[Patients' rights. More than a question of attitude].

Objectives: To analyze hospital and primary care physicians' knowledge of certain patients' rights recently modified by Spanish Law 41/2002 (law of patient autonomy).

Material And Methods: We performed a voluntary survey of hospital and primary care physicians who were presented with three problem situations drawn from court decisions and the law of patient autonomy.

Results: Among interviewed physicians, 78% were familiar with the law of patient autonomy.

Adverse events in hospitals: the patient's point of view.

Background: The publication of the report "To err is human: building a safer system" by the Institute of Medicine incited a profuse research addressing improvements in healthcare safety. However, there is still little acknowledgement of the key role of the patient in preventing adverse events of medical care. The aim of this review is to analyse and compare studies about patient's perception and opinion about care safety in hospitals.

Ability of treatment week 12 viral response to predict long-term outcome in genotype 1 hepatitis C virus/HIV coinfected patients.

Objective: Guidelines recommendation to extend treatment duration in genotype 1 hepatitis C virus (HCV)/HIV-coinfected patients who clear the virus later than treatment week 4 is not evidence-based. Our main objective was to study the ability of week 12 viral response [early virologic response (EVR)] to predict long-term outcome in patients treated for 48 weeks.

Design: Multicenter retrospective cohort analysis.

Multifocal community-acquired necrotizing fasciitis caused by a Panton-Valentine leukocidin-producing methicillin-sensitive Staphylococcus aureus.

We describe a rare case of multifocal necrotizing fasciitis (NF) complicating a single vaccine injection. Injection of hepatitis B vaccine of a 16-year-old immunocompetent woman developed into rapidly spreading multifocal NF of the right arm and the thighs, with septic shock. Treatment with antimicrobial therapy and surgical debridements allowed amputation to be avoided with a favourable outcome.

Catheter dysfunction and dialysis performance according to vascular access among 736 critically ill adults requiring renal replacement therapy: a randomized controlled study.

Objective: To compare dialysis catheter function according to catheter site.

Design: Multicenter, open, randomized controlled trial.

Setting: Nine university-affiliated hospitals and three general hospitals in France.

[Hospital clinical safety from the patient's point of view: validation of a safety perception questionnaire].

Background: Approximately 10% of hospitalized patients suffer an adverse event during their hospital stay. An important proportion of subjects also feel that they have a high risk of suffering such an event during an eventual hospitalization.

Aim: To determine the perception on clinical safety among patients discharged from a hospital.

Improving clinical trials in the critically ill.

Objective: To propose ways in which clinical trials in intensive care can be improved.

Methods: An international roundtable conference was convened focused on improvement in three broad areas: translation of new knowledge from bench to bedside; design and conduct of clinical trials; and clinical trial infrastructure and environment.

Results: The roundtable recommendations were: improvement in clinical trials is a multistep process from better preclinical studies to better clinical trial methodology; new technologies should be used to improve models of critical illness; diseasomes and theragnostics will aid inpatient population selection and more appropriate targeting of interventions; broader study end points should include morbidity as well as mortality; more multicenter studies should be conducted by national and international networks or clinical trials groups; and better collaboration is needed with the industry.

Value of procalcitonin for diagnosis of early onset pneumonia in hypothermia-treated cardiac arrest patients.

Purpose: Early onset pneumonia is frequently reported after cardiac arrest, despite the fact that therapeutic hypothermia and post-resuscitation disease manifestations make it difficult to diagnose. We aimed to assess the ability of serum procalcitonin (PCT) measurements to help diagnose pneumonia in this setting.

Methods: Retrospective study of consecutive patients admitted to a single academic medical intensive care unit (ICU) for successfully resuscitated cardiac arrest (July 2006-March 2008).

Toll-like receptors 2 and 4 contribute to sepsis-induced depletion of spleen dendritic cells.

Depletion of dendritic cells (DC) in secondary lymphoid organs is a hallmark of sepsis-induced immune dysfunction. In this setting, we investigated if Toll-like receptor (TLR)-dependent signaling might modulate the maturation process and the survival of DC. Using a model of sublethal polymicrobial sepsis induced by cecal ligation and puncture, we investigated the quantitative and functional features of spleen DC in wild-type, TLR2(-/-), TLR4(-/-), and TLR2(-/-) TLR4(-/-) mice.

Interobserver concordance in the assessment of liver fibrosis in HIV/HCV-coinfected patients using transient elastometry.

