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La hemorragia postoperatoria es la complicación más estudiada y temida de la adenoidectomía,debido a que ésta se realiza en una región anatómica pequeña y muy vascularizada. Se desconocelas consecuencias de esta complicación en nuestro país, lo que motivó la realización del presenteestudio.Se realizó un estudio descriptivo retrospectivo para determinar la incidencia de hemorragiapostoperatoria, a través de la revisión de las fichas clínicas de todos los pacientesadenoidectomizados en la cátedra de Otorrinolaringología del Hospital de Clínicas desde enero de2003 a agosto de 2006. Se estudiaron los datos demográficos, la hemorragia postoperatoria consus características y manejo, además de otras complicaciones menores. Durante el periodoestudiado fueron intervenidos 508 pacientes, con una edad promedio de 6,4 ± 2,7 años ycorrespondiendo el 56,9% al sexo masculino. El 3,15% (n=16/508) de los pacientes presentóhemorragia en las primeras 24 horas del postoperatorio, de los cuales 4 (0,8%) fueron a unarevisión quirúrgica y en 1 paciente (0,2%) fue colocado un tapón nasofaríngeo. En ningún caso fuenecesaria una transfusión sanguínea. La incidencia de hemorragia en esta casuística fue de 3,15 %y se presentó en todos los casos en las primeras 24 horas del postoperatorio. Considerando lasdemás complicaciones, el 15 ,6 % tuvieron vómitos y el 1,4 % fiebre, razón por la cual no seríarecomendable el manejo ambulatorio de los pacientes

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We report our findings on the effects of intraplaque injection of verapamil for the treatment of Peyronie's disease. We followed 11 men with Peyronie's disease in a nonrandomized constant dose study. During our study, four men received testosterone supplementation; five received vitamin E and/or potassium aminobenzoate (potaba) concurrent with verapamil; two received injections of verapamil only. Plaque size decreased significantly in 7 of 11 patients (55%); softening occurred in 6 (55%); 4 of 8 patients (50%) had decreased curvature. Deformities and symptoms did not recur in any patients who reported improvement. Three of 11 (27%) patients failed treatment and elected to undergo surgical correction. All four (100%) of our study participants with pain had complete resolution after intraplaque verapamil injection compared with Levine et al's 91%. We have demonstrated that intraplaque verapamil injection is a promising treatment for Peyronie's disease in that it may circumvent surgical intervention and may be used with concurrent therapies.

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The efficacy and safety of clobetasol propionate 0.05% scalp application was evaluated in 378 patients with moderate to severe scalp psoriasis in a double-blind vehicle-controlled parallel group study. After 2 weeks of twice-daily applications, 81% receiving active drug versus 22% receiving vehicle had clearing of 50% or greater. Complete clearing was seen in 26% with active drug and 1% with vehicle. Local side effects were primarily burning or stinging in 11% and 10% of patients treated on an active or a vehicle regimen, respectively. The morning cortisol levels of 168 patients were checked at baseline and again after 2 weeks of drug therapy. Subnormal morning plasma cortisol values were seen in 5% of the patients receiving active drug and in 5% receiving vehicle; 13% of those taking active drug versus 5% taking vehicle had a 50% or greater decrease in morning cortisol at the 2-week visit compared with baseline values. Clobetasol propionate 0.05% scalp application appears to be a safe and an effective treatment for scalp psoriasis.

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Mometasone furoate (Elocon) is a newly formulated and unique medium-potency synthetic 17-heterocyclic corticosteroid. The efficacy and safety of the ointment and cream formulations (0.1 percent) of the corticosteroid, administered once daily, were compared with those of the ointment and cream formulations of fluocinolone acetonide 0.025 percent administered three times daily and triamcinolone acetonide 0.1 percent administered twice daily in four multicenter clinical studies. They were conducted involving psoriasis patients with chronic and moderate to severe disease. Evaluation of change in disease sign scores indicated that mometasone ointment, applied once daily, was significantly more effective (P less than 0.01) than fluocinolone ointment, applied three times daily, and triamcinolone ointment, applied twice daily. The cream formulation of mometasone was significantly more effective (p less than 0.001) than fluocinolone cream, applied three times daily, and equivalent to triamcinolone cream, applied twice daily. The incidence of local adverse experiences following treatment with the ointment or cream formulations of mometasone was minimal. Mometasone ointment and cream provide a highly effective once-a-day treatment for moderate to severe psoriasis with minimal risk of side effects.

