La Prensa medica mexicana最新文献

The exchange among the elements of amniotic liquid is a dinamic process which keeps stable the concentration of their components, showing a variable relation with the maternal plasma in the differents stages of gestation. Thus the formations of the kidneys modifies the amniotic liquid with the urine excretion and then, factors as swallowing; the secretions of the skin and bronchi are factors which are implicated in its production. The amniocentesis is important in the study of high risk fetus, particulary with a prognostic value in the pregnancy sensitized to the Rh factor. The non cultivated celle give us information about the sexual chromatine and enzymes, to get a quick diagnosis, but this has to be confirmed with a culture cells for a final diagnosis, especially in diseases caused by inborn errors of metabolism.

In Mexico liver abscesses are frequent and most of them are produced by amibas. Sometimes the ethiology is caused by bacterias and its ethiological diagnosis is difficult therefore the specifics treatment takes longer and this may increase mortality. In this issue, the clinical laboratory scand caracteristics are presented on six patients having liver abscess caused by Salmonella as well as its evolution and reaction to treatment.

In the present study total body water was determined in a group of cardiac patients, using titriated water. The study was performed in a service of internal medicine of an important hospital in Mexico City. Of the 30 patients originally evaluated, only 23 could be considered cardiacs; of these 47.83% had an excess of water, 39.13% had a normal amount and 13.04% were dehidrated. The patients belonged to both sexes and their ages were anywhere between 14 and 82 years. Very often, other aliments or conditions were present which had a bearing on the total body water. The test is innocuous and the bother to the patient is minimal constituting a valuable auxiliary to the clinician.

A case is presented of a 54 year old male patient, admitted to the hospital because of indolent abdominal growth limited to the upper and lower left abdominal quadrants with out genitourinary symptoms of ten years duration. The intravenous pielogram showed that the left kidney was enlarged and of cystic appearance with functional exclusion, the right also had multiple cystic cavities. The selective renal arteriography confirmed the above findings. At surgery it was found a huge left cyst, of 20 X 20 cm., with thin walls and dysplastic changes, the ureteropyelic junction was atresic. A survey of the literature is done, stressing the fact that the coexistence of cystic kidneys with dysplastic changes is frequent in the pediatric age, existing few case reports in adults. Brief considerations are made of this nosologic entity and the outline for proper diagnosis and treatment are made.

We show our experience in 12 patients treated during a year with weekly intermittent dialysis whit a rigid catheter for 36 hours a week. Patients were on a diet of 50 g. of proteins a day, normocaloric without sodium or fluid restriction. They received supplementation whith iron, calcium, vitamins B, C and folic acid, anabolic hormonal and, in some cases, furosemide hypotensives and antibiotics. Patients received the procedure for a mean of 8 months. The results show the following mean values: blood pressure: 143 +/- 12/99 +/- 3 mm. Hg., plasma urea 208 +/- 62 ng./dl.; creatinine 21 +/- 2 mg./dl., hematocrit 25 mm. and 8.0 g. hemoglobin. There was light increase of glucose, K, P, Mg, alkaline phosphatase. Na, CO2, proteins cholesterol, albumin and Ca keep in normal values. Nine patients passed to hemodialysis after a mean period of nine months and three of them received a kidney transplant. Three are still in peritoneal dialysis, one of them for 18 months. We compared our results with a similar group of patients who were treated with non-regular peritoneal dialysis. Our group had less cardiovascular complaints, or infections and keep more adequate body weight, and also got more survival in better conditions with less days in hospital, they received less blood transfusion. We concluded that weekly peritoneal dialysis is an alternative method of treatment in uremic patients for longer period of time even though frequently paracentesis.