Osteoporosis: ¿Diagnóstico o signo de sospecha?

Objetivo: Se presenta un caso clínico de un paciente varón de 52 años que acude a consulta de Neurología por referir en los últimos meses deterioro progresivo del estado general con deterioro cognitivo, espe- cialmente de memoria y funciones ejecutivas, debilidad proximal en las cuatro extremidades, dolor en zona lumbar y disminución de 10 cm de talla. Se realizó una densitometría ósea siendo diagnosticado de osteoporosis precoz. Resultados/conclusión: En la analítica se objetivó aumento del cortisol libre en orina (1725 g/24h), con ACTH detectable (89 pg/ml) compati- ble con síndrome de Cushing ACTH-dependiente. Se realizaron pruebas para diferenciar un posible origen hipofi sario o ectópico realizándose un cateterismo de senos petrosos (CSPI) dado que se trata de la prueba con mayor sensibilidad demostrada. INGLÉS: We present the case of a fifty-year-old male who presented at the Neurology Service. During the previous months he had noticed progressive cognitive deterioration, and particularly a loss of memory and executive abilities, as well as proximal weakness of the four limbs and lumbar tenderness. He had lost ten centimetres of height. A bone densitometry was performed, which showed early osteoporosis. RESULTS/CONCLUSIONS: The laboratory results showed an increase in urine cortisol excretion (1725 g/24h), with detectable plasma ACTH concentration (89 pg/ml), suggesting ACTH-dependent Cushing's syndrome, Additional tests were run in order to determine a hypothalamic or ectopic location of the syndrome. To this end, a bilateral inferior petrosal sinus sample (BIPSS) was performed for ACTH determination. BIPSS is the test that has been proven to have the best sensitivity to achieve differential diagnosis of ACTH-dependent Cushing's syndrom

A colorectal cancer susceptibility new variant at 4q26 in the Spanish population identified by genome-wide association analysis

This work was partially supported by the CENIT program from the Centro Tecnológico Industrial (CEN-20091016), grants from the Spanish Institute of Health Carlos III (ADE10/00026, PI09/02444, PI12/00511, Acción Transversal de Cáncer) grants from the Fondo de Investigacion Sanitaria/FEDER (08/1276, 08/0024, PS09/02368, 11/00219, 11/00681), and by COST office through COST action BM1206. SCB is supported by contracts from the Fondo de Investigación Sanitaria (CP 03-0070). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Centro Tecnológico IndustrialInstituto de Salud Carlos IIIFondo de Investigación Sanitaria / FEDE

Agronomic and environmental factors influence weed composition and canola competitiveness in southern Manitoba

Canola yield in Manitoba has reached a plateau in recent years. The causes for this, as related to agronomic, environmental, weed interference and canola competitiveness factors, were identified using observational data from 31 canola fields in southern Manitoba in a 2-yr on-farm research study. Agronomic and environmental factors contributing to weed density and composition were determined with multivariate canonical correspondence analysis. Agronomic and environmental factors most influential on absolute and relative canola biomass were determined with multiple regression analysis. Most weeds were adaptable across a broad range of crop environments; however, some functional groups of weeds were either positively or negatively favored by specific environmental or agronomic conditions. Absolute canola biomass prior to bolting was greater as soil growing degree days (GDD) increased and canola was dense and seeded early. Lower weed density, increased soil GDD, and reduced surface soil moisture were significant factors contributing to higher relative canola biomass. Results from this study indicate that seeding canola early and at a rate sufficient to achieve a dense crop stand can increase canola competitiveness and reduce weed interference. Key words: Agronomy, canola, competitiveness, environment, weeds </jats:p

Efficacy of the hypothermic compression bandage in the surgical wound of cardiac devices

