Carcinoma de células renales detectado por una forma inusual de metástasis / Renal cell carcinoma detected by an unusual form of metastasis

Propósito: Describir un caso de metástasis de carcinoma de células renales inusual en su forma de presentación clínica.Material y métodos: Mujer de 45 años con tumefacción del pulpejo del quinto dedo de la mano derecha.Resultados: El estudio histopatológico de la biopsia revela que se trata de una metástasis de carcinoma de células claras compatible con carcinoma de células renales.Conclusiones: Es importante el diagnóstico precoz en los carcinomas de células renales, por lo que hay que estar familiarizado con formas de presentación inusuales que son muy frecuentes en esta neoplasia y pueden ser motivo de dilación (AU)

[Immuno-nutritional prognostic factors in acute cholecystitis]. / Estudio de factores pronósticos inmunonutricionales en la colecistitis aguda.

A set of parameters that could be used to identify possible immunonutritional disturbances and serve as clinical evolution markers were measured in 210 patients diagnosed of acute cholecystitis (136 females and 74 males, 64.8 and 35.2% respectively) who were admitted into the Surgery Service of the Hospital General de 1++Elche. The prognostic evaluation indices were: a) Nutritional: hematocrit, hemoglobin, total protein, albumin, transferrin; b) Immunological: total lymphocytes and delayed hypersensitivity reaction test. The results obtained were analyzed and compared to those of the literature in this field.

[Bacteriologic findings as a prognostic factor in the course of acute cholecystitis]. / Hallazgos bacteriológicos como factor pronóstico en la evolución de la colecistitis aguda.

We made a bacteriological study of bile in a consecutive study of 210 patients studied in the General Surgery Department of the General Hospital of Elche (Spain) who underwent cholecystectomy for acute lithiasic cholecystitis, as a prognostic factor in the clinical evolution of these patients. The results obtained led us to the following conclusions. 1. The presence of positive bile culture is a risk factor predisposing to postoperative septic complications. 2. Bile cultures were more frequently positive in patients over 60-years-old. 3. In the early stages of the disease, positive cultures were more frequent. 4. The organism most often isolated was E. coli, so antibiotic treatment should be directed mainly against this agent.