Revista medica de Panama最新文献

Erythropoietin (EP) injected subcutaneously (SC) 2 or 3 times a week, respectively, or intravenously (IV) 3 times a week, increased the hemoglobin and the hematocrit of all the patients so treated. The total units of EP used was less when it was administered SC. EP once or twice a week, respectively, administered SC also increased the hemoglobin and hematocrit in each case, and the total amount of EP used was also less.

The author reports 12 girls, 4 to 8 years of age, and 2 boys, a newborn and a 6 year old, with ectopic ureter diagnosed at the Children's Hospital in Panama City. In 7 of the girls the ureter drained into the vaginal vestibule and in 5, into the urethra. In the boys, the ureter drained into the prostatic urethra in one and in the perineal region in the other. All the patients had had incontinence and urinary tract infection. The author present the clinical history of a 3 year old girl with the diagnosis of right renal agenesis, absence of the right ureteral meatus and urinary incontinence, in whom resection of the hypoplastic, dysplastic right kidney and the atretic right renal artery was done. The distal ureterogram, performed during the operation, showed drainage into a Gartner's cyst (residual of a Wolff's cyst) which then drained into the vagina.

The authors determined the frequency of genes and haplotypes of the HLA system in 965 panamanian men and women not related to each other, between 6 and 65 years of age. The HLA-A locus genes with the highest frequency (f) were A2, with f 0.1763; A24, f 0.1584; A30, f 0.1340; A23, f 0.1069; A3, f 0.0774. The other 20 genes each had less than 0.07. The genes with the highest frequency for locus HLA-B were B35, f 0.1946; B44, f 0.0904; B7, f 0.0774; B60 and B61, f 0.0582. For locus HLA-C, the most frequent genes were Cw3 with f 0.1549 and Cw4, f 0.1444. For locus HLA-DR, the most frequent genes were DR2 with f 0.1283; DR3, f 0.0620; DR7, f 0.0409. The most frequent haplotypes in the panamanian population were A2-B35 with f 0.0382; A3-B35, f 0.0191; A24-35, f 0.0287; A24-B61, f 0.0239; A29-B44, f 0.0287; A30-B42, f 0.0239; A23-B44, f 0.0191; A1-B8, f 0.0143. The authors conclude that the panamanian population exhibits a high degree of polymorphism for loci HLA-A, B and C, while for locu HLA-DR the frequency is the median when compared with that in caucasian, negro and oriental groups; and that, according to locus, predominant genes originating from these groups and found, corroborating the multiracial origen of the panamanian population.

Human biodiversity originates partially from human microevolution, which have produced different populations. This biodiversity is responsible for most of the variability in drug response. We present the methodology employed in population pharmacology studies and general information about the CYP2D6 and NAT2 systems. We report results obtained in Embera and Ngawbe Amerindians, who are characterized by a low phenotypic and genotypic CYP2D6 diversity. In regard to NAT2, Amerindians are distinguished by a high allelic frequency of S3 and low ones of S1 and S2, situation which is reversed in Caucasians.

The authors present the diagnosis and treatment of a fetus with hydrops secondary to severe maternal anemia. The mother was treated with blood transfusion, digoxin, spironolactone, iron and folic acid. In the two weeks of treatment the hydrops was controlled and the mother had a normal delivery at the 34th week of gestation. The newborn presented with an Apgar 7-9, Hb of 8 gm% and a normal evolution.

The authors present the clinical history of a 66 year old woman with a previous anterior myocardial infarction and periinfarct ischemia as well as ischemia in another area not related to the scar (in the posterolateral region of the left ventricle) in whom they successfully performed percutaneous coronary angioplasty of the anterior descending and circumflex arteries since the patient was not a candidate for surgical revascularization because of her clinical condition.

The authors present the clinical history of a male 44 year old patient who was hospitalized with the diagnosis of pericardial constriction and effusion and operated on as an emergency because of spontaneous cardiac rupture and was found to have a cardiac adenosarcoma. They review the literature in order to discuss a very rare cause of hemopericardium and constrictive pericarditis with epidemiologic, diagnostic, therapeutic and prognostic commentaries and secondly, to try to establish if this type case does not represent a diagnostic problem for the ecocardiographer since an angiosarcoma that occupies the pericardial space can be confused with a hemopericardium. They also mention other imaging studies that are used to better characterize and diagnose these tumors.

The authors report their results of refractive surgery with Excimer Laser Panama (Technolas unit) on 711 eyes with refractive errors. An uncorrected visual acuity of 20/30 or better was obtained in 98.9% of myopic patients. In hypermetropic patients they obtained a visual acuity of 20/40 or better in 95.9%. In 94.7% of astigmatics an uncorrected visual acuity of 20/30 or better was achieved. The patients did not complain of disturbances common after other refractive procedures, such as bright radiant spots, blinding glare of fluctuating vision. Secondary effects were minimal and patient satisfaction was very high.

The authors studied two groups of natural animal reservoirs for Trypanosoma cruzi: a wild one, the common rat Rattus rattus and the house dog, Canis canis. Thirty one naturally infected rats were evaluated with a technique developed by the authors which allows the recording of the ECG and the performance of a ventricular angiogram without altering the functional capacity of the animal. Forty four dogs were followed clinically for a period of twenty years to study the development of the cardiac lesion seen in the chronic phase of the disease. The authors demonstrate the epidemiologic importance of the dog as a reservoir and the ease with which the infection can be acquired from rats, which live in the same habitat with human patients. The most common lesions in both groups were ventricular and atrial arrhythmias and second degree AV block; and, in the dogs, also death due to refractory cardiac failure, such as is seen in the human patient. Right bundle branch block and dilatation of the right cardiac chambers was the rule in both groups. The authors discuss the pathogenesis of the ECG in the rat and its anatomical basis. They propose the possibility of establishing and standardizing this techniques in the laboratories that study rats or other species.

The Author reviews the cases diagnosed in the Republic of Panama of Mycetoma, Paracoccidioidosis, Lobo's disease, Chromomycosis, Histoplasmosis, Rhinosporidiosis, Sporotrichosis, Lepra, Rhinoscleroma, and cutaneous and mucocutaneous Leishmaniasis, and mentions the observed clinical manifestations in order to familiarize young physicians with the tropical dermatopathology which occurs in the rural areas of the country.