Pericardial tamponade as initial presentation of papillary thyroid carcinoma.

We herein describe a 19-year-old woman who presented with pericardial effusion that resulted in heart tamponade. The clinicopathological study revealed papillary carcinoma of the thyroid metastasized to the heart. Although malignant pericardial effusion is a known complication of thyroid cancer, it is rarely the first manifestation and shows a relatively favourable prognosis despite widespread metastases if adequate treatment is given.

[Advantages and drawbacks of current pharmacological treatments for smoking cessation]. / Tratamiento farmacológico en la deshabituación tabáquica. Ventajas e inconvenientes de los tratamientos actuales.

There are currently three families of drugs that are commonly used in the clinic to help smokers to stop; nicotine replacement therapy, bupropion and varenicline. Summary knowledge of the specific efficacy and contraindications of each of them can be useful before prescribing them to our patients.

Antihypertensive monotherapy and stress-induced changes in physiological activity.

The effects of two types of laboratory stressors, a structured interview and the cold pressor test, on blood pressure (BP) and heart rate (HR) were studied in normotensive individuals (n = 16), unmedicated hypertensive patients (n = 12), and medicated hypertensive patients (n = 46). Fifteen patients were in the bisoprolol group, 16 patients were in the enalapril group, and 15 patients were in the nitrendipine group. Concurrent physiologic measures, finger pulse volume (FPV), electrodermal activity, and respiratory frequency (RF), were also used to evaluate the level of stress reached by the subjects during and after the tasks. No significant differences were evident between the different treatments in BP and other physiologic responses to stressors. Patients receiving bisoprolol maintained lower HR and systolic BP values, but these differences were not related to the reaction to the stressors. No significant differences were noted in diastolic BP (DBP) between the different groups. The highest physiologic responses were obtained during the structured interview. Antihypertensive monotherapy does not attenuate cardiovascular reactions induced by acute stress in controlled laboratory conditions. In laboratory studies of the relationships between stress and hypertension, it is important that social stressors be used and that physiologic rather than cardiovascular measures of stress be recorded.

Primary renal lymphoma: report of 3 cases and review of the literature.

Primary renal lymphoma is a controversial entity. Only 29 cases have been reported since 1980. Diagnostic criteria are not well established. We report here 3 new cases and review the literature. Primary renal lymphoma was considered on the basis of uni- or bilateral nonobstructive nephromegaly with or without renal failure. In all cases, the diagnosis was made after renal biopsy. Extrarenal abdominal involvement was excluded by imaging techniques. The role of staging laparotomy remains controversial. Chemotherapy is the treatment of choice, but the prognosis is poor. We propose a clinical definition of primary renal lymphoma in order to achieve a better management of the disease.