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Introduction: In pancreatic ductal adenocarcinoma (PDA), surgical resection is the only curative treatment, but due to its late clinical presentation only 15-25% patients are candidates for curative resection. The aim of this prospective, single-center study is to determine the diagnostic utility of preoperative PET-CT for early detection of PDA and early panIN lesions., Methods: We studied the histopathological features of PDA and different panIN lesions in 139 surgical samples from patients undergoing pancreatic resection (from 2010-2014), comparing these results with preoperative PET-CT and MDCT study. For tumor diagnosis in PET-CT maximum standard SUV 2.5 was used. Pancreatic baseline SUVmax is the maximum uptake of the radiotracer 18-2FDG on the ROI curve determined for the area of the normal pancreas after pathological reassessment with areas not affected by tumours or preneoplastic lesions. Tumour Uptake Index is the ratio between the tumour SUVmax and pancreatic baseline SUVmax., Results: Using an standard maximum SUV value of 2.5, PET-CT sensitivity was 77.7% (108 of the 139 cases) against 75.5% (105 of the 139 cases) of MDCT. But when we combined this value with maximum SUV of normal pancreatic tissue from each patient, PET-CT sensitivity improved its value to 94.9%., Conclusion: A combination of studies of PET-CT in tumor and non-tumor tissue of each patient might be a very useful diagnostic tool not only for preoperative diagnosis of PDA, but also for early panIN lesions., (Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Unlabelled: HELLP syndrome (HS) occurs in 0.5-0.9% of pregnant women. According to the Tennessee criteria, it is characterised by haemolytic anaemia, thrombopenia and multi-organ dysfunction. The purpose of this article is to present the cases of four pregnant women diagnosed with HS with severe liver involvement., Patients and Method: We present the cases of 4 pregnant women of 24, 27, 28 and 36 weeks gestation, respectively. Pregnancy was terminated by urgent Caesarean section in all 4 cases. The first case required a right hepatectomy, with a good post-operative outcome; the second patient developed fulminant liver failure, dying due to multi-organ failure while waiting for a liver transplant. The third patient progressed satisfactorily with conservative medical treatment. The fourth patient required two livers transplants, being discharged from hospital three months later., Conclusions: When faced with the clinical suspicion of a HS it is essential to rule out a liver haematoma, since the treatment of choice depends on its clinical-radiological severity. If there is a rupture of the haematoma, urgent surgery is essential and, in the case of severe liver failure, a liver transplant is indicated., (Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.)

Introduction: We present a series of 146 cases of hepatic trauma (HT) treated in our hospital over a period of 8 yearsm (2001-2008), and comparing it with a previous series of 92 cases (1977-1984)., Material and Method: The mean age in the current series was 28.6 years and the majority were male. The closed traumas were mainly penetrating, with the most frequent cause being road traffic accidents., Results: The American Association for the Surgery of Trauma (AAST) classification was used to evaluate the grade of the hepatic injury. Associated abdominal and /or extra-abdominal injuries were seen in 79.5% of the patients, with the most frequent being chest trauma, compared to bone fractures in the previous series. The most common associated intra-abdominal injury was the spleen in both series. The most used diagnostic technique in the current series was abdominal CT. Simple peritoneal puncture and lavage (PLP) were the most used examinations used in the previous series. Non-surgical treatment (NST) was given in 98 cases and the surgery was indicated in the remaining 48. In the previous series, 97.8% of patients were operated on. In the current series, on the 15 patients with severe liver injuries, 5 right hepatectomies, 2 segmentectomies and 6 packing compressions were performed, with the remaining two dying during surgery due to hepatic avulsion. The overall mortality was 3.4%, being 1% in the NST group and 8.3% in the surgical patients. In the previous series, the overall mortality was 29.3%., Conclusions: The key factor for using NST is to control haemodynamic stability, leaving surgical treatment for haemodynamically unstable patients., (Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.)

In order to verify the practical usefulness and certain features of puncture-aspiration with fine needle of the prostate gland, a study and evaluation of our personal experience on 400 cytological samples was undertaken. A cyto-histological correlation was done on 130 of them. Excellent results were obtained relating sensitivity (97.14%), specificity (98.33%), efficacy (97.69%) and predictability indices. It was concluded that this was a non-aggressive, simple and quick procedure, which proved to be very economical and with a high degree of diagnostic accuracy.

The results obtained in the program "Control of overweight in children" in the programmed nurse clinic were evaluated in 25 children distributed for age and degree of overweight. The activities carried out were: control of the number of calories based on carbohydrate and fat reduction, health education using the audiovisual techniques of the program EDALNU of the Ministry of Health, and theoretical program based on it. The group with a greater overweight (higher than 20%) followed, in addition, a 1,500 calories diet. It was concluded that a balanced diet and physical exercise proved to be highly effective for the reduction of overweight in children without additional drug intervention. Obesity in children is a health problem that can be addressed in a primary care context; the role of the nursing staff is crucial through health education activities.