Malignant Pleural Mesothelioma. Case Report and Literature Review

Pleural mesotheliomas are primary mesothelial cell tumors. Lining the pleural cavity, they are closely related to asbestos exposure. They have a low incidence and poor prognosis. A 46-years-old patient, white-skinned, who attended the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos due to pain in the back and shoulders, fever, and weight loss is presented. The physical examination revealed an abolished vesicular murmur in the lower 1/3 of the right lung. The chest X-ray and CT scan showed a medium to large right pleural effusion and pleural thickening. Histological studies indicated that the lesion was compatible with epithelioid variant pleural mesothelioma. The patient is maintained with cytostatic treatment and follow-up in consultation. The objective of this study is to describe the case of a patient with malignant pleural mesothelioma, admitted to the Internal Medicine Service of the Dr. Gustavo Aldereguía Lima General University Hospital of Cienfuegos

Síndromes de la onda J

Los síndromes de la onda J constituyen un reto para la cardiología actual. Comprenden un grupo de síndromes clínicos que tienenen común la presencia de la onda J en el electrocardiograma. La presente revisión tuvo como objetivo argumentar las relaciones de algunas enfermedades y la presencia de la onda J en el electrocardiograma. Para ello se consultó un total de 28 fuentes bibliográficas, de ellas diez artículos de revistas científicas de impacto internacional, ocho libros y otras accedidas a través de las redes informáticas. Se concluyó que los síndromes de la onda J engloban varios síndromes con características clínicas y eléctricas similares, y una plataforma arrítmica común, relacionada con la amplificación de la corriente transitoria de salida de potasio. Palabras clave: onda j; potencial de acción; muerte súbit

Clinical manifestations of intermediate allele carriers in Huntington disease

Objective: There is controversy about the clinical consequences of intermediate alleles (IAs) in Huntington disease (HD). The main objective of this study was to establish the clinical manifestations of IA carriers for a prospective, international, European HD registry. Methods: We assessed a cohort of participants at risk with <36 CAG repeats of the huntingtin (HTT) gene. Outcome measures were the Unified Huntington's Disease Rating Scale (UHDRS) motor, cognitive, and behavior domains, Total Functional Capacity (TFC), and quality of life (Short Form-36 [SF-36]). This cohort was subdivided into IA carriers (27-35 CAG) and controls (<27 CAG) and younger vs older participants. IA carriers and controls were compared for sociodemographic, environmental, and outcome measures. We used regression analysis to estimate the association of age and CAG repeats on the UHDRS scores. Results: Of 12,190 participants, 657 (5.38%) with <36 CAG repeats were identified: 76 IA carriers (11.56%) and 581 controls (88.44%). After correcting for multiple comparisons, at baseline, we found no significant differences between IA carriers and controls for total UHDRS motor, SF-36, behavioral, cognitive, or TFC scores. However, older participants with IAs had higher chorea scores compared to controls (p 0.001). Linear regression analysis showed that aging was the most contributing factor to increased UHDRS motor scores (p 0.002). On the other hand, 1-year follow-up data analysis showed IA carriers had greater cognitive decline compared to controls (p 0.002). Conclusions: Although aging worsened the UHDRS scores independently of the genetic status, IAs might confer a late-onset abnormal motor and cognitive phenotype. These results might have important implications for genetic counseling. ClinicalTrials.gov identifier: NCT01590589