[Cystic tumors in the retrorectal space. Do these two cases have something in common?]. / Tumoraciones quísticas del espacio retrorrectal. ¿Tienen algo en común estos dos casos?

Cystic lesions in the retrorectal or presacral space present a broad differential diagnosis. Rare but typical lesions at this site are those related to embryonic development, which are the most frequent presacral congenital lesions in adults. Amongst these tumors, epidermoid cysts and cystic hamartomas are the most common lesions. Cystic masses, which are asymptomatic in approximately 50% of the cases at diagnosis, may show complications such as infection or malignant degeneration. Initial diagnosis is based on imaging techniques although definite lesion characterization, essential due to their malignancy risk, is given by the pathological analysis of the surgical piece.

[Acute hepatitis due to ingestion of Ecstasy]. / Hepatitis aguda tras consumo de éxtasis.

"Ecstasy" or 3,4-methylenedioxymethylamphetamine, is a synthetic amphetamine which is increasingly consumed in Spain as a "recreational" drug. It has been associated with serious medical and psychiatric side effects, though, it is popularly considered, as a non dangerous drug. The development of acute hepatitis associated with the use of "ecstasy" has been reported by other authors from areas where its use is widely spread. We report the development of acute hepatitis associated with use of "ecstasy" in a young man with successful recovery and spontaneous resolution. In other cases the acute hepatitis may have a torpid evolution with slow resolution, fulminant liver failure, and death with hepatic encephalopathy, disseminated intravascular coagulation and adult distress syndrome. An idiosyncratic toxic hepatitis might be due to either 3,4-methylenedioxymethylamphetamine or a metabolite, a contaminant in 3,4-methylenedioxymethylamphetamine manufacture, or to an additive in tablet or capsule formulation.

[Post-transfusion hepatitis in Navarra. Evidence of acute hepatitis C virus infection without elevation of aminotransferases]. / Hepatitis postransfusional en Navarra. Evidencia de infección aguda por el virus de la hepatitis C sin elevación de aminotransferasas.

BACKGROUND: To determine the incidence of postransfusion hepatitis (PTH) and hepatitis C virus (HCV) infection in blood recipients in Navarra and to evaluate the impact of excluding anti-HCV positive donors on the incidence of posttransfusion HCV infection. METHODS: 248 transfusion recipients were included, 150 in a first period before anti-HCV(+) donors exclusion, and 98 in a second period after their exclusion. A serum sample from each patient was collected, bimonthly during the first month and monthly for six months, and another serum sample, twelve months after transfusion. ALT and anti-HCV were tested in each sample with ELISA and RIBA 2nd generation. HCV-RNA was determined with a nested polymerase chain reaction assay. RESULTS: PTH incidence in 1989 was of 2.9%. This incidence decreased to 1.1% after anti-HCV ELISA 1st generation positive donors exclusion. At present, this incidence, with anti-HCV ELISA 2nd generation positive donors exclusion, is 0.8%. 80% of PTH were caused by HCV. 50% of HCV acute infection, confirmed by positive PCR, had normal ALT. CONCLUSIONS: In Navarra, HPT incidence is below 1% after anti-HCV(+) donors exclusion. There are subclinics forms of HCV acute postransfusional infection with normal ALT.