[Cutaneous metastasis of a transitional-cell bladder carcinoma]. / Metástasis cutánea de un carcinoma vesical de células transicionales.

Transitional cell of bladder carcinoma metastasizing to the skin is uncommon finding, generally appearing in the final stages such that occurred in our patient that indicated a poor prognosis. A lesion located in the pubic region and internal face of the left lower limb with at erythematous, indurated, and aggregated appearance was found. The histological examination of the specimen after cold biopsy demonstrated cutaneous metastasis from transitional cell carcinoma.

[Squamous cell carcinoma of the prostate: a further case]. / Carcinoma de próstata de células escamosas. Un nuevo caso.

We report one rare case of squamous cells prostate tumor. This histological pattern accounts for the 0.5-1% of all prostatic malignancies with certain clinical and evolutive aspects that are from those of prostate adenocarcinoma. Review of the literature seems to have a very poor prognosis such that occurred in our patient who died after 2 month of diagnosis with a poor response to the habitual treatment, perhaps due to this different cell of origin.

[Oat cell carcinoma of the bladder]. / Carcinoma de células pequeñas oat cell de vejiga.

Small cell carcinoma (CCP) of the urinary bladder is an uncommon tumor, having usually an aggressive behavior. We report a new case of CCP seen at our centre and we communicate the applied therapeutic method. Although total cystectomy followed by chemo and radiotherapy seems to be the most effective treatment, we have carried out radical RTU of the bladder accompanied by chemo and radiotherapy as conservative therapy obtaining complete remission after 2 year of diagnosis, without local and distant evidence of the disease.

Metástasis cutánea de un carcinoma vesical de células transicionales / Cutaneous metastasis from transitional cell carcinoma of the bladder

La metástasis en piel por un carcinoma vesical epitelial es una manifestación infrecuente, generalmente aparece en estadios avanzados, tal como sucedió en nuestro paciente y se asocia con un mal pronóstico. Se trata de una lesión localizada en región suprapúbica y cara interna del muslo, con aspecto eritematoso, indurada y confluente; el examen histológico tras biopsia fría resultó una metástasis por carcinoma transicional (AU)

Carcinoma de células pequeñas oat cell de vejiga / Oat cell carcinoma of the bladder

El carcinoma de células pequeñas (CCP) de localización vesical es un tumor poco frecuente, teniendo por lo general una evolución agresiva. Presentamos un nuevo caso de CCP aparecido en nuestro servicio y comunicamos la actitud terapéutica aplicada. Si bien la exéresis total de vejiga seguida de quimio y radioterapia parece ser el tratamiento más efectivo, hemos realizado RTU radical de vejiga asociada a quimio y radioterapia como finalidad conservadora, consiguiendo remisión completa después de 2 años del diagnóstico, sin evidencia local y a distancia de la enfermedad (AU)

Bacteremia caused by digestive system endoscopy.

AIM: to evaluate bacteremias caused during endoscopic examination of the digestive tract. PATIENTS AND METHODS: prospective study of randomly selected patients who underwent digestive system endoscopic examination. Emergency endoscopic examinations were excluded. RESULTS: a total of 102 patients were analyzed. Of 44 patients who underwent gastroscopy, 11 (25%) subsequently had positive blood culture, and Staphylococcus spp and Streptococcus spp were isolated. Of 30 patients who underwent colonoscopy, 3 (10%) had positive blood cultures, and Staphylococcus spp were isolated. Of 28 patients who underwent endoscopic retrograde cholangiopancreatography, 11 (39.2%) had positive blood cultures, and Escherichia coli, Morganella morganii, Staphylococcus spp and Streptococcus spp were isolated. No deaths, endocarditis or other septic phenomena were attributed to bacteremia. CONCLUSIONS: the incidence of bacteremia ranged from 10% to 39% depending on the type of endoscopy. The microorganisms that were isolated most frequently were Staphylococcus spp and Streptococcus spp. Gram-negative bacilli and enterobacteria were isolated in patients who had undergone endoscopic retrograde cholangiopancreatography.

[Decision regarding chemoprophylaxis with isoniazid in patients using parenteral drugs and infected with HIV]. / Análisis de la decisión de efectuar quimioprofilaxis con isoniazida en pacientes usuarios de drogas por vía parenteral e infectados por VIH.

OBJECTIVES: Analyze the decision to enact or to refrain from chemoprophylaxis (CP) with isoniazide (INH) in patients who are intravenous drug users (IVDU) in Spain infected by the human immunodeficiency virus (HIV), either classified or not with hypersensitive skin tests. METHODS: With the bibliographic information available and the help of decision tree, an analysis of the effectiveness and of the consequences of drug costs of CP with INH in those patients is performed. RESULTS: Overall, the HIV+ IVDU benefit from CP is an increase in survival of 80 days, with a savings of 7,252 pesetas per patient. The intradermal reaction with PPD and the retarded hypersensitivity tests (HCR) allow us to classify them in three subgroups: a) PPD+ where CP is universally admitted and thus corroborates our study; b) PPD-/HCR- where CP increases survival 201 days and saves 20,616 pesetas per patient; and c) PPD-/HCR+ where survival is increased 33 days and the pharmacological costs increase 1,536 pesetas per patient under CP. CONCLUSIONS: For the present situation in Spain, CP with INH is effective in HIV+ IVDU patients, independent of the results of the intradermal reaction skin tests.