Lymphangioma of the spermatic cord

We report a new case of spermatic cord lymphangioma in a infant 2 years old. The initial diagnosis was funicular hydrocele. The treatment was the local excision of tumor and the diagnostic was histological. Postoperative course was excellent. Must be explored the transillumination of the mass which would have led us to think other the diagnosis different from that of the cord hydrocele before the operation since it would have given negative. During the operation, must the assured that the cystic anomaly is limited to spermatic cord, to evite recurrences in the postoperative course.     

Relationship between tumor recurrence and the expression of the p53 gene in primary superficial transitional carcinoma of the bladder

Contribution of 60 patients with primary surface transitional cell tumours of the bladder where nuclear expression of p53 protein was prospectively studied and compared to known prognostic factors in an attempt to find out its role in the development of relapses. An statistically significant relationship was found between the protein expression and cytology, tumoral multifocality, stage, relapse development and tumoral progression. It can be concluded that expression of this protein can be of use as relapse predictor.     

Oftalmoplejía completa izquierda por metástasis ósea de cáncer de próstata

Prognosis in prostate cancer is determined, in greater part, by the presence of metastases. Bone metastases can occur in any part of the skeleton even, for example, at the base of the skull. We present a case of a 78 year old male who, in December 2001, presented with paralysis of the third cranial nerve. The NMR and CAT scans were normal and circulating levels of PSA were elevated. He was referred to the Urology Service where the treatment guidelines included complete androgen block. Subsequently, he developed retro-orbital pain, divergent strabismus and palpebral ptosis. CAT and NMR indicated a soft tissue mass at the sphenoid level. Treatment was Gamma Knife Radio-surgery. Since August 2004, in conjunction with the latest rise in PSA, the patient's general status deteriorated considerably and he was referred to the Oncology Service. there was an increase in the paralysis of the third, fourth and sixth cranial nerve (complete left ophthalmoplegia) and left-central facial paralysis. Metastases from prostate cancer can be disseminated via the lymphatic or the blood system. Currently, there are more metastases from large-size tumours. Metastases are critical in prostate cancer because of their adverse effect on the patient's survival. Measurements of circulating levels of prostate specific antigen and prostate acid phosphatase are very useful in the clinical diagnosis of the primary tumour, or its metastases.     

Coordinating Canada's research response to global health challenges: the Global Health Research Initiative

The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries.     

Insuficiencia cardiaca y trasplante

The mission of the Heart Failure and Heart Transplantation Section of the Spanish Society of Cardiology is to study, promote interest in, and disseminate information about all aspects of myocardial dysfunction and heart transplantation. Heart failure is a highly prevalent disorder that consumes a substantial proportion of healthcare resources. Consequently, there is a very high level of interest in the condition and a wide range of preclinical and clinical research is being carried out, including research into new ways of looking at the disease that will increase our understanding. The aim of this article was to describe current developments concerning this disease and its treatment. Firstly, the latest publications on heart failure are summarized. Then, the most recent studies on advanced heart failure and ventricular assist devices are reviewed. Finally, the latest findings on heart transplantation are reported.     

Motion artifact simulating aortic dissection on CT

We recently imaged two patients clinically suspected of having aortic dissection whose contrast-enhanced CT examinations, obtained on a new scanner with a 1-sec scanning time, showed findings suggesting an ascending aortic dissection. The subsequent clinical course and evaluation implied that the CT findings were predominantly artifactual. We identified identical artifacts in 18% of 50 consecutive contrast-enhanced CT examinations performed for a variety of indications on the same scanner. The double-lumen artifact, simulating an intimal flap, occurs in the proximal ascending aorta and is limited to one or two contiguous transaxial images. The artifact was not detected on two other CT units. We believe the artifact arises from motion of the aortic wall and the surrounding pericardial recesses during image acquisition.     

Distraction osteogenesis for the cleft lip and palate patient

Gradual maxillary distraction by modified osteotomies and external force systems is a procedure with minimal morbidity and few complications. The interaction between surgeons and orthodontists is critical, however. The wide range of possibilities for remodeling a hypoplastic maxilla by distraction allows the potential to simultaneously advance and to elongate the midface, thereby restructuring the skeletal framework with mature new bone. An expansion of all the soft tissues of the face and palate (muscles, nerves, vessels, mucosa, skin) occurs in conjunction with bone elongation. This process ultimately produces excellent functional and aesthetic results in patients with midface deficiency, thus restoring their facial appearance and avoiding many years of facial deformity and associated psychologic sequelae.     

Pancreas islet transplantation in patients with type 1 diabetes mellitus after kidney transplantation

Diabetic patients with end-stage renal disease have a high mortality rate. A combined kidney-pancreas transplant is associated with greater life expectancy. Pancreas islet transplantation is an alternative involving a lower degree of morbidity. We present two patients, of 41 and 37 years of age, with a long history of diabetes mellitus (C-peptide negative), both with a previous kidney transplant, who had been treated with 22 and 28 U of insulin/d, respectively. Both patients had frequent episodes of unawareness hypoglycemia. Pancreatic islets were infused to a total of 7809 and 19,180 IE/kg, respectively. Basal posttransplant C peptide levels were 2.9 and 1.3 ng/mL. After the implant, one patient required occasional doses of insulin, and the other patient more than 50% reduced dose. After the first implant neither patient had any episodes of unawareness hypoglycemia. HbA1c at 4 months were 6.2% and 6.9%. There were no transplant-related complications.