Revista medica de Panama最新文献

Primary Sjögren's Syndrome complicated with a renal tubular acidosis type 1 and hypocalcemic paralysis, as the principal clinical manifestation, is uncommon. Although the initial manifestations of the nephropathy are not well understood, it is believed that the invasion of mononuclear cells and the high level of circulating antibodies, play an important role in the pathogenesis of the disease. We present a patient with hypocalcemic paralysis as an initial manifestation of a latent Sjögren's disease. The glandular biopsy was normal, suggesting a mayor participation of an immunological humoral factor in the renal lesion.

We present the results of densitometry studies performed on 1031 females, from September 1996 to September 1997. The studies were subsidized by the Foundation for Metabolic and Bone Diseases and the pharmaceutical institutions. The results were classified according to the WHO recommendations, taking in consideration the age of the patients, in normal, with osteopenia and with osteoporosis. 821 (79.63%) of the patients suffered from osteopenia or osteoporosis and 807 (78.2%) were postmenopause: only 14% of them were normal and 86% with osteoporosis or osteopenia.

The effective pharmacological treatment of depression started in 1958 with the introduction of iproniazide and imipramine. New agents quickly followed with more specific actions and a safer side effect profile. Very recently, fourth generation antidepressants with dual action have been introduced. These new agents pose a challenging dilemma. Is it better to develop drugs ever more selective towards specific monoamine receptor subpopulations, or drugs that act upon several monoamines in a more focused way? The priority seems to be the investigation of the interactions of the various monoaminergic systems. This paper reviews the clinical use of the new antidepressants that implement the notion of dual action as an important element for efficacy combined with receptor-specific action as a basis for tolerability.

The Carcinoide tumors are infrequent. The come from neuroendocrine argentafine cells, probably related to cells of the APUD system. They are rarely found in the mediastinum. We are reporting a case, and bringing forward some biological, epidemiological and clinical characteristics. We also emphasize over the diagnosis and treatment, and the basics to evaluate the prognosis.

Unlabelled: The pulmonary surfactant is a lipoproteic complex that serves to lower surface tension at the air-liquid interface in the pulmonary alveoli. Approximately 2 to 4% of the pulmonary surfactant is constituted by the protein A (SP-A). The objective of the study was to determine the effects that maternal protein calorie malnutrition has on the fetal pulmonary growth and the production of SP-A messenger RNA in fetal rats.

Materials and methods: Pregnant Sprague Dawley rats were divided into two groups, which received a diet with either 8% or 21% of proteins from gestational day 1 until the day 20. In this last day 11 fetuses were extracted by caesarean section and their lungs were removed to quantify the mRNA of the SP-A. First the mRNA was boosted using the technique of reverse transcriptase and polimerase chain reaction (RT-PCR) and then its concentration was determined by means of fluorodensitometry.

Results: There was a reduction in body weight and in wet lung weights of malnourished fetuses in comparison with the normal fetuses (5.03 +/- 0.20 g vs. 4.32 +/- 0.32 g, p < 0.05 and 79.0 +/- 3.8 mg vs. 146.0 +/- 3.4 mg, p < 0.05, respectively). The densitometric analysis of the SP-A mRNA concentration demonstrated a reduction of 32% in the malnourished fetuses (0.52 +/- 0.11 vs. 0.77 +/- 0.07, p < 0.05) compared with the normal fetuses.

Conclusions: The maternal protein calorie malnutrition affected the pulmonary development and the synthesis of the SP-A mRNA. These data suggest that a defect occurrs at pre-transcriptional level that results in a diminution of the concentration of mRNA of SP-A in the neumocytes type II.

The authors present the clinical findings, diagnosis and treatment of vascular rings and their review of 12 cases treated between 1973 and 1998 at the Hospital del Niño, Panama city, Panama.

The indiscriminate use of antibiotics in intensive care units has permitted the selection of multiple resistant bacterial strains in the hospital setting. Antibiograms present the sensitivity or resistance of these strains to drugs in current use. In this study, 100 bacterial strains were isolated from patients on medical and surgical ICU wards. The strains were identified by API-20E and sensitivity testing was performed by the E-test procedure. MIC were further analyzed with the WHONET software wich permits the identification of antibiotypes. Acinetobacter anitratus, Pseudomona aeruginosa and Enterobacter cloacae were the most resistant strains. Nine antibiotypes were determinated for A. Anitratus. Predominant strain presented antibiotypes with multiple resistance to ten antibiotics. P. aeruginosa presented 10 antibiotypes, the predominant one being CTX, CRO, CTX. Antibiotype determination allows phenotypic identification or resistance patterns in particular species as well as facilitates follow up and recognition of its epidemiological distribution.

Reports of Cryptococcus neoformans isolations from patients in Panama have appeared since 1978, but to our knowledge, thIs is the first report of isolation of this organism from soil samples in the Republic. Of 25 soil samples analyzed, two (25%) yielded the organism on birdseed agar medium. Canavanine-glycine-bromthymol blue medium served to identify the isolates as belonging to C. neorformans var neoformans, and not C. Neoformans var. gattii. Initially, isolates did not have capsules, but upon passage through newborn mice, wide capsules developed. This finding has important public health implications, since non-encapsulated environmental organisms, once in the host, can develop capsules, which significantly contribute to virulence.

Fetal echocardiography can be performed as early as the 16th week gestation and with improved equipment all forms of congenital heart diseases can be detected in utero. In this article we discuss the indications for a fetal heart echocardiography and the techniques used in a fetal heart examination and review the structural and functional information that can be obtained.

The purpose of he study was to analyze the role of the Colonoscopy in the diagnosis and treatment of low intestinal hemorrhages. We studied retrospectively all patients with Hematochezia, seen by the author, from april 1984 to december 1997. We studied the clinical symptoms, causes, localizations of the bleeding and the treatment applied, either endoscopic or surgical. We also reviewed the security and tolerance of the procedure. We could detect without doubt the cause in 74 patients (51.7%), including patients with multiple colon diverticulum, where the bleeding is sometimes very difficult to detect. We concluded that the Colonoscopy is the best method to find the source of bleeding in the lower portion of the colon. The procedure is well tolerated and safe in elderly patients.