NATURAL RADIUM ISOTOPES PRESENT IN SOME COSMETIC PRODUCTS: DETERMINATION OF ACTIVITY CONCENTRATION AND DOSE ESTIMATION.

Since the early days, clays, plant extracts and raw materials have been used for therapeutic and beauty purposes. Nowadays, this use is widely spread, as a huge amount of companies have developed new cosmetics based on natural sources. This may lead to an accumulation of radionuclides that can be hazardous for people. Especially dangerous are radium isotopes (226,228Ra), which can be part of the raw materials that cosmetics are made from. In this paper, the concentration of radium isotopes of 18 natural cosmetics was determined. Concentrations resulted in the range 7.9 ± 5.0-37.6 ± 12.5 Bq kg-1 for 226Ra; and 2.5 ± 1.7-35.4 ± 2.6 Bq kg-1 for 228Ra. The effective dose in the skin has been estimated, obtaining a mean value of 13.1 ± 4.9 µSv y-1. This value is far from the reference level of 50 mSv y-1 for the public members. Therefore, no radiological risk derived from the use of these samples, has been found.

Cirrhosis-like radiological pattern in patients with breast cancer

INTRODUCTION: Hepatic toxicity of breast cancer therapy is well known, usually consisting of elevation in the serum levels of hepatic enzymes or fatty infiltration of the liver. The chemotherapeutic agents most commonly linked to hepatotoxic effects are methotrexate, anthracyclines, taxanes and cyclophosphamide. There are few reports of patients with liver metastasis having radiological findings mimicking cirrhosis, both in the presence or the absence of prior systemic chemotherapy. Hepatotoxicity of antineoplastic drugs and cellular necrosis induced by response of liver metastases to chemotherapy may play a critical role in its physiopathology. MATERIALS AND METHODS: This article reports a series of ten women with breast cancer (nine with liver metastasis) treated with chemotherapy or hormonotherapy. RESULTS: They had low risk factors for hepatic disease, but developed a cirrhosis-like appearance in the computed tomography scan. The patient without liver metastasis is the second of this kind described in the literature. Relatively few reports have documented clinical sequelae of portal hypertension. In our series, three patients had oesophageal bleeding varices needing be hospitalised. To our knowledge, these are the first cases reported in the literature. CONCLUSIONS: This suggests that some manifestations of portal hypertension may develop in association with the cirrhosis- like pattern induced by breast cancer therapy (AU)

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[Gastritis caused by Helicobacter heilmannii (Gastrospirillum hominis). Report of 3 cases]. / Gastritis por Helicobacter heilmannii (Gastrospirillum hominis). Descripción de tres casos.

Helicobacter heilmannii infection is rare. Its clinical picture is rather different from that caused by Helicobacter pylori: alterations in the gastric mucosa are milder and mainly located in the gastric antrum, and the frequency of erosions and ulcers is lower. It has been described in association with conditions similar to those related to H. pylori: peptic ulcer, chronic gastritis, gastric adenocarcinoma, intestinal metaplasia and MALT (mucose associated lymphoid tissue) lymphoma, although the incidence is lower. We describe three cases of gastritis caused by H. heilmannii, which we consider to be of interest because of the absence of cases published in Spain. One of the cases is especially unusual because of its association with a duodenal ulcer. We also describe the main features of H.r heilmannii. Its clinical treatment is similar to that used in H. pylori, with demonstrated morphological improvement of the lesions after eradication of the infectious agent.

[Pneumonia complicated with empyema in children, to operate or not? Risk factors for surgery and review of the literature]. / Neumonía complicada con empiema en niños, operar o no operar? Factores de riesgo para cirugía y revisión de la literatura.

The precise indication for surgery for pleural empyema is still a controversy. With the aim of identifying the risk factors associated with surgery in pediatric patients with empyema post-pneumonia, a retrospective case control study was performed. From 1992 to 1996, 18 children underwent surgery (cases) and 12 did not (controls). The analyzed variables were those mentioned in the literature as risk factors. More than 25 days of evolution, more than three antibiotic schemes, fever, empyema organizing phase, two or more chest tubes lasting more than nine days, multiple loculations, trapped lung and paquipleura were associated with thoracostomy and decortication (p < 0.05). We conclude that a pediatric patient with a late referral to the hospital, empyema organizing phase, and multiple loculations with large purulent collections no longer susceptible to drainage and complications that impair lung expansion will probably require major surgery.

Treatment of superior and inferior vena cava syndromes of malignant cause with Wallstent catheter placed percutaneously.

