Penile foreign bodies.

OBJECTIVE: To describe 8 cases of penile foreign bodies. METHODS/RESULTS: We provide an essentially visual overview of various objects or foreign bodies affecting the penis. CONCLUSIONS: The presence of penile foreign bodies is rarely due to an accident. These objects are placed for a wide variety of reasons, but primarily for erotic or self-arousal purposes. The consequences of penile foreign bodies can be mild or very severe, resulting in penile amputation.

Diltiazem in the treatment of the irritable bowel syndrome.

A short-term double-blind study has been conducted to evaluate the clinical efficacy of diltiazem in 18 patients with irritable bowel syndrome, divided into two groups: group A, on the sequence placebo-diltiazem-placebo for three weeks. Group B, diltiazem-placebo-diltiazem for an identical period. The substance was administered in three daily doses of 60 mg prior to meals. Clinical manifestations and the general condition were evaluated after each period of three weeks following a pre-established score. Globally, it has been impossible to demonstrate the superiority of diltiazem over the placebo, but there seems to exist a trend to the improvement of diarrhoea and abdominal pain. It will be necessary to make an additional study to delineate the efficacy of this drug in the irritable bowel syndrome.

[Pneumatocele as a form of presentation of Pneumocystis carinii pneumonia]. / Neumatoceles como forma de presentación de neumonía por Pneumocystis carinii.

Pulmonary infection by Pneumocystis carinii in patients with acquired immunodeficiency syndrome (AIDS) can result in different radiological patterns with an ever expanding spectrum. A 40-year-old male, infected with the human immunodeficiency virus (HIV), presented with toxic symptoms and multiple pulmonary cystic lesions in the context of a Pneumocystis carinii pneumonia. The rarity of this radiological presentation is discussed and literature is reviewed. In addition, the possible pathogenetic mechanisms are discussed, and emphasis is made on the need for higher suspicion index in similar presentations in patients at risk of HIV infection.

[Syndrome of allopurinol hypersensitivity. Report of a new case and review of the Spanish literature]. / Síndrome de hipersensibilidad al alopurinol. Aportación de un nuevo caso y revisión de la literatura española.

Allopurinol is a drug of wide clinical use and good tolerance. Some patients develop severe hypersensitivity due to immunologic reaction to the drug. A new case which fulfills all the diagnostic criteria of the syndrome of allopurinol hypersensitivity with associated clinical manifestations of multiple mononeuritis and evidence of granulomas and vasculitis in liver biopsy as the most significant data is reported. The syndrome was favorably resolved following withdrawal of the drug without need for corticoid therapy. The characteristics of the cases described in the Spanish literature over the last few years are globally reviewed. The absence of mortality is of note. The inconvenience of prescribing allopurinol to patients with asymptomatic hyperuricemia is emphasized.

[Spontaneous primary peritonitis due to Pasteurella multocida]. / Peritonitis primaria espontánea por Pasteurella multocida.

We present a new case of bacterial spontaneous peritonitis cirrhosis, associated to an extremely rare germ as it is Pasteurella multocida. We describe its clinical characteristics and evolution after treatment.

[An analysis of the demand for laboratory tests from primary care in a health area]. / Análisis de la demanda de pruebas de laboratorio desde atención primaria en un área de salud.

OBJECTIVE: To quantify the primary care demand for laboratory tests in a health area and to evaluate the variations in use in relation to the characteristics of the doctors, of organisation and of the population seen. DESIGN: Crossover. SETTING: A health area in the Community of Valencia with 110125 inhabitants. PARTICIPANTS: 89 primary care doctors from the area, with 8612 requests for lab. tests over 12 weeks. MEASUREMENTS AND MAIN RESULTS: All the lab. requests, including determinations (67730), diagnoses, and age and sex of patients, were recorded. Total and health consultations were calculated. The overall demand rate was 356 requests per 1000 inhabitants, with variations in the standardised rates by age of population between Districts (ranging from 242 to 548 per 1000). Lab. tests were requested for 8.6 of every 100 health consultations, with variations of up to three times this number depending on the distance from the laboratory. Women doctors asked for a higher number of determinations per request. whereas more requests were made for male than for female patients. CONCLUSIONS: There are substantial variations in primary care use of the laboratory, which are hard to explain by differences in underlying pathology. Some reasons for variation are organisational, but others remain to be tested. Findings indicate that interventions should be designed to improve the quality of laboratory use. Meanwhile, study of the causes of variations in demand continues.

Cuerpos extraños en pene / Penile foreign bodies

OBJETIVO: Mostrar 8 casos de cuerpos extraños en pene.MÉTODOS/RESULTADOS: Realizamos una presentación fundamentalmente visual de variados artilugios o cuerpos extraños de ubicación peneana.CONCLUSIONES: Raramente la existencia de cuerpos extraños peneanos se debe a accidentes. Los cuerpos extraños en pene son colocados por muy diversas razones, destacando principalmente dentro de actividades eróticas o autoeróticas, pudiendo tener consecuencias desde leves, a casos en los que puede acabar en amputación peneana(AU)

OBJECTIVE: To describe 8 cases of penile foreign bodies.METHODS/RESULTS: We provide an essentially visual overview of various objects or foreign bodies affecting the penis.CONCLUSIONS: The presence of penile foreign bodies is rarely due to an accident. These objects are placed for a wide variety of reasons, but primarily for erotic or self-arousal purposes. The consequences of penile foreign bodies can be mild or very severe, resulting in penile amputation(AU)