[Angiosarcoma of the outer ear. A case report]. / Angiosarcoma de pabellón auricular. A propósito de un caso.

Angiosarcoma (AS) is one of the rarest forms of soft tissue neoplasm. They are considered highly aggressive tumors with a poor prognosis. They range from highly differentiated tumors resembling hemangiomas to anaplastic tumors that are difficult to distinguish from carcinomas. Clinically, the appearance of these lesions varies, so confusion may arise from an initially benign appearance. AS comprise less than 1% of all sarcomas. In these patients, tumor size is an important predictor of survival. In our case, the tumor was located in the outer ear and the patient was treated with surgery, radiotherapy (65 Gy), and chemotherapy (adriamycin). A recurrence one year later was treated with salvage surgery and external carotid artery ligature to control abundant hemorrhage.

[Rendu-Osler disease. Follow-up of 6 patients treated by embolization. Nasal telecobaltotherapy in a refractory case]. / Enfermedad de Rendu-Osler. Seguimiento de seis casos tratados mediante embolización. Telecobaltoterapia nasal en un caso refractario.

Patients with Rendu-Osler-Weber disease can present severe nose bleeding. The treatment of 6 patients with this condition is reported. Supraselective embolization was the treatment of choice. One patient showed no improvement with embolization and suffered massive nosebleed requiring blood transfusion. After a review of the literature, the nasal cavity was irradiated.s.

[Validity of semiquantitative methods of microalbuminuria screening in diabetes mellitus]. / Validez de los métodos semicuantitativos de cribado de la microalbuminuria en la diabetes mellitus.

OBJECTIVE: To analyse the validity of the Micraltest and Microbumintest semi-quantitative methods for microalbuminuria screening in type 2 diabetes mellitus in primary care clinics. DESIGN: Crossover study to validate diagnostic tests. SETTING: Three general practices at an urban health centre. PATIENTS: Consecutive sample of 64 diabetics not dependent on insulin. MEASUREMENTS AND MAIN RESULTS: Each patient's own doctor performed in the consultation the semi-quantitative determinations in a simple sample of the morning's first urine. As standard, a rate of albumin excretion above 20 micrograms/min, determined by immunonephelometry in a 2-hour controlled time sample, was used. The prevalence of Microalbuminuria was 25% (C.I. 95%, 14.4-35.6). The sensitivity of Micraltest was 69% (CI, 42-88), and its specificity 52% (CI, 37-67), corresponding to the cut-off point of 10 mg/L. The sensitivity of Microbumintest was 63% (CI, 36-84), and its specificity 67% (CI, 52-79). The combination of both tests in one sample had 75% sensitivity (CI, 47-92) and 44% specificity (CI, 30-59). Negative predictive values ranged between 84 and 85%. CONCLUSIONS: The semi-quantitative microalbuminuria detection tests are of limited use in the primary care clinic. Their sensitivity and the negative predictive value obtained in an isolated sample do not seem acceptable for a screening method.