Abstract Introduction : Headache is the second most frequent cause of neurological consultations in the pediatric emergency department. Patients become frequent visi tors per year due to headaches, evidence-based treat ment should be used. Methods : A search of publications within the last 5 years was conducted in different databases. Discussion : Strategies for a systematic approach in the evaluation of red flags, and recommendations for a rational use in neuroimaging studies are presented. Primary headaches are frequently seen in the emergency department. Migraine evidence-based treatment in the emergency department is reviewed.

Resumen Introducción : Las cefaleas son la segunda causa de consultas neurológicas en la sala de emergencia pediá trica. Muchos pacientes realizan varias visitas al año por este mismo problema, debemos conocer el tratamiento basado en evidencia. Métodos : Se realizó una búsqueda de publicaciones realizadas en los últimos 5 años en diferentes bases de datos. Discusión : Se presentan recursos para investigar sistemáticamente signos de alarma, recomendaciones para el uso racional de estudio de imágenes. Las cefaleas primarias son causa frecuente de consulta en la sala de emergencia. Se presenta tratamiento que cumple el res paldo científico para su utilización en pacientes con ce faleas primarias de tipo migraña en sala de emergencia.

Abstract Chagas disease (CD) is a protozoan zoonosis caused by Trypanosoma cruzi. Reactivation of CD occurs via drug-induced immunosuppression before and during transplantation. Here, we report the case of a 62-year-old man diagnosed with classic Hodgkin lymphoma who received highly aggressive conditioning chemotherapy before undergoing stem cell transplantation (SCT). The patient tested positive for CD in pre-transplantation evaluation. The patient exhibited persistent fever and elevated C-reactive protein levels before and after SCT, and was treated with antibiotics. Micro-Strout test showed evidence of trypomastigotes and he was treated with benznidazole until tested negative. Post-transplantation seropositive patients should be screened for possible reactivation.

The measurement of emotional intelligence has had many proposals in the form of self-report. One of these is the Wong-Law Emotional Intelligence Scale (WLEIS), created for the job context and which evaluates valuation and the expression of self-emotions; valuation and recognition of emotions in others; regulation of one’s own emotions and the use of emotion to facilitate performance. There is little psychometric evidence regarding the Wong-Law Emotional Intelligence Scale in the Spanish speaking world, which could lead to it also being little used in research and professional practice. The objective of this study is to present the first results of the internal structure validity of the WLEIS in Peruvian adults. There were 120 participants (72 women) between 17 and 59 years old who responded to the questionnaire mediated by the internet. The internal structure was analyzed using structural equations methodology. A satisfactory structure of 4 factors and high factorial loads of items was found. The inter-factorial correlations were high or moderately high – and the internal consistency was good. It is concluded that the first results are acceptable – to assume that the Wong-Law model is also apparently generalizable

La medición de la inteligencia emocional ha tenido muchas propuestas en formato de autorreporte. Una de estas es el Wong-Law Emotional Intelligence Scale (WLEIS), creada para el contexto laboral y que evalúa valoración y expresión de las emociones propias, valoración y reconocimiento de las emociones en otros, regulación de las propias emociones y uso de la emoción para facilitar el desempeño. Hay poca evidencia psicométrica sobre el Wong-Law Emotional Intelligence Scale en habla hispana, lo que posiblemente conduce a que sea también poco utilizado en la investigación y práctica profesional. El objetivo del presente estudio es presentar los primeros resultados de la validez de la estructura interna del WLEIS en adultos peruanos. Fueron 120 participantes (72 mujeres) entre 17 y 59 años, quienes respondieron al cuestionario mediados por internet. Se analizó la estructura interna mediante metodología de ecuaciones estructurales. Se halló una satisfactoria estructura de 4 factores y elevadas cargas factoriales de los ítems; las correlaciones interfactores fueron altas o moderadamente altas; y la consistencia interna fue buena. Se concluye que los primeros resultados son aceptables para asumir que el modelo de Wong-Law también es aparentemente generalizable.

Syphilis is a systemic disease caused by the spirochete Treponema pallidum which can compromise the central nervous system at any stage and whose clinical presentations have been modified in recent decades. Were port the case of a 16 years old male with a 3-years history of sexual risk behavior and syphilis with no treatment who experienced headache and decreased vision for four months. Initial assessment showed right homonymous hemianopia, bilateral papilledema and left exudative retinopathy. Serological tests for syphilis: reactive HIV: non-reactive. Brain MRI revealed a single irregularly enhancing lesion in the left occipital lobe. He received treatment for syphilis for three days, and stereotactic biopsies were performed by the initial suspicion of brain tumour. Histological examination showed a chronic granulomatous consistent with neurosyphilis. In his read mission, greater affectation of acuity and visual field defect was evident. Visual evoked potentials: absent in both eyes. Penicillin G sodium was initiated for 4weeks (for evidence of improvement imagenological)associated with corticosteroids, showing serological and discrete clinical improvement at the end of treatment decreased. The gummatous neurosyphilisis a rare form of tertiary syphilis which ever considered as differential expansive intracranial lesions in HIV-seronegative individuals with reactive syphilis serology.

