Revista Médica de la UCR 7(1)

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  • Ítem
    ENDOMETRIOSIS IN THE INGUINAL CHANNEL: A CASE REPORT
    (2013-05-30 00:00:00) Quirós Alpízar, José Luis; Corrales González, Daniela
    Endometriosis is defined as the presence of functioning endometrial glands and stromal tissue outside of uterine cavity, which is estrogen depend ent. It’s usually seen in ovary, uterosacral ligament, uterus, fallopian tubes, gastrointestinal tract and genitourinary system. However we describe a case in the inguinal channel. It prevails in 10% of women in reproductive age. There are a lot of factors that contribute to this pathology like inheritance, age, female’s reproductive system’s anatomic anomalies, parity, alterations of the menstrual cycle, use of oral  ontraceptives and ambient factors. There are a lot of physiopathological theories; one of them is retrograde menstruation that could explain the etiology of the case presented. The most frequent symptom is pelvic pain and infertilit y has also been associated The best way of diagnosis is laparoscopy or laparotomy, along a histological con firmation of macrophages with hemosiderin, endometrial epithelium and endometrial glands or stroma. Malignant transformation has been observed in 0,6 -0,8% of presented ovaric endometriosis. GnRH analogues are broadly used as medical treatment, while anazol is less used because of its androgenic effects. NSAIDs combined with oral contraceptives is used to on endometrial ectopic tissue ablation trough laparoscopy. 
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    CLASSICS RISK FACTORS FOR DEVELOPING COLELITIASIS, POPULATION VÁSQUEZ OF CORONADO
    (2013-05-30 00:00:00) Álvarez Chaves, Ricardo
    The purpose of the study is to analyze the behavior of the four classical factors described in the literature, for developing gallstones: obesity, age, gender and fertility in the population of Vasquez de Coronado [1, 2, 3]. We reviewed clinical data of 334 patients who underwent surgery in the period 2006 -2011. We documented a direct association between each of these factors and presentation of gallstones.Female gender, shown as the independent variable with the largest number of cases, followed by obesity modificable factor in the promotion of healthy lifestyles. The largest number of patients under goingcholecystectomy reported three pregnancies. Finally the total study population had 117 patients aged between 40 and 49 years.
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    LEUKEMIA (PH +): DIAGNOSIS AND TREATMENT
    (2013-05-30 00:00:00) García Fallas, Miriam María
    Chronic myelogenous leukemia is considered as an exemplary for the development of molecular targeted therapies due to its pathogenesis. This disease is characterized by the presence of Philadelphia chromosome (PH+), a product of the reciprocal translocation between chromosomes 9 and 22, which causes the BCR- Abl gene. The appearance of this gene in the cellsgives rise to an oncoprotein that allows a leukemic transformation a marked decreased sensitivity to regulation letting clonal expansion manifest. In addition, this oncoprotein intervenes in myriad mechanism of differentiation and activates survival pathways. The development of Imatinib treating thisdisease blocks the action of the oncoprotein and puts into practice different techniques of molecular biology in order to define parameters of response and progression of such disease; this allows decision making regarding therapeutic changes in patients who are at risk of progression associated to Imatinib resistance, and it monitors patients with a complete and higher molecular.
