Revista Medica Herediana

Resistencia antibiótica

Experiencia en hernioplastía inguinal con anestesia local

Objetivo: Evaluar la utilidad de la cirugía ambulatoria con anestesia local en pacientes con patología herniaria inguinal. Material y métodos: Se realizó un estudio descriptivo tipo serie de casos, entre abril de 1996 y marzo de 1999, en el Servicio de Cirugía de la Clínica Fiori. Se intervinieron 1,167 pacientes por patología de pared abdominal, de las cuales 432 correspondieron a pacientes intervenidos por patología herniaria inguinal, de ellos 372 fueron operados con anestesia local, los cuales fueron incluidos en el estudio. Las técnicas quirúrgicas empleadas fueron las de Bassini y McVay, con un tiempo operatorio promedio de 30 minutos y un control a los 3 días post-cirugía. Resultados: El 72.9% de la patología herniaria inguinal se presentó en los pacientes entre los 31 y 70 años de edad. Solo el 2.6% (10 pacientes) presentaron complicaciones post-operatorias, 6 con recidivas de hernia inguinal, 2 con infección de herida operatoria, 1 con seroma y 1 con hematoma, ninguno resultó ser de gravedad; y 97.4 % (362) no presentaron ninguna complicación. No hubo complicaciones anestésicas. Conclusiones: La hernioplastia inguinal con anestesia local es efectiva, segura y económica.(Rev Med Hered 2003; 14:158-162).

Objective: To evaluate the utility of ambulatory surgery with local anesthesia in patients with inguinal hernia. Material and methods: A descriptive serial cases type study was performed between April 1996 and March 1999, at the Clinica Fiori surgery division. We intervened 1,167 patients with abdominal wall pathology, 432 of them were intervened for inguinal herniary pathology, 372 of them with local anesthesia who were included in the study. The surgical techniques used were Bassini and McVay, with an average operative time of 30 minutes, and 3 days post surgery control. Results: 72.9 % of herniary patology was observed among 31-70 years old patients. Only 2.6 % (10 patients) presented post-operative complications, 6 patients with relapse of Inguinal hernia, 2 with infection of operatorie wound, 1 with seroma and 1 with hematoma, none resulted being of graveness, and 97.4 % (362) didn´t present any type of complications. There were not anesthetic accidents. Conclusion: The surgical treatment of inguinal hernia with local anesthesia is effective, safe and economical. To evaluate the utility of ambulatory surgery with local anesthesia in patients with inguinal hernia. Material and methods: A descriptive serial cases type study was performed between April 1996 and March 1999, at the Clinica Fiori surgery division. We intervened 1,167 patients with abdominal wall pathology, 432 of them were intervened for inguinal herniary pathology, 372 of them with local anesthesia who were included in the study. The surgical techniques used were Bassini and McVay, with an average operative time of 30 minutes, and 3 days post surgery control. Results: 72.9 % of herniary patology was observed among 31-70 years old patients. Only 2.6 % (10 patients) presented post-operative complications, 6 patients with relapse of Inguinal hernia, 2 with infection of operatorie wound, 1 with seroma and 1 with hematoma, none resulted being of graveness, and 97.4 % (362) didn´t present any type of complications. There were not anesthetic accidents. Conclusion: The surgical treatment of inguinal hernia with local anesthesia is effective, safe and economical. (Rev Med Hered 2003; 14: 158-162). KEY WORDS: .

Frecuencia de diagnósticos de la especialidad de otorrinolaringología en el consultorio de medicina general en un centro de salud

