining. The adhesion and micro-hardness Vickers were evaluated according to ASTM C633-01(2008) and ASTM C1327-08 standards respectively, with adhesion values varying between 2,9 and 17,7 MPa and values of microhardness Vickers between 5,4 and 8 GPa. The results obtained indicate that these coatings could be used in industrial applications, mainly in components requiring resistance to wear and thermal shock or high temperatures, at a low cost due to reuse of solid waste as raw materials in the production of coatings, and giving a technological solution to environment problems produced by these catalysts waste.

Mediante la tecnología de proyección térmica por combustión oxiacetilénica se aplicaron sobre sustratos de acero al carbono AISI-SAE 1020 recubrimientos cerámicos a partir de residuos de catalizadores utilizados en procesos de refinación en la industria del petróleo. La adherencia y la dureza de los recubrimientos fueron evaluadas según las normas C633-01(2008) y ASTM C1327-08 respectivamente, con valores de adhesión que oscilan entre 2,9 y 17,7 MPa y valores de microdureza Vickers entre 5,4 y 8 GPa. Los resultados obtenidos permiten visualizar su posible aplicación industrial en componentes que requieran resistencia al desgaste, a las altas temperaturas o al choque térmico, a un costo menor que los elaborados con materias primas comerciales, debido a la re-utilización de los residuos sólidos en la elaboración de los recubrimientos y generando valor agregado como solución tecnológica al impacto ambientalmente negativo que generan los residuos de los catalizadores.

4343 downloads Citado 4 vezes em SciELO

Importancia del reposo en los sanatorios para tuberculosos
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Duarte G, Ignacio

; López C, Marcelo

Revista chilena de infectología

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Jun 2009, Volume 26 Nº 3 Páginas 273 - 278

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Since ancient times the main indication for the treatment of pulmonary phthisis consisted in prescribing trips to better climates, horseback riding or walking outdoors. In the second half of the XIXth century, the concept of sanatoria for TB therapy was developed in Europe, in order to confine patients in premises where abundant food, exposition to puré air and graded exercises were provided. In those places, rest progressively acquired more importance, becoming a thoroughly established ritual. In the XXth century, the regulations for the recently founded Chilean sanatoriums incorporated European schedules. In the case of Hospital Sanatorio El Peral, the rules became progressively stricter until 1952, when permanent rest in bed was determined as the regime required. This rule could be explained by the policy of using this sanatorium for the treatment of more serious forms of the disease.

Desde la antigüedad, la indicación principal para el tratamiento de la tisis pulmonar consistía en prescribir viajes hacia climas más benignos, cabalgar o caminar al aire libre. En la segunda mitad del siglo XIX se desarrolló en Europa en concepto de sanatorios para la terapia de la tuberculosis (TBC), con el objeto de confinar a los pacientes en un establecimiento que les proporcionaba alimentación abundante, aire puro y ejercicios físicos graduales. En esos lugares adquirió progresivamente mayor importancia el reposo, que se convirtió en un ritual minuciosamente establecido. En el siglo XX los reglamentos de los sanatorios chilenos, recientemente fundados, incorporaron las disposiciones europeas. En el caso del Hospital Sanatorio El Peral, el reglamento se hizo progresivamente más estricto hasta determinar en 1952 que el régimen habitual era la permanencia de los pacientes en cama. Esta norma podría explicarse por la política de destinar dicho establecimiento al tratamiento de formas graves de la enfermedad.

8526 downloads

Semblanza del Profesor Benedicto Chuaqui Jahiatt a 5 años de su muerte (1934-2003)
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Duarte G, Ignacio

; González B, Sergio

Revista médica de Chile

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Out 2008, Volume 136 Nº 10 Páginas 1343 - 1347

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

The present article commemorates the fifth anniversary of the death of Professor Benedicto Chuaqui Jahiatt, a prominent Chilean pathologist at the School of Medicine ofthe Pontificia Universidad Católica de Chile. Professor Chuaqui was well known for his teaching skills, his scientific work with international projections and his humanistic visión of medicine. His publications reflect, his wide spectrum and integrative visión of different disciplines ofboth naturalsciences and¡inguistics.

