Electrocardiogram score predicts severity of pulmonary embolism in hemodynamically stable patients.

Background: Risk stratification of patients with pulmonary embolism (PE) is essential to guide therapy. The presence of right ventricle dysfunction (RVD) and the anatomic extent of PE have been suggested to predict clinical course. The aim of this study was to assess the ability of an electrocardiogram (ECG) scoring system to predict RVD or the clot load score in normotensive patients with PE.

The hallucinations of Frédéric Chopin.

Frédéric Chopin is the epitome of the romantic artist; he had a chronic pulmonary disease that ultimately caused his death at the age of 39. An overlooked neurological condition is discussed in this paper. We consider the possibility of a temporal lobe epilepsy, as throughout his life Chopin had hallucinatory episodes, which can accompany seizure disorders.

[Infantile Amyand's hernia presenting as acute scrotum].

Amyand's hernia is a condition of exceptional presentation in children and is defined by the presence of inflamed appendix inside a inguinal hernia. It may manifest clinically as acute scrotum, inguinal lymphadenitis or strangulated hernia. The treatment is surgical and although several approaches are described, appendectomy with herniotomy by inguinal approach is considered of choice.

[Risk factors for the development of medical complications in patients with hip fracture].

Objective: To evaluate the clinical features and outcome of inpatients with hip fracture and to investigate the clinical variables associated with the risk of medical complications.

Methods: Prospective study of hip fracture patients aged 65 or more, admitted to the Department of Orthopaedic Surgery of the Xeral-Calde Hospital, in Lugo, Spain, in 2008. The different clinical and biochemical variables as regards the baseline health status and presentation features of the hip fracture and its complications were all recorded.

[Troponin-I in hemodynamically-stable pulmonary embolism: correlation with echocardiography and computed tomography angiography].

Background: Troponin-I (TnI) is a marker of severe pulmonary thromboembolism (PTE) in unselected patients. There are few articles that assess its usefulness in hemodynamically-stable patients.

Objectives: To assess the correlation between TnI levels and both echocardiographic/radiologic signs of right ventricle (RV) dysfunction or pulmonary hypertension (PH), and the severity of the pulmonary vascular obstruction.

[Implementation of the standards for monitoring parenteral nutritional support in the adult patient].

Introduction: The Group on Nutrition of the Spanish Society of Hospital Pharmacy (SEFH) recently published the practice standards for the pharmacist regarding specialized nutritional support. One of these standards includes the parameters that should be monitored for a correct follow-up of the adult patient on parenteral nutrition (PN.)

Objectives: to assess the level of monitoring of PN patients according to the practices recommended by SEFH.

[Course of alcohol withdrawal syndrome in a general hospital].

Introduction And Objective: There is little information available regarding the course of alcohol withdrawal syndrome in a general hospital. The aim of this study was to analyse the timing of the most important clinical features attributed to alcohol withdrawal, as well as their prognostic implications.

Material And Method: A cohort study of patients with a diagnosis of alcohol withdrawal syndrome was carried out at the Xeral Hospital in Lugo (Spain) between 1987 and 2003, in accordance with DSM IV-TR criteria.

Right ventricle dysfunction and pulmonary hypertension in hemodynamically stable pulmonary embolism.

Background: The main objectives of this study were to determine the incidence of echocardiography-detected right ventricle dysfunction (RVD) or pulmonary hypertension (PHT) and its correlation with computed tomography pulmonary angiography (CTPA) in hemodynamically stable patients with pulmonary embolism (PE), both at diagnosis and after 6 months follow-up.

Methods: Prospective, descriptive, single-center follow-up study.

Study Population: 103 consecutive patients, with a life expectancy of >6 months, presenting with PE and a systolic blood pressure> or =90mmHg.

[Audiovestibular manifestations in systemic vasculitis].

Systemic vasculitides constitute a heterogeneous group of diseases with frequent overlapping in their clinical findings and the size of the vessels involved. They may be primary or secondary to other diseases. Their common characteristic is the inflammation of blood vessels, giving rise to ischaemia.

Distribution of espM and espT among enteropathogenic and enterohaemorrhagic Escherichia coli.

Enterohaemorrhagic Escherichia coli (EHEC) and enteropathogenic E. coli (EPEC) translocate dozens of type III secretion system effectors, including the WxxxE effectors Map, EspM and EspT that activate Rho GTPases. While map, which is carried on the LEE pathogenicity island, is absolutely conserved among EPEC and EHEC strains, the prevalence of espM and espT is not known.

