Introduction: Postherniorrhaphy groin chronic pain is a clinical condition characterized by neuropathic pain mainly, disabling, with difficult pharmacological control, which has resulted in the search for different treatment tools. Objective: To present the case of a patient diagnosed with postherniorrhaphy groin chronic pain, resistant to medical therapy, to whom was made ??a pulsed radiofrequency by means of which achieved pain control and their reintegration into working life. Methods: A search was conducted on PubMed/Medline database, between the years 2000-2013. Results: 25 papers were reviewed to describe the case. Conclusion: In patients with postherniorrhaphy groin chronic pain resistant to pharmacological treatment, pulsed radiofrequency applied to the ilioinguinal, iliohypogastric and genitofemoral nerves is an effective alternative, available and safe with a low incidence of adverse effects or complications.

Introducción: El dolor crónico postherniorrafia inguinal es una condición clínica caracterizada por dolor frecuentemente neuropático, incapacitante, de difícil control farmacológico, lo cual ha derivado en la búsqueda de diferentes herramientas de tratamiento. Objetivo: Presentamos el caso de un paciente con diagnóstico de dolor crónico postherniorrafia inguinal, refractario al tratamiento farmacológico, a quien se le realizó una radiofrecuencia pulsada con la cual se logró control del dolor y su reintegro a la vida laboral. Métodos: Se realizó una búsqueda en la base de datos PubMed/Medline, entre los años 2000 y 2013. Resultados: Se revisaron 25 artículos para la descripción del caso. Conclusión: En pacientes con dolor crónico postherniorrafia inguinal, refractarios al tratamiento farmacológico, la radiofrecuencia pulsada aplicada sobre los nervios ilioinguinal, iliohipogástrico y genitofemoral, es una alternativa útil, disponible en nuestro medio y segura con una baja incidencia de efectos adversos o complicaciones.

OBJETIVO: O objetivo deste estudo foi avaliar retrospectivamente por 3 anos a partir de dados salivares, as terapias com carbamacepina (CBZ) e ácido valproico (VPA) em pacientes pediátricos. MÉTODOS: Foram avaliadas amostras de saliva estimuladas com ácido cítrico por método FPIA em 103 pacientes (idades 1-14 anos) em monoterapia com CBZ ou VPA ou terapia combinada CBZ-VPA. RESULTADOS: Níveis salivares de VPA se relacionaram linearmente com a dose diária, e a relação não linear foi encontrada em pacientes com CBZ. VPA não alterou as concentrações salivares de CBZ, porém a CBZ reduziu os níveis salivares de VPA em pacientes com terapia combinada. Pacientes refratários apresentaram altas concentrações de VPA. Os níveis de CBZ em pacientes não controlados não apresentaram diferenças significativas em relação aos pacientes controlados quando as doses diárias foram mais elevadas. CONCLUSÃO: Saliva estimulada com ácido cítrico é adequada para o monitoramento terapêutico. Níveis da droga na saliva em pacientes que não responderam ao tratamento pode ser explicado pelo transporte de efluxo generalizado.

OBJECTIVE: The aim of the study was to analyze retrospectively carbamazepine (CBZ) and valproic acid (VPA) salivary data collected from epileptic children during a 3-year period. METHODS: Saliva samples stimulated by citric acid were assayed by FPIA method. One hundred and three patients (aged 1-14 years) were in CBZ or VPA monotherapy or in CBZ-VPA combined therapy. RESULTS: VPA salivary levels were linearly related with daily dose, but a non-linear relationship was found for CBZ, in patients under monotherapy. VPA did not alter saliva CBZ concentration. Conversely, CBZ reduced VPA salivary levels. Non-responsive children displayed higher VPA concentrations. CBZ levels in uncontrolled patients showed non-significant difference in relation with controlled subjects even though their daily doses were higher. CONCLUSION: Citric acid stimulated saliva is reliable enough to perform therapeutic drug monitoring. Saliva drug levels in non-responsive patients would be explained according to the generalized efflux transporter overexpression hypothesis.

