[The use of antithrombotic drugs in patients with chronic atrial fibrillation in a local health area].

Background: The objective of the study is to assess the degree of ambulatory use of prophylactic antithrombotic therapy in patients with chronic atrial fibrillation (CAF) in a county health area.

Patients And Methods: A cross-sectional, prospective survey carried out in patients admitted at a community-hospital, detected 44 patients with CAF.

Results: The inappropriateness of anti-thrombotic therapy (48%) was associated with no having a previous echocardiography (p < 0.

[Colonic obstruction in Whipple's disease].

A patient with Whipple's disease presented with low intestinal obstruction and hemorrhage due to mesenteric retraction which was attributed to intra-abdominal enlarged lymph nodes. Ultrastructural findings included abundant intracellular bacilli. This complication of Whipple's disease has not been previously described and should be listed in the differential diagnosis of colonic obstruction.

[Endocarditis due to Candida albicans with peripheral arterial embolism and a cerebral mycotic aneurysm in an IV drug addict].

Endocarditis due to Candida albicans (EC) is a rare cause of endocarditis in IV drug addicts (IVDA). Its diagnostic is usually difficult and high peripheral embolization is characteristic, and could affect big vessels. The case of a female patients (IVDA) 21 years old is discussed, who showed bilateral iliofemoral embolism and cerebral hemorrhage due to mycotic aneurysm breakage in a EC.

[Severe leukopenia and thrombocytopenia and transient acquired hypogammaglobulinemia in a patient with infectious mononucleosis].

A 30-year-old male with infectious mononucleosis by the Epstein-Barr virus who presented severe neutropenia and thrombocytopenia and type IgG acquired transitory hypogammaglobulinemia as complications during the acute period of the disease is presented. Although the etiopathogenesis of these phenomena is usually associated with an autoimmune basis, the antiplatelet and antileukocyte antibodies were negative. A bibliographic revision of the hematologic alterations of this disease was carried out and it was observed that the combination of the complications described has not been previously referred, thus, the present case may be the first observation with these characteristics.

[Usefulness of echocardiography in heart insufficiency: a prospective study of 100 patients].

We prospectively evaluated 100 patients with heart failure, grades III and IV of the NYHA who were admitted to our Internal Medicine Service. In all cases a clinical diagnosis previous to the recording of the echocardiogram was made to evaluate the contributions of the latter. In 26 patients the echocardiogram gave information which had not been anticipated from the history and basic studies.

[Bacteremia in the patient with liver cirrhosis. Prospective study of 61 episodes].

We prospectively evaluated 61 episodes of bacteremia in 54 patients with hepatic cirrhosis, representing 9% of the overall number of bacteremic episodes in adult patients seen in our center during the study period. Spontaneous bacteremia represented 46% of all episodes (virtually always in patients with ascites), followed by the urinary origin (30%). Gram negative organisms were isolated in 71% of episodes.

[Bacteremia secondary to decubitus ulcer].

We have prospectively evaluated 16 episodes of bacteremia induced by decubitus ulcers. The most commonly isolated microorganisms were Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa and Bacteroides fragilis. Bacteremia was polymicrobial in 5 cases (31%).

Spontaneous bilateral chylothorax: uniform features of a rare condition.

A 67-yr-old woman was admitted with dyspnoea, chest and neck pain and swelling of both supraclavicular fossae and the neck. Chest X-ray showed bilateral pleural effusions. Thoracocentesis yielded a milky fluid with a high triglyceride level.