Gastric carcinoma and renal cell carcinoma as an atypical presentation of multiple primary malignancies: a case report and review of the literature.

BACKGROUND: Gastric carcinoma (GC) with second primary malignancy (SPM) is the most frequent combination within the multiple primary malignancies (MPM) group. The presentation of a GC associated with a synchronized SPM in the kidney is extremely rare and unusual. This study presents a rare case of synchronous tumors, describes the main associated risk factors, and emphasizes the need to rule out SPM. MAIN BODY: We present the case of a 63-year-old Hispanic woman with a history of smoking, weight loss, and gastrointestinal (GI) bleeding. GC was diagnosed by endoscopy, and during her workup for metastatic disease, a synchronous SPM was noted in the left kidney. The patient underwent resection of both tumors with a satisfactory postoperative course. A systematic review of the literature was performed using the Medline/PubMed, Science Direct, Scopus, and Google Scholar databases. A search of the literature yielded 13 relevant articles, in which the following main risk factors were reported: the treatment utilized, the grade and clinical stage, histopathological report, and in some cases survival. It is concluded that advanced age (> 60 years) and smoking are the main associated risk factors. CONCLUSION: Gastric carcinoma is the second most frequent neoplasm of the GI tract and the main neoplasm that presents a SPM. MPM screening is recommended in patients with gastric cancer. The clinical discovery of MPM of renal origin is rare and hence the importance of the current report.

Accuracy of primary bedside neonatal nurse-generated score for neonatal acute physiology (SNAP) scores.

OBJECTIVE: To determine whether 24-hour SNAP scores generated from data gathered by primary bedside nurses agreed with the SNAP scores of one trained research nurse. STUDY DESIGN: Primary bedside nurses (n = 50) in a level III private nursery collected data necessary for generating 24-hour SNAP scores on 60 consecutively admitted inborn neonates who lived at least 24 hours. The amount of time required for data collection and scoring was also determined. SNAP scores and the time required to generate them were compared with the unit research nurse's SNAP scores and time required to generate them on the same 60 patients. The Wilcoxon rank test and Spearman's rank correlation were used for statistical analyses. RESULTS: SNAP scores generated from primary bedside nursing data did not differ from those of the research nurse's SNAP scores (11.7 +/- 0.8 vs 11.4 +/- 0.9 [mean +/- SEM], p = 0.7), and they correlated well over a wide range of SNAP scores (r = 0.93, p = 0.0001). Primary bedside nurses required more time (15 +/- 0.7 vs 3.0 +/- 0.08 minutes, p = 0.0001) to generate SNAP scores than the research nurse. CONCLUSION: Primary bedside level III nurses can accurately obtain data for SNAP scores during 8- to 12-hour shifts.

Reflecting professional values in the philosophy of nursing.

If nurses are to remain central in restructuring efforts, their professional values must be at the core. Nurse administrators play a key role in promulgating values. The authors examined philosophy of nursing documents to identify professional values and found them to be lacking. They discuss their findings and their implications for nurse executives.

[Skin hypersensitivity: intradermal hypersensitivity to allergen extracts and its relation to the place of residence]. / Estudio de hipersensibilidad cutánea: intradérmica a extractos alergénicos y su relación con el lugar de residencia.

A retrospective review of 308 clinical files of patient to respond at immunological and clinical allergic service of the Centro Medico 20 de Noviembre, ISSSTE for suffer with allergica illnes, realized by aeroalergens sensitization and determination frequency (intradermoreactions mediated) and relation to area living. The patients was highly sensitive at dust and dermatophagoides (75 and 40% respectively) others aeroalergen caused sensitization in the Capriola dactylon (37%), Amarantus palmieri (35.5%), Fracxinus (34.6%), Ambrosia elatior (33%), Candida (21.4%), Penicillium (18.1%), Mucor y Rizopus (17.8% each one).

[Effectiveness of sodium cromoglycate in the reduction of bronchodilator doses in asthmatic patients]. / Efectividad del cromoglicato de sodio en la reducción de las dosis de broncodilatadores en pacientes asmáticos.

Thirty asthmatic patients, ages ranging from 6 to 72 years, who were submitted to a 14 weeks clinical evaluation, were studied measuring the severity of dysnea, coughing, expectoration and wheezing. Sodium chromoglycate (SCG) was administered in aerosol starting the second week of the study and the doses of bronchial dilators was reduced starting the fourth week, with a 25% decrease in the total established initial dosage, every two weeks. In this study, SCG showed to be useful in decreasing symptoms caused by bronchial hyperreactivity and the use of bronchial dilators in 70% of asthmatics who react with the presence of just one risk factor (cold, the most frequent).

Routes and prevalence of shedding of psittacine beak and feather disease virus.

Psittacine beak and feather disease (PBFD) virus was recovered from the feces and crop washings from various species of psittacine birds diagnosed with PBFD. High concentrations of the virus also could be demonstrated in feather dust collection from a room where 22 birds with active cases of PBFD were being housed. The virions recovered from the feces, crop, and feather dust were confirmed to be PBFD virus by ultrastructural, physical, or antigenic characteristics. Virus recovered from the feather dust and feces hemagglutinated cockatoo erythrocytes. The specificity of the agglutination was confirmed by hemagglutination inhibition, using rabbit antibodies against PBFD virus. During the test period, 26% (8 of 31) of the birds screened were found to be excreting PBFD virus in their feces, and 21% (3 of 14) of crop washings were positive for PBFD virus. Some birds in the sample group had active cases of diarrhea, whereas others had normal-appearing feces. Diarrhea was found to be the only significant indicator of whether a bird was likely to be excreting virus from the digestive tract. These findings suggest that exposure of susceptible birds to PBFD virus may occur from contact with contaminated feather dust, feces, or crop secretions. Viral particles that were morphologically similar to parvovirus (20- to 24 nm-icosahedral nonenveloped virions) also were recovered from feces of some of the birds.