Enfermedad de Behcet: Manifestaciones neurológicas y psiquiátricas observadas en dos pacientes en el Hospital Nacional Dos de Mayo (Lima, Perú).

The neurological and psychiatric manifestations in two patients who met clinical criteria of Behcet’s disease are observed and described throughout several decades. The presence of recurrent oral and genital canker sores is illustrated with images. One of the patients developed thrombosis of the femoral vein, and erythema nodosus was present in both. The ophthalmological evaluation showed absence of uveitis in both patients, and blindness by adult monocular dystrophic maculopathy without signs of retinal vasculitis in the female. Laboratory tests on blood and cerebrospinal fluid evidenced lymphocytic pleocytosis. The patergia skin test was negative. Likewise, laboratory tests determined an absence of findings compatible with other autoimmune diseases. Throughout the evaluation period, the clinical manifestations were correlated with the findings from tomography and brain magnetic resonance magnetic. Similarly, recurrent myelitis and its correlation with the results of medular magnetic resonance imaging are explained. The evaluation and follow-up period through outpatient consultation and hospitalization was prolonged: the 73-year-old male patient, who started the disease at age 35, was followed-up for 34 years; and the 50-year-old female patient, fell ill at the age of 28 and was followed-up for 8 years. This process allowed the understanding of the different morbid factors that influenced the serious evolution of the clinical picture.Se describen las manifestaciones neurológicas y psiquiátricas de dos pacientes con características clínicas de la enfermedad de Behcet, observados a lo largo de varias décadas. Se ilustra con imágenes la presencia de aftas orales y genitales recidivantes. Uno de ellos desarrolló trombosis de la vena femoral y en ambos hubo presencia de eritema nodoso. La evaluación oftalmológica determinó ausencia de uveitis en ambos pacientes y ceguera por maculopatía distrófica monocular sin signos de vasculitis retinal en la paciente mujer. Exámenes de laboratorio en sangre y en el líquido cerebro espinal evidenciaron pleocitosis linfocítica. El test cutáneo de patergia fue negativo. Asimismo, se determinó la ausencia de hallazgos compatibles con otras enfermedades autoinmunes. Durante el periodo de evaluación se correlacionaron las manifestaciones clínicas y los hallazgos en tomografía (TM) y resonancia magnética cerebral (RMC). Se explica igualmente la mielitis recidivante y su correlato con los resultados de la resonancia magnética medular (RMM). El tiempo de evaluación y seguimiento por consulta externa y durante la hospitalización en el paciente varón (73 años), que inició la enfermedad a los 35 años, fue de 34 años; la paciente mujer (50 años, inició su enfermedad a los 28 años y fue seguida por espacio de 8 años. Este proceso permitió comprender los diferentes factores mórbidos que influyeron en la grave evolución del cuadro clínico estudiado

What to do in case of an endoscopic image of gastric necrosis or ischaemia post-funduplication? A case report

The association of gastric ischemia with a fundoplication is very rare and its management is not always surgical. The present paper describes the mechanism of post-fundoplication gastric ischemia that occurred in a patient diagnosed with gastroesophageal reflux disease treated with a Nissen-type gastric fundoplication. A clinical case of the Foregut Clinic of the Hospital General de Mexico (HGM) is presented. This is a 24-year-old patient undergoing a Nissen-type fundoplication who was discharged without eventualities and who presented intestinal occlusion, acute gastric dilation and gastric ischemia

