Metástasis coroideas y cutáneas como forma de presentación de un adenocarcinoma esofágico / Choroid and cutaneous metastasis as presentation of an esophageal carcinoma

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[Personal experience in the surgery of nasal sinus polyps]. / Experiencia personal en la cirugía de la poliposis nasosinusal.

Personal opinions on surgery of polyps of the nasal cavity and paranasal sinuses, including from simple polypectomy to ethmoid microsurgery and nasal endoscopic surgery. The diagnostic importance of tomodensitometry and the essential postsurgical care are emphasized. The results of 29 patients with polyps of the nasal cavity and paranasal sinuses treated with intranasal microsurgery and endoscopic surgery are reported.

[Detection of virulence factors using DNA probes in uropathogenic strains of Escherichia coli]. / Detección de factores de virulencia mediante sondas de DNA en cepas de Escherichia coli uropatógenas.

BACKGROUND: There are several bacterial determinants that contribute to the onset of urinary tract infection by E. coli. The present study focuses on some of the virulence factors considered to be most important, as P fimbriae, the siderophore aerobactin and bacterial capsule, which were studied among 123 uropathogenic E. coli strains isolated from outpatients from the Basque Community. METHODS: Virulence factors were detected using Molecular Biology techniques, namely DNA hybridization to specific probes prepared in our laboratory. RESULTS: When probe pap2, specific for fimbrial adherence was used, 36.5% of the strains showed positive hybridization, and 66 and 73% of the strains hybridized to probes for aerobactin and common capsule region, respectively. CONCLUSIONS: We believe that this technology provides a very useful tool for rapid and easy screening of strains harbouring different virulence factors. Nevertheless, the fact that these methods detect genetic determinants that are not always being expressed must be borne in mind.

Systemic lupus erythematosus.

Pregnancy occurring in patients with diagnosed and controlled SLE will be associated with a flare of disease in 60 per cent of cases, which is not significantly different from flares in nonpregnant patients. Signs and symptoms of active SLE should be carefully evaluated and treated with steroids according to severity and organ systems involved. When pregnancy occurs with inactive kidney disease there is a 10 per cent rate of reactivation and SLE kidney disease may appear for the first time during pregnancy in 6.8 per cent of patients. These rates are similar in the control group. There will be a significantly increased abortion rate which cannot be improved with maternal treatment. There will also be a high prematurity rate and an increased number of newborns with intrauterine malnutrition that are associated with active maternal disease. The following points are important when caring for a pregnant SLE patient: 1. Maintain maternal disease inactive throughout gestation. 2. Monitor growth and development of fetus. 3. Monitor for fetal distress. 4. Interrupt pregnancy when fetal distress is diagnosed. 5. A neonatal intensive care unit should be available at the time of delivery. The short-term prognosis is good with no maternal mortality and there is no long-term deleterious influence of pregnancy on the evolution of SLE.

Linfadenopatía angioinmunoblástica: Estudio de dos pacientes / Angiolmmunoblastic lymphadenopathy: study of two patients

Se estudian dos pacientes que presentan linfadenitis angioinmunoblástica (LAI), trastorno linfoproliferativo recientemente descrito y que con frecuencia se asocia con disproproteinemia inespecífica. Se revisan brevemente los aspectos de diagnóstico: clínicos, fisiopatológicos y evolutivos de dicha afección, señalandose la edad precoz de presentación, en nuestros dos pacientes, así como la posible relación con la terapéutica anticonvulsivante en uno de ellos y la evolución benigna de ambos casos (AU)