[Leprosy and severe neuropathy in two native Spaniards]. / Lepra y neuropatía grave en dos nativos españoles.

INTRODUCTION: Leprosy is a widespread infectious disease in humans that is endemic to regions with poor sanitary conditions, especially in cases of overcrowding, malnutrition and bad hygiene. The disease is characterised by dermopathy, which is quite typical, but above all by neuropathy, which often becomes the most important element. In most cases, alterations to nerves are defined by sensory deficits that are predominantly distal and multiple neuritis in areas where nerve entrapment has taken place. CASE REPORTS: Two patients, both native Spaniards, presented largely overlapping clinical pictures, that is, a history of 'glove and stocking' type paresthesias and dysesthesias going back months or even years and functional impotence, which gave rise to a very pronounced gait disorder. In the two cases, the immunological situation was determined to be borderline lepromatous leprosy. The neurophysiological study revealed the presence of severe, diffuse sensory-motor axonal polyneuropathy that was predominantly distal, and several entrapped nerves. The dermatological illness was greatly improved by the treatment. The same was partially true, although to a satisfactory extent, of the neurological disease. CONCLUSION: We describe the cases of two Spaniards with borderline lepromatous leprosy with no past history of the disease, in whom neuropathy was the predominant symptom. We highlight the speed with which the neuropathies progressed, probably due to a change in 'polarity', and the severity of the neurological deficits in comparison with the dermopathy, in an unusual immunological situation. The growing number of native patients in the first world, even when there is no relevant history, suggests that we should not think of leprosy as something only occurring in immigrant patients from places where it is endemic, although the epidemiological relationship has still not been determined.

[Wilms tumor in adults. Case description]. / Tumor de Wilms del adulto. Descripción de un caso clínico.

OBJECTIVE: To report a case of adult Wilms' tumor, a kidney tumor that is more common in children and has a scanty incidence in adults. METHODS/RESULTS: A case of Wilms' tumor in a young male, aged 16 years, is described. The patient underwent partial surgical resection initially and nephrectomy due to tumor recurrence, with postoperative chemotherapy and radiotherapy. CONCLUSIONS: Although approximately 200 cases of adult Wilms' tumor have been reported in the literature, few meet currently accepted diagnostic criteria. The diagnosis of adult Wilms' tumor based on the findings of currently available diagnostic methods is only presumptive until the surgical specimen is analyzed. Most cases are treated as renal tumor and it is the findings of the pathological analysis that defines its nature and the need for chemotherapy and/or radiotherapy, as well as long-term follow-up. The application of therapeutic protocols for children to adults has not obtained the same percentage of cure or prognosis, although a large multicenter study is warranted to confirm the foregoing.

[An experimental study of the efficacy of politetrafluoroethylene grafts in tracheal surgery]. / Estudio experimental de la eficacia de injertos de politetrafluoroetileno en cirugía traqueal.

We studied the efficacy of polytetrafluoroethylene (PTFE) grafts in the surgical correction of extensive tracheal defects in rabbits. Results showed anastomotic stenosis in 100% of the animals after primary reconstruction when a total of six complete rings were resected. We did not appreciate tracheal stenosis in no animal when we applied a PTFE prosthesis placed around the anastomotic site. Results were not satisfactory upon repairing partial tracheal defect by means of a spindle of PTFE prosthesis. We concluded that the external tutor is useful for the surgical correction of the tracheal stenosis induced after resection of six rings in the cervical tracheal of the animal.