Asunto(s)

RESUMEN

The most common etiology of lymphedema in our environment is tumoral and, generally, it is due to treatment of the cancer itself. However, the initial presentation of prostate carcinoma as lymphedema is very rare. In fact, there aren't very few documented cases in literature. We described the case of a patient who was admitted into the hospital to be examined for lymphedema in his genitals and legs. Our patient was diagnosed of prostate carcinoma with retroperitoneal adenopathies. The best treatment in this case is block-hormonal therapy. Prognosis is very bad and the survival rate is poor within five years of diagnosis.

Asunto(s)

RESUMEN

La etiología más frecuente del linfedema en nuestro medio es la tumoral y generalmente debido al tratamiento del mismo. Sin embargo la presentación inicial del cáncer de próstata como linfedema es muy poco frecuente, habiendo muy pocos casos descritos en la literatura. Exponemos el caso de un paciente que ingresó para estudio de linfedema en región genital y en extremidades inferiores siendo diagnosticado de cáncer de próstata con adenopatías retroperitoneales. El tratamiento de elección es el bloqueo hormonal, siendo el pronóstico muy pobre y la supervivencia escasa a los cinco años del diagnóstico

The most common etiology of lymphedema in our environment is tumoral and, generally, it is due to treatment of the cancer itself. However, the initial presentation of prostate carcinoma as lymphedema is very rare. In fact, there aren’t very few documented cases in literature. We described the case of a patient who was admitted into the hospital to be examined for lymphedema in his genitals and legs. Our patient was diagnosed of prostate carcinoma with retroperitoneal adenopathies. The best treatment in this case is block-hormonal therapy. Prognosis is very bad and the survival rate is poor within five years of diagnosis

Asunto(s)

Asunto(s)

RESUMEN

No disponible

No disponible

Asunto(s)

RESUMEN

OBJECTIVES: To assess the routine indication of chest roentgenogram after thoracentesis in function of iatrogenic pneumothorax causation, following a procedure protocol. PATIENTS AND METHODS: Prospective study of 104 consecutive thoracentesis procedures performed in 76 patients. The procedure was protocolized and after each thoracentesis a chest roentgenogram was obtained within 6 hours after the procedure. The attending physician completed a questionnaire relative to patients data characteristics of the pleural effusion. RESULTS: Two pneumothorax were noted following thoracentesis (2%) which did not require pleural drainage. These pneumothorax occurred in patients with parapneumonic pleural effusions. CONCLUSIONS: The routine practice of chest roentgenogram after thoracentesis does not seem to be warranted and should be individualized. The performance of thoracentesis by physicians in training period, with procedure protocolization, minimizes the risk of pneumothorax.

Asunto(s)

RESUMEN

Objetivos. Valorar la indicación sistemática de radiografía de tórax postoracocentesis en función de la incidencia de neumotórax yatrógeno tras protocolización de la técnica. Pacientes y métodos. Estudio prospectivo de 104 toracocentesis consecutivas en 76 pacientes. Se protocolizó la técnica y tras cada toracocentesis se practicó radiografía de tórax en las 6 horas siguientes. Cada facultativo completó una recogida de los datos de cada paciente y características del derrame pleural. Resultados. Se constataron 2 neumotórax secundarios a toracocentesis (2 por ciento) que no precisaron drenaje torácico. Éstos aparecieron en pacientes con derrame pleural paraneumónico. Conclusiones. La práctica sistemática de radiografía de tórax postoracocentesis no parece justificada y ha de individualizarse. La realización de toracocentesis por médicos en formación supervisados por facultativos expertos, con protocolización de la técnica, minimiza el riesgo de neumotórax (AU)

Asunto(s)

RESUMEN

When faced with a patient with exercise-induced syncope, it is important to exclude heart disease. Nevertheless, neurally-mediated syncopes should be taken into account in the differential diagnosis and the tilt table test is essential to establish this diagnosis. We report the case of an 11-year-old boy, who presented recurrent exercise-induced fainting. The results of cardiac and neurologic tests were negative. The tilt table test with pharmacological challenge with isoproterenol infusion induced arterial hypotension and presyncope, and a diagnosis of neurally-mediated syncope was made. After initiating beta-blocker treatment, the patient has remained asymptomatic during a follow-up of 10 months.

