[Thromboangiitis obliterans (Buerger's disease). Study of 41 cases]. / Tromboangitis obliterante (enfermedad de Buerger). Estudio de 41 casos.

BACKGROUND: The aim of this study was to know the prevalence, clinical and immunological characteristics and evolution of thromboangiitis obliterans. METHODS: Between 1982-1990 41 cases of thromboangiitis obliterans were diagnosed from among 373,899 patients registered (11/100,000) according to the clinical and arteriographic criteria. Of these 41 cases 40 were males with mean age 36 +/- 7 years (mean +/- SD) with only two cases being over 45 years of age. In 40 cases was followed for 44 +/- 29 months (mean +/- SD). RESULTS: All the patients had ischemia of the lower limbs, 34% of the upper limbs, 39% superficial thrombophlebitis, 53% Raynaud's phenomenon, 5% mesenteric ischemia, and 7% myocardial infarction. In 30 symptomatic patients anticardiolipin antibodies were determined and one patient was positive for IgG antibodies. In the 23 patients in whom HLA and anticollagen antibody studies were performed a significant increase was found in HLA-B35, HLA-B40 and type VI denaturalized anticollagen antibodies compared to controls. In general the evolution was progressive when the patients continued smoking and favorable when tobacco was given up except in 2 cases who stopped smoking and in whom the disease progressed and death occurred. The total number of patients who died during follow up was 3 (7%), 2 due to mesenteric ischemia and the third during i.v. infusion of PGE1. CONCLUSIONS: The results demonstrate that thromboangiitis obliterans is a rare disease in Spain. The involvement of visceral arteries is not very infrequent with worse prognosis when the mesenteric arteries are involved. There is a significant increase of determined HLA antigens and anticollagen antibodies in the patients with thromboangiitis obliterans.

[Tubercular disease in a general hospital. Apropos of 445 cases]. / Enfermedad tuberculosa en un hospital general. A propósito de 445 casos.

Four hundred and forty-five patients diagnosed of active thoracic or extrathoracic tuberculosis during a 6 year period were retrospectively reviewed. An increase in the rate of cases was found through the surveyed period. Less than 20% of patients were over 60 years of age at the time of diagnosis. Although the most common localizations were pulmonary and pleural, the disease was exclusively extrathoracic in one fifth of patients. Ten patients died of tuberculosis; 9.6% of patients had untoward side effects of tuberculostatic drugs and 14% did not comply with the scheduled follow up.

[Inferior vena cava syndrome as first manifestation of a non-functioning adrenal carcinoma (author's transl)]. / Síndrome de vena cava inferior como primera manifestación de un carcinoma suprarrenal no functionante.

A case is studied of a non-functioning right adrenal carcinoma which is initiated clinically by a compressive syndrome of the inferior vena cava, without other clinical manifestations to suggest the origin of the tumor. The clinical findings are discussed as well as the roentgenographic images, the computerized axial tomography and surgery, which was followed by the death of the patient, with considerations concerning the possible mechanisms that might explain the death. A bibliographic review is conducted on the most outstanding aspect of non-functioning adrenal tumors and the rarity with which they present themselves in this form, of which we have found only one previous report.