Catalina alenzuela V

Estudio de prevalencia del consumo de drogas en escolares de Enseñanza Básica, a través de la metodología de pares

Background: Peer methodology (PM) is an adaptation of the privileged access interviewer methodology and is used for prevalence studies. PM estimates higher drug consumption frequencies among school and college students than self reports, since it minimizes underreporting. Aim: To assess drug abuse among students using PM. Material and methods: A random sample of 234 school students of middle and low-middle socioeconomic status, aged 9 to 14 years (53% women) were interviewed using PM about drug consumption. Results: The frequency of licit drug consumption during the last year was 29% and 15% during the last month (current consumption). The consumption of tobacco and alcohol was 20% and 18% respectively during the last year. The figures for the last month were 11% and 8% respectively. The beginning age for smoking and alcohol consumption were 11.1 ±1.5 and 11.3± 1.8 years respectively. The frequency of illicit drug consumption was 3.5%. Illicit drug users began licit drug consumption at earlier ages their non user peers. Conclusions: There is a high frequency of illicit drug consumption among school age children.

PROGRESIÓN DE LA RESPUESTA INFLAMATORIA SISTÉMICA EN PACIENTES CON APENDICITIS

Progression of the systemic inflammatory response in patients with appendicitis Introduction: The systemic inflammatory response has been described in patients with appendicitis. However, its progression from the onset of symptoms to diagnosis has not been characterized. The purpose of this study was to describe and characterize the systemic inflammatory response to appendicitis. Patients and Methods: A descriptive study was conducted. One-hundred eighty-three patients were studied divided into four groups from onset of symptoms to diagnosis. Primary outcome measure was to determine the systemic inflammatory response to appendicitis according to the established groups of time intervals. Secondary outco - me measure was the analysis of C-reactive protein for the same purpose. Results: The systemic inflammatory response variables according to diagnostic intervals showed non-significant differences on white blood cells count. Temperature and heart rate rises constantly after 48 h reaching their peak after 72 h (p = 0.001); the respiratory rate rises after 73 h (p < 0.0001). After 73 h most patients had 3 or 4 systemic inflammatory res - ponse criteria (p < 0.0001). C-reactive protein levels rise progressively showing higher levels after 48 hours (p = 0.005). Conclusions: The inflammatory response to appendicitis is progressive, being more marked along the timeline from onset of symptoms to diagnosis.

Linfoma primario de tiroides: Reporte de cuatro casos

Primary thyroid lymphoma is uncommon and usually of non-Hodgkin type. We report four female patients with thyroid lymphoma. An 81 year-old patient that was operated and received three cycles of chemotherapy and was lost from follow up. A 16 year-old patient that is operated and received full chemotherapy and was discharged free of disease. A 80 year-old patient that was operated and died due to a multiple organ failure, 50 days after hospital admission and a 54 year-old female that was operated but rejected chemotherapy and was lost from follow up.

TUMOR FIBROSO SOLITARIO DEL LÓBULO CAUDADO DEL HÍGADO

Introduccion: El tumor fibroso solitario del higado (TFSH) constituye un hallazgo tan raro que se ha publicado unicamente como reportes de caso y hasta el presente se encontraron solo 45 casos publicados en la literatura inglesa. El presente articulo describe el caso de un paciente que fue tratado en nuestra institucion por un TFSH. Reporte de caso: Paciente masculino de 59 anos de edad al que, en una tomografia abdominal computarizada que se tomo por otras causas, se encontro en forma incidental un gran tumor hepatico localizado en el lobulo caudado del higado. El paciente no referia sintomas relacionados con el tumor. En la cirugia se observo que el tumor se originaba directamente del lobulo caudado al cual lo unia un pediculo de aproximadamente 3 cm de diametro transverso. Se secciono el tumor desde su base de implantacion en el higado ligandose los vasos arteriales y venosos asi como los conductos biliares que se encontraron. Este media 15 x 9 x 6 cm y pesaba 794 g, se encontraba bien encapsulado. El diagnostico histologico fue el de un TFSH, el cual se confirmo mediante inmunohistoquimica con anticuerpos monoclonales que resultaron positivos para CD34 y vimentina en las celulas tumorales y negativos para CD117, S100, α-actina de musculo liso y desmina. Conclusiones: El TFSH es un tumor raro. El presente caso de un TFSH es el primero reportado en la literatura medica chilena y presento las caracteristicas radiologicas, quirurgicas y patologicas habitualmente descritas en estos casos.

MANEJO QUIRÚRGICO SIMULTÁNEO DE UNA PACIENTE CON CÁNCER DE PÁNCREAS DISTAL, TUMORES DEL ESTROMA GASTROINTESTINAL (GIST) GÁSTRICOS Y HEMANGIOMA HEPÁTICO

Simultaneous surgical management of a patient with distal pancreatic cancer, gastric gastrointestinal tumors (GIST) and hepatic hemangioma Introduction: The occurrence of gastric Gastrointestinal Stromal Tumors (GIST) associated to pancrea- tic adenocarcinoma has been reported in 0.2% pancreatic cancers. There are no published reports on distal pancreatic adenocarcinoma associated to gastric antral GIST and the surgical management of this clinical condition. Case report: Herein, we discuss a 75 years-old female patient who was admitted to our institution with upper digestive hemorrhage. The endoscopy showed large, superficial erosions over the cardia and on the posterior wall of the antrum a rounded sub-mucosal non-eroded lesion suspected of gastric GIST. An ab- dominal computed tomography scan found a hepatic hemangioma on the left hepatic lobe. In the pancreatic distal body and tail a solid exophytic lesion was identified. In the gastric antrum a rounded submucosal tumor in close contact with the pancreatic lesion was found. The patient was subjected to distal pancreatectomy, splenectomy, and distal gastrectomy. The biopsy identified a well-differentiated ductal adenocarcinoma locali - zed in the pancreatic tail and the proximal part of the body, resected with negative margins. The gastric tumor was positive for CD117, CD34, and DOG-1; it had a positive Ki67 in less than 2%, and 2 or less mitoses per 50 high-power fields. Conclusion. This uncommon case illustrates the occurrence of synchronous tumors of different cellular origins incidentally diagnosed and their simultaneous surgical treatment. The individual incidence of these tumors is low and if associated they probably will continue to be found incidentally.

UTILIDAD DE LA PUNTUACIÓN DE BOEY Y PORTSMOUTH-POSSUM FISIOLÓGICO EN PACIENTES CON ÚLCERA PÉPTICA PERFORADA

Abstract Performance of Boey score and physiologic Portsmouth-POSSUM in patients with perforated peptic ulcer Introduction: Surgical scores such as Boey and physiologic Portsmouth-POSSUM have been in-dependently applied to patients with perforated ulcer to stratify their surgical risk. However,there are no studies comparing both scores. The purpose of this study was to compare the performance of Boey score and Portsmouth-POSSUM in patients with perforated peptic ulcer. Methods: A retrospective comparative study was performed including 108 consecutive patients older than 15-years submitted to emergency surgery from January 2002 to June 2012. Patients operated on for perforated gastric cancer were excluded. The primary outcome measure was to compare the performance of Portsmouth-POSSUM and Boey score. Secondary outcome measures were to determine cutoff points for Portsmouth-POSSUM, Boey score, C-reactive protein (CRP), and white blood cells (WBC) count, to predict patients at risk for complications.