Revista medica de Panama最新文献

We are presenting the immunologic pattern of 100 patients with kidney transplant made from 1990-2000 at CHM CSS Dr.AAM. Eighty nine were alive related donors. Most of them were from blood group O, donors and receptors. They came from Panama, Chiriqui and Colon. Many of the donors were siblings. The grades of compatibility in frequency were D, C, A & B. For locus HLA-A the most common gen was A2 for transplanted patients and for the rest of the Panamanian population is A24. For the locus HLA-B were B35 and B38 respectively and for the locus HLA-C the most common gen was C4, and C3 for the rest of the population.

The cells of the uterine lining (endometrium) may grow, in a aggressive fashion and invade the muscular portion of the uterus. This disorder is nonmalignant but is a serious and disabling disease called adenomyosis. The author presents an actual evaluation of the diagnosis and treatment of adenomyosis with a revision of the world literature, a retrospective evaluation of personal cases that includes a very unusual case of adenomyosis.

Different surgical treatments for the ureteroceles were reviewed, but their comparison is difficult. Frequently the results are different, due to the type of patients treated, the different techniques and the recovery criteria used. We present and analyze the results in 61 patients treated during 23 years at the Children's Hospital in Panama City. 25% of our cases were reoperated (statistically acceptable). There is not one surgical technique for all cases. Each one has to be treated according to the type of lesion they present.

The Human T-Cell lymphotropic virus type I (HTLV-I) is endemic in the Caribbean basin, Japan, Central Africa and South Pacific. It as been associated to Lymphoma-Leukemia of Adult T-Cells (ATLL) and a progressive spastic paraparesis (TSP/HAM). The nationwide seroprevalence of Panama is of 1-2%. We report a case of a 73 year old male, albino, single, patient, Panamanian descendent from Jamaican immigrants who presented a skin disorder which started 1 year ago, characterized by the appearance of infiltrative, intensely pruritic papules, nodules and a non exfoliative erythroderna involving face, neck, trunk and extremities. He also had painless enlarged cervical lymph nodes, non tender hepatomegaly. Laboratory studies revealed a keukocyte count of 128,000/ml wit 67% atypical lymphocytes, serum calcium was 12.5 mg/dl, DL in 583 UNI, "flower cells" and atypical lymphocytes with hyperlobulated nuclear contour was observed in the peripheral blood smear, seropositivity to TLV-I detected by enzyme-linked immunosorbent assay (Elisa) and confirmed by Western blot assay. The skin biopsy shows a bandlike dermal infiltrates of atypical lymphoid cells with epidermotropism and Pautrier's microabscesses. Once the treatment was initiated with prednisone, cyclophosphamide, and systemic antibiotics for a bronchopneumonic process most of the cutaneous lesions cleared up although the clinical condition of our patient became progressively worse and died after a acute renal failure and a lower gastrointestinal bleeding. In 1986, the tree first cases of ATLL were identified in Panama, there has not been apparently new cases reported until now.

The primary cerebral lymphoma (non Hodgkin lymphoma) is described as a tumor confined to the central nervous system. They are considered of very low frequency, less tha 1% of the primary tumors of the central nervous system. The up to date treatment is a combination of chemio and radio therapy in patients younger than sixty years old: After this age only radiotheraphy is recommended. We present two cases of primary cerebral lypmhomas, confirmed by the pathology. Both were operated and received steroids and radiotherapy. The first one received treatment in 1992: decadron and limited radiotherapy (1400 rads). He improved clinically and the lesion disappeared. In 1996 he was reoperated because of a recurrence. At this time a resection was performed. The patient received radiotherapy. A year later no recurrence has appeared. The second case was operated on april 1997. He received radiotherapy postoperatively, He developed aphasia and hemiplegia from which recovered completely. Both patients were immuno competent and their prognosis remains uncertain.

A study of seroprevalence of Helicobacter pylori determined by ELISA IgG, was conducted in 83 consecutive healthy children. The majority of the children (55%) had the bacterium. Seropositivity was demonstrated in 55% of the age group 0-5 years old, in 47% of 6-10, and in 67%, of the group 11 to 15. Of the children without sanitary inside their homes 86% were seropositive, versus 47% of the children with sanitary in their homes.

It is presented the experience with 90 patients receiving Eritropoietin s.c. and oral iron who were in chronic haemodialysis. After basic laboratories, including iron kinetic, in all of them was stopped oral iron and started i.v. iron 60 mgs per week, but keeping the same eritropoietin doses. The results showed an increased haemoglobin level from 6.5 to 11 g/dl mean values and a decreased doses of eritropoietin between 25 to 50%. This represent an important elevation of haemoglobin levels at a significant low cost.

We reviewed retrospectively 172 cystoscopies performed in May, 1997, at the Complejo Hospitalario de la Caja del Seguro Social. All the studies were ambulatory and under local anesthesia. The most frequent indications for the endoscopic procedures were the Prostatic Syndromes 27% (47/172), uretheral strictures 13% (22/172) and lithiasis 10%(17/172).

Two hundred and three (203) open heart surgical procedures have been performed at the Complejo Hospitalario Metropolitano, from January 1997 to august 1998; Hundred and twenty-three (123) were of myocardial revascularization and twenty-four (24) of these patients were selected for revascularization without the assistance of the extracorporeal circulation machine. They were patients with chronic stable angina and had lesions of more than 95% in the descending anterior artery, high ventriculo-lateral branch and right coronary artery up to the crux cordis. In nineteen (19) patients the surgical approach was though a medical sternotomy; in four (4) through a left anterolateral thoracostomy and in three (3) of these patients a transverse sternotomy was added. There were no deaths perioperatively and at thirty (30) days there were no evidences of new Q waves or residual angina. With this technique, the time in the Intensive Care Unit and in the hospital has diminished; the patients also required less time in mechanical ventilation; less vasoactive amines are needed. In the operating room less equipment is necessary and the costs are significantly lower.

The intracytoplasmic sperm injection (ICSI) has represented an important advance in human reproduction technology, improving the results in those couples with a very low probability of achieving pregnancy. Our aim is present the results of our first experience with ICSI and MESA in Panama, Central America and the Caribe.