COVID persistente: ¿es en realidad una encefalomielitis miálgica? Revisión bibliográfica y consideraciones / Long COVID: Is it really myalgic encephalomyelitis? Bibliographic review and considerations

Las secuelas clínicas de una enfermedad tan extendida como la COVID-19 pueden ser de gran importancia para la atención primaria por su prevalencia y la morbilidad que conllevan. La definición de COVID persistente y el establecimiento de su temporalidad son dispares pero algunos autores consideran plausible que este síndrome sea en realidad una encefalomielitis miálgica. Se observan similitudes al comparar los Criterios Internacionales de Consenso para el diagnóstico de encefalomielitis miálgica con los síntomas descritos para la COVID persistente. Se recomienda la realización de analítica sanguínea, pulsioximetría, radiografía de tórax y ecografía torácica en los pacientes con síntomas persistentes después de la infección aguda. El manejo en ambos cuadros consiste en el tratamiento de los principales síntomas. La posibilidad de que la COVID-19 pueda dar lugar a un cuadro crónico como la encefalomielitis miálgica hace imprescindible un seguimiento a largo plazo de los pacientes que han presentado esta infección (AU)

Clinical sequelae of a disease as widespread as COVID-19 can be of great importance for primary care due to their prevalence and the morbidity they entail. The definition of long COVID and the establishment of its temporality are various, but some authors consider possible that this syndrome is actually myalgic encephalomyelitis. Similarities are observed when comparing the International Consensus Criteria for the diagnosis of myalgic encephalomyelitis with the symptoms described for long COVID. Blood tests, pulse oximetry, chest radiography, and thoracic ultrasound are recommended in patients with persistent symptoms after acute infection. Management in both conditions consists of treating the main symptoms. The possibility that COVID-19 can lead to a chronic condition such as myalgic encephalomyelitis makes long-term follow-up of patients who have suffered from this infection essential (AU)

[Long COVID: Is it really myalgic encephalomyelitis? Bibliographic review and considerations]. / COVID persistente: ¿es en realidad una encefalomielitis miálgica? Revisión bibliográfica y consideraciones.

Clinical sequelae of a disease as widespread as COVID-19 can be of great importance for primary care due to their prevalence and the morbidity they entail. The definition of long COVID and the establishment of its temporality are various, but some authors consider possible that this syndrome is actually myalgic encephalomyelitis. Similarities are observed when comparing the International Consensus Criteria for the diagnosis of myalgic encephalomyelitis with the symptoms described for long COVID. Blood tests, pulse oximetry, chest radiography, and thoracic ultrasound are recommended in patients with persistent symptoms after acute infection. Management in both conditions consists of treating the main symptoms. The possibility that COVID-19 can lead to a chronic condition such as myalgic encephalomyelitis makes long-term follow-up of patients who have suffered from this infection essential.

Low-level arsenic exposure during pregnancy and its association with postpartum depression: A cohort study of women from Arica, Chile.

BACKGROUND: While the relationship between inorganic arsenic exposure and psychological impairment has been studied previously, the association between low-level arsenic exposure during pregnancy and postpartum depression has not yet been examined. The objective is to estimate the association between low-level arsenic exposure during pregnancy and the Edinburgh score. METHODS: A sample of 223 women was collected from five public health services in Arica, Chile. Participation was voluntary and written consent was mandatory. Sociodemographic data related to arsenic exposure and urine samples for total inorganic arsenic assessments were collected during the second trimester. Postpartum depression symptoms were estimated by the Edinburgh Postpartum Depression scale. We examined descriptive statistics and ran multiple linear regressions. The modifying effect of age and depression history was evaluated separately. RESULTS: The median for total urinary inorganic arsenic was 14.6µg/L (range: 2-69.2µg/L), the median for postpartum depression score was 8 points (range: 0-27 points) and 20.6% of women were considered as postpartum depressed. For women older than 25years old without depression history, the adjusted coefficient for the total urinary natural logarithm of inorganic arsenic in multiple linear regressions was -2.51 (95% CI: -4.54, -0.48; P-value=0.02). For women older than 25years old with a depression history, this value was 2.09 (95% CI: -0.90, 5.08; P-value=0.16). CONCLUSIONS: In this cohort, the number of children, physical perception, depression history, stressful maternity, and age were associated with postpartum depression score. The Edinburgh score was associated with inorganic arsenic in women older than 25years without depression history.