Objetivos: Determinar la frecuencia de los diagnósticos por especialidad en consulta externa de medicina general y describir los diagnósticos más frecuentemente realizados dentro de la especialidad de otorrinolaringología. Material y Métodos: Estudio descriptivo transversal. Se determinó la frecuencia de diagnósticos por especialidad y dentro de la especialidad de otorrinolaringología realizados en un consultorio de medicina general entre los meses de junio y setiembre del 2002. Los diagnósticos fueron consignados según la codificación internacional (CIE-10). Resultados: Durante este período se realizaron 2,116 consultas con 2,499 diagnósticos. La edad promedio fue 29.85 + 17.11 años. 852 consultas (40%) se realizaron en varones y 1,264 (60%) en mujeres. Del total de diagnósticos realizados, 1,226 (49%) correspondieron a afecciones otorrinolaringológicas, 219 (8.8%) a problemas gastrointestinales, 189 (7.6%) a problemas neumológicos, 170 (6.8%) reumatológicos y 163 (6.5%) infecciones generales. Los diagnósticos dentro de la especialidad de otorrinolaringología fueron en orden de frecuencia 405 (33%) casos de rinofaringitis aguda, 361 (29.4%) de faringitis aguda y 358 (29.2%) de amigdalitis aguda. Conclusiones: Las afecciones otorrinolaringológicas correspondieron a la primera causa de consulta para el médico general en un centro de salud de la Sanidad de la Fuerza Aérea del Perú. Esto puede ser extrapolado a los demás centros de salud. Es por ello que la formación médica debería estar más orientada a este tipo de patología. : Determinar la frecuencia de los diagnósticos por especialidad en consulta externa de medicina general y describir los diagnósticos más frecuentemente realizados dentro de la especialidad de otorrinolaringología. Material y Métodos: Estudio descriptivo transversal. Se determinó la frecuencia de diagnósticos por especialidad y dentro de la especialidad de otorrinolaringología realizados en un consultorio de medicina general entre los meses de junio y setiembre del 2002. Los diagnósticos fueron consignados según la codificación internacional (CIE-10). Resultados: Durante este período se realizaron 2,116 consultas con 2,499 diagnósticos. La edad promedio fue 29.85 + 17.11 años. 852 consultas (40%) se realizaron en varones y 1,264 (60%) en mujeres. Del total de diagnósticos realizados, 1,226 (49%) correspondieron a afecciones otorrinolaringológicas, 219 (8.8%) a problemas gastrointestinales, 189 (7.6%) a problemas neumológicos, 170 (6.8%) reumatológicos y 163 (6.5%) infecciones generales. Los diagnósticos dentro de la especialidad de otorrinolaringología fueron en orden de frecuencia 405 (33%) casos de rinofaringitis aguda, 361 (29.4%) de faringitis aguda y 358 (29.2%) de amigdalitis aguda. Conclusiones: Las afecciones otorrinolaringológicas correspondieron a la primera causa de consulta para el médico general en un centro de salud de la Sanidad de la Fuerza Aérea del Perú. Esto puede ser extrapolado a los demás centros de salud. Es por ello que la formación médica debería estar más orientada a este tipo de patología. (Rev Med Hered 2003; 14: 163-166).

Objective: To determinate the frequency of diagnostics by specialty in outpatients in general practice and to describe the more frequent diagnostics in otolaryngology. Material and Methods: Descriptive, transversal study. The frequency of diagnostics by specialty and in otolaryngology at general practitioner´s consulting room was determined between June and September 2002. The diagnostics were consigned by the international codification (ICE-10). Results: 2,116 consultations with 2,499 diagnostics were performed in this period. The age average was 29.85 + 17.11 years. 852 consultations (40%) were performed in male and 1,264 in female. Of the total of diagnosis, 1,226 (49%) were of otolaryngology, 219 (8.8%) of gastroenterology, 189 (7.6%) of neumology, 170 (6.8%) of reumatology and 163 (6.5%) of general infectious diseases. In otolaryngology problems, the frequency of diagnosis were 405 (33%) cases of acute rinofaringitis, 361(29.4%) acute faringitis and 358 (29.2%) acute tonsilitis. Conclusions: Otolaryngology diseases are the first cause of consultation for general practitioners in a periferical health center of the Fuerza Aerea del Perú medical service. This can be extrapolated to the other periferical health centers. Because of that the training of the general practitioners should be more oriented towards this kind of diseases.(: To determinate the frequency of diagnostics by specialty in outpatients in general practice and to describe the more frequent diagnostics in otolaryngology. Material and Methods: Descriptive, transversal study. The frequency of diagnostics by specialty and in otolaryngology at general practitioner´s consulting room was determined between June and September 2002. The diagnostics were consigned by the international codification (ICE-10). Results: 2,116 consultations with 2,499 diagnostics were performed in this period. The age average was 29.85 + 17.11 years. 852 consultations (40%) were performed in male and 1,264 in female. Of the total of diagnosis, 1,226 (49%) were of otolaryngology, 219 (8.8%) of gastroenterology, 189 (7.6%) of neumology, 170 (6.8%) of reumatology and 163 (6.5%) of general infectious diseases. In otolaryngology problems, the frequency of diagnosis were 405 (33%) cases of acute rinofaringitis, 361(29.4%) acute faringitis and 358 (29.2%) acute tonsilitis. Conclusions: Otolaryngology diseases are the first cause of consultation for general practitioners in a periferical health center of the Fuerza Aerea del Perú medical service. This can be extrapolated to the other periferical health centers. Because of that the training of the general practitioners should be more oriented towards this kind of diseases.(Rev Med Hered 2003; 14: 163-166).

