Tromboflebitis profundas en la edad infantil

Se recogen cinco casos de variada etiolog{a (osteomielitis del ilíaco, coma diabético hiperosmolar, sepsis meningocócica con shock y C.I.D., traumatismo de cadera y cateterización de vena femoral) que cursaron con tromboflebitis profunda de vasos importantes (venas iliofemoral, femoral y tibial posterior). Se analiza la etiopatogenia de la trombogénesis y los tres principales grupos de afecciones que van a originar enfermedad tromboembólica, aquellas que producen estado de hipercoagulabilidad, las que producen alteración hemodinámica con estasis, y las causantes de lesión tisular. Finalmente se recuerda la clínica, metodos diagnósticos y tratamiento actual de esta entidad poco frecuente en la edad pediátric

Spontaneous tonsillar hemorrhage as initial presentation of acute promyelocytic myeloid leukemia

Actualmente, la hemorragia espontánea amigdalar es un signo faríngeo muy infrecuente. Su etiología habitual se relaciona con la amigdalitis crónica y su tratamiento suele ser local y sintomático. El caso clínico que presentamos refuerza la importancia del estudio integral del paciente con hemorragia espontánea amigdalar, ya que, puede ser la presentación inicial de enfermedades hematológicas graves.Currently, spontaneous tonsillar hemorrhage is a very uncommon pharyngeal sign. Its etiology is usually related to chronic tonsillitis and its treatment uses to be local and symptomatic. The case that we report reinforces the importance of the global study of the patient with spontaneous tonsillar hemorrhage because it can be the initial presentation of serious hematologic diseases

Soluble iron inputs to the Southern Ocean through recent andesitic to rhyolitic volcanic ash eruptions from the Patagonian Andes

Patagonia, due to its geographic position and the dominance of westerly winds, is a key area that contributes to the supply of nutrients to the Southern Ocean, both through mineral dust and through the periodic deposits of volcanic ash. Here we evaluate the characteristics of Fe dissolved (into soluble and colloidal species) from volcanic ash for three recent southern Andes volcanic eruptions having contrasting features and chemical compositions. Contact between cloud waters (wet deposition) and end-members of andesitic (Hudson volcano) and rhyolitic (Chaitén volcano) materials was simulated. Results indicate higher Fe release and faster liberation rates in the andesitic material. Fe release during particle-seawater interaction (dry deposition) has higher rates in rhyolitic-type ashes. Rhyolitic ashes under acidic conditions release Fe in higher amounts and at a slower rate, while in those samples containing mostly glass shards, Fe release was lower and faster. The 2011 Puyehue eruption was observed by a dust monitoring station. Puyehue-type eruptions can contribute soluble Fe to the ocean via dry or wet deposition, nearly reaching the limit required for phytoplankton growth. In contrast, the input of Fe after processing by an acidic eruption plume could raise the amount of dissolved Fe in surface ocean waters several times, above the threshold required to initiate phytoplankton blooms. A single eruption like the Puyehue one represents more than half of the yearly Fe flux contributed by dust.Instituto de Física La Plat

Atypical location of Schwannoma in Maxilla sinus

El schwannoma es tumor de que se localiza en cabeza y cuello en la mitad de los casos. La localización más frecuente es el VIII par craneal generando hipoacusia y vértigo. El tratamiento consiste en la exéresis quirúrgica. A continuación exponemos una localización rara de este tumor, el seno maxilar. La clínica consiste en cefalea e insuficiencia respiratoria nasal. No existe consenso sobre la vía de abordaje para la cirugía. En nuestro caso nos decantamos por una vía combinada: cirugía endoscópica nasosinusal (CENS) con cirugía abierta mediante antrostomia de Cadwel-Luc.Schwannoma is a tumor located in the head and neck in the middle of casos.The most frequent location is the eighth cranial nerve causing hearing loss and tinnitus. The treatment is surgical excision. Below are a rare location for this tumor, maxillary sinus. Causes of headache and nasal respiratory failure. There is no consensus on the approach to surgery. We opted for combined surgery: endoscopic sinus surgery (FESS) by external surgery of Cadwel-Luc antrostom

Multiple lipomas in ORL area

Los lipomas son tumores benignos de origen mesenquimatoso de presentación común en cualquier parte del cuerpo. La frecuencia de aparición en la cavidad oral es rara, siendo más frecuente esta localización en el sexo femenino. Estos tumores representan entre el 2-4% de todos los tumores de cabeza y cuello. Esta lesión se presenta redondeada, de consistencia blanda y color amarillento; su crecimiento es lento y suele ser asintomática. A continuación exponemos un caso clínico de un paciente con dos lipomas que afectaban a la lengua y al cuello. En estos tipos de lesiones a nivel cervical es necesario hacer diagnostico diferencial con tumores de células granulares, neurofibromas, fibromas traumáticos y malformaciones de las glándulas, salivares (mucoceles y tumores mixtos) entre otros, así como liposarcomas. Para el diagnóstico son de ayuda los estudios de imagen: RMN, TAC y ecografía. El tratamiento de elección para este tipo de tumores consiste en la exéresis quirúrgica.Lipomas are benign tumors of mesenchymal origin of common presentation anywhere in the body. The frequency in the oral cavity is rare, this location is more frequent in females. These tumors account for 2-4% of all head and neck tumors. This lesion occurs rounded, soft consistency and yellowing; slow growing and usually asymptomatic. We have presented a case of a patient with two lipomas affecting the tongue and the neck. In these types of lesions to the cervical level is necessary to make differential diagnosis with granular cell tumors, neurofibromas, traumatic fibroids and malformations of the salivaries glands (mucoceles and mixed tumors) among others, as well as liposarcomas. The diagnosis is necessary imaging studies: MRI, CT and ultrasound. The treatment of choice for these tumors is surgical excision