A rare case of a strangulated Littre's hernia with Meckel's diverticulum duplication. Case report and literature review.

INTRODUCTION: The Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract present in approximately 1-4% of the population; the MD duplication is exceedingly rare with only a few reports of it. Here we present the firs case of a strangulated Littre's hernia with MD duplication. PRESENTATION OF CASE: A 30-year-old male presented to the emergency room with clinical signs of small bowel obstruction, at physical examination, a right incarcerated inguinal hernia with erythema was found. We did a laparotomy, and two MD were found, one in the sac with ischemia, and the other 90cm from the Bahuins valve. A diverticulectomy of the ischemic diverticulum was done, and the other MD was left in place; the inguinal region was repaired with a Lichtenstein technique. DISCUSSION: The complications of the MD are 3-4 times more frequent in men, been an intestinal obstruction, hemorrhage, diverticulitis, ulceration, and perforation. A Littrés hernia is when the MD is found in the sac; this is seen in the inguinal region in 50% of the cases. The management of a Littre's hernia is the resection of the MD; it could be done by an intestinal resection or by a diverticulectomy accordingly to the Park criteria. CONCLUSION: As to our knowledge, this is the first case of an incarcerated Littre's hernia with duplication of a Meckel's diverticulum.

Uso de internet en pacientes que acuden a consulta hospitalaria de urología / Internet use in patients attending a hospital urology clinic

Hipótesis: El aumento en los conocimientos de informática de la población general y la difusión de Internet como herramienta de comunicación y conocimiento, permite a los pacientes tener un mayor entendimiento de sus patologías. Objetivo: Evaluar el uso de Internet por parte de la población de un área sanitaria y el conocimiento extraído sobre sus patologías de carácter urológico. Material y Métodos: En este estudio prospectivo se incluyeron todos los paciente mayores de edad que acudieron a consulta hospitalaria de urología entre el 1 de Septiembre y el 31 de Diciembre de 2006, en un área sanitaria de 200,000 habitantes. A todos los pacientes se les entregó un cuestionario autoadministrado para su cumplimentación, no interviniendo el facultativo en su desarrollo en ningún caso. Las variables a estudio fueron la edad (menores de 30 años, entre 30 y 60 años y mayores de 60 años), el sexo, patología del paciente (únicamente se valorarán aquellas con al menos 5 casos), el nivel educativo (ninguno, graduado escolar, estudios medios y estudios universitarios), presencia de ordenador en su casa (si/no), conocimiento de la existencia de internet (si/no), búsquedas realizadas sobre patologías urológicas e influencia de dichas consultas en su relación con el médico. Se evaluará la relación entre el uso de internet y las distintas variables mediante el test de Kruskall-Wallis. Se considerará significativa una verosimilitud de la hipótesis nula inferior a 0,05. Resultados: En total se recibieron 1.111 cuestionarios de los cuales fueron útiles para su procesamiento 1062. La edad media fue de 60,98, con un error estándar de 15,08. El 18,4 % fueron mujeres. La distribución poblacional por nivel de estudios fue: 22,2 % sin estudios, 43,5 % con graduado escolar, 27,5 con un nivel educativo medio y un 6,8 % de universitarios. El 58,4 % de los pacientes niega tener ordenador en casa, el 37,7 % desconoce lo que es internet, el 76,7 % carece de dirección de correo electrónico y únicamente el 6,7 % visitan páginas médicas pero sólo el 1,5 % reconocen haber preguntado a su médico sobre la información recibida en internet. Según la categorización por edades, los pacientes con edades inferiores a 30 años tienen significativamente unos mayores conocimientos en informática e internet (p<0,001). No obstante no se han evidenciado diferencias estadísticamente significativas entre la edad y el hecho de preguntar sobre la información recibida a través de internet (p=0,1). Las páginas web más visitadas fueron por orden de más a menos visitadas: tuotromedico.com, varicocele.com, aecc.es, wikipedia.com, prostatitis.org, ondasalud.com y mapfrecajasalud.com. Las patologías más buscadas fueron: prostatitis crónica (25 % de los pacientes afectos), cáncer de testículo (20 % de los pacientes), varicocele (18,7 %), enfermedad de Peyronie o incurvación congénita peneana (18,1 %) y estenosis de la unión pielo-uretereral (16,6 %). Conclusiones: - La explotación de internet como herramienta de información por parte de los pacientes es muy baja, debido a las características inherentes de la población, como son el bajo nivel de estudios. - Las páginas web urológicas deberían dedicar una parte amplia para la patología más frecuente en los grupos de población más jóvenes, como el varicocele o la prostatitis. No obstante, es lógico esperar que estos patrones epidemiológios se modifiquen con el paso del tiempo. - Se debería fomentar el uso de internet y de la informática en general entre los distintos grupos poblacionales en el área sanitaria a estudio

