[Asymptomatic renal carcinoma diagnosed based on synchronous metastasis in the thyroid gland]. / Carcinoma renal asintomático diagnosticado a partir de una metástasis sincrónica en tiroides.

Secondary tumors of the thyroid are very rare, being the kidney the most frequent place of the primary tumor. The majority of these metastases appear months or years after the primary renal tumor. We report the case of an asymptomatic renal carcinoma discovered after the histological analysis of a thyroidectomy piece. The treatment of the primary renal tumor was radical nephrectomy. Three years after diagnosis and treatment the patient is free of relapse.

[Hemorrhagic shock and encephalopathy. Its possible relation with heat stroke]. / Shock hemorrágico y encefalopatía. Su posible relación con el golpe de calor.

A comparative study of two patients, one affected by haemorrhagic shock and encephalopathy (HSE) and the other by heatstroke is reported. Both presented shock, disseminated intravascular coagulation, neurological damage and hepatopathy. A lowered alpha 1-antitrypsin concentration as well as a slightly increased circulating immune complexes and complement consumption were observed in the HSE patient but not in the heatstroke one. In both, cultures for bacteria were negative, the viral serology was non-specific and hepatitis A and B studies were negative. HSE patient died. A possible relationship between HSE, heatstroke, malignant hyperthermia and halothane hepatitis is postulated. Fever, potentially hepatotoxic drugs or unknown agents (HSE) might trigger this clinical picture.