Prevalencia de hemoptisis luego de la cura bacteriológica en pacientes dados de alta del Programa de Control de Tuberculosis del Hospital Nacional Cayetano Heredia

La tuberculosis produce alteraciones estructurales y de función pulmonar que persisten pese a la cura bacteriológica (secuelas). La hemoptisis es frecuente y causa gran morbilidad y demanda a los servicios de salud. Objetivo: Con el propósito de conocer sus características epidemiológicas y sus factores de riesgo, se diseñó un estudio descriptivo, analítico, con metodología de cohorte única de casos en el Programa de Control de Tuberculosis (PCT), en el Hospital Nacional Cayetano Heredia (HNCH) entre enero de 1984 y diciembre de 1996. Material y Método : Se programó visitas domiciliarias evaluando 109. Se realizó una prueba de baciloscopía en los pacientes sintomáticos. Resultados: Hemoptisis estuvo presente en 15 casos (13.76%), de los cuales 7 experimentaron recaída bacteriológica. Todos los casos tuvieron baciloscopía negativa al momento de la encuesta. Se encontró mayor frecuencia en varones (p = 0.0017 RR = 10.61) y en el grupo etáreo < 28 años (p = 0.022 RR = 2.92). Se tuvo mayor incidencia en el primer y cuarto año luego del alta. Doce casos (80%) aparecieron en los primeros tres años. Ningún factor previo al diagnóstico se asoció con hemoptisis luego del alta. Esputo hemoptoico en el cuadro inicial de tuberculosis se asoció con la presencia de hemoptisis luego del alta (p = 0.036 RR = 2.75). Hemoptisis fue estadísticamente más frecuente en pacientes que persisten sintomáticos luego del alta (tos y expectoración crónicas y ataques de sibilancias y disnea). Se observó una fuerte asociación entre recaída bacteriológica y presencia de hemoptisis luego del alta (p < 0.0001 RR = 7.8). Conclusiones: En pacientes dados de alta del PCT del HNCH, la prevalencia de hemoptisis es 13.76%, teniendo más riesgo los varones, el grupo etáreo menor de 28 años, los pacientes que presentan esputo hemoptoico en el cuadro inicial de tuberculosis, los que permanecen sintomáticos luego del alta y los que experimentan al menos un episodio de recaída bacteriológica.

Tuberculosis causes pulmonary structural and functional disorders, persisting even after bacterological cure (sequelaes). Hemoptysis is frequent and causes great morbidity and increase health services demand. Objective: To know the epidemiological characteristics and risk factors, a descriptive, analytic study was carried out with unique cohort method of patients from Tuberculosis Control Programme (PCT) of the Hospital Nacional Cayetano Heredia (HNCH) between january 1984 and december 1996. Home visits were programmed. Material and Method: We evaluated 109 patients. A baciloscopy assay was done for symptomatic patients. Results: Hemoptysis was found in 15 cases (13.76%), 7 of them had bacteriological relapse. Baciloscopy was negative in all of cases. Hemoptysis was more frequent in males (p = 0.0017. RR = 10.61) and in the group of < 28 years (p = 0.022 RR = 2.92). The incidence was major in the first and fourth years after treatment finish. None of the factors potencially cause of lung disease previous to tuberculosis diagnostic show assotiation with hemoptysis. Twelve cases (80%) appeared in 3 years after treatment finish. Bloody sputum in the first tuberculosis episode show assotiation with the presence of hemoptysis after PCT discharge (p = 0.036 RR = 2.75). Hemoptysis was more frequent in patients who persist sypmtomatic after treatment finish. A relevant result was the finding of the important assotiation between hemoptysis and bacteriological relapse after the treatment finish (p < 0.0001 RR = 7.8). Conclusion: In patients discharged from PCT of HNCH, the hemoptysis prevalence is 13.76% and the risk is increased in males, age minor than 28 years, patients with bloody sputum in the first tuberculosis episode, patients who persist symptomatic after discharge and patients who have bacteriological relapse.