Asunto(s)

RESUMEN

Ante un paciente con síncopes de esfuerzo es importante descartar la existencia de enfermedad cardíaca. No obstante, para establecer el diagnóstico diferencial hay que considerar la posibilidad de síncopes mediados por un mecanismo vasovagal, siendo la prueba de la mesa basculante una exploración de primer orden para establecer este diagnóstico. Se presenta el caso de un niño de 11 años que fue estudiado por síncopes recidivantes de esfuerzo. Las exploraciones cardiológicas y neurológicas resultaron negativas. La prueba de la mesa basculante con provocación farmacológica con isoproterenol resultó positiva por hipotensión arterial y presíncope, por lo que se estableció el diagnóstico de síncopes de etiología vasovagal. Tras iniciar tratamiento con bloqueadores beta el paciente ha permanecido asintomático tras un seguimiento de 10 meses (AU)

Asunto(s)

Asunto(s)

RESUMEN

No disponible

Asunto(s)

RESUMEN

No disponible

Asunto(s)

RESUMEN

OBJECTIVE: To analyze which genotypes of vitamin D receptor (VDR) are associated with the loss or maintenance of bone mass among spanish postmenopausal women. MATERIAL AND METHODS: A total of 105 women with postmenopausal osteoporosis and 51 postmenopausal women without osteoporosis (control group), diagnosed with bone densitometry (DEXA) were included in the study. The genetic locus was analyzed with RFLP by using the restriction enzyme BsmI. The obtained polymorphism was correlated with clinical, densitometric and metabolic parameters (including bone turnover markers). RESULTS: Two alleles were obtained with three bands of different size: one 580-570 bp band corresponding to allele B, and two 405-400 and 175-170 bp bands for allele b. None of the three VDR genotypes (BB, bb, Bb) was significantly associated with a higher or lower bone mass among the studied populations. Likewise, in the group of patients with osteoporosis no genotype was associated with bone mineral density (BMD) values or with bone turnover parameters analyzed. No differences were found between subgroups with non-severe (n = 58) and severe (n = 47) osteoporosis regarding the association with any of the three VDR genotypes. CONCLUSIONS: None of the VDR genotypes was associated with BMD loss or with the activity of bone turnover parameters analyzed in a group of spanish women with postmenopausal osteoporosis. None of the VDR genotypes confers a higher susceptibility to suffer from severe osteoporosis.

Asunto(s)

RESUMEN

Objetivo. Hemos analizado si alguno de los genotipos del receptor de la vitamina D (VDR) puede asociarse con la pérdida o el mantenimiento de la masa ósea en las mujeres postmenopáusicas españolas. Material y métodos. En el estudio se incluyeron 105 mujeres con osteoporosis postmenopáusica y 51 postmenopáusicas sin osteoporosis como grupo control diagnosticadas por densitometría ósea (DEXA). El locus genético se analizó por estudio de polimorfismo de restricción (RFLP) con la enzima de restricción BsmI. Se correlacionó el polimorfismo obtenido con parámetros clínicos, densitométricos y metabólicos (incluyendo marcadores de recambio óseo).Resultados. Se obtuvieron dos alelos que producían tres bandas de diferente tamaño: una de 580-570 pb correspondiente al alelo B y dos de 405-400 pb y 175-170 pb para el alelo b. Ninguno de los tres genotipos del VDR (BB, bb, Bb) se asoció de forma significativa con una mayor o menor masa ósea en las poblaciones estudiadas. Dentro del grupo con osteoporosis tampoco ningún genotipo se asoció con los valores de la densidad mineral ósea (DMO) ni con el de los parámetros de recambio óseo analizados. No hubo diferencias entre los subgrupos osteoporosis no severa (n = 58) y severa (n = 47) en cuanto a la asociación con cualquiera de los tres genotipos del VDR. Conclusiones. Ninguno de los genotipos del VDR se asoció con la pérdida de DMO ni con la actividad de los parámetros de recambio óseo estudiados en un grupo de población de mujeres españolas con osteoporosis postmenopáusica. Ninguno de los genotipos del VDR confiere mayor susceptibilidad a sufrir una osteoporosis severa (AU)

No disponible

Asunto(s)

Asunto(s)

RESUMEN

A 44 year-old man with a type I Neurofibromatosis (NFI) and an intercostal mass is presented. By means of percutaneous fine needle aspiration punction under CT control, this tumor could be diagnosed of neurofibroma. It is important to remark not only the role of helical CT with anatomical reconstruction in the diagnosis of intercostal tumors, but also that intercostal location of neurofibromas has been rarely reported in the literature. Because of frequent association between NFI and neoplasms, it is always necessary to perform histological study of every new tumor that appears in the course of this entity.

Asunto(s)

RESUMEN

In order to determine the changes in the clinico-pathological pattern of admitted patients in an internal medicine department, 240 patients/year were compared during the years 1984 and 1989. A predominant proportion of males was registered (3:2); which did not vary by the year. An increased tendency of the median age (55.78 vs 58.48 years) was also established. The medium time of admission (8.98 vs 9.5 days) and mortality rate (6.3% vs 7.1%) did not change. A high rate (greater than 50%) of cardiovascular and respiratory disease was found on analyzing the cause of admission; in 1989 infection caused by HIV was detected and admissions to optimize the treatment of patients with diabetes mellitus were observed which did not exist in 1984. A slight but surprising decrease in admissions due to acute ischemic cardiopathy and significant decrease of admissions owing to respiratory disease were also noted. The majority of the patients admitted had a baseline disease (85% in 1984 and 87.1% in 1989). The knowledge of these data and their variations in every hospital department will, undoubtedly, assist in achieving a better use of technical and human health resources.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)