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Pocket hematoma is one of the most frequent complications (10%) of the cardiac devices implant. To reduce the risk of bleeding, once the wound is sutured and isolated with a sterile dressing, the nurse performs a compression bandage over the area of the generator pocket. The choice of the type of bandage on the wound of the generator pocket is the responsibility of the nurse and there are several methods that vary according to the center. The vasocontrictive property of ice is known but its applicability is not demonstrated in these types of wounds. Objective Evaluate the efficacy of the hypothermic compression bandage versus conventional compression bandage, for the prevention of surgical wound post cardiac device implant hematoma in chronic oral anticoagulant and / or platelet antiaggregant treatment. Methodology This is a randomized prospective study. The protocol was accepted by ethical committee. The team of nurses from the arrhythmia laboratory recruited 310 patients (sample size with statistical calculation) who were going to undergo an implant or replacement of a pacemaker or internal defibrillator. Those patients who were under treatment with oral anticoagulant and/or platelet antiaggregants were selected. Through a list of random numbers two therapeutic branches were created: the intervention group was applied a compressive bandage with ice and the usual group lacked the conventional compressive bandage. Both bandages placed just at the end of wound closure and for 6 hours post-implant. Skin status was stratified between healthy, ecchymosis, mild hematoma and severe hematoma. The assessment of the state of the skin was performed by a blinded nurse, in the control of the wound at 7 days post intervention. The primary endpoint was the appearance of hematoma. The secundary endpoint was the appearance of severe hematoma, defined as bleeding with vital commitment that required drainage or rehospitalization. Results 310 patients participated in the study. 156 patients were randomized to the intervention group and 153 to usual care. The mean age of the sample was 73.77 ± 10.68 years and 74.8% were men. There were no significant differences between the intervention and usual care groups on any baseline demographic or clinical characteristics. A total of 13 patients presented hematoma and 36 patients presented ecchymosis. In the intervention group, 5.88% (n = 18) of ecchymosis and 1.3% (n = 4) of mild hematoma were observed. In the usual care group, 5.88% (n = 18) of ecchymosis and 2.9% (n = 9) of mild hematoma were observed. No patient in neither groups had severe hematoma. No significant differences were observed between the two types of bandage in any of the 3 levels of hematomas. There were also no significant differences between hematoma and the type of platelet antiaggregants or oral anticoagulant. Conclusion After this study it is observed that there is no difference between applying a compression bandage with or without cold. </jats:sec

Unión Ibero-Americana, Año XXIX, Núm. 9

44 páginasGRABADOS: Cádiz: Vista panorámica tomada desde la Torre de Tavira.- Vistas de España (Cádiz): Botadura del trasatlántico Santa Isabel, verificada el 20 de agosto último en el astillero de Matogorda.- El nuevo buque Santa Isabel atracado al muelle. San Salvador: Patio de la actual Universidad Nacional; Un rincón de la Quinta Modelo; Escuela de Medicina. TEXTO: España y América.- La Fiesta de la Raza.- Explotación ganadera en el Paraguay, por el Dr. Tomás Osuna.- El idioma español en las Repúblicas rioplatenses, por Horacio Araujo Villagrán.- La fatiga escolar, por Félix Rosa González V.- Fiestas patrióticas colombinas en Huelva: Carta poética, por Miguel Benítez Castro.- La neutralidad de España, por Manuel de Saralegui y Medina.- Argentina: Presupuesto para 1916.- Derechos y deberes de los españoles fuera de España, por José Marginet.- Nuevo Presidente de Venezuela: El General D. Juan Vicente Gómez, por José María Barreto.- La minería sudamericana y la unión industrial de España con la América Latina, por Fernando B. Villasante.- Fomento del Trabajo Nacional: Premio anual de 5.000 pesetas, ofrecidas por D. José Deu y Mata.- Jesús y Colón, por Anselmo Ruiz Gutiérrez.- Intercambio comercial hispanoamericano (El Salvador, Cuba).- Episodios históricos salvadoreños (La guerra con Guatemala en 1863; Sus causas aparentes; Fusilamiento de Zepeda y Castellanos), por A. Funes.- Política económica hispanoamericana: Conferencia dada el 10 de agosto, en el Ateneo Hispano-Americano de Buenos Aires, por el Sr. A. Martín Jiménez.- Libros nacionales y extranjeros, por A. Balbín de Unquera.- Acepte usted la biblioteca gratuita que se le ofrece.- Catálogo de exportadores españoles.- IV Centenario del descubrimiento del Pacífico: Catálogo de la Exposición celebrada en el Archivo General de Indias en 1913 y 1914, por Pedro Torres Lanzas.- Índice de sumarios de los números publicados en el corriente año.- Anuncios