2398 downloads

10.

Anastomosis ileorrectal en el tratamiento quirúrgico de la colitis ulcerosa: Resultados a largo plazo
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Bellolio R, Felipe

; Zúñiga A, José Miguel

; Wagner H, Pablo

; Pinedo M, George

; Duarte G, Ignacio

; Zúñiga D, Alvaro

Revista médica de Chile

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Set 2008, Volume 136 Nº 9 Páginas 1121 - 1126

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Total colectomy with ileorectal anastomosis (IRA) is an alternative to the ileoanal pouch for the surgical treatment of ulcerative colitis in a selected group of patients. This technique leaves rectal mucosa Hable to develop persistent proctitis, dysplasia and cancer Aim: To describe short and long-term results of IRA and to assess the presence of dysplasia. Material and methods: Descriptive study of patients treated with IRA. The data were obtained from the clinical records, and the present status was evaluated with an interview. A proctoscopy and biopsy was offered free of cost to the contacted patients. Results: Between 1978 and 2005, 26 patients were operated. One patient presented an anastomotic leakage that was treated with a loop ileostomy There was no operative mortality. Twenty-three patients were followed for a períod of 1 to 23 years. Three patients evolved as Crohn 's disease and two of them needed a proctectomy. Three patients died of non-related diseases. In the remaining 17, the average evacuation rate was 3.7/24 h and all were continent. None developed a rectal cancer Only two patients had their planned annual endoscopic surveillance. In 2 of the 11 patients who accepted endoscopy and biopsy, a low-grade dysplasia was found. Conclusions: IRA has low morbidity and acceptable functional results in this selected group of patients. No patient present high-grade dysplasia or cancer; however, the adherence to the endoscopic follow-up ispoor.

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11.

Evolución de los pacientes con enfermedad de Crohn de colon operados con el diagnóstico de colitis ulcerosa
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ZÚÑIGA D, ÁLVARO

; ZÁRATE C, ALEJANDRO

; FULLERTON M, DEMIAN

; DUARTE G, IGNACIO

; ÁLVAREZ L, MANUEL

; QUINTANA V, CARLOS

Revista chilena de cirugía

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Fev 2008, Volume 60 Nº 1 Páginas 35 - 40

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Bakground: Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is at present the procedure of choice for elective surgical treatment of ulcerative colitis (UC). Colectomy and ileorectal anastomosis (IRA) can be indicated in selected patients. Some patients submitted to these operations for apparent UC may subsequently evolve as Crohn's disease (CD). Objective: To report the course and prognosis of patients who evolved as CD after surgical treatment for apparent UC. Material and method: All the patients who had a surgical treatment for UC, from 1978 to 2003 were included. We identified the patients in which on follow-up the diagnosis changed to CD. Of these patients surgical variables and follow up were analyzed. Results: 114 patients were operated in this period for UC. In 9 patients (8%) their diagnosis changed to CD, based principally on subsequent clinical course and/or histological study: 3 of 20 (15%) after a total colectomy and IRA and in 6 of 84 (7%) after a proctocolectomy with IPAA. The anal canal and perineum were the most frequent localization of CD. Treatment included surgical procedures and medical treatment with anti-inflammatory and/or inmunomodulators. Two patients with a colectomy with IRA needed a proctectomy and ileostomy. Removal of ileal pouch was necessary on 1 of 6 with IPAA. In conclusion a minority of patients operated with the diagnosis of UC evolved as CD. Combined medical and surgical treatment contributed to a low rate of ileal pouch lost

