Parenteral nutrition-associated hyperglycemia in non-critically ill inpatients increases the risk of in-hospital mortality (multicenter study).

Objective: Hyperglycemia may increase mortality in patients who receive total parenteral nutrition (TPN). However, this has not been well studied in noncritically ill patients (i.e.

Fat-free mass depletion and inflammation in patients with bronchiectasis.

Fat-free mass depletion has been related to increased inflammatory activity and to increased morbidity and mortality in chronic respiratory diseases. The aims of our study were to determine the nutritional status and serum levels of adipocytokines and inflammatory cytokines in patients with bronchiectasis of any etiology and their relation with respiratory parameters. A cross-sectional study was designed that included patients aged >14 years with diagnostic criteria for bronchiectasis.

Mycophenolate mofetil and tacrolimus reduce mortality after deceased donor kidney transplantation.

A study of mortality in renal transplantation recipients showed that the combination of mycophenolate mofetil (MMF) and tacrolimus (TaC) reduced the mortality rate. We studied 1045 consecutive adult deceased donor kidney transplant recipients from 1986-2001, where follow-up to 2011 was a minimum of 10 years, to analyze the impact of these immunosuppressive drugs on patient survival. Cox multivariate analysis showed that treatment with MMF and the use of TaC instead of cyclosporine reduced the risk of death by 43%.

Rate of long-term graft loss has fallen among kidney transplants from cadaveric donors.

First-year renal allograft survival has increased, but whether this is associated with improvement in the long term is controversial. We analyzed 1045 consecutive adult deceased donor kidney transplant recipients from 1986 to 2001, with a follow-up to 2011. The aim of this study was to compare the graft half-life and attrition rates stratified by year of transplant in patients who received the graft in the periods 1986 to 1995 versus 1996 to 2001.

Negative pressure therapy as palliative treatment for a colonic fistula.

Colonic fistulas in an open wound are always a challenge for colorectal surgeons, and this report provides a technique for the appropriate management of these cases. We communicate the use of a negative pressure dressing therapy as part of the palliative care for a patient following the development of an enterocutaneous fistula. The use of this therapy allowed us to keep the patient clean and comfortable during the last few days of his life.

Klippel-Trenaunay syndrome complicating pregnancy.

The Klippel-Trenaunay syndrome is a rare congenital disorder that affects one or more limbs. It is characterised by cutaneous vascular nevi, venous malformations and hypertrophy of soft tissues and bone. There are very few cases reported in pregnant women, so the level of uncertainty is high when it appears during gestation.

Miliary pulmonary tuberculosis following intravesical BCG therapy: case report and literature review.

Miliary tuberculosis after intravesical Calmette-Guerin bacilli (BCG) therapy is rare. To date, only 23 cases have been reported. We describe the case of a patient on hemodialysis, review the literature, and call attention to the potential hazard of intravesical BCG therapy in patients on renal replacement therapy and the value of polymerase chain reaction-based methods for early diagnosis of this serious complication.

Relationship between mortality and first-day events index from routinely gathered physiological variables in ICU patients.

Objective: To test the hypothesis that the degree and duration of alterations in physiological variables routinely gathered by intensive care unit (ICU) monitoring systems during the first day of admission to the ICU, together with a few additional routinely recorded data, yield information similar to that obtained by traditional mortality prediction systems.

Design: A prospective observational multicenter study (EURICUS II) was carried out.

Setting: Fifty-five European ICUs.

Sensitivity and positive predictive value of magnetic resonance imaging in the diagnosis of elastofibroma dorsi: review of fourteen cases.

Background: Elastofibroma dorsi (ED) is a benign soft tissue tumor that classically presents as an ill-defined mass at the inferior pole of the scapula. Several studies have indicated the benefits of using magnetic resonance imaging (MRI) to identify ED. In this study, we calculate the sensitivity and positive predictive value (PPV) of MRI in the diagnosis of ED using histopathology as the gold standard diagnostic method.

Establishing the diagnosis of tuberculous vertebral osteomyelitis.

Purpose: The aim of this article has been to analyze the clinical and radiological data suggesting tuberculous vertebral osteomielitis (TVO), and then discuss the steps to be followed to achieve an aetiological diagnosis.

Methods: A thorough literature search was carried out to identify the best clinical and microbiological evidence for a fast and efficient diagnosis of TVO.

Results: The clinical and radiological diagnosis of spinal tuberculosis suffers from serious limitations, with a high percentage of cases requiring vertebral biopsy to reach a definitive diagnosis.

Depression and anxiety symptoms in bronchiectasis: associations with health-related quality of life.

Background And Purpose: Bronchiectasis causes pulmonary infections and loss of lung function, resulting in chronic respiratory symptoms and worsening health-related quality of life. The aims of this study were to measure symptoms of depression and anxiety in a sample of patients with bronchiectasis and evaluate their relationship to health outcomes and health-related quality of life.

Methods: This cross-sectional study included adolescents and adults with bronchiectasis.

Incidence of lower limb amputations in individuals with and without diabetes mellitus in Andalusia (Spain) from 1998 to 2006.

