[The value of age as a prognostic factor in the severity of acute pancreatitis]. / Valor de la edad como factor pronóstico de gravedad en la pancreatitis aguda.

Age has been considered as a risk factor for the development of complications in acute pancreatitis. To confirm the above a retrospective study was designed including 526 cases of acute pancreatitis which were classified, according to age, into two groups: group I: > 65 years, and group II: < or = 65 years. The evolution of pancreatitis was classified as mild or severe according to the criteria of the Atlanta Meeting. Furthermore, other variables which may influence in the development of complications, such as the etiology or the presence of other associated diseases at the time of the appearance of pancreatitis were taken into account. On comparison of the severity of pancreatitis in both groups significant differences were only found in the appearance of acute renal failure. A relationship was, however, observed between the existence of certain diseases (arterial hypertension, diabetes mellitus and chronic renal failure) present at the time of the appearance of acute pancreatitis and the development of complications of the latter. In addition, on comparing the epidemiologic and etiologic data of the two groups, it was found that acute pancreatitis in the elderly is more often of biliary etiology, is more frequent in females and is usually accompanied by other diseases at the time of appearance. Age in itself is not a risk factor for the development of complications in acute pancreatitis. The association of diseases at the time of the initiation of pancreatitis implies a worse prognosis.

[Esophageal Crohn's disease]. / Enfermedad de Crohn esofágica.

Crohn's disease is characterized by chronic inflammation of the digestive tract which may be localized at any level. Nonetheless, esophageal disease is infrequent. Two cases of esophageal involvement in this disease in 2 young women with a history of previous involvement at an intestinal level are presented. Esophageal involvement by Crohn's disease should be suspected in any patient previously diagnosed with this disease who presents symptoms suggestive of esophagitis, using endoscopy with multiples biopsies of the affected areas and other of normal endoscopic appearance for diagnosis.

[Neuroendocrine tumor associated with acute pancreatitis]. / Tumor neuroendocrino asociado a pancreatitis aguda.

Neuroendocrine pancreatic tumors are uncommon neoplasms. They may remain symptomless for years, and are usually of late diagnosis. A women presenting with severe acute pancreatitis diagnosed as a neuroendocrine tumor after study by the pathologist of the tissue excised at laparotomy is presented.

Melatonin concentration in the umbilical artery and vein in human preterm and term neonates and neonates with acute fetal distress.

In order to assess the existence of a rhythmic secretion of melatonin (aMT) in newborns and whether this rhythm is affected by neonatal stress, we studied 112 newborns classified in three groups: normal babies delivered at term, preterm infants born before the 38th week, and babies with fetal distress. Melatonin was measured by RIA in the umbilical artery and vein at the time of birth. Melatonin levels in umbilical arterial and venous blood showed a diurnal rhythm in all groups. Melatonin levels in umbilical cord artery and vein were closely related. Nocturnal melatonin levels were increased in newborns with acute fetal distress in comparison with normal term and preterm neonates. These results suggest that (1) a rhythm of aMT secretion exists in newborns, although it cannot be determined whether this rhythm is of maternal or fetal origin and (2) neonatal stress (acute fetal distress) increases aMT production during the night in comparison with normal term and preterm neonates.

[Extramedullary plasmacytoma and hypercalcemia]. / Plasmocitoma extramedular e hipercalcemia.

Extramedullary plasmocytoma (EMP) is an infrequent entity characterized by the proliferation of malignant plasma cells which are generally found on the mucosa of the upper respiratory tract. A case of EMP located in the right maxillary sinus is referred. Peculiarities of the same were resistance to radiotherapy with local relapse and severe hyperkalemia. Despite deliberate searching, disease dissemination could not be demonstrated.