Adenopatía inguinal silicótica: presentación de un caso / Groinal silicotic adenopathy: presentation of a case

La silicosis es una enfermedad sistémica, ocupacional, incluída dentro de las neumoconiosis, porque la principal vía de entrada es la aérea y, en consecuencia, el depósito de partículas de sílice y las reacciones tisulares se producen en el parénquima pulmonar. Hombre de 30 años, trabajador de la construcción que presentaba múltiples adenopatías mediastínicas, abdominales e inguinales en ausencia de lesión parenquimatosa pulmonar. La biopsia de una adenopatía inguinal mostró numerosas formaciones granulomatosas, no necrosantes, con material acicular birrefringente con luz polarizada compatible con sílice. Este caso tiene la peculiaridad de la presentación exclusivamente extrapulmonar de la silicosis (AU)

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[Coxiella burnetii osteoarthritis]. / Osteoartritis por Coxiella burnetii.

A case of a 25-year-old female characterized by febrile osteoarthritis and arthromyalgias as the only clinical manifestation of a Q fever is discussed. Analytical data were compatible with those of an acute inflammation and serologic findings reached diagnostic levels. Response to Doxycycline treatment was totally satisfactory. Even though associated arthromyalgias are described in some cases of Q fever as well as sporadic cases of osteoarthal infection due to Coxiella burnetii, there are no oligosymptomatic cases published as the one discussed. Some physiopathologic considerations referred to this peculiar onset are suggested.

[Correlative urinary excretion of sodium-uric acid in hyperuricemia (author's transl)]. / Eliminación urinaria correlativa de sodio-ácido úrico en hiperuricemias.

Since uricosuria is an essential compensative factor in hyperuricemia, multiple factors exist which can influence on the uric acid excretion in the tubules. Normally, 90% of the uric acid filtered by the glomerulus is reabsorbed, and its active tubular secretion forms the greater part of the uric acid present in the urine. One of the factors observed as leading to urinary excretion of uric acid, is saline overload, although this effect cannot always be achieved. This study is an attempt to assess the importance of hyperuricemia as a determinant of the action of sodium upon the urinary excretion of uric acid. The series were grouped according to the plasma and urinary values of uric acid. In cases studied, the percentage of sodium was similar independent of the excretion percentages obtained for uric acid. Nevertheless, in the groups with increased plasma levels of uric acid, a direct and significant correlation was found between the excretion percentage of sodium and that of uric acid. These data cannot be obtained in groups with normal plasma levels of uric acid. Since saline overload does not always lead to hyperuricosuria, other factors must condition the secondary effect. The obtained results suggest that hyperuricemia can be one of those factors, offering a great amount of uric acid to the renal tubule, a condition in which the sodium may act as a dragging factor which may not be possible with a lesser degree of uric acid.

[Immunopathologic implications of cryoglobulins (author's transl)]. / Implicaciones inmunopatológicas de las crioglobulinas.

Cryoglobulins are proteins which appear in the serum of some patients. Their basic characteristic is their power to precipitate at low temperatures. In this work a review is made of the data presented by several authors in regard to the origin, isolation, classification, and precipitation mechanism, as well as of the factors which influence the cryoprecipitability. We also set out the most probable etiopathogenic theories and the possible clinical findings in those patients who have these proteins altered in their serum. Finally we comment on the treatment with special reference to penicillamine.

[Diseases associated with chronic bronchopathies and plasma alpha-1-antitrypsin deficiency (author's transl)]. / Procesos asociados a broncopatías crónicas con deficiencias plasmáticas de alfa-1-antitripsina.

Two groups of patients were selected according to their plasma levels of alpha-1-antitrypsin deficiency from among 58 patients with a chronic bronchopathy. Group I had normal plasma levels of alpha-1-antytrypsin; group II had plasma values lower than normal. The pathologic conditions associated with chronic bronchopathies were studied in both groups and so were the gasometric characteristics of the same. Chronic bronchopathies in subjects belonging to group II showed a clear tendency to present normal levels of pCO2 and hydrogen ions possibly related to a greater bronchial impairment in these patients. Independently of the genetic characteristics of plasma alpha-1-antitrypsin deficiency, its general levels are the real indication of its possible etiopathogenic action. Patients with recurrent plasma alpha-1-antitrypsin deficiency, its general levels are the real indication of its possible etiopathogenic action. Patients with recurrent plasma alpha-1-antitrypsin deficiency are more susceptible to bacterial infections, liver cirrhosis, diabetes, and allergic states. All this would be related to the protective effect of this protein fraction, and its reduction according to the most recognized theories would decrease the resistance of hepatic and pancreatic cells.

Fosfomycin in acute bronchopneumopathies.

Fosfomycin has been tested in 25 adult patients with bronchial or bronchopulmonary acute processes, of which 13 were simple acute processes of a greater or lesser severity, and 12 acutenesses of chronic bronchial processes. The germs found most frequently in the sputum cultures were Streptococcus pneumoniae and Klebsiella. Fosfomycin was used intramuscularly with doses of 4 g/day, for an average of 10 days. The results obtained were 16 cures, 7 improvements and 2 failures, which represents 92% success with 8% failures.