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Objective: There are few studies available about skin response to mycotic antigens in diabetes mellitus subjects, therefore, the possible difference of skin reactivity to coccidioidin in subjects with and without diabetes mellitus was analyzed., Material and Methods: The prevalence of skin reactivity to coccidioidin in a population sample of 1651 subjects in a coccidioidomycosis endemic zone was estimated using a transversal design. Subjects with diabetes mellitus were identified and the diagnosis was validated by clinical and laboratory criteria. In order to determine the reactivity association level with the diabetes mellitus history, data was compared with the population sample, through logistic regression analysis adjusted by age, sex and residence geographical area. Odds ratio (OR) and 95% confidence intervals were obtained., Results: In the population study, there were 665 coccidioidin positive subjects (40.28% rate). Seventy six cases with diabetes mellitus were identified, 23 were positive to the test (30.26% rate) with an odds ratio of 0.63 for this group (95% CI 0.37-1.07). The OR decrease to 0.52 (95% CI 0.31-0.88, p = 0.014) with the adjusted logistic regression analysis., Conclusion: Coccidioidin reactivity was lower in the diabetes mellitus cases than in general population. It is necessary to be cautious with the coccidioidin test interpretation in people with DM 2.

Carboxyhemoglobin levels (COHb) were determined in residents of two Mexican cities (Mexico City and Toluca) at altitudes of 2200 and 2600 meters above sea level. The figures in non-smokers of both cities were slightly higher than those seen at sea level by others: 1.63% in Mexico City and 1.54% in Toluca versus 0.5-1% at sea level. There were no intercity differences in smokers and non-smokers, but there were intergroup differences in both cities (p less than 0.01 in Mexico City, and p less than 0.05 in Toluca). Our findings suggest that the most important source of carbon monoxide in smokers is tobacco smoking, and that the COHb level may be reliable index to establish active smoking.

A case of small and large cells non Hodgkin lymphoma with an unusual involvement of the lung is presented. The tumor was located in the inferior lower lobe of the right lung and coincided with hemorrhagic pleural effusion. The cytopathological study of the fluid was negative for neoplastic cells, so were the aspiration biopsy of the lung and the pleural biopsy. The transmission and scanning electron microscopic study of the pleural fluid demonstrated lymphoid atypical cells. The patient was treated by resection of the lower right lobe and pleurectomy. The difficulties in the differential diagnosis of this type on non Hodgkin lymphoma are discussed. The importance of scanning and transmission electron microscopy is stressed when the light cytologic studies are negative in processes suggestive of being neoplasms. After one year of the lobectomy and treatment with vincristine-epirubicin-cyclophosphamide and methyl-prednisolone, the patient is in good condition without evidence of neoplastic activity.

A female patient, 17 years old with Poland's syndrome and myasthenia gravis was seen due to a bronchial infection and atelectasis. The respiratory pathology was treated by bronchial aspiration and respiratory support in the intensive care unit. The myasthenia gravis improved substantially after thymectomy. The association of Poland's syndrome and myasthenia is rare and it has not been reported previously; it may be a factor in the pulmonary pathology observed in this case.