A novel monoclonal antibody to Neisseria meningitidis serogroup X capsular polysaccharide and its potential use in quantitation of meningococcal vaccines.

A novel murine hybridoma monoclonal antibody (MAb) was produced against the capsular polysaccharide (CP) of Neisseria meningitidis serogroup X (MenX) in order to develop a sandwich enzyme linked immunosorbent assay (ELISA) for the quantitation of the meningococcal polysaccharide. The MAb only reacted with the CP from MenX and did not react with CPs from N. meningitidis serogroups A, C, Y and W (MenA, MenC, MenY, MenW). The affinity constant (Ka) of the MAb measured by non-competitive ELISA was 7.25 × 10(7) M(-1). The application of this MAb in a sandwich ELISA was demonstrated by its ability to properly quantitate three lots of an experimental meningococcal CP-based vaccine. The MAb obtained in this work could be a valuable reagent for the detection and quantitation of future meningococcal vaccines containing MenX CP.

Immune adjuvant effect of V. cholerae O1 derived Proteoliposome coadministered by intranasal route with Vi polysaccharide from Salmonella Typhi.

The proteoliposome derived from Vibrio cholerae O1 (PLc) is a nanoscaled structure obtained by a detergent extraction process. Intranasal (i.n) administration of PLc was immunogenic at mucosal and systemic level vs. V. cholerae; however the adjuvant potential of this structure for non-cholera antigens has not been proven yet. The aim of this work was to evaluate the effect of coadministering PLc with the Vi polysaccharide antigen (Poli Vi) of S. Typhi by the i.n route. The results showed that Poli Vi coadministered with PLc (PLc+Poli Vi) induce a higher IgA response in saliva (p<0.01) and faeces (p<0.01) than Poli Vi administered alone. Likewise, the IgG response in sera was higher in animals immunised with PLc+Poli Vi (p<0.01). Furthermore, IgG induced in sera of mice immunised with PLc+Poli Vi was similar (p>0.05) to that induced in a group of mice immunised by the parenteral route with the Cuban anti-typhoid vaccine vax-TyVi, although this vaccine did not induce a mucosal response. In conclusion, this work demonstrates that PLc can be used as a mucosal adjuvant to potentiate the immune response against a polysaccharide antigen like Poli Vi.

Four monoclonal antibodies against capsular polysaccharides of Neisseria meningitidis serogroups A, C, Y and W135: its application in identity tests.

Murine hybridoma monoclonal antibodies (MAbs) were produced against the capsular polysaccharide (CPs) of serogroups A, C, W135 and Y meningococci (MenA, MenC, MenW, MenY) in order to develop immunological reagents for the identification of meningococcal polysaccharides. Each serogroup-specific MAb reacted with the CPs from its homologous serogroup only and did not react with CPs from the other three serogroups. The affinity constant (Ka) of the four MAbs measured by non-competitive ELISA was 6.62 × 10(9), 2.76 × 10(9), 1.48 × 10(9) and 3.8 × 10(9) M(-1) for MenA, MenC, MenW and MenY MAbs respectively. The application of these MAbs for identity tests was demonstrated by their abilities to correctly identify the CPs from serogroups A, C, W135 and Y in meningococcal CPs-based vaccines through ELISA. The MAbs obtained in this work are a very valuable set of tools for study meningococcal polysaccharides vaccines.

AFCo1 as nasal adjuvant of capsular polysaccharide from Neisseria meningitidis serogroup C induces systemic and mucosal immune responses.

Increasing emphasis is being placed on the mucosal administration of vaccines in order to stimulate mucosal as well as systemic responses. Findings from our group suggest that proteoliposome-derived cochleate (AFCo1) acts as a potent mucosal adjuvant. As an alternative to chemical conjugation, the current study aimed to determine the benefit of using AFCo1 to improve the mucosal and systemic immune responses to capsular polysaccharide of Neisseria meningitidis serogroup C (PsC), a model of a thymus-independent (TI) antigen. Therefore, intranasal (i.n.) immunization of 3 doses 1 week apart with AFCo1 plus PsC in mice was conducted. Highly specific anti-PsC IgA responses and an anti-PsC IgG response were obtained. The subclass pattern induced against PsC was similar to that induced with the meningococcal vaccine. In summary, AFCo1 as nasal adjuvant was demonstrated to be capable of eliciting mucosal and systemic specific responses against a TI antigen.

