aEEG in the first 3 days after extremely preterm delivery relates to neurodevelopmental outcomes

OBJECTIVES: Investigate relationships between aEEG in the first 72 h in extremely preterm infants with 1) infant, medical, and environmental factors, and 2) infant feeding and neurobehavioral outcomes at term and school-age. METHODS: Sixty-four preterm infants (≤28 weeks gestation) were enrolled within the first 24-hours of life and had two-channel aEEG until 72 h of life. Standardized neurobehavioral and feeding assessments were conducted at term, and parent-reported outcomes were documented at 5-7 years. RESULTS: Lower aEEG Burdjalov scores (adjusted for gestational age) were related to vaginal delivery (p = 0.04), cerebral injury (p = 0.01), Black race (p \u3c 0.01) and having unmarried parents (p = 0.02). Lower Burdjalov scores related to less NICU Network Neurobehavioral Scale arousal (p = 0.002) at term and poorer BRIEF global executive function (p = 0.004), inhibition (p = 0.007), working memory (p = 0.02), material organization (p = 0.0008), metacognition (p = 0.01), and behavioral regulation (p = 0.02) at 5-7 years. We did not observe relationships of early aEEG to feeding outcomes or sensory processing measures. CONCLUSION: Early aEEG within the first 72 h of life was related to medical and sociodemographic factors as well as cognitive outcome at 5-7 years

Aspectos epidemiológicos del cáncer de tiroides

The authors analyse the íncídence of thyroidcancer in the city of Montevideo and morta!ity inUruguay between 1988 and 1992, pointíng out thatwhi/e the former increases, the latter decreases,confirming the existence of better diagnosis andtreatment of this patho/ogy andlor /ess malignancy in thyroid cancer evolutioti. The analysís of thepersonal casuístry of one of the authors (B.Delgado) in the case of dífferentiated cancer of thethyroíd shows a predominancy in fema/es, youngand middle aged patíents, and thyroid nodule asc/ínícal presentation. From the hístologica/ poínt ofvíew, papillary carcinoma predomina/es; animportan/ percentage with cervical nades. Ourcountry has the profí/e of an endemícal zone forgoiter wíth a higher incídence of follicularcarcinomas when compared to non-endemica/zones ar endemícal ones with addítíonal iodíneintakeSe analiza la incidencia de cáncer de tiroides en laciudad de Montevideo y la mortalidad en Uruguayentre los años 1988-1992, destacándose quemientras la primera asciende, la segundadesciende confirmándonos un mejor diagnóstico ytratamiento de la patología y/o una menormalignidad en la evolución del cáncer de tiroides.El análisis de la casuística personal de uno de losautores (B. Delgado) nos muestra en el cáncerdiferenciado de tiroides un predominio del sexofemenino, una mayor frecuencia en edadesjóvenes y medía de la vida, con predominancia delnódulo tiroideo como presentación clínica.Hístológicamente se constata un predominio delcarcinoma papilar, donde un porcentaje importantese presenta con adenopatías cervicales,destacándose que nuestro país se presenta comozona endémica de bocio con una mayor incidenciade carcinomas foliculares en relación a zonas noendémicas o endémicas con ingesta adicional deiodo

Prosthetic Aortic Valve Stenosis in End-Stage Renal Failure

Although renal failure is one of the known comorbidities associated with rapid progression of aortic stenosis, it is unclear whether hemodialysis alters the progression of prosthetic aortic valve stenosis. We describe a 79-year-old female who underwent bioprosthetic aortic valve replacement 8 years ago with stable prosthetic valve area for the initial 6 years. In the last two years, coinciding with the initiation of maintenance hemodialysis, she developed progressive prosthetic valve stenosis to the point of clinical decompensation. She underwent a second prosthetic aortic valve replacement with symptom resolution. This case suggests that circulating milieu in end-stage renal failure and dialysis can accelerate the progression of prosthetic aortic valve stenosis. More frequent clinical followup and surveillance echocardiogram for dialysis patients with bioprosthetic aortic valve may facilitate timely management of valvular stenosis

Linforma no Hodgkin primario de esófago: Primera observación nacional

As regards the case of a 66 year old female patient with a primitive esophagic non-Hodgkin lymphoma with confirmed histopathologica/ diagnosis (the first in national literature) authors make a revision of the scarce international bibliography; this is an infrequent pathology with few notified cases. Authors analyse clinical presentations anddiagnostic difficulties, paraclinic with histopathological certification, treatment with chemotherapy, eventual surgery and variable evolution with bad prognosis in general.A propósito de una paciente de 66 años con un linfama no Hodgkin de esófago con diagnóstico histológico confirmado (el primero en la literatura nacional) se hace una revisión de la escasa bibliografía internacional, tratándose de una patología poco frecuente con pocos casos notificados. Se analiza la presentación clínica y las dificultades diagnósticas, la paraclínica con la certificación histológica, el tratamiento con quimioterapia, radioterapia, eventualmente cirugía, y la evolución variable en general con mal pronóstico

Vía venosa central yugular externa con catéter estándar

Authors describe a technical variety of externa/ jugular central venous access, using a standard catheter instead of the technique which employs a "J" catheter guide. Results in 48 patients are analysed and compared to international series;success was 93,8% with no complications.Se describe una variación de la realización de la técnica de vía venosa central yugular externa, utilizando catéter estándar, a diferencia de la técnica descrita con guía de catéter en "J". Se analiza y se compara con las series internacionales el resultado en 48 pacientes, con un éxito de 93.8%, no constatándose ninguna complicación

Immune-complex deposits in “pauci-immune” glomerulonephritis: a case report and brief review of recent literature

Anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis is considered a “pauci-immune” disease, characterized by absent or mild glomerular tuft staining for immunoglobulin and/or complement. We describe a 72-year-old man with progressive renal failure over five months who was found to have P-ANCA associated crescentic glomerulonephritis. Renal biopsy also revealed immunofluorescence staining for Immunoglobulin G and C3. Treatment comprised corticosteroids, cyclophosphamide, and plasmapheresis but unfortunately kidney function did not recover, likely due to substantial interstitial fibrosis at diagnosis. This case illustrates that serologic evaluation for ANCAs should not be discounted when immune deposits are present. Prompt diagnosis is warranted