Introducción: La proctocolectomía con reservorio ¡leal y anastomosis reservorio anal, (RIARA) es actualmente el procedimiento de elección en el tratamiento quirúrgico electivo de la colitis ulcerosa (CU). La colectomía total y anastomosis íleorrectal (AIR), está indicada en un seleccionado grupo de pacientes. Algunos pacientes sometidos a estas operaciones por aparente CU pueden evolucionar como una enfermedad de Crohn (EC). Objetivo: Comunicar el curso y pronóstico de pacientes que evolucionaron como EC luego de un tratamiento quirúrgico por una aparente CU. Materiales y métodos: Se identificaron a los pacientes que tuviesen tratamiento quirúrgico por CU, en el periodo 1978 al 2003. Se seleccionaron a los pacientes en los cuales en su evolución se cambió el diagnóstico a EC. En ellos se analizaron las variables quirúrgicas y su evolución posterior. Resultados: En el periodo mencionado se operaron 114 pacientes por CU. En 9 pacientes (8%) el diagnóstico cambió a EC, basado principalmente en la evolución clínica alejada y/o por estudio histológico: 3 de 20 (15%) después de una colectomía total con AIR y 6 de 84 (7%) después de una proctocolectomía con RIARA. Las localizaciones más frecuentes de las manifestaciones de la EC fueron el canal anal y periné. El tratamiento incluyó procedimientos quirúrgicos y tratamiento médico con antiinflamatorios y/o inmunomoduladores. Dos pacientes con una colectomía con AIR necesitaron una proctectomía e ileostomía. Se extirpó el reservorio en 1 de 6 pacientes con RIARA. En resumen, una minoría de pacientes sometidos a tratamiento quirúrgico con el diagnóstico de CU evoluciona posteriormente como una EC. El tratamiento combinado médico quirúrgico contribuye a una baja incidencia de pérdida del reservorio ileal

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12.

Pancreatectomía distal: indicaciones y resultados quirúrgicos inmediatos
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BUTTE B, JEAN MICHEL

; TORRES M, JAVIERA

; JARUFE C, NICOLAS

; MARTINEZ C, JORGE

; DUARTE G, IGNACIO

; MILLARD S, FERNANDO

; CABRERA T, ROBERTO

; LLANOS L, OSVALDO

Revista chilena de cirugía

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Out 2007, Volume 59 Nº 5 Páginas 360 - 365

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Resection of the pancreatic portion located to the left of the portal mesenteric axis is called distal pancreatectomy Aim: To analyze the indications and surgical results of distal pancreatectomy in patients with pancreatic tumors. Material and methods: Retrospective review of medical records of patients subjected to a distal pancreatectomy for pancreatic tumors, between 1990 and 2005. Patient features, and early complications were evaluated. Results: In the study period, 38 patients aged 53 + 5 years (29 females), were operated. The tumor was cystic in 24 patients and solid in 14. Ten patients had postoperative complications. The most common complications were pancreatic fistula in five patients, sepsis in three and catheter infection in three. No differences in the rate of complications or development of pancreatic fistula, were observed between patients subjected or not subjected to splenectomy. One patient died due to abdominal sepsis. Pathology showed 28 benign tumors (mucinous cystadenoma the most common) and 10 malignant tumors (adenocarcinoma the most common). Conclusions: The most frequent complication of distal pancreatectomy was pancreatic fistula. One patient died as a consequence of this complication. Patients subjected to splenectomy did not have a higher rate of complications