Nivel de satisfacción general y análisis de la relación médico paciente de los médicos en entrenamiento en las salas de hospitalización de medicina interna

Objetivo: Revisar la relación médico paciente y conocer el nivel de satisfacción general de los pacientes hospitalizados con respecto a los médicos. Pacientes y métodos: Estudio descriptivo transversal. Se encuestó a 64 pacientes hospitalizados en las salas de medicina interna del Hospital Nacional Arzobispo Loayza en marzo de 2003. Se valoraron los niveles de satisfacción general de los pacientes con respecto a los médicos y su comportamiento. Se consignaron las variables clínicas y demográficas: edad, sexo, nivel educativo, nivel socioeconómico, empleo, estancia hospitalaria, tiempo de enfermedad mayor a un año, número de hospitalizaciones previas en los últimos 5 años, médico en entrenamiento identificado como su médico encargado y número de pacientes a su cargo. Resultados: La edad de los pacientes en promedio fue de 42 años, 56% fueron mujeres, 34% con educación primaria, 67% en el nivel socioeconómico E, 88% veía al interno como el médico en formación más próximo a él. El nivel de satisfacción general fue 82.8%, con niveles de satisfacción menores para las habilidades de comunicación con el paciente 73%, el ejercicio de la autonomía 31%, la consideración de la perspectiva del paciente y sus valores 21% y los aspectos psicosociales 18%. Conclusión: El nivel de satisfacción general es similar al evaluado en otros países, siendo necesario reforzar en los médicos en entrenamiento: las habilidades de la comunicación, el ejercicio de la autonomía de los pacientes, la valoración de la perspectiva del paciente y los aspectos psicosociales. (Rev Med Hered 2003;14: 175-180).

Objective: To review the doctor-patient relationship and the patients level of general satisfaction by their physicians with medical care provided. Patients and methods: Cross-sectional descriptive study. We interviewed 64 patients hospitalized in the internal medicine wards of the Hospital Nacional Arzobispo Loayza in March of 2003. The level of general satisfaction of the patients with respect to the doctors behaviour was recorded. The clinical and demographic variables were: Age, sex, level of education, socioeconomic status, employment, duration of hospital stay, period of illness greater than a year, number of previous hospitalizations in the last 5 years, doctor in training identified as responsible for the patient and the number of patients he/she was assigned to. Results: The average age of the patients was of 42 years, 56% women, 34% completed primary education, 67% in the E socioeconomic status and, 88% viewed the intern as being their principal caregiver. The level of general satisfaction was 82.8%, with lower levels of satisfaction for the abilities of communication with the patient (73%), the respect for the patients autonomy (31%), the ability to consider the patients values and perspective (21%) and psychosocial aspects (18%). Conclusion: The level of general satisfaction is similar to that found in other countries, revealing the necessity of reinforcing: communication skills, respect for the perspective values and the autonomy of patients, and psychosocial aspects in the medical curriculum: To review the doctor-patient relationship and the patients level of general satisfaction by their physicians with medical care provided. Patients and methods: Cross-sectional descriptive study. We interviewed 64 patients hospitalized in the internal medicine wards of the Hospital Nacional Arzobispo Loayza in March of 2003. The level of general satisfaction of the patients with respect to the doctors behaviour was recorded. The clinical and demographic variables were: Age, sex, level of education, socioeconomic status, employment, duration of hospital stay, period of illness greater than a year, number of previous hospitalizations in the last 5 years, doctor in training identified as responsible for the patient and the number of patients he/she was assigned to. Results: The average age of the patients was of 42 years, 56% women, 34% completed primary education, 67% in the E socioeconomic status and, 88% viewed the intern as being their principal caregiver. The level of general satisfaction was 82.8%, with lower levels of satisfaction for the abilities of communication with the patient (73%), the respect for the patients autonomy (31%), the ability to consider the patients values and perspective (21%) and psychosocial aspects (18%). Conclusion: The level of general satisfaction is similar to that found in other countries, revealing the necessity of reinforcing: communication skills, respect for the perspective values and the autonomy of patients, and psychosocial aspects in the medical curriculum. (Rev Med Hered 2003; 14: 175-180 ).

