[Prevalence of tuberculous infection among health personnel]. / Prevalencia de la infección tuberculosa en el personal sanitario.

One or more tuberculin skin tests (PPD) were carried out in 1865 members of the health care staff (71%) of the Hospital Clinic from Barcelona, so as to detect the prevalence of the infection and, particularly, to identify the converters (recently infected individuals) for the recommendation of antituberculous chemoprophylaxis. A higher number of converters was found in the group with higher risk of contagion owing to professional exposure, but the differences were not statistically significant. Significant differences were not found, either, between infected and noninfected individuals classified in risk groups. In the 1865 surveyed individuals, the initial and successive (when performed) PPD testings were negative in 987 (52%). In 775 individuals (41%), PPD reaction was positive in the initial testing. In the remaining 103 (5%), PPD reactions became positive after an initial negative result (converters). 50% of the 775 individuals with positive PPD reaction were over 35 years of age. The rate of infected individuals (positive PPD reaction) and converters was not significantly higher in those health care professionals with a supposed higher degree of exposure to infection.

[Hodgkin's disease following treatment with hydantoins. Report of a case and review of the literature (author's transl)]. / Asociación de enfermedad de Hodgkin e hidantoínas. Comunicación de un neuvo caso y revisión de la literatura.

Diagnosis of Hodgkin's disease was made in a patient who had been treated with diphenylhydantoin sodium for 4 years. Three different neoplastic diseases of the lymphoid tissue following therapy with hydantoin derivatives have been reported. Pseudolymphoma is characterized by lymph node enlargement, fever, arthralgias, cutaneous rash, hepatosplenomegaly and eosinophilia. The lymph node biopsy reveals a non-malignant histopathologic pattern. Pseudolymphoma develops few weeks after administration of hydantoin and it completely disappears when medication is discontinued. Pseudo-pseudolymphoma has similar clinical and histologic characteristics than those of pseudolymphoma, but patients in this category develop a true lymphoma after an asymptomatic period. Lymphomas (Hodgkin's disease and non-Hodgkin's lymphomas) appear following prolonged treatments with hidantoin derivatives. Risk to develop lymphoma is two to four times higher for patients taking such medication. Carcinogenic mechanism of hydantoin is unknown, but it might be related to the immunosuppressive effect of this drug.

[Hypercalcemia as first manifestation of thyrotoxicosis (author's transl)]. / Hipercalcemia como primera manifestación de una tirotoxicosis.

A 53-year-old woman presented a clinical picture of hypercalcemia as the first and most prominent manifestation of hyperthyroidism. The possibility of a coexistent hyperparathyroidism was excluded, as well as any other potential cause of hypercalcemia. The hypercalcemia and its clinical manifestations disappeared a month after the antithyroid therapy was started. After 2 years, the calcemia and renal and thyroid functions continue normal. The association of hyperthyroidism and hypercalcemia is well known, but only rarely is hypercalcemia responsible for prominent clinical symptoms. It is very infrequent for the manifestations of hypercalcemia to precede those of hyperthyroidism.