Mucosal and systemic immune responses of mice to tetanus toxoid coadministered nasally with AFCo1.

Mucosal immune responses are an early and important line of defense against pathogens. The current understanding of the mucosal immune system allows us to consider the use of nasal immunization for induction of antigen-specific immune responses at the mucosal surface and the systemic compartment. Mucosal adjuvants are key for developing novel mucosal vaccines and represent 1 approach to improving mucosal and systemic immunity. However, few mucosal vaccine adjuvants are currently approved for human use. Neisseria meningitidis B proteoliposome-derived cochleate (AFCo1 - Adjuvant Finlay Cochleate 1) has been demonstrated to be a potent mucosal adjuvant. The present work demonstrates that intranasal immunization of 3 doses of tetanus toxoid (TT) coadministered with AFCo1 in mice promotes high systemic and mucosal responses. The anti-TT IgG serum titers and the mucosal anti-TT IgA in saliva and vaginal wash were significantly higher than TT alone. The analysis of antibody subclasses showed that intranasal administration of AFCo1 + TT induced not only IgG1 but also IgG2a anti-TT antibodies at levels comparable to those obtained with TT vaccine (vax-TET). These data support the fact that AFCo1 is a potent mucosal adjuvant in nasal immunization to a coadministered protein antigen.

Prostate-specific antigen levels in patients with risk factors for prostate carcinoma disorders / Níveis de antígeno específico da próstata em pacientes com fatores de risco para transtornos do carcinoma da próstata

ABSTRACT Objective: To verify the association between the prostate-specific antigen (PSA) serum concentration and the presence of risk factors for prostate diseases in adult patients with urogenital infections. Materials and methods: Analytical cross-sectional study of PSA in 60 patients aged 40 to 65 years, from January to December 2013. PSA quantification was performed in serum by solid-phase chemiluminescence in two label cycles: 1. mouse monoclonal antibody (mAb); and 2. goat polyclonal antibody (pAbs). After each cycle the free antigen was removed. The readings were taken on the INMULITE ONE Siemens® automated equipment. From the PSA, 0.0-2.5 ng/ml was used to calculate the antigen distribution trend, and a bivariate statistical analysis of PSA was as opposed to previous exams, and endogenous and environmental risk factors detected. Results: Patients between 50-60 years of age, with a family history of urogenital and sexually transmitted infections, toxic habits, and exposure to occupational risk prevailed. Sixty-two percent of patients presented normal PSA levels, and the remaining presented slightly elevated and very high PSA levels. In the statistical analysis, a significant association (p < 0.001) of PSA was found as opposed to previous tests. A significant association (p = 0.001) was also found between PSA versus age, family history, personal pathological history, toxic habits, and risk exposure. Conclusion: The high association rate found between PSA versus age and other risk factors could be used as a predictive value for prostate cancer (Pca) or other prostate disorders.

RESUMEN Objetivo: Verificar la asociación entre el nivel sérico del antígeno prostático específico (APE) y la presencia de factores de riesgo para enfermedades de próstata en pacientes adultos con infecciones urogenitales. Materiales y métodos: Estudio analítico, transversal acerca del APE en 60 pacientes con edades entre 40 y 65 años, de enero a diciembre del 2013. La cuantificación del APE fue realizada en suero por quimioluminiscencia en fase sólida en dos ciclos de marcadores utilizando: 1. anticuerpo monoclonal de ratón (mAb); y 2. anticuerpo policlonal de cabra (pAbs). Después de cada ciclo, el antígeno libre se eliminó. Las lecturas se realizaron en un equipo automatizado Immulite One Siemens®. Se utilizaron 0-2,5 ng/ml del APE para determinar el nivel de distribución del antígeno, y su análisis estadístico bivariado se estableció en comparación con exámenes anteriores y factores de riesgo endógenos y relativos al entorno. Resultados: Prevalecieron los pacientes entre 50 y 60 años de edad, con antecedentes familiares de infecciones urogenitales y de trasmisión sexual, hábitos tóxicos y exposición a riesgos laborales. Sesenta y dos por ciento de los pacientes presentaron niveles adecuados de APE; los demás, niveles ligeramente elevados y muy elevados. En el análisis estadístico, una asociación significativa (p < 0,001) de APE fue descubierta versus exámenes previos. También se descubrió una asociación significativa (p = 0,001) de APE versus edad, antecedentes familiares, antecedentes patológicos personales, hábitos tóxicos y exposición a riesgo. Conclusión: El alta asociación encontrada entre APE versus edad y otros factores de riesgo podría ser usada como valor predictivo para cáncer de próstata (CaP) u otras enfermedades prostáticas.

