Perianal leiomyomas are neoplasms arising from mesenchymal cells distributed throughout the body. Histologically have been classified into three subtypes: vascular, nonvascular and epithelioid. The vascular subtype may be solid, cavernous or venous. Leiomyomas are rare in adults, with an incidence of 0.1 %, usually within the fourth to sixth decade of life with female predominance if benign. The most frequent form of presentation is, near the anus and painless palpable nodule. The diagnosis is made by histologic and immunohistochemical criteria also are useful endoanal ultrasound and MRI. The resection is the first treatment option. Case of female patient aged 41 , who consulted for perianal nodule palpable right , with tenderness , eight months duration , with normal levels of tumor markers is presented , ultrasound reveals perianal solid right image hypochromic ( linear fibrous tissue) , measured 4.82x 6.7x 6.87cm , MRI shows space occupying lesion in the same location , without Color Doppler vascularity. Leiomyoma excision was performed in right ischiorectal fossa 4x6 cm. Histopathological study reported perianal leiomyoma epithelial In the present study a rare case of painful perianal leiomyoma is reported, explaining the clinical and histological characteristics

Esthesioneuroblastoma is a tumor arising from the olfactory neuroepithelium and its incidence is 3% of nasal tumors. The symptoms are nonspecific, but the two most common manifestations are unilateral nasal obstruction and epistaxis. The definitive diagnosis of the patients is by histological study, which is difficult because it is often confused with other neoplasms of small round cells in the nasal cavity and immunohistochemistry of biopsy samples. Current therapeutic approaches include endoscopic techniques combined with anterior craniotomy, followed by adjuvant therapy; and chemotherapy in advanced stages. A case of male 40 years of age, who consults for epistaxis predominantly in the left nostril, in the left anterior rhinoscopy It has a space-occupying lesion, white-gray appearance, no bleeding, hard consistency, with little serohematic secretion, biopsy reports a malignant small round cell tumor consistent with an olfactory neuroblastoma (esthesioneuroblastoma). The definitive diagnosis is made with immunohistochemistry. A left Total maxillectomy with placement of osteosintesis material is practiced. Due to the low incidence of these tumors, it is necessary to present existing cases, so then be studied by future generations of doctors, in order to not ignore an unusual pathology

Primary Pulmonary Lymphomas are extremely rare (0.4% of extranodal lymphomas), and are usually Mucosa-associated lymphoid tissue (MALT), with occasional diffuse large cell lymphomas. The symptoms are nonspecific, and almost half of patients are asymptomatic. The case of a male patient aged 56, who presented hits daily for 7 months of dry cough, predominantly nocturnal, associated in the past month to 39 º C fever, dyspnea on moderate exertion and greenish expectoration is presented. The laboratory tests were normal. Chest radiography showed widened mediastinum, a process in the middle lobe atelectasis effect and a nodule in the left hemithorax. Thoracic high resolution computed tomography (CT) demonstrated alveolar process right middle lobe and left lung nodule calcified nonspecific. Immunohistochemical study of lung biopsy was consistent with B-cell Lymphoma extranodal marginal zone of mucosa-associated lymphoid tissue (MALT lymphoma of the lung). Body CT and Positron Emission Tomography (PET) showed significant additional findings to determine the extent of the disease. The patient was treated with chemotherapy and is currently in good condition with no recurrence of symptoms. Because the infrequent of the disease, this case is presented and a review of the literature is made

La leishmaniasis es una enfermedad causada por la infección de un parásito protozoario del género Leishmania, transmitido por la picada de insectos hematófagos conocidos como flebotominos. El estudio tiene como objetivo determinar la presencia de flebotominos en los Distritos Sanitarios del estado Mérida y diseñar un mapa de riesgo de transmisión entomológico. Se utilizaron cuatro métodos de captura de flebotominos, los ejemplares se identificaron y se les determinó la infección natural por Leishmania. Se estimó la riqueza de especies, y se realizó un proceso analítico Jerárquico. Los resultados muestran la presencia de diversas especies de flebotominos en los Distritos Sanitarios del estado Mérida, siendo las especies de mayor frecuencia L. youngi, L. gomezi, L. ovallesi y L. walkeri. Se detectó 2,1% de infección natural con Leishmania, la cual se encontró en las 4 especies más frecuentes. Se presenta un mapa de riesgo de transmisión entomológico para el estado Mérida. El conocimiento de la situación actual de los vectores de Leishmania en el estado Mérida y el riesgo de transmisión son relevantes a la hora de considerar la prevención y posible surgimiento de nuevos brotes de leishmaniasis

In this work we report rare big hard palate destruction. We describe the diagnosis, the therapeutic management and its evolution. White male of 37 years old, who presented a 12 months perforated lesion in hard palate. 20 years of chronic snorting of cocaine and 23 years of tobacco smoke. The patient had a familiar background of Malignant Hyperthermia in 2 blood relatives operated before. The biopsy was a benign lesion. We underwent a Randal type flap to close the defect and a Rintala type flap to cover the nasal side of the fistula. It was firmed up with a resorbable collagen mesh between both flaps. The last control after 6 month of follow up showed a good result of the surgery but he relapsed with active addiction of cocaine and never consulted again. In conclusion, the chronic use of cocaine may develop destructive lesions of nose and palate. Repair is a challenge because of the difficulty in obtaining tissues in addition with the poor adherence of the patients to abandon the drug