Economic impact of pharyngocutaneou fistulae in patients laryngectomy

Objetivo: Analizar el impacto económico derivado de la hospitalización de los pacientes con fístulas faringocutá- neas (FFC) como principal evento adverso tras laringectomía total entre los años 2006 y 2011 en un hospital de segundo nivel. Método: Cálculo estimado de los costes directos generados por la FFC mediante el Grupo de Diagnóstico Relacionado (GRD) y aplicación corporativa de contabilidad analítica del Servicio Andaluz de Salud (COAN h y d) para los años mencionados. Resultados: Entre 2006 y 2011 el coste de todos pacientes con FFC fue de 3.210.586,9€, a diferencia de 1.282.708,5€ para los que no cursaron esta complicación. El coste individual en el período de estudio fue 94.429,0.26€ en las FFC y 35.630,777€ en los que no la tuvieron. Los afectados registraron un incremento de 2,66 veces en el gasto sanitario. Conclusión: La aparición de FFC tras laringectomía supone un coste elevado para el hospital y la organización sanitaria. Se deben plantear estrategias preventivas que minimicen el impacto económico de este evento adverso.Objective: To analyze the economic impact of hospitalization of patients with fistulas pharyngocutaneous (FFC) as the main adverse event after total laryngectomy between 2006 and 2011 in a secondary hospital. Method: Calculate estimated direct costs generated by the FFC using Diagnosis Related Group (DRG) and cost accounting corporate application Andalusian Health Service (COAN hyd) for those years. Results: Between 2006 and 2011 the cost of all patients was € 3,210,586.9 FFC, unlike € 1,282,708.5 for those who missed out this complication. The individual cost in the study period was € 94.429,0.26 in FFC and € 35,630.777 in those without it. The patients had an increase of 2.66 times in health spending. Conclusion: The occurrence of FFC after laryngectomy involves a high cost for the hospital and healthcare organization. Preventive strategies must be implemented to minimize the economic impact of this adverse event

Chasing cardiac physiology and pathology down the CaMKII cascade

Calcium dynamics is central in cardiac physiology, as the key event leading to the excitation-contraction coupling (ECC) and relaxation processes. The primary function of Ca2+ in the heart is the control of mechanical activity developed by the myofibril contractile apparatus. This key role of Ca2+ signaling explains the subtle and critical control of important events of ECC and relaxation, such as Ca2+ influx and SR Ca2+ release and uptake. The multifunctional Ca21-calmodulin-dependent protein kinase II (CaMKII) is a signaling molecule that regulates a diverse array of proteins involved not only in ECC and relaxation but also in cell death, transcriptional activation of hypertrophy, inflammation, and arrhythmias. CaMKII activity is triggered by an increase in intracellular Ca2+ levels. This activity can be sustained, creating molecular memory after the decline in Ca2+ concentration, by autophosphorylation of the enzyme, as well as by oxidation, glycosylation, and nitrosylation at different sites of the regulatory domain of the kinase. CaMKII activity is enhanced in several cardiac diseases, altering the signaling pathways by which CaMKII regulates the different fundamental proteins involved in functional and transcriptional cardiac processes. Dysregulation of these pathways constitutes a central mechanism of various cardiac disease phenomena, like apoptosis and necrosis during ischemia/reperfusion injury, digitalis exposure, post-acidosis and heart failure arrhythmias, or cardiac hypertrophy. Here we summarize significant aspects of the molecular physiology of CaMKII and provide a conceptual framework for understanding the role of the CaMKII cascade on Ca2+ regulation and dysregulation in cardiac health and disease.Centro de Investigaciones Cardiovasculare

Two‐photon detection of organotin Schiff base complexes in cancer cells

The early detection of cancer cells and their visualization before and after surgery are essential for successful pre‐ and post‐operative disease management. Although fluorescence imaging is a sensitive and versatile tool that is finding increasing use in clinical applications, there is a lack of tumour‐targeting fluorophores. We report here a family of fluorescent Schiff base organotin dyes (1: Et2N−L‐SnPh2, 2: Et2N−L‐SnBu2, 3: MeO−L‐SnPh2, 4: MeO−L‐SnBu2, 5: HO−L‐SnPh2, and 6: HO−L‐SnBu2, where L=2‐hydroxybenzylidene‐4‐hydroxybenzhydrazine). In addition to one‐photon‐excited fluorescence, efficient two‐photon excitation was demonstrated in compounds 1–4. Two of the compounds (5 and 6), both with hydroxyl substituents, were capable of selective accumulation in HeLa cells, allowing differentiation from normal cells (periodontal ligament cells). Compounds 1 and 3 showed excellent cancer cell staining (HeLa) using two‐photon bioimaging, which is promising for biomedicine applications