RESUMO Objetivo: Verificar a associação entre o nível sérico do antígeno prostático específico (PSA) e a presença de fatores de risco para doenças da próstata em pacientes adultos com infecções urogenitais. Materiais e métodos: Estudo analítico transversal do PSA em 60 pacientes com idades entre 40 e 65 anos, de janeiro a dezembro de 2013. A quantificação do PSA foi realizada em soro por quimioluminescência em fase sólida em dois ciclos de marcadores: 1. anticorpo monoclonal de rato (mAb); e 2. anticorpo policlonal de cabra (pAbs). Depois de cada ciclo, o antígeno livre foi retirado. As leituras foram feitas no equipamento automatizado INMULITE ONE Siemmens®. Do PSA foram usados 0-2,5 ng/ml para calcular a taxa de distribuição do antígeno, e sua análise estatística bivariada foi apresentada em oposição a exames anteriores e a fatores de risco endógenos e relativos ao ambiente. Resultados: Prevaleceram os pacientes entre 50 e 60 anos de idade, com histórico familiar de casos de infecções urogenitais e sexualmente transmissíveis, hábitos tóxicos e exposição a riscos ocupacionais. Sessenta e dois por cento dos pacientes apresentaram níveis adequados de PSA; os demais, níveis levemente elevados e muito elevados. Na análise estatística, uma associação significativa (p < 0,001) de PSA foi descoberta em oposição a exames anteriores. Uma associação significativa (p = 0,001) de PSA também foi descoberta em oposição a idade, histórico familiar, histórico patológico pessoal, hábitos tóxicos e risco à exposição. Conclusão: A alta taxa de associação encontrada entre PSA em oposição à idade e a outros fatores de risco poderia ser usada como valor preditivo para câncer de próstata (Pca) ou outras doenças prostéticas.

[Survival of patients with advanced renal carcinoma treated with interferon]. / Sobrevida de los pacientes con carcinoma renal avanzado tratados con interferón.

OBJECTIVES: To determine survival of patients with metastatic renal carcinoma treated with interferon. METHODS: Retrospective longitudinal study with 18 patients with the diagnosis of metastatic renal carcinoma treated in the University Hospital Manuel Fajardo between July 2002 and September 2007 with radical surgery and alpha 2b recombinant interferon, either adjuvant or as monotherapy. RESULTS: 74% (14/18) of the patients were males, 26% (5/18) females. 72% (13/18) underwent radical surgery plus interferon, and 28% (5/18) received interferon monotherapy. Complete response was observed in 22% (4/18); 78% (14/18) had progression. One, 2, 4 and 5-year survivals were 50%, 33%, 28%, and 22%, respectively. CONCLUSIONS: No significant response was found. There was not tumor regression in any case using interferon. Survival was better in cases undergoing radical nephrectomy plus interferon than cases treated with interferon monotherapy.

[Correlation between symptoms and survival in patients with renal cell carcinoma]. / Correlación de los síntomas de los pacientes con cáncer de células renales con la supervivencia.

OBJECTIVES: To evaluate the correlation between type of presentation in patients with renal cell carcinoma and survival. METHODS: Longitudinal retrospective study of 42 patients with clinical and histological diagnosis of renal cell carcinoma (RCC) between July 2002 and September 2007 at University Hospital Manuel Fajardo. The following variables were studied: Sex, age, clinical presentation: 1) asymptomatic: 2) symptomatic: 3) paraneoplastic syndrome; tumor stage (TNM 1997) and survival. RESULTS: There is a predominance of men over women, the age of greater incidence was between the fifth a and seventh decades. The tumors were classified as: asymptomatic 7%, 3/42; symptomatic 67%, 28/42, with flank pain 31%, 13/42; with hematuria 24%, 10/42, and tumor 10%, 4/42, the classic triad of hematuria, flank pain and mass was 2.3%, 1/42 of the patients and paraneoplastic syndrome 24%, 11/42. The patients with non-metastatic disease were 57%, 24/42 and 43%, 18/42 presented metastases. Five-year survival for patients with RCC by TNM stage was T1, 100% ( 12/12) , T2, 97% (11/12) , T3, 36% (4/11) , T4, 0% (0/7) . The survival of localized and metastatic RCC was 95%, 23/24 and 22%, 4/18 cases respectively and all stage was 64% (27/42). CONCLUSIONS: The asymptomatic RCCs were smaller; pain, hematuria, and mass were the most common manifestations in symptomatic RCC. The prognosis is dismal in patients with RCC showing paraneoplastic syndromes.