Introducción: Se denomina pancreatectomía distal a la resección pancreática a la izquierda del eje mesentérico portal. Los objetivos del trabajo son analizar las indicaciones y los resultados quirúrgicos de esta operación en enfermos con un tumor pancreático. Material y métodos: Estudio retrospectivo de 38 pacientes operados entre 1990 y 2005. Se analizaron las características clínicas, quirúrgicas y el estudio anatomopatológico. Resultados: Se operaron 29 mujeres y 9 hombres, de 52,9 + 5 años. El motivo de consulta más frecuente fue dolor abdominal en 26 enfermos. El diagnóstico se realizó con una ecografía en 7 pacientes y en 31 con una tomografía o una resonancia de abdomen. La indicación quirúrgica fue la presencia de un tumor pancreático en los 38 enfermos, quístico en 24 y sólido en 14. A 25 pacientes se les realizó una esplenectomía. Diez enfermos presentaron complicaciones postoperatorias; las más frecuentes fueron: fístula pancreática en 5, sepsis en 3 e infección del catéter central en 3. No hubo diferencias en la frecuencia de complicaciones ni en el desarrollo de una fístula pancreática entre los enfermos con y sin esplenectomía. Un enfermo falleció por sepsis abdominal. El estudio anatomopatológico mostró 28 tumores benignos y 10 tumores malignos, siendo los más frecuentes el cistoadenoma mucinoso y el adenocarcinoma, respectivamente. Conclusiones: Las pancreatectomías distales se realizaron principalmente por un tumor quístico benigno. La complicación más frecuente fue la fístula pancreática, la que llevó a la muerte a un paciente. Los enfermos esplenectomizados no presentaron más complicaciones postoperatorias que los sin esplenectomía

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13.

Antiretroviral agents and acid-base balance at delivery of the neonate
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El-Beitune, P.

; Duarte, G.

; Morais, E.N. de

; Campbell, O.

; Spara-Gadelha, P.

; Mauad-Filho, F.

; Quintana, S.M.

; Rodrigues, L.C.

Brazilian Journal of Medical and Biological Research

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Jul 2007, Volume 40 Nº 7 Páginas 957 - 961

Resumo: En | Texto: En | PDF: En

Limited evidence is available regarding antiretroviral (ARV) safety for uninfected infants exposed to these drugs in utero. Our objective was to determine if ARV administered to pregnant women is associated with decreasing umbilical arterial pH and base excess in uninfected infants. A prospective study was conducted on 57 neonates divided into three groups: ZDV group, born to mothers taking zidovudine (N = 20), triple therapy (TT) group, born to mothers taking zidovudine + lamivudine + nelfinavir (N = 25), and control group (N = 12), born to uninfected mothers. Umbilical cord blood was used to determine umbilical artery gases. A test was performed to calculate the sample by comparing means by the unpaired one-tailed t-test, with a = 0.05 and ß = 20%, indicating the need for a sample of 18 newborn infants for the study groups to detect differences higher than 20%. The control and ARV groups were similar in gestational age, birth weight, and Apgar scores. Values of pH, pCO2, bicarbonate, and base excess in cord arterial blood obtained at delivery from the newborns exposed to TT were 7.23, 43.2 mmHg, 19.5 mEq/L, and -8.5 nmol/L, respectively, with no significant difference compared to the control and ZDV groups. We conclude that intrauterine exposure to ARV is not associated with a pathological decrease in umbilical arterial pH or base excess. While our data are reassuring, follow-up is still limited and needs to be continued into adulthood because of the possible potential for adverse effects of triple antiretroviral agents.

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14.

Tumores del apéndice cecal: Análisis anatomoclínico y evaluación de la sobrevida alejada
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BUTTE B, JEAN MICHEL

; GARCIA HUIDOBRO D, MARÍA ANGÉLICA

; TORRES M, JAVIERA

; SALINAS F, MAURICIO

; DUARTE G, IGNACIO

; PINEDO M, GEORGE

; ZÚÑIGA D, ALVARO

; LLANOS L, OSVALDO

Revista chilena de cirugía

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Jun 2007, Volume 59 Nº 3 Páginas 217 - 222

