Lung cancer in women: a comparison with men and an analysis of cases diagnosed in Ourense (Spain) 1999-2006.

INTRODUCTION AND OBJECTIVE: To analyse frequency, characteristics and survival of women with lung cancer (LC), in contrast to male patients. PATIENTS AND METHODS: A retrospective study was performed in patients with LC diagnosed by histocytology from 1999 to 2006. Survival was estimated by the Kaplan-Meier method. The chi-squared test was used to compare variables. RESULTS: A total of 1,290 patients were diagnosed, 190 (14.7%) of them were women, with a mean age of 67±13 years. The percentage of smokers was 17%. Histological types: adenocarcinoma 53%, small cell 21%, squamous cell carcinoma 13%. Surgery was performed (20%) in a higher percentage of women than in men. There were no differences in survival between the two groups. CONCLUSIONS: Of the total cases diagnosed, 14.7% were women, with a lower percentage of smokers. Adenocarcinoma was the most common histological type in women. There was no differences in survival compared to men.

Cáncer de pulmón en mujeres, comparativo con hombres: análisis de los casos diagnosticados en el Complexo Hospitalario de Ourense entre 1999 y 2006 / Lung Cancer in Women: a Comparison with Men and an Analysis of Cases Diagnosed in Ourense (Spain) 1999–2006

Introducción y objetivoAnalizar la frecuencia, las características y la supervivencia de las mujeres con cáncer de pulmón (CP), comparándolas con los pacientes varones.Pacientes y métodosEstudio retrospectivo de pacientes diagnosticados de CP mediante citohistología del 1999 al 2006. Se estimó la supervivencia por el método de Kaplan-Meier. Para estimar la relación entre las variables se usó la prueba de chi-cuadrado.ResultadosSe diagnosticaron 1.290 pacientes, el 14,7% mujeres. En el grupo de mujeres la edad media (± desviación estándar) fue de 67±13 años. Eran fumadoras el 17%. Según la citohistología, el 53% eran adenocarcinomas, 21% célula pequeña y 13% epidermoide. Se realizó cirugía (20%) en mayor porcentaje que en los varones. No hubo diferencias de supervivencia con el grupo de los hombres.ConclusionesEl 14,7% de los casos fue diagnosticado en mujeres, siendo el porcentaje de fumadoras menor. La estirpe histológica más frecuente es adenocarcinoma. No hubo diferencias de supervivencia con el grupo de los hombres(AU)

Introduction and objectiveTo analyse frequency, characteristics and survival of women with lung cancer (LC), in contrast to male patients.Patients and methodsA retrospective study was performed in patients with LC diagnosed by histocytology from 1999 to 2006. Survival was estimated by the Kaplan-Meier method. The chi-squared test was used to compare variables.ResultsA total of 1,290 patients were diagnosed, 190 (14.7%) of them were women, with a mean age of 67±13 years. The percentage of smokers was 17%. Histological types: adenocarcinoma 53%, small cell 21%, squamous cell carcinoma 13%. Surgery was performed (20%) in a higher percentage of women than in men. There were no differences in survival between the two groups.ConclusionsOf the total cases diagnosed, 14.7% were women, with a lower percentage of smokers. Adenocarcinoma was the most common histological type in women. There was no differences in survival compared to men(AU)

Concurrent Sweet's syndrome and leukemia cutis in patients with myeloid disorders.

A 74-year-old woman with chronic auricular fibrillation, arterial hypertension, hypercholesterolemia, ischemic cardiopathy, and peripheral arteriopathy presented with purpuric lesions on the lower limbs (Fig. 1) and, to a lesser extent, on the anterior area of the chest. The mucous membranes were not affected. In 1989, she was diagnosed with anemia that evolved until 1998, when a bone marrow biopsy revealed a myelodysplastic syndrome unclassified in French-American-British Group (FAB). The patient has required periodic transfusions since February 1999. A skin biopsy of the purpuric lesions revealed a leukocytoclastic vasculitis; the lesions cleared with topical corticosteroid treatment. In May 1999, the patient presented with inflammatory and painful lesions localized on the vulva (Fig. 2), which had evolved over several days, without fever. No lesions were observed in other locations. A cutaneous biopsy showed an intense dermal edema and a diffuse and polymorphous dermal infiltrate involving the follicular structures. Exocytosis, spongiosis, and mucin deposits, demonstrated by Alcian blue stain, were observed in the follicular epithelium. Mature neutrophils were predominant in the dermal infiltrate, but a small number of eosinophils and immature cells were also present (Fig. 3). The myelogenous origin of the immature lining cells was further confirmed by positive staining of intracytoplasmic granules with naphthol-ASD chloroacetate sterase (Leder's stain). Vasculitis was not observed. Routine laboratory tests revealed 3030 leukocytes/mm(3) (60% neutrophils), a hemoglobin level of 8.4 g/dL, and 92,000 platelets/mm(3). Treatment with 30 mg/day of prednisone was started, and the lesions cleared slowly within 4 weeks. A new bone marrow biopsy in September 1999 showed a similar appearance to that taken in 1998. The patient died in January 2000 as a result of pneumonia with cardiac and respiratory failure. A 66-year-old man presented with a febrile syndrome that had evolved over 5 days, and painful and pruritic cutaneous lesions on the face and posterior neck (Fig. 4). Three months before, the patient was diagnosed with chronic myelogenous leukemia in acceleration phase. Examination revealed an edematous and erythematous face with pustular lesions on the surface, also involving the neck and the upper part of the back. The histopathologic examination revealed an intense edema and abscesses in the dermis. The infiltrate of these lesions was composed of mature neutrophils with the presence of abundant immature cells with a myelogenous aspect (Fig. 5). Analytical studies revealed 26,130 leukocytes/mm(3) (42% blasts). No specific treatment for Sweet's syndrome was administered and the lesions showed an improvement within 5 days. Eight days after admission, the patient died as a result of acute hemorrhage, before treatment for leukemia was initiated.

