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Introducción: el estudio de la calidad de vida global y de sus dimensiones es de gran utilidad en los adultos mayores, en tanto constituye un trazador cualitativo de la salud en este segmento poblacional, aquejado con frecuencia de discapacidades que limitan su desempeño social. Objetivos: identificar la percepción de la dimensión salud por parte los adultos mayores de la provincia de Matanzas, y su relación con variables seleccionadas, durante el primer semestre de 2007. Métodos: se realizó un estudio descriptivo de corte transversal, en un universo de 108 559 adultos mayores, de los que se seleccionó una muestra de 741 a través de la fórmula de cálculo de tamaño de muestra para estudios descriptivos, elegida por muestreo estratificado polietápico. Para la recogida de la información se aplicaron el Examen Mínimo del Estado Mental y la Escala para la Evaluación de la Calidad de Vida Percibida. Se calcularon frecuencias absolutas y porcentajes, y se aplicó la prueba de homogeneidad y otras específicas como Ridit Analysis y X² para la regresión. El procesamiento se realizó con SPSS versión 11,5, y Epidat 3,1. Los resultados de presentan en cuadros estadísticos. Resultados: predominó la categoría alta de la dimensión salud con valores de 91,7 %, aunque en la medida que se incrementa la edad hay una disminución de la percepción alta de salud (p= 0,000). La percepción alta de salud es más marcada en los ancianos con pareja, con un 95,5 %, que en los que no tienen pareja (88,2 %) (p= 0,000). A pesar de que para todas las categorías de la variable escolaridad predominó la alta percepción de salud, existe una tendencia al incremento de esta, en la medida en que aumenta el nivel de escolaridad (p= 0,000). No hubo diferencias por sexo (p= 0,506). Conclusiones: la alta percepción de salud emitida por la población objeto de estudio se expresa de manera homogénea por sexos, pero heterogénea por grupos de edades, estado conyugal y escolaridad, lo cual evidencia la relación importante que existe entre estas últimas y la dimensión investigada.Introduction: the study of the global quality of life and of its dimensions is very useful in elderly persons since it is qualitative health marker in this population segment suffering frequently of inabilities limiting its social performance. Objectives: to identify the perception of health dimension by elderly persons from the Matanzas province and its relation to the variables selected during the first semester of 2007. Methods: a cross-sectional and descriptive study was conducted in 108 559 elderly persons selecting a sample including 714 by formula of sample size calculus for descriptive studies using multistage stratified sampling. To information collection the Minimal Examination of Mental Status and the Perceived Quality of Life Assessment were applied. Absolute and percentages frequencies were estimated applying the homogeneity test and other like Ridit Analysis and X² for regression. Processing was carried out with SPSS version 11,5 and Epidat 3,1. Results are showed in statistical charts. Results: there was predominance of high category in health dimension with values of 91,7 %, although just as an increase in age there is a decrease of high health perception (p= 0,000). The high health perception is more marked in elderly persons with a couple, with a 95,5 % than those without couple (88,2 %) (p= 0,000). In spite of the fact that for all the categories of schooling variable predominated the high health perception, there is a trend to its increase according to increases the schooling level. Conclusions: the high health perception declared by study population, it is expressed in a homogenous way by sexes, but like heterogeneous by age groups, marital condition and schooling level evidencing the significant relation between these latter and the study dimension.

INTRODUCCIÓN: el estudio de la calidad de vida es de gran utilidad en las poblaciones envejecidas, en tanto constituye un trazador cualitativo de la salud en este segmento poblacional, aquejado con frecuencia de discapacidades que limitan su desempeño social. OBJETIVO: describir el comportamiento de la calidad de vida percibida en general, y su relación con variables seleccionadas en adultos mayores de la provincia de Matanzas. MÉTODOS: se realizó un estudio descriptivo de corte transversal, en un universo de 108 559 adultos mayores, de los que se seleccionó una muestra de 741, por muestreo estratificado polietápico. Se aplicaron el Examen Mínimo del Estado Mental y la Escala para la Evaluación de la Calidad de Vida Percibida. Se calcularon frecuencias absolutas y porcentajes, y se aplicó la prueba de homogeneidad y otras específicas como Bartholomew, Ridit Analysis y x² para la regresión. El procesamiento se realizó con SPSS versión 11,5, y Epidat 3,1. Los resultados de presentan en tablas. RESULTADOS: predominio de calidad de vida percibida baja, que constituyó el 43,3 % de la muestra investigada. Hubo diferencias importantes en el comportamiento de la calidad de vida por edad y escolaridad, con tendencia a empeorar en la medida que se incrementa la edad (p=0,000) y disminuye la escolaridad (p=0,000). No hubo diferencias por sexo (p=0,343) ni por estado conyugal (p=0,123). CONCLUSIONES: el predominio de baja calidad de vida en la población investigada evidencia la necesidad de continuar el estudio sobre este constructo, para lo cual resulta de interés su relación con la edad y la escolaridad.INTRODUCTION: quality of life study is very useful in aging populations, since it is a qualitative marker of health in this segment of population, frequently affected by disabling events limiting its social performance. OBJECTIVE: to describe quality of life behavior in general, and its relation with selected variables in elderlies from Matanzas province. METHODS: a cross-sectional and descriptive study was made in a cohort of 108 559 elderlies, from which we selected a sample of 741 by multistage stratified sampling. We applied the minimum Examination of Mental State and the Scale for Assessment of Perceived Quality of Life. Absolute frequencies and percentages were estimated, and Homogeneity Test was applied as well as another specific including Bartholomew, Ridit Analysis and X² for regression. Processing was performed with the SPSS version 11,5 and Epidat 3.1. Results are presented in tables. RESULTS: there was a predominance of low perceived quality of life being the 43,3 % of study sample. There were significant differences in quality of life behavior by age and schooling with a trend to deterioration in so far as age increases (p=0,000), and decrease the schooling (p=0,000). There were not differences neither by sex (p= 0,343) nor by marital state (p=0,123). CONCLUSIONS: predominance of a poor quality of life in study population shows the need of to continue the study on this basis, where its relation with age and schooling in interesting.

