Leishmaniasis, una enfermedad emergenteen España: presentación de 5 casos clínicos / Leishmaniasis, an emergent disease. Five clinical cases presentation

La leishmaniasis es un grupo de enfermedades producida por protozoos del genero leishmania, que se transmite al hombre por la picadura de un mosquito.Dependiendo de la especie y del estado inmunológico del huésped, presenta diferentes formas clínicas: cutánea, mucocutánea y visceral.Afecta a 12 millones de personas y el aumento de su incidencia la coloca a la cabeza de las enfermedades emergentes. Contribuyen a su expansiónfactores ambientales, de emigración, e inmigración, y globalización del trabajo y del ocio. También contribuye, la inmunodepresión de las personasinfectadas debida al consumo de medicamentos que alteran la inmunidad o coinfecciones víricas como el HIV. Presentamos los 5 casos de leishmaniasisatendidos en nuestro hospital de Huesca (España), en 2007, que reflejan su incidencia y variabilidad clínica (AU)

Infection whith protozoan parasites of the genus Leishmania causes a variety of clinical diseases called leishmaniases, which is transmited to humanhost by the bite of a sandfly. The clinical manifestation depends on the interaction among series of parasite and host inmunity: cutaneous, mucocutaneousor visceral. Worldwide, an estimated 12 million people are infected with leishmaniases. The number of cases of leishmaniases is increasing,globally at an alarming rate, and the leishmaniases are among in the top the emergent diseases. The ecological chaos, differents phenomena such asmigration, immunosupression caused by drughs and viral infections, globalization of work and leisure contribute to the spread and increase of the disease.We report five cases with leishmaniasis who had been atended in 2007 at our hospital in Huesca (Spain), reflecting its clinical diversity (AU)

Tumor de Merkel: estudio clínico, histológico,inmunohistoquímico y submicroscópico / Merkel cell tumour: a clinical, histological, inmunochemical and microscopic study

El carcinoma de Merkel es un tumor cutáneo primario de origen neuroendocrino poco frecuente y altamente agresivo tanto a nivel local como a distancia.Su aparición se ha asociado a múltiples etiologías entre las que destaca la exposición a la radiación ultravioleta. Si bien su diagnóstico se basaen los hallazgos clínicos e histológicos, la inmunohistoquímica resulta útil en la confirmación diagnóstica. Debido a su agresividad y mal pronósticoaún hoy no existe un tratamiento estandarizado. Presentamos el caso de una paciente con carcinoma de Merkel de gran tamaño en extremidad inferiorderecha y positividad en la técnica del ganglio centinela, revisando las técnicas diagnósticas y terapéuticas empleadas actualmente en el manejode este tumor (AU)

Merkel cell carcinoma is an inusual and aggressive primary cutaneous tumor with neuroendocrine features. Several etiological factors have been proposedspecially ultraviolet radiation exposition. Although its clinical presentation and characteristic histology are usually enough, immunochemistryfeatures are very helpful to make an accuracy diagnosis. Because of its agressive behaviour and bad outcome there are not standard therapeutic proceduresestablished nowadays. We present a case of a patient with a Merkel cell carcinoma in right lower limb. Sentinel lymph node procedure waspositive. We make a revision of diagnostic and therapeutic procedures used currently (AU)

[Children with brain seizures: impact on their families. A clinical and social study]. / Repercusión familiar de los niños afectados por crisis cerebrales: estudio clínico y social.

INTRODUCTION AND MATERIAL: Over a two-year period, a total of 23 children (13 males and 11 females) entered in the Unit of Infantile Neurology of our hospital affections of diverse types of cerebral seizures, were subjected to follow-up study prospective from the point of view medical and social, analyzing the characteristic and situation of their family environment. RESULTS AND CONCLUSIONS: Between the outputs, they have met important differences between the attitude in front of the problem of the several family groups, according to it's valued for the doctor or for the Unit of Social Work. At the beginning he is not frequent the acceptance of the illness, contrarily to the one which the denial happens to. Have been detected a tall index of anxiety-anguish between the relatives setting in connection with the correct acceptance diagnostic. They have not met differences between the attitude in front of the problem and the economical status associate referred to the profession, the instruction or the housing of the parents. The severity of the illness has not been the only factor in the integration psychosocial of the children with seizures, existing other factors of environmental character that rebound same on the medium. The disorders of the psychotic sphere was those that were affected with an old intensity.