Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 10

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 10, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, que cuenta con el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. La gestión del conocimiento es un camino para consolidar una plataforma en las empresas públicas o privadas, entidades educativas, organizaciones no gubernamentales, ya sea generando políticas para todas las jerarquías o un modelo de gestión para la administración, donde es fundamental articular el conocimiento, los trabajadores, directivos, el espacio de trabajo, hacia la creación de ambientes propicios para el desarrollo integral de las instituciones

Quiste de paratiroides gigante como presentación de una tumoración cervical

Parathyroid cysts are rare entities easily confused with thyroid cysts, which are much more frequent. They are sometimes associated with hormonal hypersecretion with manifest primary hyperparathyroidism. Diagnosis is based on cervical ultrasound and the analysis of fluid from the fine needle aspiration. The case we present illustrates the diagnostic management and is striking due to the size of the lesion.Los quistes de paratiroides son entidades raras fácilmente confundibles con los quistes tiroideos, mucho más frecuentes. En ocasiones se asocian a hipersecreción hormonal con hiperparatiroidismo primario manifiesto. El diagnóstico se basa en la ecografía cervical y el análisis del líquido de la punción-aspiración por aguja fina. El caso que presentamos ilustra el manejo diagnóstico y resulta llamativo por el tamaño de la lesión

Obesidad como factor de riesgo para complicaciones postquirúrgicas en la cirugía estética

Obesity is a global health problem which may affect the cardiovascular, metabolic, and even immunologic spheres. It has been recognized that obesity is a risk factor for the development of complications after surgical procedures, including aesthetic procedures such as abdominoplasty, augmentation and reduction mammoplasty, among others. The most frequent complications are operative site infections and deep venous thrombosis, which may be explained by the impact of obesity on the architecture and functionality of the immune system and how it affects circulatory mechanics, as well as the impact of closely-related habits, such as physical inactivity. Given the evidence, it is time to consider novel strategies to reduce the amount of possible complications in this subpopulation, which demands more rigorous research with novel protocols.La obesidad es un problema de salud global que puede afectar la esfera cardiovascular, metabólica e incluso inmunológica. Se reconoce que la obesidad es un factor de riesgo para desarrollar complicaciones luego de un procedimiento quirúrgico, incluyendo procedimientos estéticos como la abdominoplastia, mamoplastia de aumento y reducción, entre otros. Las complicaciones más frecuentes son la infección del sitio operatorio y la trombosis venosa profunda, lo cual se explica por el impacto de la obesidad en la arquitectura y funcionalidad del sistema inmunológico y por cómo afecta la mecánica circulatoria tanto la obesidad como los hábitos que típicamente se asocian a la misma, como la inactividad física. Dada la evidencia, es tiempo de considerar nuevas estrategias para evitar el mayor número de complicaciones posibles en esta subpoblación, para lo cual se necesitan nuevas investigaciones más rigurosas y con protocolos novedosos

Raynaud’s phenomenon caused by cabergoline during the treatment of a macroprolactinoma: a case report

Digital vasospasm is a known adverse effect of dopamine agonists such as bromocriptine; however, it has rarely been reported with cabergoline. We describe a case of Raynaud's phenomenon as a side effect of treatment with the latter in a 52-year-old woman with a macroprolactinoma, forcing discontinuation. In this context, we conducted a review of the literature, with emphasis on the possible criteria for discontinuation of treatment with dopaminergic agonists in patients with macroprolactinoma

Metanephrin-producing adrenocortical carcinoma: a case report

Adrenocortical carcinoma is a rather infrequent neoplasm that mostly occurs with an autonomous secretion of steroids or steroid precursors. Previous cases have been reported with simultaneous production of metanephrines, but they were associated with intercurrent pheochromocytoma or mixed corticomedular tumors. So far, only two cases of adrenocortical carcinoma that deliver medullar hormones had been published. We herein report a singular case of a 58-year-old man with a finding of an incidental adrenal mass that demonstrated metanephrine production in the hormonal study. Consequently, initial diagnosis of pheochromocytoma was established. Microscopic examination showed an adrenal mass with marked pleomorphism and frequent mitosis. Large areas of coagulative necrosis were interspersed within the tumour. After immunohistochemistry staining there was a high expression of Ki67 (>70%) showing highly proliferative behaviour.  Both cytokeratin AE1/AE3 and vimentin were positive, synaptophysin and chromogranin were negative. The surgical margins were free. Given these features, a diagnosis of metanephrin-producing adrenocortical carcinoma was done

Metanephrin-producing adrenocortical carcinoma: a case report

Adrenocortical carcinoma is a rather infrequent neoplasm that mostly occurs with an autonomous secretion of steroids or steroid precursors. Previous cases have been reported with simultaneous production of metanephrines, but they were associated with intercurrent pheochromocytoma or mixed corticomedular tumors. So far, only two cases of adrenocortical carcinoma that deliver medullar hormones had been published. We herein report a singular case of a 58-year-old man with a finding of an incidental adrenal mass that demonstrated metanephrine production in the hormonal study. Consequently, initial diagnosis of pheochromocytoma was established. Microscopic examination showed an adrenal mass with marked pleomorphism and frequent mitosis. Large areas of coagulative necrosis were interspersed within the tumour. After immunohistochemistry staining there was a high expression of Ki67 (>70%) showing highly proliferative behaviour.  Both cytokeratin AE1/AE3 and vimentin were positive, synaptophysin and chromogranin were negative. The surgical margins were free. Given these features, a diagnosis of metanephrin-producing adrenocortical carcinoma was done

Tumor mesenquimal variante no fosfatúrica: a propósito de un caso

Osteomalacia-inducing tumors (OIT) are usually benign, small and slow growing. OIT have an abnormal production of fibroblast growth factor 23 (FGF-23) which causes the inhibition of phosphate reabsorption in the proximal convoluted tubule and the inactivation of 1α-hydroxylase with consequent hypophosphatemia, phosphaturia and alteration of vitamin D metabolism, leading to the appearance of acquired osteomalacia. Recently a non-phosphaturic variant has been described. This clinical case presents a patient with a non-phosphaturic mesenchymal tumor, whose diagnosis was complicated by nonspecific initial symptoms. Keywords: mesenchymal tumor, phosphaturia, osteomalacia, FGF-23, diagnosisLos tumores mesenquimales inductores de osteomalacia (TIO) suelen ser benignos, pequeños, de crecimiento lento. Los TIO tienen una producción anormal del factor de crecimiento fibroblástico 23 (FGF-23) que ocasiona la inhibición de la reabsorción de fosfato en el túbulo contorneado proximal y la inactivación de la 1α-hidroxilasa con la consecuente hipofosfatemia, fosfaturia y alteración del metabolismo de la vitamina D que conlleva a la aparición de osteomalacia adquirida. Recientemente se ha descrito la variante no fosfatúrica. En este caso clínico se presenta un paciente con un tumor mesenquimal no fosfatúrico cuyo diagnóstico fue complicado debido a los síntomas iniciales inespecíficos. Palabras clave: tumor mesenquimal, fosfaturia, osteomalacia, FGF-23, diagnóstico