Nonoperative treatment of displaced supracondylar fractures in children: Rigault type 2 fractures.

BACKGROUND: Current opinion in the medical literature concerning displaced supracondylar fractures of the distal humerus recommends pinning because with flexion braces there is a risk of both secondary displacement and Volkmann syndrome. PATIENTS AND METHODS: We analyzed 84 children with displaced supracondylar fractures. According to Rigault's classification, 30 children had grade 2 fractures, 21 had grade 3, 28 had grade 4 and 5 had multiple fragments, which were thus outside this classification. Fractures that could be reduced to a stable position under general anesthesia were treated with a posterior long arm splint with an average elbow flexion of 113 degrees (90-140). This technique was applied in 28 of the grade 2 fractures and in 4 of the grade 3 fractures, but in none of the grade 4 fractures. RESULTS: Of the 4 cases of Rigault grade 3 fractures treated nonoperatively, 3 had to be re-reduced and 1 needed an operation later on for varus correction. Of the 28 Rigault grade 2 fractures, 27 showed excellent results, and 1 had a good result. We advise nonoperative treatment in type 2 supracondylar fractures if stable reduction is achieved.

Lower lip hypertrophy secondary to port-wine stain: combined surgical and carbon dioxide laser treatment.

BACKGROUND: Port-wine stains (PWSs) are capillary malformations that usually show progressive stasis of the vascular channels and cause slow hyperplasia of the soft and hard tissues. When these lesions involve the lower lip, macrocheilia may be developed along the time. Vascular-specific lasers are not adequate to correct these three-dimensional tissue deformities, and surgical management becomes necessary, resulting in considerable morbidity and aesthetic disturbances. OBJECTIVE: To report a case of macrocheilia secondary to PWS treated by combination of surgery and carbon dioxide laser. METHODS: A 51-year-old man with macrocheilia of the lower lip and severe functional impairment, secondary to long evolution PWS, received treatment with carbon dioxide laser vaporization and minimal surgical correction, resulting in significant improvement of the lower lip hypertrophy, good aesthetic and functional status, and preservation of the muscular function. CONCLUSIONS: Combined carbon dioxide laser and surgery treatment may constitute a valuable alternative in treatment of macrocheilia secondary to PWS because bleeding risk is minimized and improves the preservation of muscular function and aesthetic results in relationship to conventional surgical approaches.

Risks and complications of prolonged parenteral antibiotic treatment in children with acute osteoarticular infections.

This study aimed at assessing the prevalence of complications encountered during prolonged intravenous antibiotic (AB) therapy when treating acute osteoarticular (OA) infections in children. We reviewed retrospectively 60 paediatric patients treated in our department between 1988 and 1998 for acute osteoarticular infections (27 with acute haematogenous osteomyelitis, 25 with septic arthritis and 8 with septic osteoarthritis). C-reactive protein, erythrocyte sedimentation rate (ESR), and full blood count were monitored during the entire treatment. Body temperature was recorded three times per day until the fever subsided, and then daily during the remaining hospitalisation. Finally, we listed complications related to the antibiotic therapy and those linked to the presence of a venous catheter. Seventeen allergic reactions to drugs were recorded during the intravenous AB therapy. This complications occurred on average after 24.4 +/- 4.4 days of treatment. The clinical manifestations most often encountered were a delayed rise in temperature and cutaneous symptoms. Blood tests showed an isolated increase in the ESR and eosinophilia (> 1000 eosinophils/ml). Four venous catheters had to be removed, in two cases owing to their obstruction and in two cases owing to an infection. Prolonged intravenous AB therapy is not without complications due to its duration and its mode of administration. Drug allergies to AB constitute a major complication of the treatment. They may render the treatment of subsequent infections problematic and expose these patients to major allergic reactions if they accidentally encounter the molecule incriminated. Moreover, the anaesthetics required to insert a central venous catheter and the need to leave it in place for a prolonged duration constitute another source of potential complications. The duration of i.v. AB therapy could therefore be shortened if the clinical and biological evolution is favourable and the pathogen is identified.