Aneurisma de arteria carótida interna postraumático / Posttraumatic aneurysm of the internal carotid artery

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Erosión vertebral en aneurismas de aorta abdominal como causa de dolor lumbar crónico. Serie de 5 casos / Vertebral erosions in abdominal aortic aneurysms as a cause of chronic low back pain. A series of 5 cases

El dolor lumbar crónico es una causa habitual de consulta médica y se relaciona en muchas ocasiones con la enfermedad vertebral degenerativa. A pesar de ello no debemos olvidar otras enfermedades incluso en aquellos casos en los que las pruebas de imagen preliminares sugieran cambios degenerativos crónicos en la columna lumbar, y la posible presencia de un aneurisma de aorta abdominal con una rotura contenida debe ser descartada por sus implicaciones pronósticas y terapéuticas. Presentamos 5 casos de dolor lumbar crónico asociado a lesiones líticas graves del cuerpo vertebral debido a rotura crónica contenida de un aneurisma de aorta abdominal (AU)

Chronic low back bain is a common cause of medical consultation, and is often associated with degenerative vetebral disease. Despite this, we must not forget other diseases even in those cases where the imaging tests may suggest chronic degenerative changes in the lumbar spine, including the possible presence of an abdominal aortic aneurysm with a contained rupture must be ruled out due to its prognostic and therapeutic implications. We present 5 cases of chronic low back pain associated with serious lytic lesions in the vertebral body due to chronic rupture of an abdominal aortic aneurysm (AU)

[Vertebral erosions in abdominal aortic aneurysms as a cause of chronic low back pain. A series of 5 cases]. / Erosión vertebral en aneurismas de aorta abdominal como causa de dolor lumbar crónico. Serie de 5 casos.

Chronic low back bain is a common cause of medical consultation, and is often associated with degenerative vetebral disease. Despite this, we must not forget other diseases even in those cases where the imaging tests may suggest chronic degenerative changes in the lumbar spine, including the possible presence of an abdominal aortic aneurysm with a contained rupture must be ruled out due to its prognostic and therapeutic implications. We present 5 cases of chronic low back pain associated with serious lytic lesions in the vertebral body due to chronic rupture of an abdominal aortic aneurysm.

[Anaplastic large cell lymphoma. Report of an unusual case]. / A propósito de un linfoma anaplásico de células grandes con manifiesta peculiaridad de la relación clínica-patológica.

An anaplastic large cell lymphoma which fulfills all the criteria required for its inclusion among the soft tissue forms is reported. We point out in this case, in addition to its low frequency in adults, the severe systemic involvement of the disorder with out generalization, the lack of expression of the ALK1 protein, frequently positive in the generalized forms and the absence of response to polichiomiotherapy. We think that this case emphasizes the heterogenicity if the disorder on the clinical pathologycal relation ship of this kind of lymphomas.

A propósito de un linfoma anaplásico de células grandes con manifiesta peculiaridad de la relación clínica-patológica / Anaplastic large cell lymphoma. Report of on unusual case

Se describe un linfoma anaplásico de células grandes que reune todas las condiciones exigidas para incluirlo dentro de las formas descritas como "de tejido blando". Son llamativos en este caso, aparte de su escasa frecuencia en adultos, la grave repercusión sistémica del proceso, pese a no demostrarse la generalización del mismo, la ausencia de expresión de la proteína ALK1, frecuentemente positiva en las formas generalizadas, y la falta de respuesta a la poliquimioterapia. Creemos que este caso subraya la heterogenicidad del proceso en lo que se refiere a la relación clínico-patológica de este tipo de linfomas. (AU)

Malformación arteriovenosa pélvica. Evolución y tratamiento de un caso durante 17 años / Pelvic arteriovenous malformations. Evolution and treatment of a case over a period of 17 years

