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Objective: To determine the enzymatic biochemical parameters (glutamic pyruvic transaminase (ALT), glutamic oxaloacetic transaminase (AST), alkaline phosphatase (ALP), gamma glutamyltransferase (γ-GT), and lactate dehydrogenase (LDH)) in children with acute lymphoblastic leukemia (ALL) before cancer treatment. Material and Methods: A prospective experimental, observational, cross-sectional study was conducted in 30 children between 2 and 15 years old, from several Neoplastic Centers in Lima. Blood collection was performed in BD red cap Vacutainer tubes, processed in the semi-automated analyzer BIOTEC® EMP-168, with Wiener Lab Group enzyme reagents under the modified method Szaaz and UV-Optimized by IFCC, SSCC and SFBC. Finally, coding and tabulation was performed. Results: 60% were boys and 46.7% are between the ages of 2-6 years. Serum levels of AST were increased by 33.3% in boys and 50% in girls. Serum ALT values were increased in 33.3% of boys and 41.7% of girls; only 25% of girls showed increased levels of γ-GT values; ALP was increased in 44.4% of boys and 66.7% of girls. Moreover LDH levels were increased in 55.6% of boys and 41.7% of girls. Conclusions: The enzymatic tests LDH, AST, ALT and ALP are increased in children with ALL compared to normal values due to tumor lysis syndrome characterized by electrolyte abnormalities, and as a result of the massive destruction of tumor cells and rapid release of large amounts of intracellular elements.

La principal causa de daño esquelético residual son las infecciones osteoarticulares (IOA) con un tratamiento inadecuado. Objetivo: Determinar el valor del cintigrama óseo trifásico (CO3F) de urgencia en la evaluación de IOA. Material y método: Se estudiaron 38 niños en quienes se efectuaron 54 CO3F. Resultados: Análisis Global: 76% de los casos fueron principalmente articulares; el germen más frecuente fue Staphylococcus y la articulación más afectada la cadera. Nueve pacientes con CO3F preoperatorio fueron positivos con 16 focos, 86% confirmados con cultivo quirúrgico. Siete niños tuvieron CO3F negativo sin sintomatología clínica posterior. En cinco casos el estudio fue negativo para compromiso osteoarticular, pero se demostró compromiso de partes blandas con fase osteoblástica normal. En 14 de 17 casos evaluados post-cirugía, hubo relación entre el CO3F y la evolución clínica, en dos de esos casos en el CO3F se encontró una nueva localización. Conclusión: El CO3F es una herramienta útil en el diagnóstico y evaluación de las IOA agudas en población pediátrica. Un CO3F positivo es altamente seguro de IOA y uno negativo lo descarta con certeza

La principal causa de daño esquelético residual son las infecciones osteoarticulares (IOA) con un tratamiento inadecuado. Objetivo: Determinar el valor del cintigrama óseo trifásico (CO3F) de urgencia en la evaluación de IOA. Material y método: Se estudiaron 38 niños en quienes se efectuaron 54 CO3F. Resultados: Análisis Global: 76% de los casos fueron principalmente articulares; el germen más frecuente fue Staphylococcus y la articulación más afectada la cadera. Nueve pacientes con CO3F preoperatorio fueron positivos con 16 focos, 86% confirmados con cultivo quirúrgico. Siete niños tuvieron CO3F negativo sin sintomatología clínica posterior. En cinco casos el estudio fue negativo para compromiso osteoarticular, pero se demostró compromiso de partes blandas con fase osteoblástica normal. En 14 de 17 casos evaluados post-cirugía, hubo relación entre el CO3F y la evolución clínica, en dos de esos casos en el CO3F se encontró una nueva localización. Conclusión: El CO3F es una herramienta útil en el diagnóstico y evaluación de las IOA agudas en población pediátrica. Un CO3F positivo es altamente seguro de IOA y uno negativo lo descarta con certezaOne of the most important causes of residual damage in skeleton is incompletely treated osteoarticular infections (OAI). Goal: to assess the value of emergency three-phase bone scan (3FBS) in the evaluation of OAI. Methods: Thirty-eight children were studied with 54 3FBS. Results: Global analysis: 76% of the cases were principally articular; staphylococcus germs and hip's affection were the common. Nine patients with preoperative scan were positive with 16 foci, 86% confirmed by surgery cultivate. Seven children had negative 3FBS without posterior clinical symptomatology; in 5 of them it was demonstrated soft tissue involvement with normal osteoblastic phase. In 14/17 cases evaluated after surgical intervention, there was a relation between the scan and the clinical course. In two of those cases, in the 3FBS a new location was found. Conclusion: 3FBS is a helpful tool in the diagnosis and assessment of acute OAI in pediatric population. A positive 3FBS is highly accurate for OAI and a negative one rules it out securely