La sífilis es una enfermedad sistémica causada por la espiroqueta Treponema pallidum que compromete al sistema nervioso central en cualquier etapa y cuyas presentaciones clínicas se modificaron en las últimas décadas. Se presenta el caso de un varón de 16 años con antecedentes de conducta sexual de riesgo y sífilis hace 3 años, sin recibir tratamiento. Acude por cefalea y disminución de visión hace 4 meses. Evaluación inicial objetiva hemianopsia homónima derecha, edema papilar bilateral y retinopatía exudativa izquierda. Pruebas serológicas de sífilis reactivas, VIH: no reactivo. Resonancia magnética de encéfalo: proceso expansivo en lóbulo occipital izquierdo captador de contraste. Recibió tratamiento para sífilis por 3 días y por sospecha inicial de proceso neoproliferativo se realizó biopsia que evidenció proceso granulomatosocrónico sifilítico. En su reingreso, mostró mayor compromiso de agudeza y defecto del campo visual. Potenciales evocados visuales: ausente en ambos ojos. Se inició Penicilina G sódica por 4 semanas (por evidencia de mejoría imagenológica) asociado a corticoides, encontrando disminución serológica y discreta mejoría clínica al término del tratamiento. La neurosífilis gomatosa esuna presentación infrecuente de la sífilis terciaria debiéndose considerar como diagnóstico diferencial en lesiones expansivas intracraneales en individuos VIHseronegativos con serología de sífilis reactiva.

La leucemia mieloide crónica es una enfermedad con comportamiento bifásico o trifásico, 90 % de los pacientes debuta en fase crónica, 50 % asintomáticos al diagnóstico. Un porcentaje con enfermedad crónica desarrollan en tiempo variable una enfermedad más agresiva definida por un período intermedio y crisis blástica. Se diagnostica al encontrar más del 20 % de blastos en médula ósea, 30 % en sangre periférica o enfermedad extramedular. El pronóstico es pobre, al lograr respuesta completa, con una mediana de sobrevida de 3-12 meses, independiente del fenotipo. El 50 % de los pacientes tendrán una mieloide, 25 % linfoide y 25 % fenotipo indiferenciado. Un grupo de expertos clínicos de Bogotá, Colombia, revisaron la mejor evidencia sobre diagnóstico y tratamiento. La información se obtuvo de búsquedas estructuradas y varios registros de experimentos clínicos en curso. Presentamos conclusiones y recomendaciones para la toma de decisiones basadas en la mejor evidencia.

Chronic myelogenous leukemia traditionally has been characterized by a biphasic or triphasic course. 90 % of patients are diagnosed in chronic phase, which is asymptomatic in 50 % of patients. A varying percentage of patients in chronic phase develop more aggressive disease, frequently pass through an intermediate or accelerated phase, and finally evolve into an acute leukemia like blastic phase characterized by the presence of more than 20 % blasts in the bone marrow, more than 30 % of blasts in the peripheral blood or by the existence of extramedullary disease. An expert panel of Bogotá, D.C., Colombia reviewed selected literature related with of chronic myeloid leukemia obtained from advanced searches of medial literature in and from several in course clinical trials databases. The following document present the principal conclusions and some recommendations to improve outcomes of to assist practitioners to apply the best available research evidence to clinical decisions.

The case of a patient that was admitted in "Carlos Manuel de Céspedes" Provincial General Teaching Hospital, in Bayamo, Granma province, with a picture of cardiogenic shock due to cardiac tamponade caused by a Kirschner’s fragment, which migrated from the right clavicle to the myocardium, is reported. The initial treatment was conservative (pericardiocentesis) and thoracotomy with extraction of the foreign body was performed a month later. The postoperative evolution and the follow-up during 2 years have been good

Se reporta el caso de un paciente que ingresa al Hospital General Provincial Docente «Carlos Manuel de Céspedes», de Bayamo, provincia Granma, con un cuadro de shock cardiogénico por taponamiento cardíaco, a causa de un fragmento de un Kirschner, el cual migró desde la clavícula derecha hasta introducirse en el miocardio. El tratamiento inicial fue conservador (pericardiocentesis), y un mes después se efectúa la toracotomía con extracción del cuerpo extraño. La evolución posoperatoria y su seguimiento durante 2 años ha sido buena

Foi feito um ensaio em vasos, com 4 repetições, usando terra ácida e de baixa fertilidade para testar os valores fertilizantes de uréia (com e sem enxofre). nitrato de amônio e sulfato de amônio. Fez-se, a princípio, correção do pH para 6,0 e apiicação de adubo fosfatado e potássio nas doses de 90 e 120 kg/ha de P2O5 e K2O, respectivamente. As doses de N foram de 0, 120 e 240 kg/ha. A planta teste foi o milho. No ano seguinte o ensaio foi repetido, mas sem calagem e sem adição dos fertilizantes nitrogenados. No ano subsequente repetiu-se o ensaio anterior fazendo-se, porém, calagem em duas repetições de cada tratamento. Após a colheita do milho estudaram-se os efeitos residuais dos adubos nitrogenados em competição tomando-se como parâmetros de avaliação a produção de massa de matéria seca de partes aéreas e de plantas inteiras e conteúdos de nitrogênio das mesmas As principais conclusões gerais são: a. No que concerne à produção de matéria seca de partes aéreas e de plantas inteiras não houve efeito residual de N, exceto nos tratamentos correspondentes às partes aéreas de plantas que não receberam calagem. b. Não houve efeito residual das fontes nitrogenadas quando se tomou como parâmetro de avaliação o conteúdo de N das plantas.

