Luis Carbajal-Rodríguez

Terapia de reemplazo enzimático en una paciente con enfermedad de Gaucher tipo III

Introduction. Duodenal perforation is a rare life-threatening disease associated with non-accidental blunt abdominal trauma, duodenal ulcer or ingestion of steroids, acetil salicylic acid, indometacine and tolazoline, spontaneous perforation is an extremely uncommon event. A late diagnostic is the rule, since symptoms and signs may be minimal. Report of the cases. We report three cases, seen in a two weeks period, all with typical features of spontaneous duodenal perforation. Two patients had perforation of the second portion of the duodenum; a successful primary surgical repair was performed. The other patient had a perforation of the first portion of the duodenum. A pyloric exclusion was performed which had a fatal outcome. Conclusions. This is a very unusual and dangerous condition

Transferencia y transición. De la medicina del adolescente a la medicina del adulto

Epidemiologic transition of the last two decades has shown substantial changes in the features and course of diseases world-wide. Thence the need for pediatricians to delve on the management of diseases and complications formerly occurring only in adults. On the other hand physicians caring for adults are now facing diseases which were formerly fatal at relatively early ages and are currently seen in much older individuals. For this reason it has become mandatory to develop policies to encourage children, adolescents and their family to observe the continuity of their health care based on the knowledge and understanding of their disease and its risk factors. This will enhance confidence and a close relationship between a patient and his(her) physician in order to attain a sound adherence to treatment and to preclude complications thus achieving a favorable prognosis and excellent well-being.