Serial percutaneous endomyocardial biopsy is the standard for diagnosis of cardiac rejection; it is generally done on a weekly basis for the first month and then as indicated by ECG voltage; but, this method is invasive, can be done only in specialized centers, not available for the many patients who return home, requires 18-24 h before a result is obtained, delaying institution of therapy, and it is aggressive for the endomyocardium of the graft. A reliable, rapid, and noninvasive test for detection of cardiac rejection is still not available. The aim of this work was to determine whether 201Tl uptake was significantly correlated with the histological findings presenting in cardiac rejection. Auxiliary heart transplantation was carried out on 60 male rats. Graft viability was evaluated by direct palpation, ECG voltage, and 201Tl uptake during the study (from 4-6 h after transplantation to 1 month). Syngenic rats (without rejection) were used as a control group. Histological studies were done at the end of the isotope study in all animals. The statistical significance of all results was determined by means of Student's t-test. A very significant correlation between the severity of the histological findings of rejection and 201Tl uptake was found (P less than 0.001). Our results have demonstrated that 201Tl uptake detected rejection earlier than ECG voltage; moreover, 201Tl uptake was more sensitive in detecting a mild degree of rejection while ECG only detected a moderate degree. We believe that 201Tl uptake should be the screening method for the follow-up of cardiac transplantation; it offers to surgeons the opportunity to select patients for endomyocardial biopsy, with a higher accuracy than the other noninvasive methods.

A case of a previously undescribed malformation of the inferior vena cava is reported: there was distal normoposition and proximal transposition, with anterior crossing over the aorta; the right renal vein flowed into the inferior vena cava located on the left, after crossing over the anterior face of the aorta. This anomaly was shown by echography and isotopic phlebography.

La displasia renal multiquística es una entidad rara y poco conocida en nuestro medio. El objetivo de este trabajo es presentar y discutir en formar crítica del diagnóstico, evaluación perinatal de un caso de displasia renal multiquística, así como su diagnóstico diferencial.

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Objetivo: Describir la evolución clínica de pacientes con artritis reumatoide con actividad alta y moderada tratados con bDMARDS, medida con DAS28. Fundación Investigación Médica del Atlántico, periodo enero-mayo de 2015. Materiales y Métodos: Estudio descriptivo observacional serie de casos, ambispectivo, en 39 pacientes con diagnóstico de artritis reumatoide que recibieron previamente metotrexate (MTX) que se les inició bDMARDS con actividad alta y moderada según el DAS28 y les realizaron controles establecidos (3, 6, 9 y 12 meses). Resultados: La distribución del género mostró mayor frecuencia en el género femenino con el 84,6 %; la edad media fue de 51,4 ± 16,0 años; el tiempo medio de diagnóstico 7,1 ± 5,2 años; el 100 % de los pacientes ingresaron con actividad moderada y alta (DAS28), a los 12 meses de tratamiento se observó baja actividad en el 33,3 %, actividad moderada en el 56,4 % y alta actividad en el 10,3 %. Conclusiones: Los pacientes que reciben tratamiento con bDMARDS presentan una evolución clínica satisfactoria, mejorando significativamente su capacidad funcional, el daño estructural y la calidad de vida.