Fundamentos de la Salud Pública

Este libro fue escrito por una necesidad y una obligación. Los estudiantes de los últimos años de la Facultad de Ciencias Médicas tienen que rastrear en apuntes y notas de clase, muchos de ellos antiguos y escritos con defectos, para aprender Salud Pública con sus temas completos. Lo mismo les ocurre a los graduados que toman cursos de la disciplina como parte de otras especialidades o del doctorado. Por un lado la red informática ha permitido un acceso inmediato a todos los temas y problemas relacionados con Salud Pública.

[Communication between urologist and pathologist. Proposal for the standardization of histological tests requests for neoplasms]. / La comunicazione tra urologo e patologo. Proposta di standardizzazione delle richieste di esami istologici per neoplasie.

The aim of this work is to propose a new clinical data system which should accompany the histological sample for the histologic diagnosis made by the pathologist. Six different schedules on the most important urological tumours are presented: prostate (needle biopsies and surgical approach), bladder (endoscopic procedure and open surgery), kidney and ureter, testis. In each schedule the urologist provides, in a scheme, the clinical report needed for the pathologist's final diagnosis. A clear explanation of the clinical data and a faster method of filling in the form are the qualifying elements of these schedules.

[Rare renal tumors (neoplasms other than conventional renal cell carcinoma). Clinico-pathologic aspects and review of the literature]. / Tumori renali rari (neoplasms other than conventional renal cell carcinoma). Aspetti clinico-patologici e revisione della letteratura.

The clinical and pathological findings in 94 patients with surgically confirmed renal neoplasm from 1990 to 1998 have been retrospectively reviewed and a literature review is made. The heterogeneous group of rare renal tumours has been particularly considered: renal oncocytoma and oncocytomatosis, renal angiomyolipoma and renal medullary fibroma; chromophobe renal cell carcinoma (RCC), papillary RCC, multiple primary malignant RCC, hereditary RCC, renal sarcoma and sarcomatoid RCC, renal malignant fibrous histiocytoma, renal hemangiopericytoma and renal lymphoma.

[Perirenal immunoblastic lymphoma. Description of a case]. / Linfoma immunoblastico perirenale. Descrizione di un caso.

The primary perirenal localization of non-Hodgkin lymphomas is rare and normal methods of image diagnosis do not enable a reliable preoperative diagnosis. In the majority of cases renal function is not affected and this pathology is often presented as an occasional finding. The pathologies included in the differential diagnosis are renal neoplasias, abscess and inflammatory processes in a perirenal site. Echotomography shows the lesion as an hypoanechoic zone surrounding the kidney. Computed tomography show it as isodense with the renal parenchyma. Histological tests together with immunohistochemical tests identified a malignant large B cell immunoblastic-type lymphoma in the case described here, with plasmoblastic-plasmocytic differentiation and high malignancy according to the Working Formulation. The pathogenesis of this rare localisation is controversial. We maintain that lymphomatous proliferation may be triggered off by lymphatic follicles present in the perirenal space. The concomitant presence of other clinical signs, such as splenomegalia and adenopathies, may contribute to the diagnosis. On the contrary, monolateral involvement in the absence of other signs, as in this case, raises considerable problems of differential diagnosis. Perirenal lymphoma must therefore always be borne in mind in the diagnosis of renal or perirenal masses.

[Renal multifocal carcinoma with adrenal gland metastasis in a patient previously treated with radical nephrectomy: what kind of therapy. Review of the literature]. / Carcinoma renale multifocale con metastasi surrenaliche multiple in paziente già sottoposto a nefrectomia radicale dell'adelfo: quale terapia? Revisione della letteratura.

A case of multiple adrenal metastases due to renal cells carcinoma, associated with a multifocal simultaneous renal cells carcinoma has been observed in a female patient previously submitted to radical contralateral nephrectomy for the same disease. In particular, stress is laid on computerized tomography scan diagnosis and surgical procedure.