[Thoracic and retroperitoneal dissemination of multiple myeloma. 2 cases]. / Diseminación torácica y retroperitoneal del mieloma múltiple. Dos observaciones.

The dissemination of multiple myeloma out of the bone marrow is very rare, even though the observation of plasmacytosis in the bodies of patients having died of this disease is not rare. We present 2 patients affected by multiple myeloma and with extra-bone marrow plasmacytomas at the diagnosis, localized at posterior mediastinum and retroperitoneum, discovered by tomography.

[Evaluation of a combination of a diuretic and nifedipine retard for the treatment of hypertensive patients refractory to nifedipine retard]. / Evaluación de la asociación de un diurético a nifedipina retard como terapia en pacientes hipertensos refractarios a nifedipina retard.

This study assessed the effectivity of the association between a diuretic, chlorthalidone, and retard nifedipine in the treatment of patients above 50 years of age with Arterial Hypertension refractory to retard nifedipine. A prospective study of a 3-month controlled intervention was designed, in which the patients were treated with retard nifedipine for 2 months and, if they did not respond to the treatment, chlorthalidone was associated for 1 month. Out of 235 patients selected at the beginning of the study, 28 dropped out voluntarily, 24 were excluded because they did not adhere to the protocol and 30 dropped out due to side effects. After the first two months of therapy, hypertension was controlled in 60.2% of the 181 patients, whereas in the third month, only in 20% of the 44 patients considered could be controlled. Significant differences were observed between the two treatments (p < 0.001) with a 95% CI in the percentage differences of 54% versus 26.4%. These results suggest that the association of chlorthalidone and retard nifedipine does not improve the treatment of Arterial Hypertension refractory to retard nifedipine.