Hypothesis: The increase in the awareness of computers in the general population and the spread of Internet as a tool for communication and knowledge, allows patients to have greater understanding of their conditions. Objective: To evaluate the use of Internet by the population from a health area and the knowledge extracted about their urological conditions. Material and Methods: This prospective study included all patients of age who attended a hospital urology clinic between 1st September and 31st December 2006, in a health area of 200,000 inhabitants. All patients were given a self-administered questionnaire to complete; medical staff did not intervene in filling it out in any case. The study variables were age (under 30, between 30 and 60 and over 60), sex, patient’s pathology (only those with at least 5 cases were assessed), educational level (none, primary school qualification, intermediate studies and university studies), presence of a computer at home (yes/no), knowledge of the existence of internet (yes/no), searches performed on urological conditions and influence of these consultations in their relationship with their doctor. The relationship between the use of internet and the different variables was evaluated using the Kruskall-Wallis test. A probability of the null hypothesis less than 0.05 was considered significant. Results: A total of 1,111 questionnaires were received, of which 1,062 were useful for processing. The mean age was 60.98 with a standard error of 15.08. 18.4 % were women. The population distribution by level of studies was: 22.2 % uneducated, 43.5 % with primary education qualification, 27.5 % with intermediate educational level and 6.8 % university graduates. 58.4 % of patients denied having a computer at home, 37.7 % do not know what internet is, 76.7 % do not have an e-mail address and just 6.7 % visit medical pages, although only 1.5 % admit having asked their doctor about information received on internet. According to classification by age, patients under 30 have significantly greater knowledge of computers and internet (p<0.001). However, there were no significant differences shown between the age and the fact of asking about information received through internet (p=0.1). The most visited web pages were, in order of the most to least visited: tuotromedico.com, varicocele.com, aecc.es, wikipedia.com, prostatitis.org, ondasalud.com and mapfrecajasalud.com. The most searched for conditions were: chronic prostatitis (25 % of patients affected), testicular cancer (20 % of patients), varicocele (18.7 %), Peyronie’s disease or congenital penile curvature (18.1 %) and stenosis of the pyeloureteral junction (16.6 %). Conclusions: - The exploitation of the internet as an information tool on the part of patients is very low, due to the characteristics inherent to our population, such as the low level of studies. - Urological web pages should dedicate an extensive part to the most common conditions in the younger population groups, such as varicocele or prostatitis. However, it is logical to expect that these epidemiological patterns will modify with time. - The use of internet and computers in general should be promoted among the different population groups in the health area under study

[Internet use in patients attending a hospital urology clinic]. / Uso de internet en pacientes que acuden a consulta hospitalaria de urología.

