[Extreme increase in the blood erythroblast count in a patient with iron-deficiency anemia and asplenia]. / Eritroblastemia intensa en un paciente con anemia ferropénica y asplenia.

Bone marrow stress can provoke the presence of high erythroblast count in peripheral blood of patients with splenectomy, but is very rare in patients with normal spleen. Hypoxia occurring in patients with severe ferropenic anaemia could originate the occasional presence of erythroblasts in peripheral blood. An associated pathology should be excluded if there is a high normoblast count. We present the case of a 40 years old woman with ferropenic anaemia and a very high normoblast count. Hyperplastic polips were found in the gastric tissue as the cause for her anaemia. The absence of spleen explained the presence of erytroblasts. Further studies excluded the possibility of hemoglobinopathy and bone marrow studies were normal. Treatment with iron was successfully in correcting the hemoglobin levels and the normoblasts disappeared from peripheral blood also. A careful examination of the peripheral blood film and, specially the presence of Howell-Jolly bodies is the cornerstone of the possible diagnosis confirmed with the appropriate radiological studies.

[Detection campaign for hemoglobinopathies and thalassemias among school children in northern Extremadura]. / Campaña de detección de hemoglobinopatías y talasemias en la población escolar del norte de Extremadura.

PURPOSE: To detect carriers of thalassaemia and haemoglobin variants among the northern Extremadura school population. MATERIAL AND METHODS: The study was carried out in the Plasencia health service area, comprising about 120,000 people. All children between 4 and 15 years of age were offered to take part in the programme. The first-stage screen was mean corpuscular volule (MCV) measured in a Coulter STKS automatic counter. When low VCM was detected, ferritin estimation was carried out; if ferritin was normal, hemoglobin A2 was quantified. Haemoglobin electrophoresis at pH 8.4 was performed in all samples whatever the MCV, and patients were classified into the following groups: iron deficiency, beta-thalassaemia, Hb Lepore, structural haemoglobin variant, or atypical microcytosis. RESULTS: Out of 22 schools from 20 towns, 2,818 children were studied, the participation reaching 75.48%. Lower than normal MCV was found in 162 children (5.74%), who were grouped as follows: thalassaemia, 15 cases (0.53%), Hb Lepore, 8 cases (0.28%), iron deficiency, 77 cases (2.73%), atypical microcytosis, 55 cases (1.95%), and structural variants 7 cases (0.24%). These variants were further identified as HbS (3), Hb Hofu (1), in natives, and HbC (3) in children from Morocco. Higher prevalence of anomalies was seen in some places: Riolobos, 1.5%, Galisteo, 2.5%, Jaraiz de la Vera, 3.02%; a significant group of Hb Lepore carriers was detected in this last town. CONCLUSIONS: The prevalence of abnormalities seen in some small towns or villages grants this type of programmes as such places, which could be considered as isolated communities, might provide a number of high-risk couples.

[Trans-sigmoid urinary diversion and dediversion and cancer: experimental study]. / Derivación y desderivación urinaria transigmoidea y cáncer: estudio experimental.

The present experimental study was carried out in 75 female Wistar rats. End-to-side vesicosigmoidostomy was performed in 65; the remaining 10 rats comprised the control group. Thirty-three rats were de-diverted at 1 and 2 months later. The site of the vesicosigmoid anastomosis was assessed histologically at 1, 2, and 3 months postoperatively in diverted rats, and at 1 and 2 months in de-diverted rats. Squamous metaplastic changes and variable degrees of transitional cell line neoplasm were observed in the diverted rats. Bladder changes did not regress significantly after de-diversion. No structural changes were observed at the level of the sigmoid. This experimental animal model confirms the oncogenic potential of mixing feces and urine, and shows that de-diversion does not achieve significant regression of bladder tumor lesions.