Atención primaria pregrado

La atención de salud debe ser ambulatoria, y lahospitalización solo cuando sea indispensable, la causason la urbanización y el aumento de la expectativa devida. La tendencia comienza en 1945 en Inglaterra,la Declaración de Alma Ata en 1978 de OMS. EnLatino América 1975 y en Venezuela en 1979. Secreó la Especialidad Médica MEDICINA FAMILIAR,el primer posgrado fue en el Centro Ambulatorio deCaricuao del IVSS por Carmen Cedraro de Carpio yRafael Anselmi 1982. La OPS dirigió la ejecución yel desarrollo. Describimos la estructura curricularMedicina Familiar. En 16 países estudiados haydocencia de APS en pregrado. Hoy debe haber unMédico General-Familiar por cada 500 familias o2 500 personas. Necesitamos 12 000 médicos conposgrado en Medicina Familiar. Son las conclusionesy recomendaciones: 1. La Atención Primaria deSalud (APS) es el eje en la conservación de la salud,la prevención y el tratamiento. 2. La APS debe juntocon la Historia Médica Electrónica ser enseñada en elPregrado de la Facultad Medicina. 3. Creen la OPS yla OMS, que debe ser desempañada por los Municipiosjunto con la Educación Preescolar artículo 178 aparte5 de la Constitución Nacional. 4. La AcademiaNacional de Medicina de Venezuela debe participarloa: 1. Las Facultades y Escuelas de Medicina, 2.Sociedades Científicas de la Especialidades Médicas,y 3. Autoridades Gremiales Colegios de Médicos yFederación Médica.Palabras clave: Atención médica en Ambulatorios; Medicina Familiar a nivel Municipal.SUMMARYThe center of health care must be ambulatory andhospitalization used when is essential. The urbanizationand the increase of life expectancy reinforce the idea.Return to General Physician 1945 in England. TheDeclaration of Alma Ata in 1978 WHO. Health for allin the year 2000. In Latin America 1975 Venezuelain 1979. The family medicine medical specialty wascreated, the first postgraduate program in Venezuelawas in the outpatient center of Caricuao of the IVSS’sby Carmen Cedraro de Carpio and Rafael Anselmi1982. The PAS was the leader in implementationand development for the public welfare. We describecurricular structure of the postgraduate in familymedicine. In 16 countries all there are APS teachingin undergraduate. Should be a General-Familiardoctor 500 families or 2 500 people. Venezuela need12 000 physicians in family medicine. The conclusionsand recommendations: 1.The APS is the base in theconservation of the health, in the prevention andtreatment of diseases. 2. The APS must togetherwith the electronic medical history should be taughtto the undergraduates. 3. Following the thinkingof the PAHO and the WHO should be played by themunicipalities along with preschool education as thea-side says 5 of article 178 of the existing NationalConstitution. 4. These three principles, the NationalAcademy of Medicine of Venezuela must do so in theknowledge of: 1. Faculties and Schools of Medicine,2. Scientific Societies of the Medical Specialties,and 3. Authorities Union Colleges of Physicians andVenezuelan Medical Federation.Key words: Medical Care in Ambulatory; MunicipalFamily Medicin

Historia Médica Electrónica

La Historia Médica Electrónica es un concepto en evolución que se define como una recopilación sistemática de información digital de salud de los pacientes o las poblaciones, por medio de los informes elaborados por los institutos prestadores de salud. En la década de 1960, Lawrence L. Weed describe por primera vez el concepto de registros médicos electrónicos o computarizados y describe un sistema para automatizar y reorganizar los registros médicos de los pacientes para mejorar su utilización y así llevar a la mejor atención al paciente. Se la puede aplicar en: 1. Asistencia, 2. Docencia, 3. Investigación Clínica y Epidemiológica, 4. Gestión Clínica y planificación de recursos, 5. Control de calidad Asistencial y Legal. En Venezuela desde 1971, Tinedo, Ramón, Gómez Cova, David 1974, Irma Senior de Blankenburg 1980, Tulio López Ramírez 1985, Felipe Bello 1986 y muchos otros trataron el tema de la Historia Médica y la calidad del acto médico. Hicimos el estudio por la red de 20 países que consideramos los más importantes, con el fin de tener una visión global de la situación. En todos ellos se usa la HME pero la extensión de su uso no es uniforme. Señalamos los niveles de atención médica, y la clasificación y características de los Hospitales y Ambulatorios. Hacemos especial énfasis en el control de la calidad del acto médico. Participaron dos Profesores de la Escuela Razetti UCV, tres médicos que hicieron experiencias con la HME, un Especialista en Salud Pública y un Cirujano de Tórax.Palabras clave: Historia Médica Electrónica. Calidad y control de la atención médicaSUMMARY The electronic medical record is an evolving concept that is defined as a systematic collection of digital health information of patients or populations, through reports prepared by health providers’ health institutes. In the 1960’s, Lawrence L. Weed describes for the first time the concept of electronic or computerized medical records and describes a system for automating and reorganize the medical records of patients to improve their use and thus take the patient to the best care. It can be applied: 1. Healthcare, 2. Teaching, 3. Clinical research and epidemiological, 4. Clinical management and planning of resources, 5. Quality healthcare and Legal Control. In Venezuela since 1971, Tinedo, Ramon, Gómez Cova, David 1974, Irma Senior Blankenburg 1980, Tulio Lopez Ramirez 1985, Felipe Bello 1986 Senior and many others addressed the issue of the medical history and the quality of the medical act. We did the study by the network of 20 countries we consider to be the most important, in order to have a global view of the situation. MEH is used in all, but the extension of its use is not uniform. We pointed out the levels of medical care, and classification and characteristics of hospitals and clinics. We make special emphasis on the control of the quality of the medical act. Involved two teachers from the school Razetti UCV, three doctors who made experience with the EHR, a public health specialist and a chest surgeon.Key words: Electronic medical History. Quality and control of the health care.&nbsp