Objectives: Although the reproducibility of transient elastometry (TE) in hepatitis C virus (HCV)-monoinfected patients seems to be high, this may not be the case in HIV/HCV-coinfected patients because of different degrees of steatosis and/or inflammation. This study was aimed to determine the interobserver concordance of TE measurements in HIV/HCV-coinfected patients.

Methods: A total of 188 patients were evaluated in a cross-sectional, prospective study in two hospitals.

Efficacy and safety of pegylated interferon plus ribavirin in HIV and hepatitis C virus-coinfected patients with advanced immunosuppression.

Background: The aim of this study was to assess the efficacy and safety of pegylated interferon (IFN) plus ribavirin (RBV) in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected patients with severe immunodeficiency in a clinical cohort. BACKGROUND. A total of 542 HIV-infected patients receiving treatment with pegylated IFN plus RBV from June 2001 through April 2007 were included in this study.

[How to identify adverse events in emergency services? A guide agreed for the screening].

Objective: Since a third of adverse events (AE) occur outside hospital, the Emergency Services are a suitable place to look at their incidence. We considered designing a screening guide, adapted to the conditions of the emergency services, to identify AE.

Material And Methods: A qualitative technique was applied (nominal group) in which 14 professionals participated.

Impact of observer experience on the reproducibility of transient elastometry in HIV/HCV co-infected patients.

Background: Data on the influence of observer experience on transient elastometry (TE) in hepatitis C virus (HCV) infection are scarce, and there are no data on HCV/HIV co-infected patients.

Methods: TE determination was conducted by an experienced and an inexperienced observer in 93 patients who were divided into three groups according to the chronological order of their attendance. The interobserver variability of TE results was analyzed by the intraclass correlation index (ICC) and the interobserver agreement of the classification of significant fibrosis and cirrhosis by the kappa index.

[News items about clinical errors and safety perceptions in hospital patients].

Objective: To analyze how news items about clinical errors are treated by the press in Spain and their influence on patients.

Methods: We performed a quantitative and qualitative study. Firstly, news items published between April and November 2007 in six newspapers were analyzed.

Fast fibrosis progression between repeated liver biopsies in patients coinfected with human immunodeficiency virus/hepatitis C virus.

Unlabelled: A few studies have assessed the observed fibrosis progression between serial liver biopsies (LB) in human immunodeficiency virus (HIV) / hepatitis C virus (HCV)-coinfected patients. Approximately half of the patients progressed at least one fibrosis stage over a short period of time. The risk factors for this fast progression need clarification.

[Perceptions of clinical safety after hospital discharge].

Objective: Patient perception of clinical safety has been scantly studied. This study describes the frequency of clinical errors from a patient point of view, their perception of safety and its relationship with the information received.

Material And Methods: Descriptive study based on a postal survey to 336 surgical patients, 20 days after the discharge from the hospital (the corrected rate of response is 75.

Antibody-specific detection of CAIX in breast and prostate cancers.

Carbonic anhydrase IX (CAIX) is frequently expressed in human tumors and serves as a marker for hypoxia. Further, CAIX expression is considered a predictor of poor survival in many, but not all, cancer types. Herein, we compare the specificity of two CAIX antibodies: the M75, monoclonal antibody which recognizes an epitope in the N-terminus and a commercially available polyclonal antibody generated against a C-terminal peptide (NB100-417).

[Non alcoholic steatosis in HIV infection].

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatosis (NASH) are common conditions in the setting of HIV infection, especially if HCV coinfection or metabolic syndrome's features are present. The factors that contribute to the progression of NAFLD to NASH and fibrosis are not completely known and the role of antiretroviral therapy is especially controversial. Although the natural history of NASH in the setting of HIV infection is unknown, it may emerge as one of the leading causes of liver disease over the long term in these patients.

Predictors of patient satisfaction in surgery.

Background: We sought to evaluate the satisfaction of surgical patients in order to identify predictors of patient satisfaction, using a cross-sectional surgery patients' survey in 24 public hospitals in Spain and a total of 15,539 inpatients and 7,899 outpatients.

Results: Seventy-seven percent of inpatients and 88.3% of outpatients were satisfied (chi(2) = 509.

Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005-2006).

Objective: To describe the evolving epidemiology, management, and risk factors for death of invasive Candida infections in intensive care units (ICUs).

Design: Prospective, observational, national, multicenter study.

Setting: One hundred eighty ICUs in France.