Leiomiosarcoma retroperitoneal tras tumor de músculo liso de potencial maligno incierto

Uterine smooth-muscle tumors are not easy to classify. We report a case of uterine smooth-muscle tumor of uncertain malignant potential, which metastasized to retroperitoneal leiomyosarcoma in the left obturator cavity.     

Adenocarcinoma seroso papilar sobre pólipo endometrial

We report two cases of uterine papillary serous carcinoma in endometrial polyps, which were diagnosed and treated in Donostia Hospital in San Sebastián, Spain. Although the tumors were classified as early stage, both patients suffered disease relapse and progression.     

Effectiveness of the antibiotic lock therapy for the treatment of port-related enterococci,Gram-negative,or Gram-positive bacilli bloodstream infections

Objective

The purpose of this study is to evaluate the efficacy of antibiotic lock therapy to treat port-related enterococci, Gram-negative, or Gram-positive bacilli bloodstream infections.

Patients and Methods

We conducted a prospective observational study including all patients with port-related bacteremia diagnosed at the Clinica Universitaria de Navarra, Pamplona, Spain. During a 36-month period, 110 patients were diagnosed with port-related bacteremia. Of these patients, 18 met criteria to be enrolled in the study. They were treated with a combination of systemic and antibiotic lock therapy (12–24 h/day during 7–14 days). Treatment effectiveness was assessed by clinical and microbiologic criteria.

Results

Treatment was associated with clinical and microbiologic success in 88.8% of our patients (2/2 of the Propionibacterium acnes, 5/5 of the Corynebacterium spp., 6/7 of the Gram-negative bacillus, and 3/4 of the Enterococcus faecium port-related bloodstream infections). Mean increase of port life span for all patients after bacteremia was 288 days (range, 0–1403 days).

Conclusion

Antibiotic lock therapy combined with systemic antibiotics appears to be a safe and effective treatment of port-related bacteremia caused by enterococci, Gram-negative, or Gram-positive bacilli if the patient is stable and no septic syndrome is associated.     

Antigens for the immunodiagnosis of Echinococcus granulosus infection: An update

The taeniid tapeworm Echinococcus granulosus is the causative agent of the echinococcal disease, an important zoonosis with worldwide distribution. Accurate immunodiagnosis of the infection requires highly specific and sensitive antigens to be used in immunodiagnostic assays. The choice of an appropriate source of antigenic material is a crucial point in the improvement of the diagnostic features of tests, and must be based on the developmental stage of the parasite and the host. The most common antigenic sources used for the immunodiagnosis of echinococcal disease are hydatid cyst fluid, somatic extracts and excretory-secretory products from protoscoleces or adults of E. granulosus. Hydatid cyst fluid is the antigenic source of reference for immunodiagnosis of human hydatidosis, which is mainly based on the detection of antigens B and 5. Somatic extracts have been widely used in the serodiagnosis for E. granulosus infection in dogs and ruminant intermediate hosts, although in the last few years the detection of excretory-secretory products of the worm in faeces (coproantigens) have become the most reliable method for the detection of the parasite in the definitive host. This review emphasizes recent advances in the identification and characterization of novel antigens with potential for the immunodiagnosis of echinococcal disease. Progress in recombinant technologies and synthetic peptides are also discussed. The paper highlights the need to search for new antigenic components with high diagnostic sensitivity and specificity, a fact that remains a crucial task in the improvement of the immunodiagnosis of the disease.