Sleeping disorders in older adults. Diagnostic and therapeutic update

Sleeping disorders in the elderly are a frequent condition. However, it is a part of relatively new medicine, since it has only been in the last 40 years it has really studied. The objective of this review is to deepen and update diagnostic and therapeutic aspects of these disorders, which is always a challenge for the doctor who attends this age group

Right Traumatic Diaphragmatic Hernia: A Case Report and A review

Diaphragmatic hernia constitutes an infrequent form of diaphragmatic disease and a high index of sospecha for its diagnosis. The lesions of the left side seem to be the most frequent according to the review of the medical literature. This is the case of a patient with a 15 year- history of right hemithorax due to car accident who presented to the internal medicine emergency service with weakness and shortness of breath . His skin and mucous membranes were pale and vesicular murmurs were abolished in the inferior two thirds of the right hemithorax. The patient was ordered a complete blood count (CBC), an antero-posterior chest x -ray, an abdominal ultrasound , a thoracic-abdominal ultrasound, a chest computerized axial tomography, respiratory function tests and a medulloculture. The computerized axial tomography revealed a right hemithorax filled with intestinal loops, liver and gallbladder. The patient was surgically treated realizing the presence of a right multivisceral diaphragmatic hernia which was corrected by hernioplasty with prothesis of the polypropylene. The patient recovered satisfactorily . For its uncommon presentation it has been published

Neurofibromatosis tipo 1 o enfermedad de Von Recklinghausen. Presentación de caso

La neurofibromatosis tipo I o enfermedad de Von Recklinghausen es una de las enfermedades genéticas que afectan el sistema nervioso, denominada así por su origen común embrionario. Es una enfermedad autosómica dominante, progresiva, de evolución impredecible, que afecta la piel y el sistema nervioso central y periférico. Se presenta el caso de una escolar, femenina, de siete años de edad que ingresó en el Hospital Pediátrico Paquito Gonzáles Cueto debido a la presencia de varias manchas en la piel color “café con leche”. Se recogió como antecedente familiar la presencia de neurofibromatosis tipo 1 en la abuela y bisabuela materna, esta última ya fallecida por dicha causa. Al examen físico se constataron nódulos de Lisch en espesor del iris del ojo izquierdo. Los estudios de imágenes evidenciaron varias lesiones nodulares hiperintensas en T2 y FLAIR, a nivel de la cápsula interna y externa bilateral y ventricular izquierda, la mayor de 20 x 11 mm, así como imagen hipointensa a nivel del nervio óptico izquierdo, de 7 mm. Se diagnosticó como neurofibromatosis tipo I. Por ser una de las enfermedades menos estudiadas en nuestro medio se decidió la publicación de este caso

Influenza A (H1N1). Radiological Patterns

The influenza A (H1N1) has a wide radiological spectrum, difficult to differentiate from other epidemic respiratory diseases. One of the distinctive elements seems to be the quick evolution of the imagenologic lesions in the sick persons, as well as the slow resolution of these manifestations. The chest fillm is of vital importance to make a precise diagnosis, and it constitutes an indispensable tool for the identification of the cases according to the affection degree (light, moderate, and severe), besides contributing as an essential way to the classification of the patients according to a grade of uncertainty. Although as a confirmation complementary is not definitive, it is important in defining if a case is suspicious or probable

Image Characterization of Cancer of the Colon

Background: Cancer of the colon is the second cause of death due to cancer worldwide, alter lung cancer in males and breast cancer in females. It is not possible to confirm the patient’s diagnosis without the result of image tests such as barium enema, ultrasound cytology or biopsy of the lesion. Objective: To characterize cancer of the colon through images. Methods: Descriptive study which included all the patients discharged from “Dr. Gustavo Aldereguía Lima” General Hospital with a confirming diagnosis of cancer of the colon. The variables under study were: sex, age, past and family history of the disease, its way of presentation, location, image findings and histological diagnosis. Shi square was used for a 95 % exactitude where p<= 0,05. Results: Cancer of the colon was more frequently detected in the age group of 50 to 59 years of age in both sexes meanwhile in the age group 70 to 79 years of age the disease affected males. It was mainly associated to idiopathic ulcerative colitis and to family history of cancer of the colon and cholecystectomy. Suggestive symptoms were predominant in the findings. The most frequent location was in the left part of the colon. There was correlation between the results of the ultrasound and barium enema the X-rays.Conclusion: Ultrasound was of great usefulness, but barium enema is the test of choice in our environment for the diagnosis of cancer of the colon