Meningeal carcinomatosis as the initial manifestation of lymphoma / Carcinomatosis meníngea como manifestación inicial de linfoma

Introduction: Leptomeningeal carcinomatosis (LC) is diagnosed in 4-15% of cancer patients, and most cases (70%) are in the advanced phase of the disease. In only 5-10% of patients with LC, it is the initial manifestation of cancer.Case report: We present a case of a 46-year-old man with leptomeningeal carcinomatosis as the first manifestation of type B high-grade lymphoma. Cerebrospinal fluid (CSF) showed pleocytosis with a predominance of mononuclear cells, hyperproteinorrhachia, and glucose consumption. CSF cytology was negative for malignant cells in two samples. Magnetic resonance imaging and CSF flow cytometry gave the diagnosis.Discussion: LC is a diagnostic challenge. Differential diagnosis arises with infectious processes (tuberculosis) and autoimmune diseases. In cerebrospinal fluid, flow cytometry (FCM) has a higher sensitivity than cytology for the diagnosis of LC.(AU)

Isolated testicular polyarteritis nodosa.

Isolated polyarteritis nodosa is a rare condition that may be triggered by local exposure to certain agents capable of provoking local immunostimulation without a systemic immune reaction. Isolated polyarteritis nodosa in the testes presents similar histologic characteristics as those of systemic inflammation, although infarcted areas in the testis are more common in generalized polyarteritis nodosa. Definitive diagnosis requires histologic study. We present the case of a 26-year-old patient with isolated testicular polyarteritis nodosa whose symptoms consisted predominantly of intense testicular pain and slight enlargement of both testes.

Effect of N-acetylcysteine on antioxidant status in glycerol-induced acute renal failure in rats.

Myoglobinuric acute renal failure has three pathogenic mechanisms: tubular obstruction, renal vasoconstriction, and oxidative stress. The latter is generated through the iron released from the group hemo of the myoglobin. Iron induces the formation of high-activity oxygen free radicals that increase oxidative stress and provoke lipid peroxidation and cellular death. This oxidative stress can be measured in several ways, both total or partially with the total antioxidant status or the intermediate enzymes. On the other hand, N-acetylcysteine is a demonstrated substance with antioxidant properties. The aim of the present work was to assess the effect of N-acetylcysteine on the oxidative stress in the glycerol-induced acute renal failure in rats model. We observed that the animals treated with N-acetylcysteine showed an improvement in the antioxidant activity given by an increase in the total antioxidant status and glutathione reductase levels in serum. This improvement was greater when treatment was administered before the induction of rhabdomyolysis. Nevertheless, the observed increase in antioxidant status was only statistically significant for glutathione reductase but not for total antioxidant status. Our results support an important role for N-acetylcysteine in the treatment of this form of acute renal failure, although we think that oxidative stress is not the main pathogenic mechanism of the tubular necrosis induced by rhabdomyolysis, tubular obstruction and renal vasoconstriction being still more important.

Utilidad clínica de las troponinas cardíacas / Cardiac troponins and their current clinical application

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