Study of a Leptospirosis Outbreak in Honduras Following Hurricane Mitch and Prophylactic Protection of the vax-SPIRAL® Vaccine.

Honduras was one of the Central American countries most severely hit by Hurricane Mitch. Torrential rains and heavy flooding created conditions conducive to a leptospirosis outbreak in the country. A group of Cuban scientists studied 68 patients from the Department of Cort�s - one of the country's hardest hit areas - presenting clinical and epidemiological profiles indicative of leptospirosis. Blood and serum samples were taken from all subjects. A microscopic agglutination test (MAT) was used to identify Leptospira strains and to assess protection conferred by vax-SPIRAL® (Cuban leptospirosis vaccine) against the isolated strain. Prevalence of leptospires in the kidneys and liver was also verified. A male predominance was found in the group aged 15-49 years. Municipalities in this Department with the largest number of cases were San Pedro Sula, La Lima, and Chamelec�n. The most frequent symptoms included fever, headache, myalgia, and generalized discomfort. Over 80% of subjects reported presence of rodents in their homes, as well as contact with stagnant water and domestic animals. The strain isolated from positive blood cultures was from the Icterohaemorrhagiae serogroup, which was highly virulent in the animal model used. Protection was 100% in hamsters inoculated with vax-SPIRAL® and subsequently challenged with the Honduran strain. Additionally, macroscopic analysis of organs from immunized animals that survived the challenge showed no signs of leptospirosis infection.

Biodistribución de IgA secretora purificada de calostro humano en fluidos biológicos de ratón Balb/c / Biodistribution of the secretory IgA purified from human colostrum in biological fluids of Balb/c mice

La IgA secretora humana (IgAsh) es estructural y funcionalmente liberada por el ambiente mucosal, con la capacidad de neutralizar antígenos, participa en la aglutinación y exclusión de estos y previene la adherencia de patógenos a las superficies del epitelio mucosal. En este estudio se evaluó la biodistribución de la IgAsh purificada de calostro, después de su administración por vía intranasal, en el modelo de ratón Balb/c y se determinaron los niveles de esta inmunoglobulina en diferentes fluidos biológicos mediante ELISA. Los resultados mostraron la presencia del anticuerpo en saliva de los animales del grupo que recibió la IgAsh en todos los intervalos de tiempo estudiados. En las muestras de lavado tráqueo-bronquial se obtuvo solo la presencia del anticuerpo a las 2 y 3 h posteriores a la inoculación. A partir de los resultados obtenidos consideramos interesante en el futuro utilizar este modelo experimental para evaluar el papel protector de esta inmunoglobulina como candidato terapéutico frente a la infección por Mycobacterium tuberculosis(AU)

The human secretory IgA (IgAsh) is structural and functionally released by the mucosal environment, with the ability to neutralize antigens and participating in promoting the binding and exclusion of them and preventing the adhesion of pathogens to mucosal epithelial surfaces. In this study, the biodistribution of hsIgA purified from colostrum was evaluated, after being administered intranasally to BALB/c mice model and the levels of this immunoglobulin in several biological fluids were determined by ELISA. Results showed the presence of antibody in saliva samples from animals that received the IgAsh, which was significantly higher than levels found in samples from non-treated animals, at all time intervals. In samples of tracheobronchial lavage, high antibody levels were only obtained two and three hours after the inoculation of the animals of the group that received the IgAsh, compared to the non-treated group. According to the results obtained, we consider interesting to evaluate the protective role of this immunoglobulin as a therapeutic candidate against the infection by M. tuberculosis in a near future(AU)

[Adrenal myelolipoma. Case report and bibliographic review]. / Mielolipoma de la glándula suprarrenal. Informe de un caso y revisión de la literatura.

