[Multiple familial osteochondromatosis: presentation of a case]. / Osteocondromatosis múltiple familiar: a propósito de un caso.

Enchondromas are benign cartilage tumours that grow slowly in the bone metaphysis. They may involve solitary or multiple lesions. Enchondromatoses include a heterogeneous group of hardly distinguishable syndromes characterised by the presence of multiple enchondromas that may cause musculoskeletal malformations (secondary to limb shortening), scoliosis, pathological fractures, or pseudoarthrosis. The most dreaded complication, osteochondrosarcoma, occurs in up to 25% of patients. We present the case of a 67-year-old male with no previous diagnosis, requiring attention due to the appearance of a painful tumour in his left hip which degenerated rapidly over the past year. Family history and clinical-radiological data confirmed the diagnosis of Multiple Familial Osteochondromatosis. Although clinical evolution and imaging led to suspect a malignant degeneration (osteochondrosarcoma), this was not confirmed by the histopathological study of the surgical sample.

Osteocondromatosis múltiple familiar: a propósito de un caso / Multiple familial osteochondromatosis: presentation of a case

Los encondromas son tumores benignos de cartílago que crecen de forma lenta en las metáfisis de los huesos. Pueden ser lesiones solitarias o múltiples. Las encondromatosis comprenden un grupo heterogéneo de síndromes, difíciles de diferenciar, caracterizados por la presencia de múltiples encondromas que pueden llegar a producir malformaciones musculoesqueléticas (secundarias al acortamiento de extremidades), escoliosis, fracturas patológicas o seudoartrosis. La complicación más temida, el osteocondrosarcoma, puede acontecer hasta en el 25% de los pacientes. Exponemos el caso de un varón de 67 años, sin diagnósticos previos conocidos, que consulta por la aparición en cadera izquierda de una tumoración dolorosa y rápidamente deformante en el último año. Los antecedentes familiares y los datos clínico-radiológicos confirmaron el diagnóstico de osteocondromatosis múltiple familiar. Aun cuando la evolución clínica y los estudios de imagen hicieron sospechar una degeneración maligna (osteocondrosarcoma), esta no se confirmó en el estudio histopatológico de la pieza quirúrgica (AU)

Enchondromas are benign cartilage tumours that grow slowly in the bone metaphysis. They may involve solitary or multiple lesions. Enchondromatoses include a heterogeneous group of hardly distinguishable syndromes characterised by the presence of multiple enchondromas that may cause musculoskeletal malformations (secondary to limb shortening), scoliosis, pathological fractures, or pseudoarthrosis. The most dreaded complication, osteochondrosarcoma, occurs in up to 25% of patients. We present the case of a 67-year-old male with no previous diagnosis, requiring attention due to the appearance of a painful tumour in his left hip which degenerated rapidly over the past year. Family history and clinical-radiological data confirmed the diagnosis of Multiple Familial Osteochondromatosis. Although clinical evolution and imaging led to suspect a malignant degeneration (osteochondrosarcoma), this was not confirmed by the histopathological study of the surgical sample (AU)

[Quality assurance of prenatal care in a rural health center]. / Garantía de calidad de la vigilancia prenatal en un centro de salud rural.

OBJECTIVE: This study was carried out with the aim of evaluating the quality of Prenatal Care (PNC) and improving attention to the pregnant woman. DESIGN: This was a retrospective evaluation, with a later monitoring of two indicators: an early start to care and an evaluation of risk. Site. The study was undertaken in a rural Primary Care Centre. PATIENTS AND OTHERS PARTICIPANTS: For purposes of the evaluation all the pregnant women (222) looked after between 1988 and 1990 were studied; for the monitoring, all those between July 1990 and June 1991. MAIN MEASUREMENTS AND RESULTS: On the first evaluation, both the starting of PNC within the first 12 weeks (in 65% of cases) and the evaluation of obstetric risk at the first visit (29% compliance) were considered unacceptably low. With the help of corrective measures and simple practical monitoring, 100% compliance was reached in 12 months. The risk evaluation on subsequent visits (between 73 and 95% compliance) and the number of checks (90% compliance) were considered adequate, and no intervention was made. CONCLUSIONS: We concluded that the PNC programmes should include quality assurance activities, as these have a positive effect on the improvement of medical care.