An experiment was carried out in pots with four repetitions using an acid soil with poor fertility in order to test the residual values of urea (with and without sulphur), ammonium witate and ammonium sulphate. In the begiming the pH were corrected up to 6,0 and applications of phosphate and potassium fertilizers in quantities of 90 and 120 kg/ha of P(2)0(5) and K(2)0 were respectively done. The quantities of N were 0, 120 and 240 kg/ha. The test plant was corn (Zea mays L.). In the following year this test was repetead, without pH correction and without adding nitrogenous fertilizers. In the subsequent year the same experiment was repeated making, however, pH corrections in two repetitions of each treatment. After havesting the residual effects of the employed fertilizers were studied using the dry matter productions as avaluation parameters. It was concluded that in what concerning the dry matter production of the whole plant and the root-free plant no residual effect of nitrogen was found, except in the corresponding treatments of root-free plants where the pH was not corrected.

Foi feito um ensaio em vasos, com 4 repetições, usando terra ácida e de baixa fertilidade para testar os valores fertilizantes de uréia (com e sem enxofre), nitrato de amônio e sulfato de amônio. Fez-se, a princípio, correção do pH para 6,0 e aplicação de adubo fosfatado e potássio nas doses de 90 e 120 kg/ha de P(2)0(5) e K(2)0, respectivamente. As doses de N foram de 0, 120 e 240 kg/ha. A planta teste foi o milho. No ano seguinte o ensaio foi repetido, mas sem calagem e sem adição dos fertilizantes nitrogenados. No ano subsequente repetiu-se o ensaio anterior fazendo-se, porém, calagem em duas repetições de cada tratamento. Após a colheita do milho estudaram-se os efeitos residuais dos adubos nitrogenados em competição tomando-se como parâmetros de avaliação a produção de massa de matéria seca de partes aéreas e de plantas inteiras e conteúdos de nitrogênio das mesmas, os teores de alumínio trocável do solo, de hidrogênio potencial, hidrogênio trocável, indices pH e porcentagens de nitrogênio das terras. As principais conclusões gerais são: a. Relativamente ao Al3+ trocável, nos tratamentos que receberam calagem não houve efeito residual dos adubos nitrogenados, mas na ausência do corretivo o sulfato de amônio apresentou efeito considerável. Os demais apresentaram efeitos menos pronunciados. b. De um modo global, no que se refere ao H+ potencial e trocável não houve efeito residual dos fertilizantes nitrogenados nos tratamentos que sofreram correção da acidez, mas, naqueles que não receberam CaCO3 houve algum efeito residual, sobretudo do sulfato de amônio. c. Quando se tomou o valor pH como índice de avaliação do efeito residual, apenas o sulfato de amônio baixou o pH das terras, tanto nos tratamentos que receberam calagem como nos que não a receberam. d. Não houve efeito residual dos fertilizantes nitrogenados quando ele foi avaliado pelo teor de N do solo. e. Quando se emprega fertilizantes amoniacais com frequência, sobretudo o sulfato de amônio, deve-se atentar para a correção da acidez do solo.

An experiment was made in pots with four repetitions using an acid soil with poor fertility in order to test the residual values of urea fertilizer (with and without sulphur), ammonium nitrate and ammonium sulphate. In the beginning the pH were correct up to 6,0 and applications of phosphate and potassium fertilizers in quantities of 90 and 120 kg/ha of P(2)0(5)and K(2)0 were respectively done. The quantities of N were 0, 120 and 240 kg/ha. The test plant was corn (Zea mays L.). In the following year this test was repeated without pH correction and without adding nitrogenous fertilizers. In the subsequent year the same experiment was repeated making however, pH corrections in two repetitions of each treatment. After havesting the residual effects of the employed fertilizers were studied using the following items as avaluation parameters: contents of exclangeable Al and H, potencial H, pH and nitrogen of the soils. The main conclusions were as follows: a. There was no residual effect of the nitrogen treatments when the nitrogen content of the soil was taben as a reference point. b. Refering to the exchangeable Al , the treatments that received pH correction showed no residual effect of the nitrogenous fertilizers, but in the abence of the corrective the ammonium sulphate presented a con siderable effect. The others showed less pronounced effects . c. In a general way, what concerns the potencial and exchangeable H there was no residual effect of the nitrogenous fertilizers in the treatments with corrections but in those that did not receive lime there was some residual effect especially of ammonium sulphate.