Prevalencia del cáncer de próstata en la comuna de Talca, VII región Chile / Prevalence of prostate cancer in the seventh region of Chile

Background: In 1998, there were 1,218 deaths in Chile caused by prostate cancer. This figure results in a death rate of 16.6 per 100,000 males for this disease. Aim: To assess the prevalence of prostate cancer in the Seventh Region of Chile. Material and methods: A probabilistic sample of 327 males aged 40 to 59 years old was studied. In all, a codified questionnaire was applied, a digital rectal examination was performed and a blood sample was drawn to measure prostate specific antigen. All digital rectal examinations were performed by the same observer. Patients with an abnormal rectal examination or prostate specific antigen were subjected to a prostatic biopsy under ultrasound guidance. Results: In 14 subjects, the digital rectal examination was considered abnormal and in seven, prostate specific antigen was over 4 ng/ml. All subjects with elevated prostate specific antigen had an abnormal rectal examination. In three of the 14 subjects, the biopsy showed a well differentiated adenocarcinoma. All three were aged over 50 years old. The resulting calculated prevalence of prostate cancer was 9.2 per 1,000 males (CI 4.2-14.1). Conclusions: the cost effectiveness of screening for early diagnosis of prostate cancer must be calculated, to decide its incorporation in preventive medical examinations

Addison inaparente: causa de drástica reducción del requerimiento de insulina en una paciente con diabetes, tiroiditis de Hashimoto y enfermedad de Basedow / Unapparent Addison: cause of striking reduction of insulin requirements in a patient with diabetes, Hashimoto's thyroiditis and Basedow's disease

We report a 30 years old woman with sporadic poliglandular autoimmune syndrome type II, first seen with an insulin dependent diabetes mellitus and a Grave-Basedow disease that became spontaneously with positive antimicrosomal antibodies. Six years later she presented with persistent vomiting and remarkable reduction in insulin requirements. She had low basal and stimulated cortisol levels and the diagnosis of severe adrenal failure was reached. A CT scan showed normal adrenal glands, she dis not have cutaneous hyperpigmentation nor evidences of mineralcorticoid deficit. A selective autoimmune damage of the fascicular zone was assumed but a selective damage of ACTH producing pituitary cells cannot be discarded. The importance of investigating adrenal function in cases of unexplained reduction of insulin requirements is emphasized