Patologia Clinica

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The role of clinical ultrasound or Point-of-Care Ultrasound (POCUS) in patients with urgent pathology has expanded exponentially in recent years. With clinical ultrasound, physicians can make a quick assessment and decide how to act in time critical situations. Ocular ultrasound is one of the most recently developed applications. In patients with severe non-traumatic ocular pathology it has numerous clinically relevant uses: retinal detachment, occlusion of the central retinal artery or optic nerve pathologies, among others...

Subcutaneous fat necrosis of the newborn is a rare lobular panniculitis. It is characteristic of term or post-term neonates with a history of perinatal compromise or maternal gestational pathology. The cutaneous manifestations consist of erythematous and indurated subcutaneous plaques and nodules located over the dorsal region and the shoulders. Diagnosis is clinical and pathological. Histopathological findings include lobular panniculitis with a lymphohistiocytic inflammatory infiltrate with few neutrophils, fatty necrosis, deposition of radial needle-shaped crystals in the adipocytes, and possible calcification and hemorrhage...

INTRODUCTION: The small bowel capsule endoscopy (SBCE) has revolutionised the study of small bowel diseases. The objective of this study is to determine the indications, findings and diagnostic yield of SBCE in a national registry. PATIENTS AND METHODS: An observational, analytical cross-sectional study was carried out, analysing the SBCE records at seven centres in the country, where different variables were collected. RESULTS: 1,883 SBCEs were evaluated...

Gerbode defect is a communication from the left ventricle to right atrium and it could be categorized in congenital or acquired. It is a rare condition that can represent as much as 0.08% of all septal defects. Those acquired defects can be associated to endocarditis and after valvular surgery. The objective is to report a case of Gerbode atria-ventricular septal defect in Instituto Nacional de Cardiología Ignacio Chavez. The present case is about a 36 years old male patient with a typical presentation of mitral regurgitation, the echocardiogram reports a perforation in the anterior mitral leaflet and a Gerbode ventricular septal defect, that represents the heterogeneity of the clinical presentation of this pathology, also we show the findings in imaging studies that contributed to diagnosis and its surgical resolution...

Major interventions in cardiovascular surgery of patients with aortic pathology can result in the compromise of perfusion of organs distant from the surgery site, the gastrointestinal tract being one of the most sensitive to hemodynamic changes, especially in extreme age groups with a high risk of morbidity and mortality. The case of a young infant is reported, with a history of Turner syndrome, who is led to correction of aortic coarctation plus arch hypoplasia, presenting as a postoperative complication a picture of emphysematous gastritis with systemic compromise, a process that was favored by low cardiac output post-pump and the presence of early urosepsis, all of which was interpreted as part of the spectrum of non-occlusive mesenteric ischemia syndrome...

Introduction: The post-transplant lymphoproliferative disorders (PTLD) are characterized by an uncontrolled pathological lymphoid proliferation as a consequence of transplant immunosuppression therapy. Objective: To characterize the clinical and pathological characteristics of PTLD in a cohort of adult patients with liver transplant during a 15 year period at the Hospital Universitario Fundación Santa Fe de Bogota. Materials and methods: We conducted an observational retrospective study by searching for the PTLD cases diagnosed during the study period in the databases of the Liver Transplantation Unit and the Pathology Department...

ANTECEDENTES: El carcinoma renal con diferenciación sarcomatoide confiere un pronóstico sombrío por su evolución metastásica; a mucosa oral corresponde menos del 1%. CASO CLÍNICO: Mujer de 66 años, tumor dependiente de riñón izquierdo con reporte de patología de carcinoma renal de células claras patrón sarcomatoide, tumor gingival en maxilar izquierdo, biopsia con metástasis de células claras sarcomatoide...

ANTECEDENTES: La encefalopatía posterior reversible se relaciona con enfermedades hipertensivas del embarazo, con clínica inespecífica. El diagnóstico se realiza mediante resonancia magnética y electroencefalograma, y el tratamiento oportuno evita complicaciones. CASO CLÍNICO: Primigesta de 15 años con embarazo pretérmino, hipertensión arterial y convulsiones tónico-clónicas, que desarrolló encefalopatía posterior atípica con múltiples lesiones cerebrales...

The natural history of urinary kidney stone disease includes the risk of relapses and can be associated with the risk of chronic kidney disease, bone and cardiovascular disease. For this reason, a wide clinical-metabolic assessment of the kidney stone patient is of great importance since the first presentation of the stone, to set an appropriate preventive treatment. The proposed diagnostic-therapeutic pathway includes a careful medical history, in order to highlight a secondary kidney stone disease and the main risk factors for kidney stones, chronic renal disease, or cardiovascular and bone disease; a metabolic evaluation on multiple levels, according to the severity of the disease, and the presence or absence of risk factors, and appropriate instrumental investigations...