**Susceptibilidad antimicrobiana de Staphylococcus aureus sensible, con sensibilidad "BORDERLINE" y resistentes a la meticilina**

Objetivo: Determinar las susceptibilidad a diversos antibacterianos de tres categorías de S. aureus según su sensibilidad a la meticilina. Materiales y Métodos: Se aislaron 76 cepas de S. aureus que colonizaban pacientes y personal de salud de tres servicios del Hospital Honorio Delgado de Arequipa, de los cuales 36 fueron sensibles a meticilina (MSSA), 15 con susceptibilidad "borderline" (BORSA) y 25 fueron resistentes a la meticilina (MRSA). Se les sometió a antibiograma a 14 antibacterianos. Resultados: El único antibiótico al cual todas los aislamientos fueron sensibles fue vancomicina. Los MRSA fueron resistentes a todos los b-lactámicos excepto imipenem que obtuvo 64% de susceptibilidad. Los BORSA mantuvieron un 80% de sensibilidad a cefalotina y un 100% al imipenem. Los antibióticos cefalotina, imipenem, ciprofloxacina, cotrimoxazol, rifampicina, eritromicina, tetraciclina, cloranfenicol, lincomicina y gentamicina tuvieron sensibilidades variables (p<0.01) entre las tres categorías; una mayor proporción de MSSA fue sensible a estos antibióticos, luego los BORSA y finalmente los MRSA. Las cepas multi-resistentes fueron mucho más frecuentes en los MRSA que en los otros dos grupos (p <0.01). Conclusión: Existe en nuestro medio cepas de S. aureus con resistencia "borderline" a meticilina. Hay diferencias entre la sensibilidad a diversos antimicrobianos entre los tres grupos de S. aureus. Esta diferenciación podría beneficiar una terapia antimicrobiana más racional. Se debe aplicar en todo aislamiento de S. aureus las recomendaciones internacionales para la detección de meticilino resistencia.

Objective: To determine the susceptibility to different antibacterials of three categories of S. aureus according to its susceptibility to methicillin. Methods: 76 S. aureus strains that colonized patients and health workers were isolated from three Departments at Hospital Honorio Delgado in Arequipa, 36 of which were susceptible to methicillin (MSSA), 15 had borderline susceptibility (BORSA) and 25 where resistant to methicillin (MRSA). They underwent antibiogram for 14 antibacterials. Results: The only antibiotic to which all isolates were susceptible was vancomycin. MRSA were resistant to all betalactamics except imipenem that obtained 64% susceptibility. BORSA keep an 80% susceptibility to cephalotin and 100% to imipenem. The antibiotics cephalotin, imipenem, ciprofloxacine, cotrimoxazole, rifampicine, erithromycin, tetracycline, cloramphenicol, lincomycin and gentamycin had variable susceptibilities (p<0.01) among the three categories, a bigger proportion of MSSA were susceptible to these antibiotics, less for BORSA and lesser for MSSA. The multiresistant strains were more frequent in MRSA that in the other groups (p < 0.01). Conclusions: There are S. aureus strains in our environment with borderline susceptibility to methicillin. There are differences in the susceptibility to any antibacterials among the three groups of S. aureus; this differences can lead to a more rational antibacterial therapy. We should apply international recommendations for methicillin resistance detection in every strain isolation. : To determine the susceptibility to different antibacterials of three categories of S. aureus according to its susceptibility to methicillin. Methods: 76 S. aureus strains that colonized patients and health workers were isolated from three Departments at Hospital Honorio Delgado in Arequipa, 36 of which were susceptible to methicillin (MSSA), 15 had borderline susceptibility (BORSA) and 25 where resistant to methicillin (MRSA). They underwent antibiogram for 14 antibacterials. Results: The only antibiotic to which all isolates were susceptible was vancomycin. MRSA were resistant to all betalactamics except imipenem that obtained 64% susceptibility. BORSA keep an 80% susceptibility to cephalotin and 100% to imipenem. The antibiotics cephalotin, imipenem, ciprofloxacine, cotrimoxazole, rifampicine, erithromycin, tetracycline, cloramphenicol, lincomycin and gentamycin had variable susceptibilities (p<0.01) among the three categories, a bigger proportion of MSSA were susceptible to these antibiotics, less for BORSA and lesser for MSSA. The multiresistant strains were more frequent in MRSA that in the other groups (p < 0.01). Conclusions: There are S. aureus strains in our environment with borderline susceptibility to methicillin. There are differences in the susceptibility to any antibacterials among the three groups of S. aureus; this differences can lead to a more rational antibacterial therapy. We should apply international recommendations for methicillin resistance detection in every strain isolation.