HYPOTHESIS: The increase in the awareness of computers in the general population and the spread of Internet as a tool for communication and knowledge, allows patients to have greater understanding of their conditions. OBJECTIVE: To evaluate the use of Internet by the population from a health area and the knowledge extracted about their urological conditions. MATERIAL AND METHODS: This prospective study included all patients of age who attended a hospital urology clinic between 1st September and 31st December 2006, in a health area of 200,000 inhabitants. All patients were given a self-administered questionnaire to complete; medical staff did not intervene in filling it out in any case. The study variables were age (under 30, between 30 and 60 and over 60), sex, patient's pathology (only those with at least 5 cases were assessed), educational level (none, primary school qualification, intermediate studies and university studies), presence of a computer at home (yes/no), knowledge of the existence of internet (yes/no), searches performed on urological conditions and influence of these consultations in their relationship with their doctor. The relationship between the use of internet and the different variables was evaluated using the Kruskall-Wallis test. A probability of the null hypothesis less than 0.05 was considered significant. RESULTS: A total of 1,111 questionnaires were received, of which 1,062 were useful for processing. The mean age was 60.98 with a standard error of 15.08. 18.4% were women. The population distribution by level of studies was: 22.2% uneducated, 43.5% with primary education qualification, 27.5% with intermediate educational level and 6.8% university graduates. 58.4% of patients denied having a computer at home, 37.7% do not know what internet is, 76.7% do not have an e-mail address and just 6.7% visit medical pages, although only 1.5% admit having asked their doctor about information received on internet. According to classification by age, patients under 30 have significantly greater knowledge of computers and internet (p<0.001). However, there were no significant differences shown between the age and the fact of asking about information received through internet (p=0.1). The most visited web pages were, in order of the most to least visited: tuotromedico.com, varicocele.com, aecc.es, wikipedia.com, prostatitis.org, ondasalud.com and mapfrecajasalud.com. The most searched for conditions were: chronic prostatitis (25% of patients affected), testicular cancer (20% of patients), varicocele (18.7%), Peyronie's disease or congenital penile curvature (18.1%) and stenosis of the pyeloureteral junction (16.6%). CONCLUSIONS: --The exploitation of the internet as an information tool on the part of patients is very low, due to the characteristics inherent to our population, such as the low level of studies. --Urological web pages should dedicate an extensive part to the most common conditions in the younger population groups, such as varicocele or prostatitis. However, it is logical to expect that these epidemiological patterns will modify with time. --The use of internet and computers in general should be promoted among the different population groups in the health area under study.

Competitive retention of lead and cadmium on an agricultural soil.

Lead and cadmium contamination of an agricultural soil has been studied using batch and column experiments. Thermodynamics of the retention phenomena may be represented by a Langmuir isotherm for an aqueous metal concentration up to 100 mg L(-1). First order kinetics with respect to the solid phase yield good predictability for both batch and column experiments. Kinetics and thermodynamics of lead retention predominate over those of cadmium. As a consequence, lead is preferentially retained and can even displace sorbed cadmium. In the event of an spill involving both metals, cadmium would move further in the soil and its aqueous concentration downstream could be even higher than that of the influent solution, increasing potential risks. A two-region model has been used to fit all the experimental results. Satisfactory predictions for column experiments are obtained with parameters which are consistent with those obtained for the batch experiments, for which sorption is described by a Langmuir isotherm including competitive retention.

Cyclizations of enynes catalyzed by PtCl2 or other transition metal chlorides: divergent reaction pathways.

1-en-6-ynes react with alcohols or water in the presence of PtCl2 as catalyst to give carbocycles with alkoxy or hydroxy functional groups at the side chain. The reaction proceeds by anti attack of the alkene onto the (eta2-alkyne)platinum complex. The formation of the C-C and C-O bonds takes place stereoselectively by trans addition of the electrophile derived from the alkyne and the nucleophile to the double bond of the enyne. Formation of five- or six-membered carbo- or heterocycles could be obtained from 1-en-6-ynes depending on the substituents on the alkene or at the tether. Although more limited in scope, Ru(II) and Au(III) chlorides also give rise to alkoxy- or hydroxycyclization of enynes. On the basis of density functional theory (DFT) calculations, a cyclopropyl platinacarbene complex was found as the key intermediate in the process. In the presence of polar, nonnucleophilic solvents, 1-en-6-ynes are cycloisomerized with PtCl2 as catalyst. Formation of a platinacyclopentene intermediate is supported by DFT calculations. The reaction takes place by selective hydrogen abstraction of the trans-allylic substituent. Cycloisomerization of enynes containing disubstituted alkenes could be carried out using RuCl3 or Ru(AsPh3)4Cl2 in MeOH.