OBJECTIVES: We report one case of adrenal myelolipoma in a female patient presenting with right lumbar pain over six months. METHODS: Diagnostic work included ultrasound, intravenous urography (IVU) and CT scan. RESULTS: The patient underwent right adenomectomy with the working diagnosis of adrenal myelolipoma. We describe the pathology report. CONCLUSIONS: Myelolipoma may present hematopoietic, fat and bone components. It continues being an incidental finding. Ultrasound and CT scan are effective diagnostic tests. Asymptomatic small tumors, smaller than 4 cm, may be monitored with watchful waiting. Symptomatic tumors greater than 4 cm should be extirpated because of the risk of spontaneous rupture with retroperitoneal bleeding. Bilateral adrenalectomy for big tumors implies medical replacement with hydrocortisone.

The adjuvant potential of synthetic alkylglycerols.

Alkylglycerols (AGs) have shown immune stimulant and adjuvant activity in many studies, but natural sources are not so accessible and their extraction from them is very complicated. Therefore, a group of chemists at IFAL have synthesized AG analogs. The aim of this work was to evaluate the adjuvant potential of different synthetic AGs. A mix of ovoalbumin (Ova) and AGs increase anti-Ova IgG antibodies production in sera of immunized mice. The predominant subclass was IgG1 although higher levels of IgG2a were observed as the carbon chain length of AGs increased. AGs also induced the production of IL-12 and nitric oxide (NO) in the U937 human histiocyte and J774 mouse macrophage cell lines, respectively. These results indicate that synthetic AGs are effective adjuvants for the standardized antigen, Ova.

[Incidental renal cell carcinoma]. / Carcinoma de células renales incidental.

OBJECTIVES: To report the incidence and management of incidental renal cell carcinoma (RCC). METHODS: We performed a retrospective longitudinal and panel study for our case series between January 1990 and December 2003. Thirty cases of RCC were analyzed, 6 of which were incidental. RESULTS: 4 patients were males (66.6%) and 2 females (33.3%); age ranged between 28 and 72 years. Reason for consultation was related with gastrointestinal symptoms. Ultrasound and CT scan are the most useful studies. Clinical stage was 4 T1 (66.6%), 2 T2 (33.3%). 4 radical nephrectomies and 2 conservative surgeries (partial nephrectomy and tumorectomy) were performed. A dose of 3 million units of alpha 2b recombinant interferon (IFN alpha 2b r) was given Intramuscularly two times a week over 6 months. Follow-up ranged between 120 and 60 months and none of the patients had evidence of tumor activity. CONCLUSIONS: The incidence of incidental RCC in our hospital is 20%. Clinical stage was always low and survival is directly related to stage. Conservative surgery showed similar survival than radical surgery.

[Solubilization of components of outer membrane of Leptospira interrogans serovar mozdok by sodium desoxycholate and triton X-100 and evaluation of their immunogenic capacity and homologous and heterologous protection induced in hamsters]. / Solubilización de componentes de membrana externa de Leptospira interrogans serovar mozdok mediante desoxicolato de sodio y tritón X-100 y evaluación de su capacidad inmunogénica y proteceión homóloga y heteróloga inducida en hámsters.

Two detergents (triton X-100 and sodium desoxycholate) were evaluated as solubilizing agents of the components of the outer membrane of Leptospira Pomona serovar mozdok. It was obtained a greater yielding of proteins on applying the treatment with triton X-100. The variants formulated starting from the extracts obtained showed a high immunogenicity and capacity of homologous protection against the challenge in hamster.

[Cryptorchidism and cancer]. / Testiculos no descendidos y cancer.

OBJECTIVES: To demonstrate the presence of neoplasic degeneration within non descended testicles and the effect that late orchydopexy could have in the increased incidence. METHODS: We review the medical records of 22 patients with the diagnosis of malignant testicular tumor cared for at the Department of Urology of the Hospital CQ D Comandante M. Fajardo between 1982 and 2004, looking for history of cryptorchidism, age at the time of orchydopexy (if carried out), histological diagnosis and stage, and post operative outcome. We include one case which did not belong to this series because it was not reported previously. RESULTS: Four patients with history of cryptorchidism were found, the youngest was 12 years old and the time of orchydopexy and the oldest 57. All cases of testicles outside the scrotum at the time of diagnosis were seminomas. The only case with successful orchydopexy presented teratocarcinoma and died before two years from orchiectomy. All cases of seminoma received radiotherapy and are disease-free with negative tumor markers. CONCLUSIONS: Cryptorchid testicles operated after the age of two years only provide hormonal supply adequate for development of secondary sexual features but not fertility, so that in unilateral cases late orchydopexy would only help to detect neoplasic degeneration before the appearance of pain or symptoms from metastases. If there are not important psychological or cosmetic reasons orchiectomy should be the first therapeutic option for adult's cryptorchidism.

