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

Pseudomyxoma peritonei (PMP) is a condition characterized by progressive accumulation of mucinous ascites and implantation of mucinous tumors in the peritoneal cavity. This article is a bibliographic review in which 44 bibliographical sources were used. From the information collected, we can say that the PMP is a rare disease, which has the epithelial neoplasms of the appendix as its main etiology. Its clinic is classically presented with vague abdominal symptoms. The most used diagnostic method is CT. Its treatment is based on surgical resection together with intraperitoneal chemotherapy (HIPEC), a method that has shown, in recent years, to increase survival compared to traditional therapy (only surgical resection). However, the research studies carried out so far have been with small populations, of a retrospective type and are not multicentric, for which reason there is not enough evidence to support the definitive management for this pathology

Autoimmune encephalitis against the N-methyl-D-aspartate receptor (NMDA-R) is a newly discovered disease that occurs mainly in young women. It is characterized by the presence of autoantibodies against NMDA receptor, specifically against the GluN1 subunit; which generates psychotic symptoms, movement disorders, autonomic dysfunction and even coma. About 50% of patients present ovarian teratoma when completing the studies. This disease is reversible and treatable, therefore diagnosis and treatment are essential. The first line of treatment includes steroids, intravenous G immunoglobulin or plasmapheresis. The second line consists of rituximab and cyclophosphamide. In addition, in the cases where a tumor is documented, the extirpation of it is considered fundamental.

Whipple's disease is a systemic, rare, chronic and infectious disease caused by the bacterium Tropheryma whipplei, member of the order of Actinomycetos.1 The discovery of Whipple's disease and its causative bacterium, Tropheryma whipplei, is an excellent example of how modern technologies have contributed to medical knowledge. Although Whipple's disease was first described in 1907, the first successful cultivation of Tropheryma whipplei took place almost a century later, in the year 2000.2 The disease has an age of presentation mainly between 40 and 60 years, with an average age at the beginning of 50 years. The man to woman ratio is approximately 8: 1.3 By the year 2007, only about 1000 cases have been reported.4 Because of the disease´s exceptionally low incidence, it was decided to make this case report to make the medical community aware of how diverse the clinical presentation of the disease may be.

Infective endocarditis (IE) is a serious disease, fatal in many cases, its diverse nature makes it a pathology of difficult diagnosis. Although advances in diagnostic techniques and in medical, surgical and critical care interventions have favorably modified the course of this disease, IE still represents a major therapeutic challenge that must be addressed quickly in an integrated way by a specialized team

We present the case of a 38-year-old male patient, homeless, drug-dependent condition, with no known medical history; whom, due to weight loss, hematemesis and bloody diarrhea studios, was diagnosed with acquired immunodeficiency syndrome with infection due to pulmonary tuberculosis; antimycobacterial therapy was started. After 15 days of initiation of antituberculosis therapy, antiretroviral therapy was initiated. The picture evolved with hemodynamic deterioration and the patient died. The autopsy showed findings compatible with disseminated tuberculosis.

Urethral stricture is one of the main causes of obstructive symptoms in men and has a significant impact on the life of those suffering it because of multiple complications. It is divided into anterior and posterior according to the bulbar urethra; anterior includes it. We present the case of a male of 36 years of age with history of obstructive symptoms, macroscopic hematuria and urethral bleeding of 4 years of evolution of unknown etiology. Bulbar urethral stricture was diagnosed by flexible urethrocystoscopy and management was started with dilatations and subsequently urethrotomy.

The rectal prolapse it is a non frequent pathology, it’s pathophysiology is not clear, but includes a pelvic floor disorder; also it is a disease with a great impact on the lifestyle of patients who suffer from it. Typically occurs in older adult women, but it can occur in men and women of all ages. The most frequent clinical manifestations include fecal incontinence, constipation, and a rectal mass sensation. The diagnosis can be made by physical exam or it can be confirmed in suspicious cases with a defecography; in turn, multiple complementary studies like MRI, cystography, colon transit, anal manometry, the latency of the terminal motor of the pudendal nerve and colonoscopy can be made. The decision of submitting these studies should be assessed independently in each case. The cornerstone of the treatment of rectal prolapse is the surgery with an abdominal approach, for it’s greater effectiveness; or failing the perineal approach. Despite being the treatment of choice, all patients should be initially instructed about medical treatment because it diminishes the symptoms and can improve the quality of lifestyle of the patients.

Migraine is the most common primary headache seen in the first level of attention causing disability, it´s more common in women and especially during reproductive ages. Migraine shows a relationship with levels of estrogen and progesterone, as well as with the fluctuations in both. During pregnancy, migraine can appear for the first time, get worse or more frequently improve. Its diagnosis is centered in the detection of red flags that might suggest a secondary headache. The therapeuthic approach can be divided in profilaxis and in acute treatment, and in pharmacologic and non-pharmacologic options. The first line of treatment in both are the non-pharmacologic therapies, followed respectively by beta blockers (propranolol and metoprolol) and acetaminophen. In profilaxis it is also acceptable the use of amitriptyline. The prescription of triptans, especially sumatriptan, appears to the safe, nonetheless it is preserved as a third line treatment. Opioids despite its effectiveness are not recommended. Recommendations during breast-feeding follow a similar line.

The primary care is the initial site for consultation of patients with rheumatic disease. The most common symptom for which these patients consult is joint pain, however, the patient should be questioned about the presence of extrajoint manifestations such as constitutional symptoms, ocular pathology, cutaneous and vascular manifestations which raise the diagnostic suspicion of rheumatic systemic autoimmune diseases

Moderate cognitive impairment is a syndrome characteryzed by impaired memory without affecting the functional abilities of the individual. This condition is associated with an increase in mortality and depression. It has associated multiple risk factors such as: being older, obesity, hyperglycemia, inflamatory states, high blood presion, strokes, coronary arterial desease, atrial fibrillation, cronic renal desease and sedentarism among others; which leads to controlling these factors in the best way to avoid the appearance and Progression to dementia.