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Warts are common among children and adolescents. Due to these patients' low pain thresholds and thinner skin, some modalities used for the treatment of warts in adults are inappropriate for younger patients. I describe my experience with a keratolytic formulation in a polyacrylic vehicle that provides an especially well-tolerated and effective therapeutic regimen for warts in children and adolescents.

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A case of renal-cell carcinoma metastatic to the thyroid eight years after the removal of the primary tumor is presented, with the aspiration cytologic and histologic findings described. This unusual presentation and the incidence and behavior of renal-cell carcinomas and tumors metastatic to the thyroid are discussed.

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A case of ITP where the spleen was infiltrated diffusely and extensively by foamy macrophages is described. Among these macrophages were also clusters of cells with the morphologic and tinctorial characteristics of ceroid or "sea-blue" histiocytes. The ultrastructural characteristics of the foamy and ceroid histiocytes are described. Transition of ceroid cells into foamy macrophages is demonstrated, and intermediate forms were observed. It is postulated that the ceroid or sea-blue histiocytes are macrophages that contain platelets at an early stage of digestion, and when the phagocytosis of these platelets is completed, the macrophages become foamy. Therefore, it is suggested that the foamy cells and ceroid or sea-blue histiocytes seen in the spleen in cases of ITP are macrophages that have ingested and metabolized the abnormal platelets.

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Tumors make up almost 25% of the causes of cutis verticis gyrata. An underlying dermal nevus or neurofibroma is the tumor most often found. Two new cases of cutis verticis gyrata caused by an intradermal nevus cell nevus (cerebriform intradermal nevus) are presented. The importance of early diagnosis and aggressive surgical excision and plastic reconstruction in an attempt to minimize the emotional trauma of the required surgery is stressed. Cerebriform intradermal nevi are a type of large congenital nevi and should be evaluated with this in mind.

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The authors report a case of chest skeletal muscle involvement by recurrent adenocarcinoma of the breast, in which individual myofibers were invaded by breast carcinoma cells. This unusual type of skeletal muscle involvement is especially interesting because it is known that the sarcolemma of skeletal myofibers is very resistant to enzymatic, mechanical, and chemical breakage.

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Two mentally retarded siblings, one with severe segmental scleroderma and the other with atrophoderma of Pasini and Pierini, were found at the ages of 6 and 10 years to have phenylketonuria (PKU). The belief that a common pathomechanism exists between morphea and atrophoderma of Pasini and Pierini is supported by the case of the two siblings. Disorders in tryptophan metabolism can occur in both PKU and scleroderma. For a low phenylalanine diet to be effective in PKU, it has to be instituted at an early age. Phenylketonuria should be considered in infants and children with sclerodermatous skin lesions.

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A case of a Moraxella osloensis bacteremia mimicking a case of gonococcemia, complete with cutaneous manifestations, is presented. The importance of confirming all positive smears with inhibitory and noninhibitory culture media is stressed.

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In a series of 1,002 cases of primary colorectal adenocarcinomas diagnosed during a ten-year period there were 62 (6.2%) patients who had two or more primary colorectal adenocarcinomas. Most of the tumors were more than 5 cm away from each other: 27 carcinomas were separated by 6-10 cm, 16 were separated by 11-20 cm, and 12 were separated by more than 20 cm. It is concluded that the incidence of synchronous carcinomas of the colon is sufficiently high to warrant a search by both surgeon and endoscopist for additional tumors some distance from the initial lesion.

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Five cases of prostatic carcinoma invading the rectum were found on reviewing 161 prostatic carcinomas over a five-year period. A summary of the clinical and laboratory findings of these cases is given. A review of previous reports in the literature and discussion of the modality of presentation and methods of diagnosis of this entity are presented. The importance of differentiating a primary rectal carcinoma from a prostatic carcinoma involving the rectum is emphasized.

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