Rates and predictors of relapse in first-episode non-affective psychosis: a 3-year longitudinal study in a specialized intervention program (PAFIP).

Relapses may represent a critical hazard in schizophrenia spectrum disorders as they are associated with an increased risk of a clinical and functional deterioration. Preventing relapse after recovering from a first psychotic episode has become a major challenge due to its critical impact on lifelong functionality. This study explored the rate of first and second relapses and the predictors associated with these relapses in a large cohort of non-affective psychosis patients during a period of 3 years after the first break of the illness.

Multidisciplinary Care Models for Patients With Psoriatic Arthritis.

Objetive: To describe (structure, processes) of the multidisciplinary care models in psoriatic arthritis (PsA) in Spain, as well as barriers and facilitators of their implementation.

Methods: A qualitative study was performed following structured interviews with 24 professionals (12 rheumatologists, 12 dermatologists who provide multidisciplinary care for patients with PsA). We collected data related to the hospital, department, population and multidisciplinary care model (type, physical and human resources, professional requirements, objectives, referral criteria, agendas, protocols, responsibilities, decision- making, research and education, clinical sessions, development and planning of the model, advantages and disadvantages of the model, barriers and facilitators in the implementation of the model.

[Amyotrophic neuralgia associated with bilateral phrenic paralysis treated with non-invasive mechanical ventilation].

Amyotrophic neuralgia is an uncommon neuropathy characterized by severe unilateral shoulder pain. Isolated or concomitant involvement of other peripheral motor nerves depending on the brachial plexus such as phrenic or laryngeal nerves is unusual(1). Its etiology is unknown, yet several explanatory factors have been proposed.

[Acute miopericarditis as the presenting feature of adult-onset Still's disease].

Adult Still's disease (ASD) was described by George Still in 1896. ASD is a rare inflammatory disorder, of unknown etiology, whose clinical manifestations are manifold. Diagnosis requires high clinical suspicion and exclusion of different etiologies.

[Definitive removal of immunosuppressors].

There's no controlled and prospective studies which show the safest and most effective way to reduce or suspend immunosuppression drugs dosage, and only few groups have published their own protocols. There are reasons to discontinue the immunosuppression therapy; the high incidence of infections is the most important. However, a fast withdrawal is not free of problems, like are residual renal function decline and graft intolerance signs, which could take to nephrectomy, a high risk intervention.

[Impact of advanced kidney disease on transplanted patients and their return to dialysis].

Although long-term outcomes also improved, graft loss caused by chronic allograft nephropathy remains an important obstacle. This situation, together with the progressive increase in the number of renal transplant patients, means that the population of transplant patients readmitted to a dialysis program will be progressively greater. The mortality rate in patients starting dialysis after graft loss has been reported as variable, though higher than that observed in patients with a functioning graft and that observed in patients on dialysis treatment.

[Isolated mesencephalic stroke related to a ruptured intracranial dermoid cyst].

Dermoids cysts are embrionary benign lesions that comprise approximately 0.04-0.25% of all intracranial tumors.

[Practical aspects regarding endoscopic treatment for epistaxis].

Introduction: A prospective study is presented to evaluate some practical and financial aspects regarding surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoidal (AE) arteries performed to control posterior nasal bleeding.

Patients And Methods: 35 patients admitted at the ENT ward between 2004 and 2006 were included in the study, and distributed into two groups depending on the protocol applied in each case. Until March 2005 the surgery was performed if there was failure or insecurity of the posterior packing, and since that date a substitutive surgical protocol (not including posterior packing) was applied.

[Utility of the surgical treatment for severe epistaxis by endoscopic approach of sphenopalatine and ethmoidal arteries].

Introduction: To evaluate the efficacy and cost-effectiveness of the treatments used for controlling epistaxis, particularly compared with the surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoid (AE) arteries, a intervention prospective-retrospective study is presented with the aim of assessing the feasibility of these surgical techniques as an alternative to conventional treatments.

Patients And Methods: 184 consecutive patients admitted in the ENT ward between the years 1997 and 2005 were included in the study, and distributed into three groups depending on the last treatment applied to control their bleeding: AP group.- anterior packing (n=98); PP group.

[Controlling retests in a universal hearing screening program].

Introduction: To evaluate the influence of several factors in the need for retesting in the first stage of a universal auditory screening program, a prospective and statistic study is presented, specially remarking the differences found between two health systems (public and private).

Patients And Methods: 18,073 children born in the 1999-2004 period were included in the study, in the context of a universal screening protocol based on Otoacoustic emissions and ABR, and distributed into three groups depending on their place of birth (A: public hospital; B: private hospital; C: children from other region).

Results: Significant differences were found between the groups (7.

[Value of nutritional support in patients with pharingocutaneous fistula].

Introduction: A prospective and statistic study is presented to evaluate the efficacy of nutritional support in the postoperative care of patients with pharyngocutaneous fistula after laryngectomy.

Patients And Methods: All patients who developed pharyngocutaneous fistula after total o partial laryngectomy between 2001 and 2004 were included and assigned to the study group if a supplementary and enteral nutrition was started through the nasogastric tube, and to the control group if a conventional liquid diet was given. Nutrition of patients in the study group was controlled by an Endocrinologist.

[Early detection of hearing loss. Example of intervention in public health].

Introduction: We present a statistic study comparing all the options we can take to face congenital deafness as a problem of public health.

Patients And Methods: We collected and analyzed data obtained between 1991 and 1995, just before our universal screening program started. They were separated into two groups with the 144 children explored using ABR, and the results were compared depending on the option taken in each group (no screening or high risk screening) and finally with those obtained in a universal program.

[Male with sudden-onset dementia associated with long lasting diarrhea as manifestations of Whipple's disease].

A case of a 55-year old male with Whipple's disease who consulted for dementia (aggressivity, memory loss of recent events, sleep rhythm disturbances) is presented. Furthermore, the patient had referred changes in intestinal movement four years beforehand in addition to erratic arthralgias. Response to treatment (trimethoprim-sulfamethoxazole for one year) was favorable with resolution of both the neurologic and gastrointestinal pictures.