Hígado nodular

Historia clínica: Varón de 61 años, bebedor y fumador, con EPOC severo, varices esofágicas, diabetes mellitus tipo 2 a tratamiento con hipoglucemiantes. Ingresa por neumonía extrahospitalaria y a las 72 horas hace un íleo paralítico de evolución tórpida a pesar de las medida habituales y fallece

Cuerpos de inclusión en las fibras miocárdicas de un paciente con epilepsia

Historia clínica:  Mujer de 20 años, con crisis epilépticas. Fallece por broncoaspiración. La sección histológica corresponde a corazón macroscópicamente normal

Sudden death in the first trimester of pregnancy

como es sabido, entre las primeras causas de mortalidad materna durante el embarazo se encuentran los episodios de tromboembolismo venoso. Varios estudios poblacionales ya han demostrado que dicho riesgo se encuentra aumentado de manera muy significativa en caso de embarazos logrados mediante técnicas de Fertilización in vitro (FIV). Sin embargo, apenas existen casos en la literatura que ilustren estas situaciones de emergencia. Presentamos el caso de una mujer de 40 años, embarazada de mellizos mediante FIV, en su 12ª semana de gestación, que fallece tras dos días con clínica de mareos, taquicardia y ahogos. La finalidad de su publicación es doble: por un lado llamar la atención ante uno de los riesgos que acompañan la gestación y, por otro, poner en valor la función del médico forense y el estudio autópsico como fuente de recogida de información de salud pública.The venous thromboembolism and thromboembolic events remain the leading cause of death during pregnancy and postpartum in developed countries. Recent investigations have provided an important evidence of significantly increased risk of venous thromboembolism after in vitro fertilization (IVF) pregnancies. Nevertheless, there are few case reports showing these emergency situations. We report the case of a 40 years old woman, in her twelve week of a twin after IVF pregnancy, who dies after two weeks with dizziness, tachycardia and respiratory distress. Our objective is double: to highlight the risks of the pregnancy even in developed countries and, on the other hand, to enhance the role of the forensic pathologist and the forensic studies as epidemiological information gatherers

Histiocytoid cardiomyopathy and ventricular noncompaction presenting as sudden death in an adult male

Histiocytoid/oncocytic cardiomyopathy (HCM) is a rare, distinctive arrhythmogenic disorder that presents as arrhythmia or sudden death in infants and children. Ventricular noncompaction (VNC) is a rare cardiomyopathy characterized by a thickened endocardial layer of noncompacted myocardium and a thin epicardial layer of compacted myocardium. Only six cases of the association of both cardiomyopathies have been reported previously in the literature. All these cases were in children. To the best of our knowledge, a case of HCM has not been described in the adult. We report the case of a 45-year-old man with an increased heart weight and involvement of both ventricles by HCM and VNC cardiomyopathy. Besides, multiple foci of myocardial disorganization were detected. He died suddenly while hiking. The association of both processes HCM and VNC was an unexpected finding at autopsy. The death was linked to functional abnormalities of the cardiac histiocytoid cells, and it was favored by a state of abnormal development of the heart

Fallo hepático fulminante de etiología indeterminada

Historia clínica: Varón de 82 años que ingresa procedente de urgencias con el diagnóstico de insuficiencia hepática. Dolor abdominal de mes y medio de evolución y cuadro de diarrea. En los hallazgos de la autopsia destaca un pólipo pediculado de 5cm en intestino grueso

Riñones congestivos y hemorrágicos

Historia clínica: Mujer de 39 años ingresada por sospecha de púrpura trombótica trombocitopénica. Comienza con tratamiento esteroideo y sufre parada cardiorespiratoria que no remonta tras 40 minutos de reanimación

Estenosis aórtica

Historia clínica: Varón de 72 años, estenosis aórtica severa e infarto agudo de miocardio

Relevant features in steel structures teaching in building construction by project-based learning

Congreso celebrado en la Escuela de Arquitectura de la Universidad de Sevilla desde el 24 hasta el 26 de junio de 2015.New approaches to teaching are moving towards a learning ever more active, practical and closer to professional sector, and have converged in a competence based education proposed by the European higher education area. Moreover, advances in computer calculations and its applications for structural analysis have brought a revolution in the professional area of structural engineering. Considering these circumstances, we have designed and implemented an educational program for teaching steel structures based on a Project based learning (PBL) method. In this paper we summarize the main features of the educational program, its implementation, results and evaluation; we analyze the performance of PBL in our context and compare some aspects of traditional teaching and our PBL; and finally we identify the most important characteristics required by teaching steel structures through the project based learning method

Lesión tumoral en piel

Historia clínica: Mujer de 94 años ingresada por hemorragia digestiva alta. En la autopsia se encuentra tumor en: pulmones, ganglios linfáticos generalizados, suprarrenal, corazón y piel