Population structure and reproductive behavior of Sinaloa cichlid Cichlasoma beani (Jordan, 1889) in a tropical reservoir

The population structure and reproductive condition of the Sinaloa cichlid Cichlasoma beani from samples obtained from June 2000 to July 2001 were determined. Samples in the first week each month from the largest trader of tilapia in the Aguamilpa Reservoir in Mexico and were caught in gillnets (9.6 and 11.4 cm stretch-mesh size). Of 596 specimens, there were 427 males and 169 females; monthly sex ratio, frequency of lengths by the multinomial distribution, timing of reproduction, condition index, and size at first maturity was determined. Differences in the sex ratio and monthly totals were significant, favoring males, except for September 2000 and March 2001. From one (August 2000) to three modal groups (July 2000 and June 2001) were identified by size. There were no significant differences in standard length weight relationships by sex, which indicated that a shared model for both genders is appropriate, and isometric growth was detected. Based on the proportion of mature and partially matures fish, the main reproductive period was April through June; size at first maturity was 18.9 cm. Water temperature was not significantly related to the percentage of mature and partially matures Sinaloa cichlids or spawning. These findings provide information for regulating the Cichlasoma beani fishery in this region such minimum legal size and non-fishing period

Expression of long-chain polyunsaturated fatty acids biosynthesis genes during the early life-cycle stages of the tropical gar Atractosteus tropicus

Long-chain (≥C20) polyunsaturated fatty acids (LC-PUFA), including eicosapentaenoic acid (EPA, 20:5n-3), arachidonic acid (ARA, 20:4n-6) and docosahexaenoic acid (DHA, 22:6n-3), are essential in multiple physiological processes, especially during early development of vertebrates. LC-PUFA biosynthesis is achieved by two key families of enzymes, fatty acyl desaturases (Fads) and elongation of very long-chain fatty acid (Elovl). The present study determined the expression patterns of genes encoding desaturases (fads1 and fads2) and elongases (elovl2 and elovl5) involved in the LC-PUFA biosynthesis during early life-stages of the tropical gar Atractosteus tropicus. We further analyzed the fatty acid profiles during early development of A. tropicus to evaluate the impact of Fads and Elovl enzymatic activities. Specific oligonucleotides were designed from A. tropicus transcriptome to perform qPCR (quantitative polymerase chain reaction) on embryonic and larval stages, along with several organs (intestine, white muscle, brain, liver, heart, mesenteric adipose, kidney, gill, swim bladder, stomach, and spleen) collected from juvenile specimens. Fatty acid content of feeds and embryonic and larval stages were analyzed. Results show that fads1, fads2, elovl2 and elovl5 expression was detected from embryonic stages with expression peaks from day 15 post hatching, which could be related to transcriptional and dietary factors. Moreover, fads1, fads2 and elovl2 showed a higher expression in intestine, while elovl5 showed a higher expression in liver, suggesting that the tropical gar activates its LC-PUFA biosynthetic machinery to produce ARA, EPA and DHA to satisfy physiological demands at crucial developmental milestones during early development.The study was financially supported by Consejo Nacional de Ciencia y Tecnología (CONACyT) by project CB-2016-01-282765. Authors thank CONACyT for the fellowship grants

Diario de Campo: Boletín Interno de los investigadores del área de Antropología. 84 (2006) mayo. Diario de Campo

- La industria eléctrica en México por Saúl Escobar Toledo. - De aquí y de allá. Migración, mercado de trabajo e identidad en una comunidad nahua del sureste de Tlaxcala por Nazario A. Sánchez Mastranzo. - Plan de manejo de la Sierra de San Francisco, Baja California Sur por María de la Luz Gutiérrez Martínez. - Reflexiones sobre salud-enfermedad y cultura por Rosa María García Macué y Laura Elena Corona de la Peña. - Literatura indígena por Irene A. Jiménez. - Discurso historiográfico, universidad y democracia en América Latina por Carlos Mariano Tur Donati. - Algunas aclaraciones acerca de la historia temprana de Amenalco, Querétaro por Rafael Parra. - Archivo histórico de Luz y Fuerza por José Francisco Coello Ugalde. - La legislación en materia de cultura por Bolfy Cottom. - Cultura y desarrollo apuntes para una política institucional por Anna Graciela Bedolla Giles. - Células madre: Uso, perspectiva y controversia por Adrian Martínez-Meza. - Suplemento 37. Materia inestable: reflexiones sobre historia reciente. – Documentos. El H. Senado de la República y la Reforma Constitucional