When the earth trembles in the Americas: the experience of Haiti and Chile 2010.

The response of the nephrological community to the Haiti and Chile earthquakes which occurred in the first months of 2010 is described. In Haiti, renal support was organized by the Renal Disaster Relief Task Force (RDRTF) of the International Society of Nephrology (ISN) in close collaboration with Médecins Sans Frontières (MSF), and covered both patients with acute kidney injury (AKI) and patients with chronic kidney disease (CKD). The majority of AKI patients (19/27) suffered from crush syndrome and recovered their kidney function. The remaining 8 patients with AKI showed acute-to-chronic renal failure with very low recovery rates. The intervention of the RDRTF-ISN involved 25 volunteers of 9 nationalities, lasted exactly 2 months, and was characterized by major organizational difficulties and problems to create awareness among other rescue teams regarding the availability of dialysis possibilities. Part of the Haitian patients with AKI reached the Dominican Republic (DR) and received their therapy there. The nephrological community in the DR was able to cope with this extra patient load. In both Haiti and the DR, dialysis treatment was able to be prevented in at least 40 patients by screening and adequate fluid administration. Since laboratory facilities were destroyed in Port-au-Prince and were thus lacking during the first weeks of the intervention, the use from the very beginning on of a point-of-care device (i-STAT®) was very efficient for the detection of aberrant kidney function and electrolyte parameters. In Chile, nephrological problems were essentially related to difficulties delivering dialysis treatment to CKD patients, due to the damage to several units. This necessitated the reallocation of patients and the adaptation of their schedules. The problems could be handled by the local nephrologists. These observations illustrate that local and international preparedness might be life-saving if renal problems occur in earthquake circumstances.

[Cancer in AIDS patients: experience at a general hospital in the Province of Buenos Aires]. / Cáncer en enfermos de SIDA. Experiencia en un hospital general en la Provincia de Buenos Aires.

Twenty three HIV+ patients with cancer (2% of the infected population: 1100 patients) were treated at our Hospital between January 1987 and July 1997. Twelve patients (52%) had Kaposi's sarcoma (KS), five (22%) presented non Hodgkin lymphoma--B cell type (NHL), the remaining patients presented other non AIDS defining neoplasias. The patients with NHL presented, at the time of diagnosis, several infrequent localizations, poor tolerance to chemotherapy with a mean survival of 3 months. The patients with Kaposi sarcoma had neither positive response to recombinant Interferon alfa 2 nor to the etoposide regimens. A relatively high percentage (13%) of Hodgkin-disease (HL) was observed. Unlike previously consulted data, there was no apparent increased incidence of NHL. HIV+ patients with cancer who underwent conventional radiotherapy presented major toxicity and adverse effects not currently observed in non HIV+ patients.

Tallimustine in advanced previously untreated colorectal cancer, a phase II study.

Tallimustine is a novel benzoyl mustard derivative from distamycin A with a unique mode of action. It is a DNA minor groove binder and produces highly sequence-specific alkylations. Previous studies have shown significant anti-tumour effects in animal models. We performed a phase II study in previously untreated patients with advanced colorectal cancer, using a schedule of i.v. bolus infusions of 900 microgram m-2 once every 4 weeks. Seventeen patients were enrolled, and no responses were documented in 14 evaluable patients. Toxicity mainly consisted a highly selective neutropenia, which warrants further investigation of this agent in combination with myeloid growth factors.

[Colorectal cancer: surgery or is there something else?]. / Cáncer de colón y recto: cirugía, hay algo Más?

The standard modality to treat colorectal cancer in potentially curable patients is, undoubtedly, surgery. The concept of precautional chemotherapy used in tumors located elsewhere, has put forward a clinical trial that proved its effectiveness and improved survival. We report the use of two modalities (chemotherapy and radiotherapy) along with surgery as part of a multidisciplinary treatment of patients with colorectal cancer.

Dysfunction of the monocyte-macrophage system in the idiopathic minimal change nephrotic syndrome.