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Appendiceal tumors correspond to 0.5% of all gastrointestinal tumors and their prognosis depends on the type of lesion. Aim: To analyze the clinical and pathological features of appendiceal tumors and their prognosis. Material and methods: Review of medical records of patients in whom an appendiceal tumor was detected during the pathological study in a Clinical Hospital, between 1981 and 2006. Results: Sixty seven patients were identified (mean age 45.3+ 19.6 years, 39 females). Fifty nine were operated due to the suspicion of an acute appendicitis, that was confirmed pathologically in 37. Thirty six patients had a neuroendocrine tumor, 18 had a benign tumor, seven an adenocarcinoma, five an adenocarcinoid and one a neuroendocrine plus a mucinous cystadenoma. A hemicolectomy was performed in a second operation in four patients with a carcinoid tumor, three with an adenocarcinoma, one with an adenocarcinoid and in one with a peritoneal pseudomyxoma. Five years survival was 100% in patients with benign tumors, 97% in those with neuroendocrine tumors, 75% in those with adenocarcinoid tumors and 62% in those with adenocarcinoma. Conclusions: Most appendiceal tumors were discovered during the pathological study of the surgical piece of appendicectomies performed due to the clinical suspicion of an acute appendicitis. Survival of patients was dependent on the type of tumor

Introducción: Los tumores del apéndice cecal corresponden al 0,5% de las neoplasias gastrointestinales y su pronóstico depende del tipo de tumor. Objetivos: Analizar las características de los tumores apendiculares y los factores que influyen en su sobrevida. Material y Métodos: Estudio retrospectivo de los pacientes con un tumor apendicular operados entre 1981 y 2006 en el Hospital de la P. Universidad Católica. Se evaluaron las características clínicas, anatomopatológicas (AP) y la sobrevida alejada. Se utilizó la prueba de Fisher, el test de Wilcoxon y curvas de Kaplan-Meier. Resultados: Se operaron 67 enfermos, 39 mujeres y 28 hombres con una edad de 45,3 + 19,6 años. En 59 enfermos la operación se realizó por sospecha de apendicitis aguda, la que se confirmó en el estudio AP en 37 de ellos. En 36 pacientes se demostró un carcinoma neuroendocrino, en 18 un tumor benigno, en 7 un adenocarcinoma, en 5 un adenocarcinoide y en uno un carcinoma neuroendocrino y un cistoadenoma mucinoso. Se realizó una hemicolectomía en un segundo tiempo operatorio a 9 enfermos: 4 con un carcinoide, 3 con un adenocarcinoma, 1 con un adenocarcinoide y uno con un pseudomixoma peritoneal. La sobrevida a 5 años fue de 100% en los enfermos con un tumor benigno, 97% en los con un carcinoma neuroendocrino, 75% en los con un adenocarcinoide y 62% en los con un adenocarcinoma (p<0,05). Conclusiones: En la mayoría de los enfermos el diagnóstico de tumor se obtuvo como un hallazgo del estudio anatomopatológico en apendicectomías indicadas por sospecha de apendicitis aguda. En la sobrevida influyó fundamentalmente el tipo histológico del tumor

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15.

Fibrosis Hepática congénita: un espectro clínico variable: Casos clínicos
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Harris D, Paul

; Fodor O, Daniel

; Cavagnaro SM, Felipe

; Egidio S, Marcia Di

; Duarte G De C, Ignacio

; Fava P, Mario

Revista médica de Chile

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Jun 2004, Volume 132 Nº 6 Páginas 733 - 741

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Congenital hepatic fibrosis (CHF) is an autosomic dominant disease that has been associated with polycystic kidney disease. Aim: To describe the medical management of 5 children with CHF and to evaluate the presence and extension of the associated renal disease. Patients and methods: Retrospective review of the medical charts of 5 children with CHF, aged 2 to 14 years. Results: Three children presented autosomic recessive polycystic kidney disease, which was diagnosed before the appearance of liver disease manifestations. They presented a more severe liver damage, with a more aggressive clinical course requiring use of transjugular intrahepatic porto-systemic shunts (TIPS) or surgical porto-systemic shunts to control portal hypertension. The other two children, in whom the diagnosed was based on asymptomatic hepatomegaly, had normal renal function and structure with a more benign clinical course. Conclusions: The diagnosis of CHF should be suspected not only in children with polycystic kidney disease but in those children with persistent, hard consistency, left lobe predominance hepatomegaly (Rev Méd Chile 2004; 132: 733-41)

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