Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

La granulomatosis con poliangeítis es una patología poco común, caracterizada por la afectación a nivel de vía aérea superior, pulmón y riñón. Las lesiones otorrinolaringológicas son la manifestación más frecuente de la enfermedad, donde lo más común es el compromiso de cavidad nasal y senos paranasales. A nivel otológico, el hallazgo más frecuente es la otitis media serosa, pero también puede afectar oído externo e interno. Las manifestaciones en cavidad oral no son frecuentes, y se presentan como úlceras orales o hiperplasia gingival en fresa. La estenosis subglótica es una manifestación que puede llegar a amenazar la vida del paciente. Hallazgos clínicos e imágenes sugestivas de esta enfermedad, ANCA-C positivo y una biopsia positiva de la zona afectada pueden ayudar a realizar el diagnóstico. Se debe iniciar el tratamiento sistémico y local lo más rápido posible para evitar complicaciones irreversibles y mejorar la calidad de vida del paciente.

 Energy protein wasting is a clinical syndrome with important implications in patients with chronic kidney disease, increasing mortality morbidity;  Supplementation with nutritional formulas improves the nutritional status of patients with chronic kidney disease in dialysis and predialysis.

Migraine is a chronic neurovascular, episodic and multifactorial condition; It affects men and women in western countries. It is caused by genetic and environmental factors. The clinical presentation is going to be a recurrent headache, this can be pulsatile or not and can be associated with nausea, vomiting, photophobia or phonophobia. Neuroimaging studies are performed in the presence of red headache flags. The treatment of acute pain is determined according to the severity and frequency of migraine attacks and the taking or not of prior medication.

La operación de trasplante hepático es la única terapia absoluta para enfermedades hepáticas en etapa terminal y como todo procedimiento quirúrgico no está exento de riesgos y complicaciones que pueden agravar la condición clínica postoperatoria de su receptor e incluso producirle la muerte. También como todo procedimiento quirúrgico, no está exento de que se establezcan denuncias por responsabilidad profesional relacionadas a complicaciones quirúrgicas directas, enfermedades que ocurren en la atención postoperatoria, y al resultado quirúrgico insatisfecho. Al respecto, las complicaciones de un procedimiento médico como este, aunque estén descritas de esta forma en la literatura médico-científica, y puedan hacer pensar que con ello se descarta que haya mediado responsabilidad profesional en su génesis, en un caso de denuncia por responsabilidad profesional deben ser analizadas considerando los mecanismos involucrados en su producción, a la luz del manejo médico brindado, que permitan afirmar o descartar la relación causal con un manejo médico no indicado, inadecuado, inoportuno o no apegado a las normas. Las complicaciones directas más comunes post trasplante hepático son vasculares (relacionadas a la arteria hepática, la vena porta, las venas hepáticas y la vena cava inferior), biliares, parenquimatosas, perihepáticas, y neoplásicas. El expediente médico en que consten los riesgos del procedimiento, el momento en que se diagnostica cualquier eventual complicación y los criterios y tratamiento considerados en su manejo, así como un consentimiento informado adecuado se transforman en una evidencia de análisis importante y adquiere relevancia la buena comunicación médico paciente.

Thanks to the predominance of the frequentist school, nowadays, inference from the data obtained in clinical trials, is mainly done by using the P value and the alpha probability of error. These two, despite being useful and important statistical tools, have limitations that are not widely understood, leading to confusion about its meaning and utility. When doing clinical research, there must be good comprehension of the problem at hand, the outcomes and the optimal statistical tools to employ, in order to get conclusions as true as possible. The preference of some statistical methods over another, generates a limited vision and interpretation of the evidence.   

Sacral agenesis is an infrequent congenital pathology that afecta a small part of the population. Its clinical presentation has a wide and variable spectrum. It can range from mild cases where the patient is asymptomatic, to sever cases where the patient is not able to walk nor sit or even presents a condition known as sirenomelia. There are a number of factor that can predispose the presentation of this pathology, the most notorious one is diabetes mellitus during pregnancy. It has been documentes that a grate amount of other malformations may be associated with sacral agenesis, these generally involve the musculoskeletal system, digestive system and the urinary system. also, there are certain syndromes that have been associated to this malformation, for example VACTREL and Curarrino syndrome, among others. The diagnostic may be made parentally or postnatally. It is essential to make an early diagnosis, and to manage this affection in an individualized manner with a multidisciplinary approach.    

Social anxiety is one of the most common anxiety disorders. Its essence lies in a fear disproportionate to public scrutiny, for fear that it leads to humiliation or shame. Because of the social nature of social anxiety, there is a constant exposure of the person to his phobia, however, this does not lead to improvement of symptoms. This particular characteristic of social anxiety disorder guided the studies towards attentional processes in terms of information processing, in order to elucidate that throughout the continuous exposure there is no attenuation of the symptomatology. Studies have repeatedly shown that when attention networks are altered, they propitiate and maintain high levels of social anxiety, due to the way in which information is processed. The following systematic review aims to clarify the particularities of attentional involvement in social anxiety. This was done with studies of the last three years that focus on the coupling and disengagement processes specifically within the attention guidance network. Most of these conclude that attentional engagement is the process that works in a problematic way in social anxiety disorder. Other studies do not obtain the same results, so the importance of considering other variables when evaluating the attention-oriented network is debated in order to elucidate whether there are other factors that influence the alteration of attention which in turn are responsible for that social anxiety disorder persists.

Sleep is a physiological and reversible state of consciousness, in which there is a partial and temporal disconnection from the environment and an increase in the threshold of responsiveness to external stimuli. The human being spends around a third of his life asleep. Multiple benefits and functions of sleep have been described and it is known that sleep deprivation has detrimental consequences for health. Neurophysiologically, there are two mayor stages of sleep, non-rapid eye movement sleep (which also has three stages N1, N2 and N3) and rapid eye movement sleep. Also, in sleep, there are numerous regulatory systems involved such as sleep-promoting and wake-promoting centers and REM sleep promoters and inhibitors. These systems use a variety of neurotransmitters, like orexin, which can promote or inhibit wakefulness. The transition between awake and asleep is regulated by a flip-flop switch system that makes it subtle and quick. Furthermore, this transition is regulated by two processes; the S process, which is a homeostatic one, related to the wakefulness hours and the C process or the circadian process, which is regulated by the suprachiasmatic nucleus. Proper knowledge of the neuroanatomy and neurophysiology of sleep is necessary to understand the physiopathology and the treatment of the sleep disorders.

Myofibroblastoma (MFB) of the breast belongs to a benign mesenchymal tumor1, this group of solid neoplasias of the breast are uncommon, also can generate a diagnostic challenge specially in the diagnosis with de needle biopsy2. In this review we refer to a case of a male patiente with a diagnosis of a infiltratin ductal carcinoma in the core needle biopsy with a pathological diagnosis of the surgery specimen of a epitheloid cell myofibroblastoma of the breast.  

Eosinophilic myocarditis (EM) was first described in 1936 by Wilhelm Loeffler. This pathology presents an infiltration of eosinophils in myocardium, with hypereosinophilia  association or not, with several etiologies described, and even cases of unknown cause. The clinical presentation of this pathology can be a little symptomatic, until presenting heart failure or death, can also develop restrictive cardiomyopathy by fibrosis. The definitive diagnosis is made by endomyocardial biopsy, where the histology shows infiltrates of eosinophils and necrosis of myocytes. The most used treatment in this pathology are corticosteroids with good results in most cases.