Donovanosis, reporte de caso

La Donovanosis es una enfermedad ulcerativa crónica y progresiva que ataca por lo común la región genital, es producida por el Calymmatobacterium granulomatis, bacteria Gram negativa. La Azitromicina ha emergido como la droga de elección para su tratamiento. Se presenta un caso de Donovanosis en un varón de 46 años, quien tenía relaciones heterosexual y homosexual, el cuál presento papula anal que evoluciono a una úlcera crónica, le realizan el diagnostico de tumoración anorrectal a descartar una neoplasia anorrectal y le realizan colostomía. El retardo en la sospecha clínica en un área no endémica concluyo con su diagnóstico con un extendido en lámina para microscopia con coloración Giemsa

Recomendaciones para la buena práctica de la medicina en anestesiología

At present, the Anesthesiology is recognized as a medical discipline and the activities of the anesthesiologist are wide, since it interferes in all the processes that happen during the anesthetic - surgical act. The most common reason of damages or serious complications they are associated with faults in the suitable ventilation of the patient. The aim of the present work is to generate specific and general recommendations directed to specialists of Anesthesiology, from the analysis of the complaints received in the CONAMED. There were analyzed all the complaints received for the specialty of anesthesiology from June, 1996 to May, 2001. Sociodemographic variables were included, information about institution of health and motive of complaint among others. There was included information of the Medical Integral Valuation, to obtain the type of used anesthesia. For the analysis descriptive statistics was used, for this intention it was used SPSS 10.1. Results: there was analyzed a whole of 97 complaints, 74.2 % of the complaints corresponded to the female sex, average of age 34.3 years, the major proportion of the complaints were to institutions of Social Security (67.0%). The proportion of malpractice for type of institution was of 75 % in the private roads, 57.4 % in Social Security and 52.6% in the Public Services. Problems identified with major frequency in the complaints with malpractice were in order: dural puncture, encephalopathy ischemic and cerebral irreversible damage and injury of nervous roots. Five deaths related with anesthesia were identified. The results obtained in the present work as for the problems in the practice of anesthesiology are very similar to the reported ones in the literature and a proportion of cases they can be prevenibles across a better training and supervision of the procedures that are realized.En la actualidad, la Anestesiología se reconoce como una disciplina médica y las actividades del anestesiólogo son amplias, ya que se involucra en todos los procesos que ocurren durante el acto anestésico-quirúrgico. La causa más común de daños o complicaciones serias están asociadas con fallas en la ventilación adecuada del paciente. El objetivo del presente trabajo es emitir recomendaciones generales y específicas, dirigidas a los especialistas de Anestesiología, a partir del análisis de las quejas recibidas en la CONAMED. Se analizaron todas las quejas recibidas en la CONAMED para la especialidad de anestesiología de junio de 1996 a mayo de 2001. Se incluyeron variables sociodemográficas, de la institución de salud y motivo de queja entre otras. Se incluyó información de la Valoración Médica Integral, para obtener el tipo de anestesia utilizada. Para el análisis se empleó estadística descriptiva, para este propósito se utilizó el paquete estadístico SPSS 10.1. Resultados: se analizaron un total de 97 quejas, 74.2% de las quejas correspondieron al sexo femenino, promedio de edad pacientes 34.3 años, la mayor proporción de las quejas correspondió a instituciones de Seguridad Social (67.0%). La proporción de mala práctica por tipo de institución fue de 75% en las privadas, 57.4% en seguridad social y 52.6% en servicios públicos. Los problemas identificados con mayor frecuencia en las quejas con mala práctica fueron: perforación de duramadre, seguida por la encefalopatía anoxoisquémica, el tercer lugar para daño cerebral irreversible y lesión de raíces nerviosas. Se identificaron 5 defunciones relacionadas con la anestesia. Los resultados obtenidos en el presente trabajo en cuanto a los problemas en la práctica de la anestesiología son muy semejantes a los reportados en la literatura y una proporción de casos pueden ser prevenibles a través de una mejor capacitación y supervisión de los procedimientos anestésicos que se realizan

First lacustrine varve chronologies from Mexico: impact of droughts, ENSO and human activity since AD 1840 as recorded in maar sediments from Valle de Santiago

We present varve chronologies for sediments from two maar lakes in the Valle de Santiago region (Central Mexico): Hoya La Alberca (AD 1852–1973) and Hoya Rincón de Parangueo (AD 1839–1943). These are the first varve chronologies for Mexican lakes. The varved sections were anchored with tephras from Colima (1913) and Paricutín (1943/1944) and 210Pb ages. We compare the sequences using the thickness of seasonal laminae and element counts (Al, Si, S, Cl, K, Ti, Mn, Fe, and Sr) determined by micro X-ray fluorescence spectrometry. The formation of the varve sublaminae is attributed to the strongly seasonal climate regime. Limited rainfall and high evaporation rates in winter and spring induce precipitation of carbonates (high Ca, Sr) enriched in 13C and 18O, whereas rainfall in summer increases organic and clastic input (plagioclase, quartz) with high counts of lithogenic elements (K, Al, Ti, and Si). Eolian input of Ti occurs also in the dry season. Moving correlations (5-yr windows) of the Ca and Ti counts show similar development in both sequences until the 1930s. Positive correlations indicate mixing of allochthonous Ti and autochthonous Ca, while negative correlations indicate their separation in sublaminae. Negative excursions in the correlations correspond with historic and reconstructed droughts, El Niño events, and positive SST anomalies. Based on our data, droughts (3–7 year duration) were severe and centred around the following years: the early 1850s, 1865, 1880, 1895, 1905, 1915 and the late 1920s with continuation into the 1930s. The latter dry period brought both lake systems into a critical state making them susceptible to further drying. Groundwater overexploitation due to the expansion of irrigation agriculture in the region after 1940 induced the transition from calcite to aragonite precipitation in Alberca and halite infiltration in Rincón. The proxy data indicate a faster response to increased evaporation for Rincón, the lake with the larger maar dimensions, solar radiation receipt and higher conductivity, whereas the smaller, steeper Alberca maar responded rapidly to increased precipitation

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS