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- SourceAvailable from: Jordi Bruna[Show abstract] [Hide abstract]
ABSTRACT: Dissemination of neoplastic cells into the cerebrospinal fluid (CSF) and leptomeninges is a devastating complication described in patients with epithelial-cell neoplasia (leptomeningeal carcinomatosis, LC) and lymphomas (lymphomatous meningitis, LyM). Information about the surrounding inflammatory-cell populations is scarce. In this study we used flow cytometry immunophenotyping to describe the distribution of the main leukocyte populations in the CSF of 83 patients diagnosed with neoplastic meningitis (LC, n=65; LyM n=18). We compared these data with those obtained in the CSF from 55 patients diagnosed with the same groups of neoplasia without meningeal involvement (solid tumors, n=36; high-grade lymphoma, n=19). Median (interquartile) rates of lymphocytes, monocytes and polymorphonuclear (PMN) cells were 59.7% (35-76.6), 24% (16-53) and 1.5% (0-7.6) in LC, and 98.5% (70.8-100), 1.5% (0-29.3), and 0% in LyM (p<0.001). No difference was observed between patients with breast (n=30) and lung adenocarcinoma (n=21), nor with different rates of malignant CSF involvement. Patients with lymphoma (with or without LyM) had a similar CSF leukocyte distribution, but patients with LC and cancer patients without LC had a distinctive PMN cell rate (p= 0.002). These data show that CSF samples from patients with LC have a higher number of inflammatory cells and a different leukocyte distribution than the CSF from patients with LyM. Description of PMN cells is a distinctive parameter of patients with LC, compared with the CSF from patients with LyM and patients with cancer but without LC.
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ABSTRACT: Herpes zoster is the reactivation of varicella zoster virus; this disease commonly occurs in patients over 50 years old and immunocompromise is known as the most important risk factor for the onset of this condition. Herpes zoster ophthalmicus is the clinical variant that gives more complications to the patient. Clinical presentation of this disease in children is rare. We aim to present an 8 year old female patient who, came to the emergency room of the Guadalajara's Civilian Hospital with macules and confluent vesicles on right facial region, Hutchinson's sign and no immunocompromise. Herpes zoster ophthalmicus was diagnosed. She was hospitalized for clinical evaluation and to rule out superinfection. This clinical scenario was aggressively treated with topical and systemic acyclovir in order to reduce possible complications. An episode of anterior uveitis appeared one week later and was successfully controlled with topical steroids and cycloplegic.
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ABSTRACT: Priapism is a urologic emergency described by Hinman in 1914 and is defined as a painful erection without sexual stimuli lasting more than 4 hours and not resolved by ejaculation. Our aim was to present a case and to carry out a review of the literature. A 32-year-old man presented with an erection of 24-hour progression. He had a history of alcoholism, smoking, and cocaine use, having ingested the latter 48 hours prior. Fine needle aspiration and irrigation of the corpora cavernosa were carried out without success, followed by a Winter procedure with partial response, and gasometry with a persistent ischemic pattern. The Al-Ghorab procedure with complete detumescence was performed finding gasometric evidence of arterial/venous short circuit. Hemogram revealed acute myeloid leukemia. Despite the existence of clinical guidelines for the management of priapism secondary to leukemia, efficacy depends on the instauration time of the priapism. Rapid restoration of the blood flow, regardless of the etiology of the priapism, is mandatory for preventing ischemic damage and sequelae.
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