Biomedical subjects
Publications and source records attributed to A Sarría.
The authors report a case of Wolfram's syndrome and discuss the evolution of the symptoms in relation with the data in the literature. The possibility of an association of Wolfram's syndrome with the HLA system is suggested. The use of carbamazepine in the treatment of the diabetes insipidus present in this syndrome is discussed.
Four new observations of diaphysary tubular stenosis or Kenny-Caffey's syndrome are studied, the first in the spanish literature. They belong to two unrelated families. Cases 1 and 2 are a son and his mother; cases 3 and 4 are first cousins of, apparently, normal consanguineous parents. In the last two cases hypocalcemic tetany of recurrent evolution and congenital glaucoma were verified. For the purpose of this serie a revision is made of the cases reported on the literature. They are a total of eight observations, including the cases studied in this paper. A discussion is made, especially, on the genetic mechanism of this skeletal dysplasia, which in cases 3 and 4 present remarkable peculiarities.
The case of a 12 2/12-year-old boy with an HGH secreting eosinophilic adenoma is presented. The histologic investigation included conventional and ultrastructural techniques. The pre- and postoperative (1, 7, 11, and 20 months) hormonal controls are analyzed, indicating the persistence of HGH anteropituitary activity, even though surgical sectioning of the pituitary stalk was performed and the activities of thyroid, corticoadrenal and gonadotropin functions decreased. It is suggested that the hypothalamo-pituitary relationship may be maintained by extraportal venous circulations.
In the care of 5178 live newborns from October 1971 to October 1974, 252 (4.7%) cases of bacterial infections were diagnosed. Of this number, 131 were full-term and 121 premature newborns. The three most frequent types of infections were gastroenteritis (103 cases = 40.8%), urinary tract infections (77 cases = 30.5%), and septicaemia (51 cases = 20.2%). The three organisms most frequently found were E. coli, Proteus and Enterobacter. The prevalence of gram-negative over gram-posivite germs was very remarkable. In 38 infected newborns the highest IgM levels were achieved at the acme of the illness, and they decreased when the infection subsided.
In the present study, health is considered a subject of insurance whose protection has become a Fundamental Right. In the same line, health care has acquired a contractual character whose "nature" has evolved from individual to collective, expressed in terms of "health care insurance", public or private. In such context, outcome measurement becomes necessary to be able to define the variables of the System and, subsequently, the contracting conditions. Having an understanding of the economic impact is required to analyze the costs and, in consequence, the financial necessities of the System; as well as the clinical results in order for the insured to have some realistic expectations of the benefits that can be expected from the health care that is offered. In turn, the vertiginous rhythm of technological innovation that characterizes the modern medicine forces to the continuous revision of the state of the art framed in a health sector whose multifactorial profile confers it growing complexity. In conclusion, health technology assessment becomes indispensable to identify health care effectiveness, to facilitate its efficient management, to define responsibilities and to offer guarantees to the users; all which is already part of an ethical body that, day by day with more clarity, is being configured by the legislation and that, in turn, guarantees the survival of the Health Care System.
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