Correlación de los síntomas de los pacientes con cáncer de células renales con la supervivencia / Correlation between symptoms and survival in patients with renal cell carcinoma

OBJETIVO: Analizar la correlación existente entre los síntomas de los pacientes con Carcinoma de Células Renales y la supervivencia.MÉTODO: Se realizó un estudio retrospectivo longitudinal de 42 pacientes con diagnóstico clínico e histológico de carcinoma de células renales tratados durante el período comprendido entre julio del 2002 a septiembre 2007 en el hospital Universitario Manuel Fajardo. Se analizaron las variables de: sexo, edad, forma de presentación de la enfermedad (asintomática, sintomática y síndrome paraneoplásico), estadio tumoral de la clasificación de TNM y sobrevida.RESULTADOS: El hallazgo asintomático se presentó en el 7%, 3/42 de los casos y se manifestaron por síntomas el 67%, 28/42, el dolor en el 31%, 13/42, la hematuria en el 24%, 10/42, el tumor en el 10%, 4/42, la tríada clásica (dolor, tumor y hematuria) en el 2.3%, 1/42 de los pacientes. El resto de los enfermos el 24%, 11/42 acudieron por síndrome paraneoplásico. El 57%, 24/42 al momento del diagnóstico no tenían metástasis y el 43%, 18/42 con enfermedad metastásica. La supervivencia para los estadios no metastásicos fue del 95%, 23/42 y para el metastásico del 22%, 4/18.CONCLUSIONES: El diagnóstico de carcinoma de células renales asintomático fue muy pobre, la presentación más frecuente fue el dolor, la hematuria y la masa palpable y representa la mayoría de las veces enfermedad avanzada. Los pacientes con síndrome paraneoplásicos tienen grave pronóstico con una baja supervivencia(AU)

OBJECTIVES: To evaluate the correlation between type of presentation in patients with renal cell carcinoma and survival.METHODS: Longitudinal retrospective study of 42 patients with clinical and histological diagnosis of renal cell carcinoma (RCC) between July 2002 and Septem-ber 2007 at University Hospital Manuel Fajardo. The following variables were studied: Sex, age, clinical presentation: 1) asymptomatic: 2) symptomatic: 3) paraneoplastic syndrome; tumor stage (TNM 1997) and survival. RESULTS: There is a predominance of men over women, the age of greater incidence was between the fifth a and seventh decades. The tumors were classified as: asymptomatic 7%, 3/42; symptomatic 67%, 28/42, with flank pain 31%, 13/42; with hematuria 24%, 10/42, and tumor 10%, 4/42, the classic triad of hematuria, flank pain and mass was 2.3%, 1/42 of the patients and paraneoplastic syndrome 24%, 11/42. The patients with non-metastatic disease were 57%, 24/42 and 43%, 18/42 presented metastases. Five-year survival for patients with RCC by TNM stage was T1, 100% (12/12), T2, 97% (11/12), T3, 36% (4/11), T4, 0% (0/7). The survival of localized and metastatic RCC was 95%, 23/24 and 22%, 4/18 cases respectively and all stage was 64% (27/42).CONCLUSIONS: The asymptomatic RCCs were sma-ller; pain, hematuria, and mass were the most common manifestations in symptomatic RCC. The prognosis is dismal in patients with RCC showing paraneoplastic syndromes(AU)

Sobrevida de los pacientes con carcinoma renal avanzado tratados con interferón / Survival of patients with advanced renal carcinoma treated with interferon

OBJETIVO: Determinar la sobrevida de los pacientes con carcinoma renal metastásico tratados con Interferón.MÉTODOS: Estudio retrospectivo longitudinal de 18 pacientes atendidos en el Hospital Universitario Manuel Fajardo entre julio del 2002 a septiembre del 2007, con diagnóstico de carcinoma renal metastásico tratados con cirugía radical e Interferón Alfa 2b recombínante adyuvante a la cirugía o como monoterapia.RESULTADOS: El 74%, 14/18 de los pacientes fueron masculinos, el 26%, 5/18 femeninos. Al 72%, 13/18 se les realizó cirugía radical más Interferón y el 28%, 5/18 se le administró el Interferón como monterapía. Se observó respuesta completa en el 22%, 4/18 y progresión en el 78%, 14/18. La sobrevida fue del 50%, 33%, 28% y 22% a 1, 2, 4 y 5 años respectivamente.CONCLUSIONES: No se encontró respuesta significativa. No hubo regresión de la carga tumoral en ningún caso con el uso del Interferón. La sobrevida fue mejor en los casos que se les realizó nefrectomía radical más Interferón que en los casos tratados con Interferón como monoterapia(AU)