Aims: We studied the changes in the incidence of lower limb amputation (LLA) in Andalusia from 1998 to 2006 in the population with and without diabetes.

Methods: We undertook a retrospective study of all LLA performed in Andalusia in people aged 30 years old, with or without diabetes, between 1 January 1998 and 31 December 2006. We obtained the crude and standardized incidence rates by year, and sex for three periods: 1998-2000, 2001-2003 and 2004-2006 and calculated the RR of requiring LLA in patients with diabetes.

Quantitative real-time polymerase chain reaction improves conventional microbiological diagnosis in an outbreak of brucellosis due to ingestion of unpasteurized goat cheese.

Rapid diagnosis of individuals involved in brucellosis outbreaks can sometimes be difficult with conventional microbiological techniques. We analyzed, for the first time, the diagnostic yield of a real-time polymerase chain reaction (PCR) assay in a family outbreak of brucellosis due to consumption of unpasteurized goat cheese. PCR correctly identified all symptomatic cases.

Neonatal carnitine palmitoyltransferase II deficiency associated with Dandy-Walker syndrome and sudden death.

Neonatal onset of carnitine palmitoyltransferase II (CPT II) deficiency is an autosomal recessive, often lethal disorder of the mitochondrial beta-oxidation of long-chain fatty acids. It is a rare multiorgan disease which includes hypoketotic hypoglycemia, severe hepatomuscular symptoms, cardiac abnormalities, seizures and lethargy, as well as dysmorphic features. Until now, only 22 affected families have been described in the literature.

Multiplex real-time polymerase chain reaction: a practical approach for rapid diagnosis of tuberculous and brucellar vertebral osteomyelitis.

Study Design: Case-control study for assessing a diagnostic test.

Objective: The aim of this study was to analyze the diagnostic yield of a multiplex real-time polymerase chain reaction (PCR) assay in the differential diagnosis of tuberculous vertebral osteomyelitis (TVO) and brucellar vertebral osteomyelitis (BVO).

Summary Of Background Data: Vertebral osteomyelitis (VO) is one of commonest osteoarticular complications of tuberculosis and brucellosis.

Recovery of native renal function after kidney transplantation.

IgA nephropathy is the most frequently occurring glomerulonephritis in the developed world. It is treated in the terminal phase via dialysis and transplantation. Posttransplantation recurrence is common, but evolves slowly.

Pharmacokinetics of once- versus twice-daily tacrolimus formulations in kidney transplant patients receiving expanded criteria deceased donor organs: a single-center, randomized study.

Background: Noncompliance to immunosuppressive treatment is 1 of the risk factors for kidney graft loss. The once-daily, prolonged-release tacrolimus formulation may improve treatment adherence. We sought to compare the pharmacokinetics of both tacrolimus formulations in older de novo recipients of a cadaveric renal transplant from an expanded-criteria donor.

Renal transplantation in old recipients from expanded criteria donors selected by kidney biopsy.

Background: In Spain, the number of ideal kidney transplant donors has fallen, with at the same time an increase in the number of older recipients on the waiting list.

Aim: To analyze the results of expanded criteria cadaveric donor kidney transplants into older recipients using grafts selected by kidney biopsy.

Patients And Methods: We studied 360 kidney transplant recipients who had been followed to December 2009: 180 in the study group and 180 in a control group composed of younger patients who received grafts from non-expanded criteria donors between 1999 and 2006.

The EPIFARM study: an observational study in 574 community pharmacies in Spain characterizing patient profiles of men asking for erectile dysfunction medication.

Introduction: Community pharmacists may be an important first point of contact for erectile dysfunction (ED) patients, but to date there are no reports of the characteristics of men approaching pharmacists for ED advice or treatment.

Aim: To characterize the profiles of men with and without phosphodiesterase-5 inhibitors (PDE5i) prescription asking for ED treatment at the pharmacy.

Methods: A multicenter, observational, cross-sectional study was conducted in Spanish community pharmacies September-November 2008.

No association of TAP and LMP genetic polymorphism in human brucellosis and its complications.

Molecules involved in antigen processing (LMP) and peptide transport (TAP) are coded by polymorphic genes. This polymorphism may influence the peptide antigen selection process and play a role in the pathogenesis of human brucellosis. We studied the polymorphism of the antigen processing and transport genes (LMP and TAP) in 61 patients with human brucellosis and 102 controls from southern Spain.

Long-term improvement of deceased donor renal allograft survival since 1996: a single transplant center study.

Background: The rate of acute rejection (AR) has decreased significantly, but whether this is associated with improvement in long-term graft survival is controversial.

Methods: We analyzed 1445 consecutive adult deceased donor kidney transplant recipients from 1985 to 2005, over two periods (1985-1995 vs. 1996-2005) to compare long-term graft survival.

Management of obstructive renal failure caused by bilateral renal aspergilloma in an immunocompetent newborn.

Fungal infection of the kidneys is a rare condition that has been reported in premature babies and in diabetic or immunocompromised adult patients. Candida spp. is the most frequent micro-organism involved.