Introducción. Las malformaciones arteriovenosas (MAV) pélvicas son poco frecuentes. Habitualmente se presentan en adultos jóvenes sin predominio de género. Un alto número de ellas son asintomáticas y, por tanto, frecuentemente pasan desapercibidas. Si ocasionan manifestaciones, éstas son predominantemente en forma de dolor o masa palpable, que puede comprimir estructuras vecinas con expresividad clínica variable. El diagnóstico se realiza mediante estudios de imagen, como angiografía, eco-Doppler, TAC o RM. El tratamiento de esta patología es difícil, con alto número de recidivas, y en el caso del tratamiento quirúrgico, con alto índice de complicaciones. Caso clínico. Se presenta un caso de MAV pélvica que se ha tratado y se ha seguido en nuestro servicio durante un período de 17 años. La paciente, una mujer joven sin antecedentes de interés, acudió a nuestra consulta con clínica de edema y varices en la extremidad inferior izquierda. Se realizó el diagnóstico mediante arteriografía y el tratamiento se llevó a cabo mediante embolización percutánea. A lo largo de los 17 años siguientes, la paciente ha presentado varias recidivas que han precisado nuevas embolizaciones, con períodos asintomáticos intercalados de hasta 10 años. Conclusiones. Las MAV son una patología inusual, con una alta tasa de recidiva, independientemente del tipo de tratamiento elegido. El tratamiento percutáneo de las mismas ofrece las ventajas de una menor morbimortalidad y la posibilidad de repetición frente al tratamiento quirúrgico, por lo que según la bibliografía existente, debe ser la terapéutica de elección. (AU)

[A case of pulmonary sarcoidosis induced by interferon alfa treatment in a female patient with hepatitis C]. / A propósito de un caso de sarcoidosis pulmonar inducido por tratamiento con interferón alfa en una paciente con hepatitis C.

In spite of the generalized use of alpha interferon to treat hepatitis C there are very few cases in the literature on pulmonary sarcoidosis due to this therapy. A new case with this diagnosis is reported and the possible pathogenic mechanisms driving alpha interferon to sarcoid histologic changes are discussed.

A propósito de un caso de sarcoidosis pulmonar inducido por tratamiento con interferón alfa en una paciente con hepatitis C / Pulmonary sarcoidosis following interferon alpha therapy for chronic hepetitis C

A pesar del amplio uso de interferón alfa en el tratamiento de la hepatitis C las observaciones de sarcoidosis pulmonar secundarias a este tratamiento referidas en la bibliografia son muy escasas. Se aporta un nuevo caso al respecto y se discuten los posibles mecanismos patogénicos que, condicionados por el interferon alfa, conducirían a los cambios histológicos sarcoidóticos (AU)

Iliac arteriovenous fistula secondary to iliac aneurysm rupture associated with pulmonary embolism and anuria.

We present a case of iliac aneurysm rupture that started with high-output cardiac failure and anuria and later presented as a pulmonary embolism that needed a preoperatory filter for the cava vein.

[Incidence of primary gastric lymphoma and H. pylori infection in the central zone of Asturias]. / Incidencia de linfomas gástricos primarios y de afectación por H. pylori en la zona central de Asturias.

OBJECTIVE: We review our experience with primary gastric lymphomas type B of low (MALT) and high grade in a population of 366,635 people during 4 years and after performing 9,268 gastroscopies. RESULTS: The incidence of these lymphomas in our medium is similar to that found in the world population. Possible disagreements among the biopsy histology and that of the subsequent gastrectomy samples is pointed out. CONCLUSIONS: The frequency of H. pylori involvement in our primary gastric lymphomas is similar to that reported in the literature for the age of our patients, for the MALT lymphomas an well as for the type B high grade.