[Mesoblastic nephroma in the adult: report of a new case]. / Nefroma mesoblástico del adulto: aportación de un nuevo caso.

OBJECTIVE: A case of adult mesoblastic nephroma is presented. The clinical features, treatment, histological diagnosis and outcome are discussed. METHODS/RESULTS: A 68-year-old patient in whom a renal mass had been detected by ultrasound is described. The patient underwent radical nephrectomy. The anatomopathological analysis demonstrated a mesoblastic nephroma. No signs of recurrence have been observed at 3 years' follow-up. CONCLUSIONS: Mesoblastic nephroma of adulthood has a benign behavior and recurrence is rare after surgery.

[The detection of human papillomavirus 16, 18, 35 and 58 in cervical-uterine cancer and advanced degree of squamous intraepithelial lesions in Western Mexico: clinical-molecular correlation]. / Detección de papilomavirus humano tipos 16, 18, 35 y 58 en cáncer cervicouterino y lesiones escamosas intraepiteliales de alto grado en el occidente de México: correlación clínico-molecular.

The purposes of this study were to estimate the infection frequency of Human Papilomavirus (HPV) and to identify the viral types in patients with diagnosis of uterine cervical cancer (UCC) and High Grade Squamous Intraepitelial lesions (HGSILs), and to correlate the molecular findings versus HPV infection suggestive clinical findings. Biopsies from 50 patients (37 HGSILs and 13 UCC) histopathologically diagnosed were studied. The presence of HPV were detected by means of the polymerase chain reaction (PCR) using consensus primers for types 6, 11, 16, 18, 31, 33, 35, and 58 among others, as well as specific primers for some of them. The frequencies for HPV 16, 18, 33, 35, and 58 in HGSIL samples were 24.3, 2.7, 0, 5.4 and 16.2% respectively. In UCC samples were 61.5, 7.7, 0, 0 and 15.4% with significative differences only for HPV 16. Clinical findings (histologic, colposcopic and histopathologic), showed deficient diagnostic accuracy in the identification of HPV 16 in HGSIL, wich resulted less frequent and there is a high frequency of HPV. These results are similar to those previously described in our country and the other populations, with the exception of HPV16 in HGSIL, wich resulted less frequent and there is a high frequency of HPV 58 in our region. When analyzing clinical features with the presence of HPV DNA, we conclude that these are insufficient to discard or establish the possibility of HPV infection in patients with HGSIL's and UUC.

Detección de papilomavirus humano tipos 16, 18, 35 y 58 en cáncer cervicouterino y lesiones escamosas intraepiteliales de alto grado en el occidente de México: correlación clínico-molecular / Papilomavirus type 16, 18, 35 and 58 detection in cervicouterine cancer and high grade squamous intrapitelial lesions in México: Clinic-molecular-correlation

Los propósitos de este estudio fueron estimar la frecuencia de infección por papilomavirus humano (PVH) e identificar los tipos presentes en pacientes con diagnóstico de cáncer cerivicouterino (CaCu) y lesiones escamosas intraepiteliales de alto grado (LEIAG) y correlacionar los hallazgos moleculares contra los hallazgos clíncos sugestivos de infección por PVH. Se estudiaron biopsias provenientes de 50 pacientes (37 LEIAG y 13 CaCu) diagnosticadas histopatológicamente. Se detectó la presencia de PVH por medio de la reacción en cadena de la polimerasa (RCP) utilizando iniciadores consenso para los tipos 6, 11, 16, 18, 31, 33, 35 y 58 entre otros, así como iniciadores específicos para algunos tipos. Las frecuencias de infección para los PVH 16, 18, 33, 35 y 58 en las muestras de LEIAG fueron 24, 2, 0, 5 y 16 por ciento respectivamente. En las muestras de CaCu fueron 61, 7, 0, 0 y 15 por ciento encontrando diferencias significativas sólo para PVH 16. Los hallazgos clínicos (histológicos, colposcópicos e histopatológicos) mostraron una precisión diagnóstica deficiente en la identificación de PVH. Estos resultados son similares a aquellos informados en otras regiones de México con la excepción de la frecuencia de PVH 16 en LEIAG, la cual resultó menor y la frecuencia elevada de PVH 58 en nuestra región. Al contrastar los hallazgos colposcópicos, citológicos e histopatológicos con la presencia de DNA de PVH, concluimos que estos hallazgos son insuficientes para descartar o establecer la presencia de PVH en pacientes con LEIAG y CaCu.

