Diarrea crónica refractaria y malabsorción secundaria a hipogammaglobulinemia común variable, infestación crónica por giardia lambila y gastrectomía total por adenocarcinoma gástrico: un manejo nutricional complejo

Gastric cancer is a frequent cause of cancer-related mortality in the world. Surgery is the only potentially curative therapy, although the adverse effects of surgery are common and considerable. Common variable immunodeficiency is in many cases cause of gastrointestinal system problems such as chronic diarrhea caused by infestation with giardia lamblia, nodular lymphoid hiperplasia ad loss of villi leading frequently to malapsortion and malnutrition. Nutritional deficiencies due to malapsorption (postgastrectomy and secondary to loss of villi, giardiasis and common variable inmunodeficiency) are common. We present the case of a patient with gastric cancer who underwent a gastrectomy with common variable hipogammaglobulinemia and chronic infestation by giardia lamblia, with serious diarrhea resistant to treatment and malabsorption.

Fracturas inestables de radio distal. Nuestra experiencia en osteosíntesis con placa volar de ángulo variable

OBJECTIVE: assess the functional, subjective and radiological results obtained in patients treated with variable-angle locking plate for unstable distal radius fracture and compare these results with current studies. PATIENTS AND METHOD: From October of 2008 to July of 2011, 20 patients were included who had undergone intervention using the volar approach to the Flexor Carpi Radialis. The average follow up was 18 months. Both clinical and radiological results were analyzed. The Mayo Wrist Score and DASH questioner were used. RESULTS: The average age was 50 years; 50% men and 50% women. The consolidation of the fracture was verified in all cases. An average volar angle was obtained of 5º, radial inclination of 19º, radial height of 10.5 mm, and ulnar variance of -1 mm. The clinical assessment revealed an average dorsal flexion of 75º, palm flexion of 70º, supination of 75º and pronation of 73 º. The results for the DASH questionnaire showed an average of 17.8 and 82.7 for the Mayo Wrist Score. CONCLUSIONS: Our experience has provided some good results, both in functional and subjective as well as radio logical terms, similar to those found in studies with implants from the same generation.

Confabulation in schizophrenia: a neuropsychological study.

Confabulation has been documented in schizophrenia, but its neuropsychological correlates appear to be different from those of confabulation in neurological disease states. Forty-five schizophrenic patients and 37 controls were administered a task requiring them to recall fables. They also underwent testing with a range of memory and executive tasks. The patients with schizophrenia produced significantly more confabulations than the controls. After correcting for multiple comparisons, confabulation was not significantly associated with memory impairment, and was associated with impairment on only one of eight executive measures, the Brixton Test. Confabulation scores were also associated with impairment on two semantic memory tests. Confabulation was correlated with intrusion errors in recall, but not false positive errors in a recognition task. The findings suggest that confabulation in schizophrenia is unrelated to the episodic memory impairment seen in the disorder. However, the association with a circumscribed deficit in executive function could be consistent with a defective strategic retrieval account of confabulation similar to that of Moscovitch and co-workers, interacting with defective semantic memory.