Grados de depresión en padres de niños con cáncer / Depression grades in parents which have cancer children

Es bien conocido que las enfermedades somáticas padecidas por los pacientes, afectan el estado psicológico de las personas con quienes estos guardan un vínculo cercano. Intentamos corroborar este hecho aplicándoles test de Hamilton a 58 padres de pacientes, hospitalizados en las alas de oncología pediátrica de diversos centros de salud de Caracas. Se observó una prevalencia de depresión en el 90% de los padres y además pudimos ver que los grados de depresión variaban de acuerdo a ciertos determinantes como el tiempo de desarrollo de la enfermedad y el ambiente del centro hospitalario. Siendo por ende necesario brindar atención psicológica especializada a los acompañantes de los pacientes en los distintos centros de salud

It is well known that the suffering of an illness can affect not only the patient, but also every person that relates intimately to him. We attempted the verification of this statement by applying Hamilton tests to 58 parents of patients which were hospitalized in the several pediatric oncology-specialized health care centers in Caracas. The outcome was a predominance of depression in 90% of the parents; in addition, observed how the different degrees of depression could fluctuate according to certain factors like: Development time of the illness and the hospital’s environment. It is necessary to provide specialized psychological care to the relatives or any companions of the patients hospitalized in health care centers

Aortic-neck dilation after endovascular abdominal aortic aneurysm repair (EVAR): can it be predicted?

PURPOSE: This study was performed to evaluate whether dynamic computed tomography (CT) can provide functional vessel information predicting outcomes of aortic neck in patients undergoing endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: Twenty patients with and 20 without AAA were enrolled. Electrocardiographically (ECG)-gated data sets were acquired with a 64-slice CT scanner. Axial pulsatility measurements were taken at three levels: 2 cm above the highest renal artery; immediately below the lowest renal artery; 1 cm below the lowest renal artery. Three independent readers performed the measurements. Systolic and diastolic blood pressures were measured in the brachial artery to calculate arterial-wall distensibility expressed as pressure strain elastic modulus (Ep). Cross-sectional area change, wall distensibility and Ep value were statistically compared. RESULTS: No significant differences were found in terms of Ep values in the suprarenal and juxtarenal level. In the AAA group, a significantly higher value was obtained at the infrarenal level. A subgroup of patients with AAA (45%) had a significantly higher Ep value at the infrarenal level. CONCLUSIONS: Dynamic CT provided insight into the abdominal aorta pathophysiology. Identifying patients with higher infrarenal distensibility could change selection of graft size to improve proximal fixation.

[Renal cholesteatoma]. / Colesteatoma renale.

Renal cholesteatoma is an extremely uncommon disease. The renal pelvis is the most common site, but the lesion can be localized, even if rarely, in a calix or in the ureter. Histologically it consists of a keratinizing desquamative squamous metaplasia, with absence of cellular atypia in the urothelium, therefore cholesteatoma is not considered as a premalignant lesion. Authors report a case of renal cholesteatoma and take into consideration particularly the question regarding the diagnostic approach, that in spite of the help of new imaging techniques, as TC, is unable to arrive at a certain diagnosis, and the therapeutic approach, that must be conservative, when it's possible and according to the majority of Authors.

[Renal adenocarcinoma associated with a polycystic kidney (presentation of a case and review of the literature)]. / Adenocarcinoma renale associato a rene policistico (presentazione di un caso e revisione della letteratura).

The Authors report a case of renal neoplasm association to polycystic kidney. The report was quite occasional, as the patient was not aware to be bearer of a renal dysembryopathy, although such a familiarity was existing formerly. The diagnosis was placed subsequently to ascertainments aiming at establishing the origin of a transient arterial hypertension, occurring recently, in absence of any other symptomatology.

[Neoplasms of the male urethra: diagnosis and therapy]. / Le neoplasie dell'uretra maschile: diagnosi e terapia.

Neoplasms of male urethra are particularly interesting for the diagnostic and therapeutical problems involved, urologist surgeons may be charged to resolve. The authors effected an anatomo-pathologic, diagnostical and especially therapeutical framing, by reviewing the data reported by the literature. The indications the Authors may draw therefrom are favourable to a radical surgery, even in consideration of the extensive nature of such tumours and the poor successes, in terms of survival, got by the conservative therapy.

Radical cystectomy in the treatment of advanced bladder cancer.

Thirty-two cases of advanced bladder cancer (pT3b-pT4) undergoing radical cystectomy are compared with other similar series of patients of the same stages submitted to different treatments (radiotherapy, chemotherapy and combined treatments) reported in the literature. Survival rates at 3 and 5 years are analyzed in relation to the anatomopathological stage, cellular grading, lymph node infiltration, surgical risk and relative mortality. The results confirm that radical cystectomy is presently the most effective treatment.

Ultrasound and computed tomography in staging of bladder tumours.

Eighty-seven patients with proven bladder tumours were retrospectively reviewed with ultrasound (US) and computed tomography (CT), in order to define the stage of the neoplasm. The tumours were divided into three groups with respect to the TNM classification system. Results indicate that US could predict an exact staging of the bladder tumours in 80.6% of cases in the first group (P1), 68.9% of cases in the second group (P2 - P3), and 90.0% of cases in the third group (P4). CT could predict an exact staging in 61.3% of the bladder tumours in the first group, 91.1% in the second group, and 90.0% in the third group. This finding suggests that the capability of US in detecting bladder tumours in stage P1 may avoid the use of CT, while in subsequent stages CT becomes valuable for the evaluation of extravesical invasions and lymph node metastasis.

Mycoplasma pneumoniae infection complicated by paroxysmal cold hemoglobinuria with anti-P specificity of biphasic hemolysin.

A 7-year-old boy with Mycoplasma Pneumoniae infection complicated by transitory paroxysmal cold haemoglobinuria (PCH) is described. The Donath-Landsteiner-antibody exhibited anti-P specificity; hemolytic activity was partially inhibited against papainized erythrocytes at 0 degrees C incubation temperature and increased from 8 degrees C upwards. The association of Mycoplasma pneumoniae infection with PCH has been described 4 times only and in one instance where specificity was stated it was anti-I.