Estimated varicella incidence on the basis of a seroprevalence survey.

Varicella is a disease caused by varicella-zoster virus. It is transmitted via the respiratory route, is highly communicable and mainly affects young children. An effective vaccine is now available, whose routine use is advised by health authorities in the USA and which can prevent severe disease, although breakthrough infections do occur. In deciding whether or not to include a vaccine in the routine vaccination schedule, knowledge of the morbidity of the disease in question is fundamental. Although reporting of varicella is compulsory in Catalonia, doctors only have to report the weekly number of cases diagnosed, and not their age distribution. Given that recent data on the prevalence of the infection in Catalonia according to age groups is available, it was considered that, using these data, an estimation of age-related incidence could be made. The objective of the present study was to estimate the incidence of varicella in Catalonia on the basis of the available seroprevalence data. A curve was fitted to the observed prevalence and point prevalence estimates for all ages were obtained. The incidence was derived by smoothed prevalence for each of these age groups. Estimated variance of the estimated incidence was obtained by the delta method. Predicted prevalence in the 0-4 years age group was calculated by the smoothed prevalence. The model that best fitted the sample prevalence was the exponential function. The estimated number of varicella cases in this study was 46,419 (95% CI 40,507-52,270). As the population in Catalonia in 1996 was 6,090,040, the previous results give an incidence rate of 762.2 per 100,000 persons/year with their 95% CI (666.1-858.3). The method described may be applied to the study of incidence rates in relation to the prevalence of diseases if we accept that the infection produces permanent immunity; the risk of mortality is the same for infected and non-infected subjects and that the disease incidence and population remain constant in time.

[Burned out testicular tumor]. / Tumor testicular fundido.

OBJECTIVE: The present article reviews the different aspects of "burned out" testicular tumor. METHODS: A survey of the literature on "burned out" testicular tumor in Medline 1980-1999 was performed. The selected articles referenced in the present study were reviewed. RESULTS: The "burned out" phenomenon is the regression of a testicular tumor focus after distant metastasis whose cause is unknown. However, characteristic histological lesions have been identified, such as lesions comprised of collagen tissue containing neoplastic cells. The diagnosis is based on the anatomopathological study of the orchidectomy specimen, which should be performed in patients with extragonadal germ cell tumor and alterations detected on physical or ultrasound examination. CONCLUSIONS: "Burned out" testicular tumor should be taken into account in patients with extragonadal germ cell tumor. The importance of a thorough physical examination and testicular ultrasound evaluation is emphasized. Chemotherapy may not be effective. Orchidectomy may improve the outcome in these tumors.

[Percutaneous treatment of retroperitoneal abscesses]. / Tratamiento percutáneo de los abscesos retroperitoneales.

UNLABELLED: The retroperitoneal abscess is an uncommon disease, that must be treated by drainage. The progressive use of the percutaneous drainage, under ultrasound or computed tomography guidance (CT), has changed the therapeutical management and has demonstrated to be a valid alternative to surgical drainage. From 1986 to 1998, 16 patients with retroperitoneal abscesses were treated by percutaneous drainage (14 with CT and 2 with ultrasound guidance). This method eradicated the abscess in 13 cases, in 2 was necessary a new function to cure the abscess, and 1 patient, with a severe sepsis, died. Percutaneous drainage was the unique treatment used in 12 patients. In the remaining four, the patients' clinical status improved after percutaneous drainage, and they were able to undergo subsequent elective nephrectomy. CONCLUSIONS: Percutaneous drainage of retroperitoneal abscesses has been established as a viable alternative to surgical intervention. This method can resolve the abscess or improve the patient' clinical status to undergo elective surgery.

