Tratamiento del hepatocarcinoma / Hepatocarcinoma treatment

No disponible

Manejo terapéutico de la infección crónica por virus C / Chronic C virus infection management

No disponible

Fibrosis mediastínica idiopática asociada a hipercoagulabilidad. A propósito de un caso / Idiopatic mediastinal fibrosis in association with hypercoagulability state. A case report

La fibrosis mediastínica es una entidad de baja frecuencia y de etiología desconocida en la mayor parte de los casos. Se caracteriza por la presencia de una masa fibrótica en el mediastino que puede invadir estructuras vecinas tales como el esófago, la tráquea, el nervio recurrente, la vena cava superior etc. Solamente un 1-2 por ciento de pacientes con fibrosis mediastínica presentan un cuadro de obstrucción de vena cava superior, y esta es producida en casi todos los casos por compresión extrínseca por el magma fibrótico. Se presenta el caso de un paciente con un trastorno de hipercoagulabilidad asociado a fibrosis mediastínica con obstrucción de la vena cava superior por trombosis (mecanismo intrínseco) así como su evolución satisfactoria tras el tratamiento combinado con anticoagulación oral y tamoxifeno (AU)

No disponible

[Idiopathic mediastinal fibrosis associated with hypercoagulability: a case report]. / Fibrosis mediastínica idiopática asociada a hipercoagulabilidad. A propósito de un caso.

Mediastinal fibrosis is a rare and unknown disease characterized by the presence of a fibrotic mass in the anterior mediastinum that can invade close structures as gullet, trachea, recurrent nerve, superior cava vein etc. Only 1-2% of patients with mediastinal fibrosis associate superior cava vein obstruction. When it appears, it is produced by extrinsic compression for fibrotic magma in almost all the cases. A case of hypercoagulability disorder associated with mediastinal fibrosis and superior cava vein obstruction by thrombosis (intrinsec mechanism), and the satisfactory evolution after the treatment with oral anticoagulation, corticosteroids and tamoxifen is presented.

Linfoma difuso de células T de cérvix uterino: una localización inusual de un tumor poco frecuente / Diffuse t-cEll lymphoma of the uterine cervix: an unusual location for a non-common disease

Los linfomas no hodgkinianos son tumores relativamente frecuentes. Sin embargo, las formas extraganglionares lo son menos, y la localización en cérvix uterino es excepcional. Se presenta el caso de una paciente anciana con sintomatología probablemente no relacionada con el tumor, en quien se llegó al diagnóstico a raíz del hallazgo casual de una gran distensión vesical producida por la compresión del tracto urinario inferior causada por el tumor. La masa pélvica es una de las formas de presentación de los linfomas de cérvix uterino. El diagnóstico se realizó en este caso mediante biopsia transvaginal bajo anestesia general. La biopsia mostró un linfoma difuso de células T, situación aún más excepcional, ya que la mayor parte de los casos publicados de linfomas de cérvix son linfomas de células B. Es de subrayar la importancia de distinguir los linfomas de carcinomas o sarcomas uterinos ya que los linfomas suelen tener una buena respuesta al tratamiento con radioterapia (AU)

[Diffuse T-cell lymphoma of the cervix uteri: an unusual localization of an infrequent tumor]. / Linfoma difuso de células T de cérvix uterino: una localización inusual de un tumor poco frecuente.

Non-Hodgkin lymphomas are frequent tumors. However, extraglandulary forms are very unusual, and the location in the uterine cervix is also extraordinary. A case of an elderly woman with symptoms not related with the tumor, in whom the diagnosis was made from the incidental finding of a distended obstructive bladder is presented. Pelvic mass is one of the forms of presentation of primary malignant lymphomas of the uterine cervix. Diagnosis was made in this case by transvaginal biopsy under general anesthesia. Biopsy showed a diffuse T-cell lymphoma, a very rare finding considering that most of published cases are B-cell type. The importance of distinguishing malignant lymphoma from undifferentiated carcinoma or sarcoma is emphasized since cervical malignant lymphoma can be successfully treated with irradiation.

[Mesenteric panniculitis in the differential diagnosis of abdominal pain]. / La paniculitis mesentérica en el diagnóstico diferencial del dolor abdominal.

Mesenteric panniculitis is a rare disease affecting adipose tissue of the mesentery that may result in the development of large masses in the abdomen. Diffuse chronic or intermittent abdominal pain is the most frequent symptom. It usually follows a benign course though surgery is sometime needed. We describe a patient with recurrent abdominal pain who was diagnosed of mesenteric panniculitis. An abdominal CT scan oriented to the diagnosis and an open laparotomy and biopsy was needed for a definitive diagnosis. A brief review of the literature is added.

[Cyclosporin A in the treatment of Eaton-Lambert myasthenic syndrome]. / Ciclosporina-A como tratamiento del síndrome miasteniforme de Eaton-Lambert.

The Lambert-Eaton myasthenic syndrome (LEMS) is a disorder of he cholinergic neurotransmition at the presinaptic terminal of the neuromuscular junction. Clinically it is characterized by muscular weakness, hyporeflexia and autonomic dysfunction. In this entity thet presence of antibodies against calcium channels impair acetylcholine release. Whe used cyclosporin-A in a patient with LEMS and this resulted in a complete clinical and neurophysiological recovery after four months of therapy.

[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.

[Spontaneous tumor regression. Report of 2 cases]. / Regresión tumoral espontánea. A propósito de dos casos.

Two cases of spontaneous tumor regression (STR) occurring in a patient with non Hodgkin lymphoma and in another patient with squamous carcinoma of the lung are presented. Both cases fulfill the criteria of STR defined by Everson and Cole. Recent results obtained in basic and clinical studies have indicated that immunological mechanisms could play an important role in STR. The mediator effects more frequently referred are: 1) generation of antineoplastic cytotoxic cells; 2) production of immunoregulatory cytokines by lymphocytes and monocytes, and 3) possible cross reaction between tumor and bacterial antigens. These mechanisms of action are discussed in relation to the presented cases.