El carcinoma papilar intraquístico es una forma rara de cáncer de mama, con una incidencia del 0,5-1 % de todos los cánceres de mama. Es un tumor que predominantemente afecta a las mujeres de avanzada edad. Aunque esta rara entidad se creyó que era una variante de carcinoma ductal in situ, algunas lesiones pueden ser tumores de bajo riesgo de invasividad. El tumor tiene un excelente pronóstico sin tener en cuenta que sea in situ o invasivo. Por lo tanto, un diagnóstico preciso juega un papel crucial en el manejo de pacientes con esta entidad. Se reportó un caso de carcinoma papilar intraquístico, en una mujer de 75 años de edad. Entre los hallazgos patológicos se encontró que el tumor midió 2 cm y se encontraba situado en el cuadrante inferoexterno de la mama derecha. En el ultrasonido realizado se informó una imagen “ecolúcida”, de bordes bien definidos, y en la mamografía se planteó la presencia de una imagen nodular de contornos irregulares. El diagnóstico histopatológico fue el de un carcinoma papilar no invasivo, dentro de una lesión quística que midió 1 cm, con nódulo sólido en su interior de 0,5 cm con grado nuclear bajo. Se le realizó una tumorectomía amplia. Actualmente se mantiene bajo control. Para la confección del presente trabajo se consultó 17 materiales entre revistas y libros de Cirugía. El mismo se propuso reportar un caso de carcinoma papilar intraquístico, demostrando cuan extraño resulta esta patología para los especialistas del tema.

Objective: To describe the ultrasound, histopathological and genetic characteristics of uveal melanoma in a Mexican-Mestizo population., Material and Methods: A total of 39 enucleated eyes with a histopathological diagnosis of uveal melanoma were assessed by describing the clinical findings, and ultrasound, histopathological and genetic features., Results: A high correlation was observed between tumour height measurement using ultrasound and histopathology. In our cases, tumour size and reflectivity were higher compared with those reported in the literature. The preliminary data on the molecular assessment of the tumours show the presence of an unreported polymorphism (T>C IVS5+34) and one sample with GNAQ mutation (A>C CAA>CCA Gln 209 Pro)., Conclusion: Ultrasound is a reliable method to identify the size of the tumour. Furthermore, knowledge of the molecular mechanisms promises new perspectives for the development of new targeted therapeutics. Fortunately this leads to progress in the treatment of patients with metastatic disease or prevents it in those at high risk., (Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm., Material and Methods: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members., Results: Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and IV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis., Conclusions: Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.

Background: p53 mutations constitute the most frequent genetic abnormality observed in breast cancer. The molecular study of p53 mutations not only provides prognostic information but also allows a better understanding of tumor biology. Most of the studies on p53 have been done by immunohistochemistry procedures. In this study we compare the sensitivity of immunohistochemistry and molecular genetics methods for the detection of p53 mutations., Patients and Methods: Forty tumors obtained from breast cancer patients that underwent modified radical mastectomy were analyzed for p53 mutations at exons 5 to 6 through PCR-single stranted conformational polymorphism (SSCP)-sequencing. Moreover, the tumor expression of p53 protein was analyzed by means of immunohistochemistry., Results: All tumors could be amplified by PCR and analyzed by the SSCP technique. Six tumors (15%) showed and altered electrophoretic mobility. In these cases a mutation was confirmed by gene sequencing. On the other hand, only two of these six tumors were positive in the immunohistochemical analysis., Conclusions: The results confirm the utility of the PCR-SSCP technique for detection of p53 mutations and suggest to be more sensitive than immunohistochemistry.

We report the first experience of the use of GM-CSF as prophylaxis of ganciclovir induced severe bone marrow suppression in a CMV seropositive patient with acute myeloid leukemia who underwent a complete remission after an allogeneic bone marrow transplantation from an identical HLA sibling who also was CMV seropositive. A successful bone marrow engraftment was documented by day 14. Once peripheral blood counts stabilized, the patient received ganciclovir 5 mg/kg TIW. By day 73 severe neutropenia was documented but a spontaneous improvement occurred with discontinuation of ganciclovir. From day 100 to day. 110 he received daily ganciclovir at a dose of 5 mg/kg and the same dose of GM-CSF without signs of toxicity. There was no evidence of either acute graft versus host disease or of CMV infection. One year after transplantation he relapsed and died of complications of acute leukemia.