Mastocytosis consists of a group of disorders characterized by a pathologicincrease in mast cells in tissues including skin, bone marrow, liver, spleen, andlymph nodes. Mastocytosis is a rare disease and general practitioners have limited exposure to its clinical manifestations, diagnosis, classification, and management. Moreover a complete and clear review in this field is not easy founded. Diagnosis of mastocytosis is suspected on clinical grounds and is established by histopathologic examination of involved tissues such as skin and bone marrow. The most common clinical sign of mastocytosis is the presence of typical skin lesions of urticaria pigmentosa. Most patients experience symptoms related to mast cell mediator release, and prevention of the effects of these mediators on tissues constitutes the major therapeutic goal in the management of mastocytosis. Despite recent advances in knowledge about the pathophysiology, diagnosis, and classification of mastocytosis, a curative treatment for mastocytosis does not now exist; furthermore mastocytosis is a chronic diseases with different severity grades but in all of them with an important negative impact on quality of live of patients. Management of patients within all categories of mastocytosis includes: 1. A careful counselling of patients (parents in paediatric cases) and care providers. 2. Avoidance of factors triggering acute mediator release. 3. Treatment of acute mast cell mediator release. 4. Treatment of chronic mast cell mediator release, and if indicated. 5. An attempt to treat organ infiltration by mast cells. The goal of this review is to provide a practical guide focus on diagnostic criteria for the different treatment options currently available and their management.

Las mastocitosis pertenecen al grupo de las llamadas "Enfermedades Raras"; es decir, enfermedades poco frecuentes; por ello, es difícil que los médicos, en general, posean la experiencia suficiente para enfocar de forma adecuada su diagnóstico y su tratamiento. El diagnóstico de las mastocitosis se establece por la clínica y los hallazgos histopatológicos en biopsias de los órganos afectados como piel y médula ósea. El signo clínico más frecuente de las mastocitosis es la presencia de lesiones de urticaria pigmentosa. La mayoría de los pacientes presentan síntomas relacionados con la liberación de mediadores del mastocito y la prevención del efecto de estos mediadores sobre los tejidos constituye la clave del tratamiento y manejo clínico de las mastocitosis. En la actualidad no existe un tratamiento curativo, por lo que se trata de unas enfermedades crónicas que tienen un impacto negativo sobre la calidad de vida. El manejo de las mastocitosis para cualquiera de sus categorías incluye: 1. Un cuidadoso entrenamiento en los cuidados de la enfermedad a los pacientes y padres en caso de las formas pediátricas. 2. Evitación de la liberación de mediadores. 3. Tratamiento de los episodios agudos de liberación de mediadores. 4. Tratamiento de los síntomas crónicos de liberación de mediadores. 5. Tratamiento de la infiltración de mastocitos en diversos órganos. El objetivo de esta revisión es la elaboración de guías completas y a la vez prácticas de manejar sobre el diagnóstico, tratamiento y manejo clínico de las mastocitosis.

In spite of the systematic educational work carried out as regards pregnancy in adolescence all over the country since the 70's, an increase is observed at the health care units with a negative repercussion on the indicators of morbidity and perinatal mortality I. As a result of it , a prospective and descriptive study of the results attained by "Julio Alfonso Medina" Gynecoobstetric Teaching Hospital, in Matanzas, during 2001, and by "Mario Muñoz Monroy" Territorial Hospital, in Colón, from 1999 to 2001, was conducted. Of 3 000 births ocurrred at the hospital of Matanzas, 362 corresponded to adolescents for an incidence of 12,06 %, and of a total of 7 195 births that took place at the hospital of Colón, 895 were also adolescents, for an incidence of 12.4 %.The results were discussed and compared and it was observed that although with very similar incidences, there was a significant increase of cesarean section, preterm gestational time with the subsequent rise of the low birth weight indicator, and an elevated index of asphyxia and influence of this group on late fetal mortality differently from the results of the Provincial Teaching Hospital.

A pesar de los trabajos sistemáticos educativos que desde la década del 70 se viene efectuando a lo largo del país para evitar embarazo en la adolescencia, este ha aumentado en las unidades hospitalarias asistenciales, con su repercusión negativa en los indicadores de morbilidad y mortalidad perinatal I. Por las razones anteriores se realizó un trabajo prospectivo y descriptivo de los resultados de los hospitales docente ginecoobstétrico de Matanzas "Julio Alfonso Medina" (durante el año 2001) y el hospital territorial de Colón "Mario Muñoz Monroy" (en el período de 1999-2001). De un universo de 3 000 nacimientos ocurridos en el hospital de Matanzas, 362 correspondieron a adolescentes para una incidencia de 12,06 %, y de un total de 7 195 nacimientos ocurridos en el hospital de Colón, 895 correspondieron también a adolescentes para una incidencia de 12,4 %.Se discutieron los resultados y se observó que aunque con incidencias muy parecidas en el hospital de Colón fue considerable el incremento de las cesáreas, el parto pretermino con el consiguiente aumento del indicador de bajo peso, así como un elevado índice de asfixia con influencia de este grupo en la mortalidad fetal tardía a diferencia de los resultados del hospital de Matanzas.