We studied the function of phagocytes and the distribution of lymphocyte subpopulations in 23 patients with Idiopathic Minimal Change Nephrotic Syndrome. All the patients were in relapse at the time of the study. The latter was performed before specific therapy was started. Our control group consisted of 26 normal children who were studied while undergoing routine analysis prior to plastic surgery. Polymorphonuclear leukocytes from the patients showed no alterations in their ability to ingest and to kill candidas. On the contrary, peripheral blood monocytes had a normal phagocytic function with a decreased candidacidal activity when compared to normal controls (p less than 0.001). No correlation was found between serum immunoglobulin levels and the monocyte lytic function. The absolute number of B lymphocytes was significantly increased (p less than 0.05), whereas the absolute number of total lymphocytes, T lymphocytes and T4+ and T8+ cell subsets did not differ from those of the age-matched normal controls. Natural killer cells were functionally normal.

Haemolytic uraemic syndrome associated with faecal cytotoxin and verotoxin neutralizing antibodies.

Forty-nine patients with a diagnosis of idiopathic haemolytic uraemic syndrome (HUS) were investigated to determine evidence of infection by verotoxin-producing Escherichia coli (VTEC). Free faecal cytotoxin active on Vero cells (VT) was detected in 15 out of 49 patients (31%). Seroconversion or high titres of VT-neutralizing antibodies were detected in 11 out of 18 patients (61%). The results of the present study suggest an association between HUS and infection by VTEC.

Tratamiento del lecho perineal en la operación de miles / Management of the perineal sinus in miles' operation

Se analizan 39 casos operados en la 1ra. Cátedra de Cirugía del Hospital de Clínicas entre 1971 y 1979. Se comparan dos métodos de tratamiento del lecho perineal en la operación de Miles: A) el taponaje con gasas y B) el cierre primario con drenaje aspirativo. Se concluye que en los casos indicados el cierre primario con drenaje aspirativo ha demostrado en los no complicados un menor tiempo de cicatrización y un mayor confort del enfermo

Tratamiento del lecho perineal en la operación de miles / Management of the perineal sinus in miles operation

Se analizan 39 casos operados en la 1ra. Cátedra de Cirugía del Hospital de Clínicas entre 1971 y 1979. Se comparan dos métodos de tratamiento del lecho perineal en la operación de Miles: A) el taponaje con gasas y B) el cierre primario con drenaje aspirativo. Se concluye que en los casos indicados el cierre primario con drenaje aspirativo ha demostrado en los no complicados un menor tiempo de cicatrización y un mayor confort del enfermo (AU)

5 flourouracilo en altas dosis: fundamentos y toxicidad / 5 fluorouracil in high doses: basis and toxicity

El 5 fluorouracilo es el quimioterápico fundamental en el tratamiento del cáncer digestivo. Para obtener un mejor índice terapéutico, se puede emplear este fármaco en altas dosis (3 gr./m2), asociado a allopurinol, que previene la toxicidad en tejidos normales. En este trabajo se evalúan fundamentalmente los efectos colaterales en 20 pacientes portadores de neplasias avanzadas. Se demuestra la aparición de efectos tóxicos en un nivel aceptable que permite el uso de esta forma de suministrar el fármaco mencionado

5 flourouracilo en altas dosis: fundamentos y toxicidad / 5 fluorouracil in high doses: basis and toxicity

El 5 fluorouracilo es el quimioterápico fundamental en el tratamiento del cáncer digestivo. Para obtener un mejor índice terapéutico, se puede emplear este fármaco en altas dosis (3 gr./m2), asociado a allopurinol, que previene la toxicidad en tejidos normales. En este trabajo se evalúan fundamentalmente los efectos colaterales en 20 pacientes portadores de neplasias avanzadas. Se demuestra la aparición de efectos tóxicos en un nivel aceptable que permite el uso de esta forma de suministrar el fármaco mencionado (AU)

[5-fluorouracil in high doses. Principles and toxicity]. / 5 flourouracilo en altas dosis. Fundamentos y toxicidad.

5 fluorouracil (5FU) is considered the most important chemotherapeutic agent for gastrointestinal cancer treatment. High dose 5FU (3 gr./m2), given together with allopurinol to prevent normal tissue toxicity may be used to get a better therapeutic index. Toxic effects are specially considered in this paper, where effects in 20 advanced gastrointestinal patients are evaluated. Taking into consideration the results obtained, we consider it can be safely used in this way.