Incidencia de linfomas gástricos primarios y de afectación porH. pylori en la zona central de Asturias / Incidence of primary gastric lymphoma and of H. pylori infection in the central zone in Asturias

Objetivo: Se revisa en este trabajo nuestra casuística de linfomas gástricos primarios tipo B de bajo (MALT) y alto grado en una población de 366.635 habitantes durante 4 años y en la que se realizaron un total de 9.268 gastroscopias. Resultados: La incidencia de estos linfomas es en nuestro medio similar a la indicada como habitual en la población mundial. Se advierte de las posibles discrepancias entre la histología de la biopsia y la de las piezas de gastrectomía posteriores. Conclusiones: La frecuencia de afectación por H. pylori de nuestros linfomas gástricos primarios es equiparable a la considerada como normal en la bibliografía para la edad de nuestros pacientes, tanto en los casos de linfomas MALT como en los de tipo B de alto grado (AU)

[Castleman's disease: a histological concept for a wide clinical spectrum]. / Enfermedad de Castleman: un concepto histológico para un amplio abanico clínico.

A literature review about Castleman's disease after a clinical case with different manifestations of this entity was done. Special emphasis on the histological and clinical aspects of the sickness was given. The different pathological patterns and their broader spread do not match necessarily with the different clinical presentations described. Further conclusions regarding their evolution, prognosis and treatment response can not be easily obtained from these data.

[A case of uterine leiomyoma with pulmonary metastasis]. / Un caso de leiomioma uterino con metástasis pulmonares.

In a 34-years-old patient complaining about persistent dry cough, multiple bilateral pulmonary nodules were observed. The extremely good condition of the patient and the history of resection four years before of an uterine myoma suggested a pulmonary leiomyomatosis. The hystological study after a pulmonary segmentomy confirmed this diagnostic suspicion. The presence of benign pulmonary metastasis in an uterine leiomyoma is a very rare complication. We review the literature therapeutic aspects of this interesting entity.

[Mixed type-II cryoglobulinemia associated with a chronic hepatitis C virus infection]. / Crioglobulinemia mixta tipo II asociada a infección crónica por virus C de la hepatitis.

We describe the case of a patient with non A-non B post-transfusional cirrhosis and type-II mixed cryoglobulinemia, who showed in relation with said processes several acute symptoms of vasculitis, polyarthritis, pericarditis and autoimmune hemolytic anemia, finally dying due to an advanced hepatocellular insufficiency. In this patient the determination of antibodies against hepatitis C virus (anti-HCV) was positive, that is why we assume a possible relationship between both processes and the first literature references, after the clonation of the hepatitis C virus (HCV) genome, are reviewed.

[Acute-phase reactants in sepsis]. / Reactantes de fase aguda en la sepsis.

In 71 patients with fever and bacteremia without complications, a prospective study of acute-phase reactants is done. Raises in haptoglobin, ceruloplasmin, alpha-1-antitrypsin, protein C, beta-2-microglobulin, IgA and ferritin serum levels, together with leucocytosis and GSR, were very significant when diagnosis was done. Fibronectin, sideremia and transferrin were lowered. After 3 and 6 days of treatment haptoglobins, alpha-1-antitrypsin, protein C, ferritin, leucocytosis and GSR are lowered, while immunoglobulins, sideremia, transferrin and fibronectin raised, the latter until normalization. Fibronectin as well as changes in iron metabolism were very reliable parameters of inflammation and favorable evolution.

[Epidemiological study of prisoners at risk for AIDS in a Spanish prison]. / Estudio epidemiológico en reclusos con riesgo de SIDA en una prisión española.

Different proportions of the several AIDS risk practices in a Spanish prison during 1988 were studied. Also a epidemiologic study of the infectious diseases of the prisoners with some risk of this type was carried out. Of 135 prisoners with risk of AIDS, it was found that 91.2% of them were drug addicts. The index of positive HIV in all the population study was of 65.2%. 81.5% of the sample had at least one B hepatitis marker and 11.1% had HBs-Ag. 15.4% of the last group also showed HBe-Ag positive. Histories of non-A, non-B hepatitis were not evaluated in 9.6% of all the patients studied. 53.3% had sexually transmitted diseases. It is important to mention the high index of active tuberculosis found (12.6% of the sample), which is higher than the maximum values found in various similar papers. We did not find any differences in the grade of affectation between HIV+ and HIV-.