Preventive treatment with alendronate of loss of bone mineral density in acute traumatic spinal cord injury. Randomized controlled clinical trial.

Study Design: Randomized controlled clinical trial of two parallel groups.

Objectives: Analyse the efficacy of primary prevention with alendronate on the loss of bone mass which occurs during the first year of traumatic SCI, measured by double-energy X-ray bone densitometry (DXA).

Setting: National Hospital for Paraplegics (HNP), Toledo, Spain.

High-Flow Oxygen with Capping or Suctioning for Tracheostomy Decannulation.

Background: When patients with a tracheostomy tube reach a stage in their care at which decannulation appears to be possible, it is common practice to cap the tracheostomy tube for 24 hours to see whether they can breathe on their own. Whether this approach to establishing patient readiness for decannulation leads to better outcomes than one based on the frequency of airway suctioning is unclear.

Methods: In five intensive care units (ICUs), we enrolled conscious, critically ill adults who had a tracheostomy tube; patients were eligible after weaning from mechanical ventilation.

[Diagnostic usefulness of procalcitonin and C-reactive protein in the Emergency Department for predicting bacterial meningitis in the elderly].

Objetives: To analyse and compare procalcitonin (PCT) and C-reactive protein (CRP) as tools for detecting bacterial meningitis (BM) in the elderly (>74 years of age).

Methods: A prospective, observational, descriptive, analytical study of 220 consecutive patients aged ≥1year and diagnosed with acute meningitis in an emergency department between September 2009 and July 2014.

Results: A total of 220 patients (136 [62%] male) were studied.

[Diagnostic and prognostic power of biomarkers to improve the management of community acquired pneumonia in the emergency department].

Objectives: To analyse the usefulness and performance of several biomarkers [C-reactive protein (CRP), mid-regional pro-adrenomedullin (MR-proADM), procalcitonin (PCT)] and lactate in predicting short- and medium-term mortality compared with the prognostic severity scales (PSS) usually employed for community-acquired pneumonia (CAP) and in assessing the aetiological suspicion of infection by Streptococcus pneumoniae and bacteraemia.

Methods: Observational, prospective and analytical study was conducted on patients who were diagnosed with CAP in our emergency department (ED). The data collected included socio-demographic and comorbidity variables, Charlson index, priority level according to the Spanish Triage System (STS), stage in the Pneumonia Severity Index (PSI) and in the CURB-65 (confusion, urea, respiratory rate, blood pressure and age ≥65years), criteria of severe CAP, microbiological studies, and biomarkers determinations.

Improved management of community-acquired pneumonia in the emergency department.

Objectives: To determine the impact of implementing clinical practice guidelines (CPGs) in the treatment of community-acquired pneumonia (CAP) in the emergency department (ED) by analyzing case management decisions (admission or discharge, appropriateness and timeliness of antibiotic therapy, complementary tests) and the consequent results (clinical stabilization time, length of hospital stay, re-admission to ED and mortality).

Methods: A prospective, observational, descriptive, comparative study carried out from 1st January 2008 to 1st August 2009 in two phases: before and after the implementation of the "Management of CAP in ED" SEMES-SEPAR (Spanish Society of Emergency Medicine - Spanish Society of Pneumology and Thoracic Surgery) clinical practice guidelines from 2008. Two hundred adult patients treated in the ED with a diagnosis of CAP were included in the study, both in the pre-intervention and post-intervention groups.

Utero-ovarian anastomoses and their influence on uterine fibroid embolization.

Purpose: To correlate clinical outcomes after uterine artery embolization (UAE) performed to treat uterine fibroids with the presence of varying types of utero-ovarian anastomoses (UOA).

Materials And Methods: A retrospective analysis was performed of all uterine angiograms from 202 patients (mean age 42 y, range 28-54 y) who underwent UAE because of heavy menstrual bleeding, dysmenorrhea, or anemia or a combination of these symptoms. UOA were classified as absent or present, unilateral or bilateral.

Randomized comparison of nasolacrimal cryoplasty versus plastic lacrimal stenting in the management of epiphora in adults.

Purpose: To evaluate the efficacy of plastic polyurethane stents compared with nasolacrimal cryoplasty in the management of epiphora in adults.

Materials And Methods: Patients (N = 37; mean age, 64 years; range, 34-86 y; six men, 31 women) with severe epiphora with partial/complete obstruction of the nasolacrimal system were randomized to have a plastic stent inserted (n = 19) or to undergo balloon dilation cryoplasty (n = 18). Both procedures were conducted on an outpatient basis.

Endovascular stenting as the first step in the overall management of malignant superior vena cava syndrome.

Objective: Self-expandable metal stents were inserted in cancer patients with superior vena cava (SVC) syndrome to assess their effectiveness as a primary treatment for symptom relief.

Subjects And Methods: Between January 1993 and June 2008, Wallstent prostheses (n = 208) were inserted in 149 cancer patients (137 men, 12 women; median age, 65 years; age range, 44-84 years) diagnosed as having SVC syndrome. A single stent was sufficient to restore vessel patency in 102 patients, two stents in 36, three stents in 10, and four stents in one.

[Serological diagnosis of atrophic gastritis with a combination of pepsinogen I and II, gastrin-17 and anti-Helicobacter pylori antibodies].

Objective: Noninvasive diagnosis of atrophic gastritis would help to identify individuals at increased risk of gastric carcinoma. In the present study, we evaluated the utility of a serological panel combining pepsinogen I and II, gastrin-17, and anti-Helicobacter pylori antibodies (Gastropanel) as a screening method for atrophic gastritis.

Patients And Methods: The serological panel was evaluated in 56 patients divided in two groups: group 1 consisted of 47 patients with uninvestigated dyspepsia and group 2 was composed of nine consecutive patients with gastric carcinoma.

[Digoxin dosing in the aged: new pharmacokinetic system versus Jellife and Koup methods].

To evaluate three methods for digoxin dose adjustment in aged patients, we determined the plasma digoxin levels that would be attained in 87 aged patients with doses adjusted to the kidney function by means of three separate procedures. Mean patient age was: 79.0 +/- 6.