Ictiosis y embarazo: a propósito de un caso / Icthyosis and pregnancy: a purpose of a case

La ictiosis son afecciones dermatológicas, caracterizada por piel descamativa, por anormal queratinización, acompañada de eritrodermia, lesiones erosivas y piel acartonada. Su frecuencia es 1/200000 pacientes. Se presenta caso de paciente de 26 años, primigesta, con gestación de cronología imprecisa por FUM y 25 semanas por ecografía, quien consulta por ARO, presentando eritrodermia y queratodermia generalizada. A las 38 semanas de gestación por ecografía, inicia trabajo de parto, presentando desaceleraciones variables por distocia funicular, realizándosele cesárea de emergencia, extrayendo RN vivo, sano, sin afección dermatológica. Se hace notar q0ue la ictiosis no afecta el desarrollo fetal ni agrava la condición materna.

Fat distribution evaluated by computed tomography and metabolic abnormalities in patients undergoing antiretroviral therapy: preliminary results of the LIPOCO study.

BACKGROUND: Fat distribution abnormalities have been reported in patients treated with various antiretroviral drug regimens. The LIPOCO study is an ongoing observational study of unselected HIV-infected patients which aims to better characterize such disorders and their metabolic correlations. METHODS: Cross-sectional analysis of data collected at baseline in the first 154 male patients included. Investigators divided patients into four predetermined clinical categories of fat distribution: lipoatrophy, obesity, mixed condition and normal. Body composition (tetrapolar bioelectrical impedance analysis and skinfold thickness), fat distribution [computed tomography (CT) scan], plasma glucose and insulin concentrations both fasting and during an oral glucose tolerance test and endocrine and lipid profile were measured and compared between the four groups. RESULTS: Patients in the lipoatrophy group had significantly decreased abdominal and mid-thigh subcutaneous fat area values and elevated levels of plasma triglycerides. Patients in the obese and mixed groups had significantly increased intra-abdominal fat area values and elevated levels of plasma insulin and C-peptide. The CT scans identified some patients with isolated subcutaneous fat accumulation but no other alterations in fat distribution and no insulin resistance. Visceral adipose tissue measured by CT scan was positively correlated with fasting insulin and the sum of insulin levels (P < 0.0001). Fasting insulin as well as the sum of insulin levels were negatively correlated with the delta HIV-RNA (log(10)). In a multivariate logistic regression model, the use of stavudine significantly correlated with fat wasting in both nucleoside reverse transcriptase inhibitor and protease inhibitor groups: odds ratio (OR), 413 [95% confidence interval (CI), 5.2-999; P = 0.0068] and OR, 2.08 (95% CI, 0.92-7.0; P = 0.058) respectively, when compared with the use of zidovudine. Neither lamivudine or didanosine use, nor the use of protease inhibitors were significantly associated with fat distribution abnormalities or fat wasting. CONCLUSIONS: These preliminary results suggest that three major types of fat distribution abnormalities may occur in isolation or in association in HIV-infected patients undergoing active antiretroviral therapy: a fat depletion or 'lipoatrophy' syndrome which might be related to the use of stavudine; a mixed or fat redistribution syndrome related to an unusual side-product of effective virus control; and a subcutaneous adiposity syndrome reflecting increase in caloric intake.

Precancerous lesions of the larynx: clinical and pathologic correlations and prognostic aspects.

BACKGROUND: Medical literature on the development of malignancy shows wide-ranging limitations depending on the criteria considered, but all authors agree that the presence of dysplasia in the sample is an important prognostic sign. METHOD: This is a retrospective study of 248 patients controlled and treated at the ENT and Pathology Departments of the Hospital Clinic in Barcelona between 1981 and 1991 for larynx lesions. Biopsy studies of the following pathologic entities were carried out: keratosis, chronic inflammation, and papilloma of the adult. The degree of dysplasia present in each sample was assessed. RESULTS: The overall percentage of malignancy was 15.6% in this series. Malignancy developed in 8.7% of the cases without dysplasia and in 31% (p < 0.0001) with dysplasia. The groups were correlated with gender, age, and smoking habit. The presence of epithelial dysplasia is an important prognostic factor. The risk of malignant transformation increases if the dysplasia occurs in smokers.

[The laryngeal involvement in Kaposi's sarcoma in the acquired immunodeficiency syndrome]. / Afectación laríngea por sarcoma de Kaposi en el síndrome de inmunodeficiencia adquirida.

Kaposi's sarcoma (KS) is a malignant vascular neoplasm characterized, in its classical form, by a slow evolutive course, beginning in the lower extremities. Lately have been reported more and more cases of this entity associated with the acquired immunodeficiency syndrome (AIDS), running much more aggressively. In ENT-pathology are not uncommon this kind of neoplasm in the oral cavity and oropharynx. However at larynx's level such descriptions till now had been sporadic. The AA. present a KS case sitting in the epiglottis of an AIDS patient. They emphasize the importance of a throughout ENT-examination of these patients and also remark the necessity of performing various and deep biopsies in order to gain a diagnosis that can be relied on. Finally, they review the updated management alternatives for this sort of pathology.

[Necrotizing osteitis of tympanal bone. Report of 2 cases]. / Osteítis necrotizante de hueso timpanal. A propósito de dos casos.

A large variety of process can cause necrosis of the bony external ear canal, found by means otoscopic examination. Two cases with a final diagnosis or external ear canal cholesteatoma are reported. A revision of the main characteristics of this uncommon entity is performed, with a special emphasis to avoid that the scarcity of clinic symptoms favour its growing in depth.

An unusual case of Castleman's disease restricted to the neck.

An unusual case of Castleman's disease (CD) restricted to the left cervical area is reported. CD is rarely confined to the cervical area; when it occurs, it is usually of the hyaline-vascular subtype and small in size. This case was atypical due to its histology (plasma-cell variant), big size (15 x 11 x 6 cm) and the absence of general symptoms. In spite of surgical excision, the disease recurred 11 months later. However, subsequent surgery followed by chemotherapy resulted in a long-lasting control of the disease.

[Characteristics of the course of glottic cancer]. / Caractéristiques évolutives du cancer glottique.

We present a retrospective study of the course of glottic cancer in a series of 302 cases. We studied the precise tumour localisation, the treatment carried out, the anatomico-pathological characteristics of the resected tissue and the results obtained as a function of the therapy used. It would seem important to stress the necessity of homogenizing the results of various authors by: presenting a series large enough for the results to be significant; there should be detailed total and prolonged follow up of patients, with use of similar evaluation parameters.

[Solitary plasmacytoma of the upper respiratory and digestive tracts. Report of 3 cases]. / Plasmocytome solitaire des voies aéro-digestives supérieures. Présentation de trois observations.

Three cases of plasmocytoma of cervicofacial localization are reported and diagnostic and therapeutic methods and prognostic factors reviewed. One patient had localized cervicofacial amyloidosis. A literature review confirmed the rarity of this tumor and its marked oncologic differences from epithelial type tumors and multiple myeloma.

[Route of tumoral extension of cancers of the rhinopharynx. Anatomo-clinical study]. / Modalités de l'extension tumorale des cancers du rhino-pharynx. Etude anatomo-clinique

Seventy two cases of nasopharyngeal carcinoma were studied. The manner of spread varied with the primary site, 49 being lateral and 23 postero-superior. The clinical and radiological findings were correlated with the histological appearance on autopsy material derived from serial sections of the base of the skull.