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    ENDOVASCULAR TREATMENT OF A MIDDLE CEREBRAL ARTERY BIFURCATION ANEURYSM
    (2013-05-30 00:00:00) Rosales Bravo, Luis Manuel; Cabezas Campodónico, Carlos; Quiroga Galindo, Mónica; Hernández Gaitán, Manuel
    Cerebral aneurysms of the middle cerebral artery are a frequent cause of spontaneous subarachnoid hemorrhage. The surgical neck clipping-to prevent rebleeding-has traditionally been the treatment of choice. Currently depending on the morphology of the aneurysm sac, the ratio neck / dome and the absence of arterial branches that arise from the aneurysm sac, make possible the endovascular treatment of aneurysms using coils.This technique achieves complete exclusion of the aneurysm from the cerebral blood flow with a low rate of recanalization and complications. The goal of treatment is to exclude the aneurysm from the cerebral circulation preventing the rebleeding, reduce he risk of thromboembolic complications and reduce mortality in this patient ́s group. Through a clinical case is showed an endovascular treatment of a ruptured sacular middle cerebral artery bifurcation neurysm. In the Costa Rica ́s medical literature this is the firt reported case
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    RECTAL CANCER; SURGICAL MANAGEMENT
    (2013-05-30 00:00:00) Brenes Coto, Leslyn Andrés
    Rectal cancer is defined as a tumor located between the anal verge and 15 cm within anal verge. In rectal cancer, a precise preoperative staging allows to categorize patients for different available treatments, as well as decide the best surgical treatment. The different treatment options that can be used in each case depend fundamentally on the extension of the tumor at the time of diagnosis. The main surgical objective is to achieve a resection with an a ppropriated total mesorectal scission, greater number of lymph nodes and negative distal and radial margins. These surgical parameters have been used as quality indicators and have prognostic implications in terms of overall and disease--free survival. Total mesorectal scission with preservation of hypogastric nerves has shown a reduction in rates of sexual and bladder dysfunction as well as lower local recurrence.
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    TUMORS IN COSTA RICA; EMPHASIS ON COLORECTAL CANCER
    (2013-05-30 00:00:00) Young Leitón, Jean Carlo
    Currently in Costa Rica colorectal cancer has an incidence of 9,49% in men for every 100000 inhabitants, making it the fourth most common cancer in the country, while women ranked sixth in incidence with a 9,22 %. Furthermore, mortality is the fifth most deadly tumor in men and women became the thirdmost common cause of death. This last point is the most significant, because with respect to mortality in women happens to be the fourth leading cause in 2000 to be the third in 2010, up from cervical cancer. The above data are based on studies by the Ministry of Health for the year 2007 (incidence) and 2010 (mortality). Described multiple risk factors, among which are those modifiable as diet, smoking and obesity and non-modifiable as polyposis syndromes and hereditary colon cancer is not associated with these. Usually early symptoms of colorectal cancer are nonspecific, so they show up in more advanced stages of the disease when the clinic is more evident, rectal bleeding being one of the most common symptoms. Treatment will depend on whether the tumor is in early or advanced stages, where appropriate surgery along with adjuvant chemotherapy has shown better in healing rates.
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    MODIFICATION OF CALDWELLLUC’S APPROACH FOR THE ANATOMIC LEARNING OF THE ORBIT
    (2013-05-30 00:00:00) Rodríguez Vargas, Gabriel; Guevara Arroyo, Victoria
    Classically, orbit dissection approach is done trans cranially, hindering mobilization and complete visualization of the total content of the orbit. By a transmaxillary approach with orbital floor removal and bilateral cantholysis, performed with just a basic dissection kit, a high speed rotation tool and magnifying lenses, the Anatomy Department of the University of Costa Rica presents in this study a new proposal for detailed visualization of all the anatomical structures contained within the orbit, based on a modification of the Caldwell-Luc surgical technique. This approach must be reserved only for the academic study of the orbit and not as a surgical technique due to the complications already known that opened transmaxilary approaches, such as Caldwell-Luc’s provide ti patients.
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    NEUROBIOLOGY OF HUMAN MORAL BEHAVIOR
    (2013-05-30 00:00:00) Blázquez Arroyo, Juan Luis; Peláez Pezzi, María Belén
    In recent years there have been numerous studies, with different approaches, whose goal is to understand the neural basis of our social and moral behavior. New findings show that morality has certain innate components, that would be common to all human beings, while others are acquired (learned and recorded in the brain) and culturally specific.Neuroscientific studies have shown that some brain regions, particularly in the prefrontal cortex, are essential to moral behavior, as individuals injured in these territories show serious deficits in moral decisions. Moreover, in the last years, based on clinical neurology and functional neuroimaging, neuroscientists have been able to analyze the neural mechanisms that underlie moral behavior. The data obtained suggests that many of the emotional brain structures whose primary function would be to make easier our social life, have an essential role in judgment and moral behavior, generating quick intuitions of what is right and wrong. Such a system would work integrated with the system responsible for conscious deliberation in order to solve the most complex or ambiguous dilemmas.