OBJECTIVES: To determine survival of patients with metastatic renal carcinoma treated with interferon.METHODS: Retrospective longitudinal study with 18 patients with the diagnosis of metastatic renal carcinoma treated in the University Hospital Manuel Fajardo between July 2002 and September 2007 with radical surgery and alpha 2b recombinant interferon, either adjuvant or as monotherapy.RESULTS: 74% (14/18) of the patients were males, 26% (5/18) females. 72% (13/18) underwent radical surgery plus interferon, and 28% (5/18) received interferon monotherapy.Complete response was observed in 22% (4/18); 78% (14/18) had progression. One, 2, 4 and 5-year survivals were 50%, 33%, 28%, and 22%, respectively. CONCLUSIONS: No significant response was found. There was not tumor regression in any case using interferon. Survival was better in cases undergoing radical nephrectomy plus interferon than cases treated with interferon monotherapy(AU)

[Adrenal gland cyst. Report of one case and review of the literature]. / Quiste de la glándula suprarrenal. Informe de un caso y revisión de la literatura.

OBJECTIVES: To report one case of adrenal gland cyst in a patient presenting with lower urinary tract symptoms. The diagnosis and therapeutic aspects are discussed. METHODS: Diagnostic studies included ultrasound, KUB x-ray, CT scan and fine needle aspiration. RESULTS: Conservative treatment was chosen after the diagnosis of uncomplicated adrenal gland cyst with oligosymptomatic obstructive uropathy. CONCLUSIONS: The reliability of diagnostic tests (radiological and cytological) for adrenal cysts leave surgical treatment for symptomatic tumors and complicated cases; an incidental finding does not justify surgery.

[Renal fibrosarcoma. Report of a case]. / Fibrosarcoma renal. Presentación de un caso.

OBJECTIVES: To describe one case of renal fibrosarcoma in a patient who presented with left flank pain, fever and palpable mass. We review clinical data, diagnosis, therapeutic aspects and prognostic factors for this type of tumor. METHODS: The study of the patient included intravenous urography, ultrasound, and CT scan. Left radical nephrectomy was performed. RESULTS: The patient remained asymptomatic for 14 months, but then presented with a tumor in the frontal-parietal area, dying ten months later due to generalized metastasis. CONCLUSIONS: Fibrosarcoma is an rare malignant tumor arising from renal mesenchyma with poor prognosis. In radiological tests renal sarcomas show malignant tumor characteristics, but without a specific histology they cannot be differentiated from a renal cell carcinoma.

[The role of CT scan in the diagnosis of renal cell carcinoma]. / Valor de la tac en el diagnóstico del cáncer de células renales.

OBJECTIVES: To establish the role of CT scan as a reliable and effective method in the diagnosis of renal cell carcinoma (RCC) and to report the experience with this radiological test at the Manuel Fajardo Hospital. METHODS: 29 patients with the diagnosis of RCC who underwent CT scan during the period between January 1992 and December 2002 were evaluated. All patients were preoperatively classified as stages I to IV by CT scan. Tumor stage was confirmed by surgical findings and pathology report, and matched with preoperative CT scan evaluation in all cases. RESULTS: 29 patients with the diagnosis of RCC were treated, 65.5% were males and 34.5% females between 48 and 73 years of age. In 100% of the tumors were confirmed by ultrasound (US) and CT scan, and their limits were well defined. CT scan detected regional lymph nodes in 3.4% of the patients, distant lung metastases in two patients (6.8%) and bone metastases in one (3.4%). Preoperative study showed a tumor limited within the kidney in 72.3% of the patients, not exceeding Gerota's fascia in 17.2%, and extending outside Gerota's fascia in 10.3%. All patients underwent radical nephrectomy through an anterior approach and CT scan precision was confirmed, being quite similar to that of the surgical procedure. CONCLUSIONS: CT scan with or without contrast is the most precise method of diagnostic confirmation and staging currently available, achieving 100 percent of the diagnosis in comparison with other diagnostic modalities.