[Paracentesis as abdominal decompression therapy in neuroblastoma MS with massive hepatomegaly].

Neuroblastoma MS with massive hepatomegaly is a small percentage of cases of neuroblastoma. It is more common in infants less than 4-6 weeks of life, and involves, in contrast to the standard of the NB MS, poor prognosis given the complications that can have. In the case of abdominal compartment syndrome it is recommended a quick start of chemotherapy, associating or not radiation therapy, to try to reduce the size of the liver, and if necessary, decompressive laparotomy.

Intraabdominal germinal tumor originated from an ectopic testis.

Objective: We report the case of a 54 year old man with an intraabdominal germinal tumor originated from an ectopic testis, and its treatment.

Methods: The tumor was diagnosed with percutaneous biopsy and treated with three cycles of BEP (bleomycin etoposide, platinum ), showing an important decrease of its size. Treatment was completed with the excision of the remnant mass and regional lymphadenectomy.

Factors influencing the symmetry of Parkinson's disease symptoms.

Introduction: The presence of asymmetry in symptoms and clinical signs favours the diagnosis of Parkinson's disease (PD). The aim of this study is to analyse this symptom asymmetry as a function of different variables and compare it with other parkinsonisms.

Materials And Methods: 201 Patients with PD were studied.

[Subcutaneous nodules as a sign of malignant lymphoproliferative syndrome].

Unlabelled: Skin involvement in children with malignant processes usually appears at the same time or after the diagnosis of the primary tumour. We present the case of a girl with cutaneous involvement prior to the diagnosis of a malignant lymphoproliferative process. A previously healthy 5-month old girl who presented with an inflammatory subcutaneous lesion on the right foot.

Ultrasound-guided artificial insemination: a randomized controlled trial.

Background: The aim was to ascertain whether using ultrasound guidance during intrauterine insemination (IUI) could increase pregnancy rates (PRs).

Methods: The population under study consisted of 73 consecutive couples subjected to IUI in our Human Reproduction Unit, between June and December 2006, with a total of 231 IUI cycles performed. The patients were randomized using a computer-generated random numeric table into two groups: ultrasound-guided IUI group (n = 33) and clinical IUI group (n = 40).

Genetics of pseudohypoparathyroidism: bases for proper genetic counselling.

Pseudohypoparathyroidism (PHP) is characterized by hypocalcemia and hyperphosphatemia due to resistance to parathyroid hormone (PTH). Patients with PHP-Ia often show additional hormone resistance and characteristic physical features that are collectively termed Albright's hereditary osteodystrophy (AHO). These features are also present in pseudopseudohypoparathyroidism (PPHP), but patients with this disorder do not show hormone resistance.

[Treatment of Gout: Reflections From the GEMA Study].

Evaluation of clinical handling of gout come from published surveys, but no audit on daily clinical practice has been published yet. The present study issues an audit of rheumatology practice in Spain for the diagnosis and treatment of gout from data of 803 patients from 41 rheumatology units, and related to the EULAR recommendations. Gout diagnosis was crystal-based in 26% of the patients.

[Infections in Patients With Rheumatoid Arthritis Undergoing Anti-TNFα Drug Therapy].

Infections are more frequent in patients with rheumatoid arthritis (RA). The capacity of the anti-TNF drugs (infliximab, etanercept, and adalimumab) to increase the risk of infections has been a motive of discussion during the past years. Only in two of the trials that have allowed the marketing of the infliximab and adalimumab more serious infections were observed.

[General recommendations over perimenopausal transition therapy].

Background: Medical attention during perimenopause requires different therapeutic strategies.

Objective: To define strategies for the attention of perimenopause women that can favor a healthy aging.

Methods: Review of influencing factors and lifestyle modifications that can be introduced in perimenopause to prevent pathologies.

[Autologous hematopoietic stem cell transplantation followed by oral bexarotene in a patient with advanced mycosis fungoides].

We describe the case of a 17-year-old patient with rapidly progressing and aggressive mycosis fungoides, with multiple cutaneous tumors and large cell transformation. She was initially treated with 3 cycles of high-dose chemotherapy with mega-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) without response, leading to the decision to undertake autologous hematopoietic stem cell transplantation. Partial remission of the disease was achieved with this treatment and subsequent introduction of oral bexarotene led to complete remission, which has been maintained for more than 3 years with good tolerance of oral therapy.