Introduction: celiac disease is a medical condition that is characterized by its varied forms of clinical presentation and its association with other autoimmune pathologies. The objective is to describe the case of a patient who presented for consultation due to alopecia areata. Methodology: observational, descriptive, retrospective study of a 24-year-old obese male Results: among the routine studies positive serology for celiac disease was detected and confirmed with digestive endoscopy...

INTRODUCTION: Solid-pseudopapillary neoplasms (SPN), or Frantz tumor, is a rare, low-grade neoplasm that occurs mainly in young women. It was described in 1959 by Virginia Frantz and constitutes 0.2-2.7 % of all pancreatic tumors. Computed tomography (CT) plays an important role in the diagnosis of this pathology of scarce reporting. The objective of the present study is to describe the epidemiological and tomographic characteristics of the SPN in the Instituto Nacional de Enfermedades Neoplásicas (INEN) of Peru...

Tryptase is a serin-protease produced and released by mast cells after IgE-mediated or non-IgE mediated stimuli. We here review the various aspects related to the molecular characteristics of the enzyme and its biological effects, the genetic basis of its production and the release kinetics. Recommendations for the clinical use of tryptase measurement developed by a task force of Società Italiana di Patologia Clinica e Medicina di Laboratorio and Associazione Allergologi Immunologi Italiani Territoriali e Ospedalieri are given on the best procedure for a correct definition of the reference values in relation to the inter-individual variability and to the correct determination of tryptase in blood and other biological liquids, in the diagnosis of anaphylaxis (from drugs, food, insect sting, or idiophatic), death from anaphylaxis (post mortem assessment) and cutaneous or clonal mastcell disorders...

This paper, written by Professor Rosario Maiorca, describes the everyday professional life in the institutes of Clinica Medica and subsequently of Patologia Medica at Parma University in the second half of the fifties and in the first years of the sixties of the past century. Those institutes and that period, which have been very important for the birth of Nephrology in Italy, have already been described, from the historical standpoint, in an Italian monograph on the history of our specialty for the period 1957-2007...

INTRODUCCTION: Acute appendicitis is a pathology caused by inflammation of the cecal appendix , due tocthe obstruction of the appendicular lumen,witch leads to a venous congestion and then eventually to an arterial compromise of the appendicular wall with the consequent perforation of it.The main problem of this pathology in children under 4 years is the high index of appendicecal preforations presented by patients at the time of diagnosis,mainly driven by an unspecific clinical presentation,which leads to a low index of suspicion and a high percentage of complications in that age group...

Introduction: Aeromonas is a common cause of gastroenteritis but occasionally it can cause extraintestinal infections. The incidence of bacteremia by this genus is very low and in general the patients have associated base diseases. Materials and methods: Retrospective analysis of episodes of bacteremia by Aeromonas spp. during a period of eight years in the National Hospital of Clinics of the city of Córdoba, emphasizing age, sex, associated comorbidities, clinical presentation, focus, origin of the infection, clinical evolution, species prevalence and antimicrobial sensitivity of the same ...

INTRODUCCIÓN: Los pacientes inmunocomprometidos presentan respuesta inflamatoria limitada que puede retrasar el diagnóstico de la apendicitis aguda (AA). OBJETIVO: Evaluar si el inmunocompromiso puede afectar el curso clínico y evolución de la AA. MÉTODO: Análisis retrospectivo, comparativo, de pacientes sometidos a apendicectomía por AA: con VIH, diabetes mellitus tipo 2 (DM2) y sin otra patología. RESULTADOS: Se revisaron 128 pacientes con AA intervenidos quirúrgicamente (53...

INTRODUCCIÓN: La histiocitosis de células de Langerhans (HCL) es un trastorno histiocítico raro y su incidencia exacta se mantiene desconocida; se ha diagnosticado en todos los grupos de edad, pero es más común en los primeros 3 años de vida. Se caracteriza por lesiones únicas o múltiples de tipo osteolítico causadas por proliferación clonal de células histológicamente similares a las células de Langerhans; su presentación clínica es heterogénea...

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INTRODUCTION: The popliteal artery aneurysm (AAP) is localized and irreversible walls of the popliteal artery dilation. It is rare pathology is the second most common location of true aneurysms after aortic, and the first location within the peripheral aneurysms. It is characterized by affecting mainly men at an average age of 65, whose manifestations are mainly ischemic, finishing lower limb amputation in a frequency ranging as appropriate between 7 and 20 percent. Our goal is to make the presentation of a case of AAP with subacute arterial ischemia, along with a literature review of the topic...