Co-infection by Streptococcus anginosus and Mycobacterium tuberculosis: three case reports.

Introduction: Bacterial infections may appear as sequelae of remote tuberculous infections, especially thoracic infections. The simultaneous appearance of tuberculosis and bacterial infection is not common, and, to our knowledge, the association of infection by Streptococcus anginosus and Mycobacterium tuberculosis has not been reported previously in the literature.

Case Presentation: We report three cases of dual infection with Streptococcus anginosus and Mycobacterium tuberculosis that were first diagnosed as pyogenic abscesses because of an isolation of Streptococcus anginosus.

[Clinical course and features of the alcohol withdrawal syndrome in a general hospital].

Introduction: Despite its frequency and high clinical burden, few studies have analyzed the clinical features of the alcohol withdrawal syndrome in a hospital setting. Our purpose was to describe its manifestations and clinical course in a general hospital.

Patients And Methods: Patients with a diagnosis of alcohol withdrawal since January 1983 to December 2003, according to the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders criteria, at the Xeral-Calde General Hospital in Lugo, were studied.

A prospective observational study of the effectiveness, safety, and effect on fatigue of darbepoetin alfa for the treatment of chemotherapy-induced anaemia.

Objective: Anaemia is common in cancer patients treated with chemotherapy. Darbepoetin alfa (DA) is the only erythropoiesis-stimulating protein approved for administration at weekly and every-three-week intervals in cancer patients receiving chemotherapy. This article investigates the effectiveness, tolerability and effect on fatigue of DA.

[Simultaneous suprasellar and pineal germinoma: a case report].

Introduction: Tumours in the pineal region are rare (0.3-2.7%) and most of the ones that do occur are germ cell tumours, of which germinoma is the most frequent.

[Delirium: etiology and pathophysiology].

The physiopathology of delirium has still not been characterized in depth, although this entity can be defined as a functional brain disorder provoked by one or multiple organic causes that display a common clinical syndrome. Certain specific brain regions that are involved in delirium have been identified, such as the prefrontal cortex, the thalamus and the basal ganglia, especially in the nondominant hemisphere. Functional changes occur in a large number of neurotransmitters: the most frequent and best characterized are a reduction of cholinergic function and an increase in dopaminergic and gabaergic function, although alterations in almost all neurotransmitter systems (serotoninergic, noradrenergic, glutaminergic, histaminergic) have been found.

[Analysis of the investigation activity of the internist from the Public Bid of Employment in Galicia].

Objectives: The aim of the present study was to assess the investigative activity of the internists. Data were collected from the Public Bid of Employment (PBE) performed in Galicia in 2005, and compared with the rest of medical subspecialities.

Methods: The results from the PBE related to internal medicine and medical subspecialities are available in the web page of the Galician Service of Health.

[Should we use oral replacement for vitamin B12 deficiency as the first option of treatment?].

Objective: Analyze whether the tablets available in Spain are useful for oral replacement in the treatment of vitamin B12 deficiency.

Methods: From June 2003 to December 2005, patients with vitamin B12 deficiency attended at the Internal Medicine Clinic, were offered the possibility of starting or switching to oral therapy. Clinical and biochemical responses were monitored at baseline and at 2, 4, 6, 12, 18 y 24 months of follow-up.

[Clostridium myonecrosis: a complication of inguinal hernia repair].

Clostridial myonecrosis is a necrotizing soft tissue infection characterized by muscular necrosis and, by extension, that of the surrounding tissue. If this infection develops quickly, it can cause septic shock and death if treatment is delayed. This infection does not occur frequently in civil medicine but nor is it exceptional after traumatic injuries or as a septic infection resulting from certain surgical interventions.

[Carotid intraplaque hemorrhage: MRI findings].

Intraplaque hemorrhage is one of the complications of atherosclerotic plaques. It causes clinical manifestations of ischemia without hemodynamically significant stenosis. MRI has a high capacity for the study of the tissular components of atheromatous plaques and is an efficacious diagnostic method in cases of intraplaque hemorrhage.

Typing of intimin (eae) genes from enteropathogenic Escherichia coli (EPEC) isolated from children with diarrhoea in Montevideo, