Degeneración cerebelosa paraneoplásica y anticuerpos anti-Yo / Paraneoplastic cerebellar degeneration and anti-Yo antibodies

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Unexpected postmortem diagnosis of Acanthamoeba meningoencephalitis following allogeneic peripheral blood stem cell transplantation.

Meningoencephalitis caused by pathogenic free-living amebas is usually fatal. Only a few cases of Acanthamoeba meningoencephalitis, diagnosed at autopsy, have been reported following hematopoietic stem cell transplantation. We here report a case of Acanthamoeba meningoencephalitis following allogeneic peripheral blood stem cell transplantation with rapidly evolving neurologic symptoms that remained unexplained. Magnetic resonance imaging failed to show brain lesions and cerebrospinal fluid was negative for microbiological cultures. Definite diagnosis was an unexpected autopsy finding. As overall and teaching hospital autopsy rates are declining worldwide, we must emphasize the need of autopsy exams if we want to improve our knowledge as the best way to care for our patients.

Prevalencia de la beta-talasemia en el Área sanitaria de Cartagena / Beta-Thalasemia prevalence in Cartagena sanitary area

Objetivo: Conocer la prevalencia de la beta-talasemia en nuestra área sanitaria, la cual no se había estudiado previamente y detectar los portadores para control y consejo genético. Material y métodos: Estudiamos la prevalencia de esta patología en nuestra área sanitaria, de la cual no existían datos previos. Realizamos un estudio prospectivo de 10237 hemogramas de pacientes analizados en nuestro laboratorio (3.95 por ciento de la población total de nuestro área) siendo un 35 por ciento hombres y un 65 por ciento mujeres. La selección de las muestras de los pacientes se realizó a partir del volumen corpuscular medio de los hematies (VCM) <=70 fL; a todos ellos se les determinó la ferritina, hemoglobina A2 y morfología eritrocitaria óptica. Conclusiones: Detectamos un 1.39 por ciento de la microcitosis, de las cuales el 0.38 por ciento fueron diagnosticadas de beta-talasémicas y un 0.88 por ciento de ferropenias; el 0.13 por ciento restante eran secundarias a otras patologías (AU)

Nonrigid registration of 3D tensor medical data.

New medical imaging modalities offering multi-valued data, such as phase contrast MRA and diffusion tensor MRI, require general representations for the development of automated algorithms. In this paper we propose a unified framework for the registration of medical volumetric multi-valued data using local matching. The paper extends the usual concept of similarity between two pieces of data to be matched, commonly used with scalar (intensity) data, to the general tensor case. Our approach to registration is based on a multiresolution scheme, where the deformation field estimated in a coarser level is propagated to provide an initial deformation in the next finer one. In each level, local matching of areas with a high degree of local structure and subsequent interpolation are performed. Consequently, we provide an algorithm to assess the amount of structure in generic multi-valued data by means of gradient and correlation computations. The interpolation step is carried out by means of the Kriging estimator, which provides a novel framework for the interpolation of sparse vector fields in medical applications. The feasibility of the approach is illustrated by results on synthetic and clinical data.

Duplicación gástrica en el adulto. Caso clínico / Gastric duplication in an adult. A case report

Presentamos un caso de duplicación quística gástrica en un paciente de 58 años de edad, de localización antral. Se analizan las características anatómicas de este tipo de malformaciones, los medios diagnósticos empleados y se revisa la bibliografía referente a dicha patología (AU)

[Systemic mastocytosis and secondary acute myeloid leukemia]. / Mastocitosis sistémica y leucemia mieloide aguda secundaria.

Systemic mast cell disease (SMCD) is an idiopathic disorder in which mast cells proliferate and accumulate in various organs including the skin, bone marrow, liver, spleen and lymph nodes. SMCD is regarded as a myeloproliferative disorder for any authors. Associated hematologic disorders can be found in up to one third of patients with SMCD. It may be due to the apparent close relationship between the mast cell and the myeloid cell.

Mastocitosis sistémica y leucemia mieloide aguda secundaria / Acute myeloid leukemia secondary a systemic mastocitosis

La mastocitosis sistémica es una enfermedad en la cual los mastocitos proliferan y se acumulan en distintos tejidos como la piel, médula ósea, hígado, bazo y ganglios linfáticos. Algunos autores la consideran como un síndrome mieloproliferativo. Una tercera parte de los pacientes desarrollan otras neoplasias hematológicas, apoyando el origen mieloide del mastocito (AU)

Rifampicin causes false-positive immunoassay results for urine opiates.

The treatment of tuberculosis usually includes the antibiotic rifampicin, especially in patients with concomitant human immunodeficiency virus infection. Some of these patients are in withdrawal therapy for drug abuse. When opiate screening is carried out in patients receiving rifampicin, false positive results are detected with the kinetic interaction of microparticles in solution method. We evaluated this interference in a Cobas-Integra analyzer and found a 12% cross-reactivity of rifampicin for antibiotic concentrations ranging from 0.19 to 6.08 mumol/l (156 to 5000 micrograms/l). This effect is not explained by the colour of the rifampicin solutions. Calculations assuming first order kinetics of elimination show that more than 18 hours after a single oral dose of 600 mg of rifampicin, a false positive result for opiates could be obtained. This indicates that the risk of a false positive result must always be considered when urine samples from these patients are analyzed.

[Pregnancy, breast cancer and tumor infarction]. / Embarazo, cáncer de mama e infartación tumoral.

Breast cancer is infrequently associated with pregnancy. However, such cases often pose diagnostic and treatment problems. The infarction of breast lesions is likewise uncommon, and generally hinders intraoperative morphologic diagnosis. A 33-year-old woman in the 37th week of pregnancy presented with a breast tumoration of progressively increasing size and associating mastalgia. Following fine-needle aspiration and trut-cut biopsy with posterior amplified tumorectomy and axillary dissection, a ductal neoplasm was identified with an infarction affecting 90% of the tumoral surface. The where no axillary adenopathies, and the patient was estrogen receptor-negative. An analysis is made of this rare association of pregnancy and infarcted breast cancer, with an evaluation of the role of fine-needle aspiration and/or gestation may play in the occurrence of tumor infarction.