Transmission of Pneumocystis carinii DNA from a patient with P. carinii pneumonia to immunocompetent contact health care workers.

The transmission of Pneumocystis carinii from person to person was studied by detecting P. carinii-specific DNA in prospectively obtained noninvasive deep-nasal-swab samples from a child with a documented P. carinii pneumonia (PCP), his mother, two contact health care workers, and 30 hospital staff members who did not enter the patient's room (controls). Nested-DNA amplification was done by using oligonucleotide primers designed for the gene encoding the mitochondrial large subunit rRNA of rat P. carinii (P. carinii f. sp. carinii) that amplifies all forms of P. carinii and internal primers specific for human P. carinii (f. sp. hominis). P. carinii f. sp. hominis DNA was detected in samples from the patient and all of his contacts versus none of the 30 hospital staff members. The results, as previously shown in murine models of P. carinii pneumonia, document that person-to-person transmission of P. carinii is possible. This observation suggests that immunocompromised patients not on PCP prophylaxis should not enter the room of a patient with PCP, and it also raises the question as to whether healthy contacts can transmit the disease to immunocompromised patients at risk.

Tratamiento percutáneo de los abscesos retroperitoneales / Percutaneous drainage of retroperitoneal abscesses

El absceso retroperitoneal es una entidad clínica poco frecuente, cuyo tratamiento se basa en el drenaje. La introducción progresiva de las técnicas percutáneas de drenaje, bien mediante control ecográfico o bien utilizando la tomografía axial computerizada (TAC), ha modificado su abordaje terapéutico, siendo alternativas válidas al tratamiento quirúrgico tradicional. Presentamos una serie de 16 pacientes diagnosticados de absceso retroperitoneal entre 1986 y 1998, que fueron tratados mediante punción percutánea (en 14 casos dirigida por TAC y en 2 median-te control ecográfico). Se consiguió la resolución del absceso en 13 casos, recurriendo en 2 (ambos fueron tratados mediante nueva punción) y falleciendo 1 paciente que presentaba una sepsis grave. En 12 de los pacientes fue el único tratamiento aplicado, practicándose en los 4 restantes nefrectomía tras la mejoría del estado de los pacientes. CONCLUSIONES: El tratamiento percutáneo de los abscesos retroperitoneales supone una alter-nativa válida al tratamiento quirúrgico tradicional, bien como tratamiento definitivo, bien como tratamiento paliativo que nos permite mejorar el estado clínico del paciente de forma previa a la cirugía (AU)

[Surgical management of the penile fractures. Our experience]. / Tratamiento quirúrgico de la fractura de pene. Nuestra experiencia.

UNLABELLED: The fracture of the penis is an uncommon injury that is defined as a rupture of the tunica albuginea of the corpus cavernosum. We present our experience in 9 cases admitted to our department between 1989 and 1998. Most of the cases were caused by traumatism during sexual intercourse. Clinical presentation and physical examination were enough to make the diagnosis. The treatment was surgery in all cases, with evacuation of the hematoma and reconstruction of the rupture with absorbable suture. The result about penile function and curvature was excellent in all cases. There was no cases of penile incurvation nor erectil disfunction. CONCLUSIONS: In our experience, surgical management of the penile fracture has good results, with no erectil disfunction, nor penile incurvation.

Determination of diesel genotoxicity in firebreathers by micronuclei and nuclear abnormalities in buccal mucosa.

Diesel or its derivatives could have aneuploidogenic and/or clastogenic activity. Hence, the genotoxicity of diesel gases has been studied, considering exposure to them as potentially carcinogenic. The results obtained by different authors suggest the need to know the effects of direct and chronic exposure to diesel in humans, as in the case of the street workers called 'firebreathers' who fill their buccal cavity with diesel and then spread it to a burning torch many times during the day in order to give a 'dragon show' for 5 h a day and 6 days a week. The buccal samples of eight firebreathers were collected, processed and scored according to the criterion established by Tolbert et al., 1992 and then compared with positive and negative control groups. The results revealed that diesel was not micronucleogenic although it induces some nuclear abnormalities.