[Evaluation of the grade of knowledge of the recommendations for the prevention and care of pressure sores in Critical Units].

Introduction: The appearance of pressure sores (PS) is an event linked to the clinical safety of the patient and the available epidemiological information indicates that these injuries are a significant problem in the Critical Units. This present study aims to determine the grade of knowledge of the nurses in these Units on the evidence based recommendations of prevention and treatment of PS.

Methodology: Descriptive, cross-sectional study conducted in 8 Critical Units of 3 hospitals.

[Occlusion of the first septal branch with microcoils in a patient with hypertrophic obstructive cardiomyopathy].

Nonsurgical septal reduction by induced septal infarction is one of the management options in the treatment of patients with hypertrophic obstructive cardiomyopathy. Good immediate and long-term clinical and hemodynamic results have been reported with this technique for occlusion of the first septal branch of the anterior descending coronary artery followed by ethanol infusion. This is the first report of a case in which nonsurgical septal reduction with microcoils has been attempted.

[Tumoral markers and acute-phase reactants in the diagnosis of pancreatic cancer].

Objective: To analyze the diagnostic accuracy of the following parameters in the diagnosis of pancreatic cancer: carcinoembryonic antigen (CEA), tissue plasminogen activator (TPA), carbohydrate antigen 19-9 (CA 19-9), carbohydrate antigen 50 (CA 50), alpha-1-antitrypsin (AAT), alpha-2 macroglobulin (AMG), and ceruloplasmin (CP). PATIENTS AND MENTOD: We prospectively studied 58 patients with pancreatic cancer, 40 with alcoholic pancreatitis and 40 healthy controls, in whom the above-mentioned parameters were analyzed. Receiver operating characteristic curves (ROC curves) were analyzed.

[Community-acquired pneumonia due to Legionella pneumophila serogroup 1. Study of 97 cases].

Introduction: Legionella pneumophila is the causal agent of 5% to 12% of sporadic community-acquired pneumonia cases, though rates are changing with the use of new diagnostic methods.

Methods: This is a retrospective study of all patients admitted to our hospital with community-acquired pneumonia due to Legionella pneumophila between 1997 and 2001. Diagnostic criteria included either a positive Legionella serogroup 1 urinary antigen test or seroconversion and a chest radiograph consistent with pneumonia.

[Guided transcatheter valvulotomy in pulmonary atresia with intact ventricular septum].

Transcatheter valvulotomy in pulmonary atresia with an intact ventricular septum can be used as a first step to create biventricular circulation and to stimulate further development of the hypoplastic right ventricle. We describe our experience in a case of a neonate with this congenital cardiac defect who underwent successful transcatheter perforation of the atretic pulmonary valve. This report highlights the utility of a special technique based on the use of a gooseneck snare positioned just above the atretic valve to guide the advance of a coronary guidewire.

[Antiepileptic drugs used in childhood. New products and new concepts].

Introduction: Eight new antiepileptic drugs (AED) have been marketed in Spain since 1990 and others will soon follow.

Objective: To review the concepts underlying the development of the new drugs, as well as their indications, efficacy and safety.

Development: Pharmacologic antiepileptic intervention is no longer solely directed towards an anticonvulsant effect, but also to epileptogenic prevention, disease modification and reversal of pharmacoresistance.

[Oral and cervicofacial actinomycosis. Presentation of five cases].

Background: Actinomycosis is a suppurative and granulomatous chronic infectious disease caused by Actinomyces sp. and most commonly affecting the cervicofacial area.

Aim: To study the clinical characteristics of patients with actinomycosis, with regard to clinical history, presentation, method of diagnosis, treatment and follow up.

[10-year prospective study on the incidence and risk factors for type 2 diabetes mellitus].

Background: The aims of this study were to determine the incidence of diabetes mellitus type 2 and to define the associated risk factors.

Patients And Method: A 10-year prospective study was done over 584 people identified by screening of the Lejona (Vizcaya, Spain) adult population in 1985. Data on age, sex, body mass index, family history of diabetes mellitus and blood pressure were collected.