Conocimientos sobre incontinencia urinaria en pacientes hospitalizados

Objetivo: Determinar el nivel de conocimientos sobre incontinencia urinaria (IU) en pacientes hospitalizados. Material y métodos: Estudio transversal, descriptivo; se entrevistó una muestra por saturación de 325 pacientes hospitalizados de 30 años a más del Hospital Nacional Cayetano Heredia (HNCH), Lima - Perú, utilizando un cuestionario de conocimientos sobre incontinencia, considerándose como adecuado conocimiento cuando había más de 50% de aciertos en él. Resultados: Solamente 35.7% tuvieron conocimiento adecuado sobre IU. Hasta 90% conocía acerca del éxito del tratamiento y posibilidad de curación de los pacientes incontinentes. Sin embargo, 75% consideraron erróneamente que la IU era consecuencia inevitable del envejecimiento, mientras menos de 50% de pacientes conocía el papel de ciertos medicamentos y ejercicios en la IU. Conclusiones: Se demostró un pobre conocimiento general sobre la IU, siendo necesaria una intervención de los profesionales de la salud en la educación de la población, sobre todo hospitalizada y con factores predisponentes para desarrollar IU, para así poder modificar las ideas erróneas que existen sobre el tema. (Rev Med Hered 2003; 14: 186-194).

Objective: To find out knowledge about urinary incontinence (IU) in hospitalized patients. Material and Methods: A cross sectional, descriptive study; a saturation sample of 325 hospitalized patients 30 years old or more at Hospital Nacional Cayetano Heredia (HNCH), Lima - Peru, was used. A knowledge questionnaire about incontinence was used, considering appropriate knowledge when more than 50% of correct answers were given. Results: Only 35.7% had an appropriate knowledge about IU. Up to 90% were aware of treatment effectiveness and of cure possibility of the incontinence patients. Nevertheless, 75% erroneously believed that UI was due to aging, while less than 50% of the patients knew the role of certain medicines and physical therapy in IU. Conclusions: There is a poor knowledge about IU, and it is necessary an intervention of health professionals in the education of people, specially in persons hospitalized with predisposing factors for developing IU, in order to be able to modify wrong ideas about the subject. (Rev Med Hered 2003; 14: 186-194).

Estafilococo Meticilino resistente, un problema actual en la emergencia de resistencia entre los Gram positivos

Las lesiones de tronco de coronaria izquierda: ¿cirugía o intervencionismo?

In recent years there has been some improvement in surgical and interventional techniques that have modified the classical indications making them more risky. Left main coronary stenoses are even more dreadful lesions, and the results of percutaneous management are odd with varying mortality (10-12% on average), and high morbidity. Moreover we have small number of cases in the literature. Comparing these results with surgery, we find the later to be safer with mortality under 4%, low morbidity and a long term experience in the management of this pathology. Results, moreover, tend to favor surgery in the coronary restenosis in spite of the use of stents. ( Rev Med Hered 2003; 14: 204-206).

Caso clínico en el Hospital Nacional Arzobispo Loayza

Daniel Carrión: mito y realidad

**Bacteremia por Staphylococcus epidermidis y abceso de partes blandas en un paciente post-operado: reporte de un caso**

We report a case of an 11 year old male who presented with bacteremia by S. epidermidis and soft tissue abscesses after a bone autograft procedure. The patient received only medical treatment, resolving the abscesses successfully. We also did a review of the literature on S. epidermidis bacteremia, an entity which has acquired increasing importance in the etiology of hospital infections. (Rev Med Hered 2003; 14:221-223).

Lematización para palabras médicas complejas: implementación de un algoritmo en LISP

The automated retrieval of files depends critically on the ability to generate precise signs concepts. Stemming is a technique very useful but medical terms are very complex terms which need special attention. Our main was to develop a modular algorithm for complex medical terms in order to follow a new space of research on Information retrieval. The algorithm was developed using LISP, a programming language, and exhaustive controlled list of rules. As a result, we found good precision with less recall when we asked for concepts saving signs concepts for each medical term.

Obtención de ácido desoxirribonucleico (ADN) útil para análisis genético, a partir de uñas recortadas

Obtaining deoxyribonucleic acid (DNA) is the starting point for most genetic analysis. Nails are an accessible source of DNA. The present communication reports the successful extraction of genomic DNA from fresh nails, as well as from nails collected a month before the extraction. Amplification in two different regions of the human beta-globin gene was achieved by of the polymerase chain reaction. The described method, is a simple, non invasive method. Nail clipping material may be considered a convenient material for genetic analysis.