Carcinogenesis by many small molecular weight chemicals involves either a direct action of the chemical on cellular DNA or metabolism of the parent chemical to an active or ultimate form, which can than react with cellular DNA to produce a permanent chemical change in a DNA structure. A free radical is an atom or molecule that has one or more unpaired electron(s). These are highly reactive species capable of wide spread, indiscriminate oxidation and per oxidation of proteins, lipids and DNA which can lead to significant cellular damage and even tissue and/or organ failure. . Oxidative stress is a leading cause to damage cells by oxidation. The rate at which oxidative damage is induced (input) and the rate at which it is efficiently repaired and removed (output). Xenobiotics are a compound that is foreign to the body. Xenobiotics can produce a variety of biological effects, including pharmacologic responses, toxicity, genes, immunologic reactions and cancer. Oxidative stress is a leading cause to damage cells by oxidation. The rate at which oxidative damage is induced (input) and the rate at which it is efficiently repaired and removed (output). This communication highlights the role of carcinogens as environmental pollutants with the possible mechanism of free radicals, oxidative stress and xenobiotics

El objetivo de la investigación fue determinar las concentraciones plasmáticas de cortisol materno secundarias al uso de betametasona para la maduración pulmonar fetal. Se realizó una investigación con un diseño tipo cuasi-experimental y una muestra no probabilística intencional de 106 pacientes que acudieron a la consulta pre-natal de alto riesgo del Hospital Central “Dr. Urquinaona". Una vez seleccionadas las pacientes se le administró inyecciones intramusculares de betametasona (12 mg) por dos días consecutivos. Las mediciones se realizaron en tres ocasiones: La primera medición, antes de la administración de la primera dosis de betametasona; la segunda medición, 24 horas después de la segunda y última inyección; y la tercera medición, siete días luego de la administración de la última dosis de betametasona. Se observó que las inyecciones con betametasona producían disminuciones de las concentraciones plasmáticas de cortisol materno, ya que el valor de la primera medición fue de 30,1 +/- 9,4 picogramos/dL, las concentraciones disminuyeron a 5,6 +/- 1,9 picogramos/dL durante la segunda medición y luego aumentaron a 23,2 +/- 4,2 picogramos/dL a la tercera medición. Las variaciones de las concentraciones de cortisol de la segunda y tercera medición se consideraron estadísticamente significativas al compararlas con las concentraciones iniciales (p = 0,001). Se concluye que el uso de betametasona para inducir la maduración pulmonar fetal produce disminución significativa en las concentraciones plasmáticas de cortisol materno

Several immunopathogenic mechanisms have been proposed to explain the massive increase of vascular permeability observed in the severe forms of infection by Dengue Virus (DENV). Our aim was to determine the kinetic changes of inflammatory mediators (IL-8, TNF- α), soluble early lymphocyte activation markers (sIL-2R, sTNF-Rp75) and soluble fractions of cell adhesion molecules (sICAM-1 and sVCAM-1) as indicators for early recognition of disease severity in patients with laboratory-confirmed dengue. Twenty patients classified as Dengue±Warning Signs (D±WS) and thirty patients with Severe Dengue (SD) were included in the study. Serums of apparently healthy individuals were included as controls. Compared with normal subjects, D±WS cases did not show significant differences in the levels of IL-8 or TNF-α during the acute nor in the critical stages of the disease; however, in D±WS cases levels of sICAM-1 and sVCAM-1 were higher than controls during both phases; in contrast, significant increase of sTNF-p75 and sIL2R levels were observed during the critical phase of the disease. Compared with both dengue patients and controls, patients with SD showed significant rise in the levels of IL-8 and TNF-α during the critical phase of the disease and a significant increase in adhesion molecules were detected in both phases, but the highest levels of sVCAM-1 and sIL-2R were observed only during the acute stage of the disease. In conclusion, sIL-2R and sVCAM-1, as early markers of lymphocyte and endothelial activation, would serves as indicators of severity during the acute phase of dengue infection

Recientemente el Ministerio del Poder Popular para la Educación convocó a una Consulta Nacional por la Calidad Educativa, acto en el cual el Ministro expresó: “es para lograr que Venezuela sea un país potencia”. Otro funcionario sentenció, “somos el segundo país en América Latina y quinto en el mundo con mayor presencia de jóvenes en recintos universitarios”. En efecto, la matrícula universitaria creció 203% entre el año 1997 y el 2010; en 1997 había 756.000 estudiantes universitarios inscritos, cifra que aumentó hasta 2.294.000 en el año 2010. Estadísticas que generan muchas interrogantes, una de ellas relacionada con la “calidad educativa”; lo cual nos obliga a recordar que hay programas e indicadores confiables para un auténtico diagnóstico del rendimiento de la educación, particularmente de primaria y secundaria. Sin embargo, quienes han conducido la educación en nuestro país, nunca evaluaron seriamente su rendimiento; peor aún, en la última década se ha sacrificado la calidad educativa en aras de la cantidad de matrícula

The objective of research was to establish total vascular endothelial growth factor (VEGF) concentrations in patients with preeclampsia and healthy normotensive pregnant women and to relate Doppler findings to serum concentrations. One hundred sixty patients were selected. Forty-seven severe preeclamptic patients (group A), 33 mild preeclamptic patients (group B) and 80 healthy pregnant women with a similar age to patients in study groups were selected as controls (group C). Blood samples for total VEGF and measurements of pulsatility index, resistance index and systolic/ diastolic blood flow ratio of uterine arteries were done in all patients before labor and immediately after diagnosis in the study group. Patients in group A and B showed higher total VEGF concentrations than group C (p < 0.05). Measurements of pulsatility index, resistance index and systolic/ diastolic blood flow ratio of uterine arteries were higher in both groups of preeclamptic patients (p < 0.05). When correlation of plasma total VEGF concentrations with Doppler velocimetry values, there were observed that it was significant with all three evaluated parameters (p < 0.05). It is concluded that preeclamptic patients showed higher plasma total VEGF concentrations than normotensive pregnant women and there is a significant correlation between plasma concentrations and parameters of Doppler velocimetry of uterine arteries