Objective: To assess SV in our RRT population in the period 1976-2012 as well as the influence of technique transference (TT)., Material and Methods: The study included a retrospective cohort of 993 patients. Data were classified as transplant (Tx), change in technique, exitus or lost to follow-up. SV for TT was determined in patients with over 12 weeks of permanence., Results: The mortality risk adjusted for age, sex, dialysis technique or diabetes mellitus (DM) showed that the estimated risk of death increased by 4.8% per year increase (HR=1.048; 95% CI: 1.04-1.06; P<.001) and was 44% higher in diabetics compared to non-diabetics (HR=1.44; 95% CI 1.16-1.76; P<.01). Regarding SV for TT, patients who initiated HD had a shorter survival than those who initiated PD and transferred to HD (P=.00563)., Conclusion: In our experience, SV in RRT is dependent on age and coexistence of DM. It would be beneficial to reinstate the concept of "comprehensive care", in which RRT would start with PD and later transfer to HD., (Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread., Objective: To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area., Material and Methods: This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night., Results: In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94., (Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Psoriatic lesions affecting the scalp, nails, palms, and the soles of the feet are described as difficult-to-treat psoriasis and require specific management. Involvement of these sites often has a significant physical and emotional impact on the patient and the lesions are difficult to control with topical treatments owing to inadequate penetration of active ingredients and the poor cosmetic characteristics of the vehicles used. Consequently, when difficult-to-treat sites are involved, psoriasis can be considered severe even though the lesions are not extensive. Scant information is available about the use of biologic therapy in this setting, and published data generally comes from clinical trials of patients who also had moderate to severe extensive lesions or from small case series and isolated case reports. In this article we review the quality of the scientific evidence for the 4 biologic agents currently available in Spain (infliximab, etanercept, adalimumab, and ustekinumab) and report level i evidence for the use of biologics to treat nail psoriasis (level of recommendation A) and a somewhat lower level of evidence in the case of scalp involvement and palmoplantar psoriasis., (Copyright © 2013 Elsevier España, S.L.U. y AEDV. All rights reserved.)

Introduction: Minor Surgery is an ever-increasing programmed activity in Primary Health Care Centres. The aim of this paper is to determine the relationship between the clinical diagnosis prior to Minor Surgery and its concordance with the histological results., Material and Methods: We carried out a retrospective study using the registered activity log in a Primary Health Care Centre in the region of Valdejalón of Aragón., Subjects: A total of 1231 patients were included between April 1999 and June 2009. A total of 1391 diagnoses were given, together with the corresponding medical care., Measurements: Clinical diagnosis and histological results, and the level of correlation between both., Results: A total of 820 samples were submitted for histological study (59% of the total sample). Eleven of the main clinical and histological diagnoses were evaluated, and a contingency table was prepared. The result of the correlation gave a Kappa coefficient of 0.638., Conclusions: Once the results were analysed and compared to similar studies of Minor Surgery carried out in Primary Care, our results confirm that there is a high correlation between the clinical diagnosis and the histological results., (Copyright © 2011 Elsevier España, S.L. y SEMERGEN. All rights reserved.)

Crohn's disease is often complicated by intestinal strictures. Symptomatic strictures refractory to medical therapy usually require surgery. Endoscopic balloon dilatation is an alternative to surgery. We report the case of a patient with Crohn's disease with asymptomatic ileocecal stricture, which was identified after intestinal obstruction due to an impacted foreign body. The patient underwent endoscopic dilatation and the foreign body was extracted. We provide a review of the literature on endoscopic balloon dilatation of intestinal strictures in Crohn's disease.

The content of the principal carotenes with biological activity (alpha-, beta, gamma-carotene and beta-criptoxantine) in green pepper (Capsicum annuum var. Anaheim) was determined in order to investigate the vitamin A content during the traditional process of ripening and drying. The analytical technique used was high pressure liquid chromatography (HPLC) with a Novapack C18 column and acetonitrile/methanol/tetrahydrofuran (58V:35V:7V) as a mobile phase. The results showed differences in vitamin A activity of 7.2 +/- 0.8, 51.1 +/- 2.4 and 55.3 +/- 1.2 micrograms of RE/g dry matter for immature, mature and dry pepper fruit respectively (p < 0.05). Approximately 95% of total activity was due to beta-carotene being synthesized faster than the other carotenes under study during the ripening process. Total vitamin A activity reached its highest value at 14 days after harvest (2738.8 +/- 128.6 micrograms RE/100 g of edible portion), with a decrease in activity with time.