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TITLE: Encefalopatia por contraste tras cateterismo cardiaco.

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The treatment of cardiovascular disease has considerably evolved over the past 20 years, resulting in a reduction in cardiovascular mortality among the general population. Such improvement in patient outcome may be partly attributed to interventional cardiology procedures. However, these encouraging results are not uniformly observed in men and women and the rate of cardiovascular mortality in female patients remains unchanged. A number of studies have shown a poorer outcome in women with coronary artery disease undergoing percutaneous coronary intervention. Several reasons may explain the difference in post-PCI outcome between men and women. More advanced age and higher percentage of diabetics are documented clinical factors. Other angiographic factors such as vessel size, smaller in the female population, may also account for such a difference. Finally, the occurrence of vascular complications is one of the reasons affecting the outcome of female patients. The radial vascular approach contributes to the reduction in the incidence of complications which may compromise survival. This vascular route may be more complex in the female population because of the size of the radial artery which is smaller than in men. Nevertheless, the transradial approach is very safe and efficient in experienced hands and it is probably one of the techniques which may help close the prognosis gap between men and women undergoing PCI.

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The Aigües de Barcelona Laboratory has been working on odour and taste research in water for 15 years. During the entire period its basic tool has been the FPA (Flavour Profile Analysis) standard method, used by a group of trained tasters. This paper reports the main activities of the panel in recent years, such as the recruitment and training of panellists, the wheel of descriptors used, the Aesthetic Quality Index (AQI) developed for the quality control of water supplies, various research studies, and taste and odour episodes in which it has helped.

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A 37 year-old woman presented with type D2 familial dysplastic nevus syndrome with melanoma. A melanoma was excised of her back and more than one hundred pigmented lesions, four of which presented histologic characteristics of dysplastic nevus were observed. Several relatives of her presented multiple nevi and a sister of her mother and a brother of the patient had been diagnosed of melanoma. It is well established that such kind of nevi are precursor for melanomas, particularly familial forms. The clinical identification of such lesions is very simple and facilitates the diagnosis and early treatment of melanoma.

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We report 2 cases of congenital porokeratotic eccrine nevus in a 5-year-old girl and a 7-year-old boy. The clinical manifestations were those of nevus comedonicus palmaris. The histologic picture consisted of comedo-like dilatations and cornoid lamellae involving the eccrine ostia and ducts. One of the cases showed anomalies in the dermal eccrine ducts. We believe that these lesions are eccrine hamartomas unrelated to porokeratosis. We review similar cases from the literature and discuss the differential diagnosis.

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Ultrastructural findings in 2 cases of actinic granuloma are presented. The changes observed at the periphery of the lesion and in the elastic fibers, with early stage of damage, were similar to those described in actinic elastosis. Later, an histiocytic reaction which was apparently directed against damaged elastic fibers was observed. The ultrastructure confirms the light-microscopic findings, but does not clarify the etiology of the lesion or its relation to granuloma annulare.

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We compared the incidence and morphologic appearance of eosinophilic globules in Spitz's nevi, malignant melanoma and compound nevi. Eosinophilic globules were frequently found in Spitz's nevi, specially in those with junctional or compound features. An statistical significant increase of eosinophilic globules was found in Spitz's nevi when compared with malignant melanoma. Eosinophilic globules are not an reliable criteria for a diagnosis of a bening lesion. The use of multiple histologic parameters for differential diagnosis is necessary.

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2 cases of malignant hidroacanthoma simplex are reported. Prominent ultrastructural findings were sparse tonofilaments and villous-like, interdigitating cytoplasmic processes connected by small desmosomes. Positive intracytoplasmic stain for carcinoembryonic antigen was found in 1 case. Benign and malignant eccrine poromas and hidroacanthoma simplex appear to be related neoplasms on the basis of ultrastructural and immunohistochemical findings.

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Three cases of actinic granuloma which presented anular lesions with central atrophy in the frontotemporal region are reviewed. Microscopy changes showed the center of the lesion devoid of elastic fibers, an inflammatory reaction at the edge of the lesion and normal elastic fibers in the surrounding area. We discuss the differential diagnosis with granuloma annulare and the possible etiological role of previous actinic damage.

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