Superior vena cava syndrome (SVCS) and inferior vena cava syndrome (IVCS) represent a severe symptomatic complication of some malignant tumors. Although radiation therapy and chemotherapy are elective, symptomatic relief takes 7-10 days to be achieved, and poor symptomatic benefit can be obtained in relapsed or resistant tumors. We report on a palliative approach using Wallstent catheters placed percutaneously in a series of 16 patients. Results obtained in relief of symptoms were excellent (complete response of cephalea, jugular enlargement, and collateral circulation achieved in 100% [16/16] of patients; complete response of edema obtained in 93% [15/16] of patients). Achievement of symptomatic response was obtained for all symptoms during the first 24 h poststenting, except for edema and dyspnea. Mean duration of patency of the stents was 6.4 months (range 2-17 months). Rates of morbidity and complications were very low. Dyspnea was a quite resistant symptom, and only four of 13 patients (31%) obtained complete response, while partial improvement was obtained in the other nine (79%). However, placement of the stents does not preclude the use of radiation therapy or chemotherapy. We think that these results and those from other studies warrant larger multicentric trials.

Efficacy of oral tegafur modulation by uracil and leucovorin in advanced colorectal cancer. A phase II study.

A phase II study was performed to assess the efficacy and toxicity of UFT (tegafur-uracil in the molar ratio 1:4) modulated with leucovorin (LV) in previously untreated patients with advanced colorectal carcinoma (CRC). 79 patients with measurable advanced colorectal cancer (CRC) and no prior chemotherapy were included. 75 patients were evaluable for toxicity and response. The regimen consisted of LV 500 mg/m2 administered intravenously on day 1, followed by oral UFT 390 mg/m2 on days 1-14. Patients received oral LV 15 mg every 12 h on days 2-14. Treatment was repeated every 28 days for a minimum of four courses per patient. Three hundred and ninety-eight cycles of chemotherapy were delivered (median five per patient). 7 patients (9%) had a complete response, and 22 a partial response for an overall response rate of 39%. Mild gastrointestinal toxicity was dose limiting: grade 3-4 diarrhoea appeared in 9% of patients. Other grade 3-4 toxicities were nausea/vomiting and mucositis in 4% of patients, gastric pain and leucopenia in 3%. Oral UFT modulated by oral LV is active in advanced CRC and can be administered on an outpatient basis with no significant toxicity requiring hospitalisation. Given its excellent tolerance profile and low toxicity, the regimen should be thoroughly studied and compared with 5-fluorouracil modulated by LV.

[Leukocyte adherence inhibition test in tumor patients]. / Test de inhibición de la adhesividad leucocitaria en el enfermo tumoral.

The leukocytes from cancer patients lose the capacity to adhere themselves to the tube glass surface when they are incubated with antigenic extracts of neoplasms of the same histologic type, as observed employing the leukocyte adherence inhibition (LAI) test. The authors confirm that the LAI test is organ-specific when primary tumors are employed as a source of antigens. Contrarily, the LAI test does not give a useful diagnostic information when antigens from metastases are employed. On the other hand, the practice of cell counts at 20 minutes intervals, shows that we are not dealing with a true adherence inhibition, but with a massive initial adherence of the leukocytes to the glass surface, followed by the further detachment of the cells. The phenomenon depends on cell concentration and it is not observed when less than 1000 leukocytes mm2 are used.

[Carcinoid tumor of the thymus gland with multiple metastases. Report of a case (author's transl)]. / Carcinoide de timo con metástasis múltiples. A propósito de un caso.

A pregnant woman in the 29th, week of gestation was admitted to the hospital with mediastinal pressure symptoms. A tentative diagnosis of lymphoma was made and the patient was given chemotherapy (vincristine, ciclophosphamide and adriamycin) plus radiotherapy, but no objective response was obtained. During the postoperative period (cesarean section) the patient developed clinical symptoms of muscular paralysis of unknown etiopathogenesis. Biopsy of a cervical lymph node showed histological pattern of tumor of the APUD system (chemodectoma). Multiple metastases appeared in the lungs, bones, brain, heart and ovaries in spite of treatment with various chemotherapeutic agents (vincristine, actinomycin D, CCNU and DTIC). Necropsy revealed the existence of a large tumor of the thymus gland, which histopathologic structure resembles to that of carcinoid. Ultrastructural examination showed abundant granules of neurosecretion confirming an APUD tumor. Cushing-like appearance of the patient was attributed "a posterior" to ACTH released by the tumor. A review ofthe clinical features, endocrine function and anatomical localizations of carcinoid tumors is included.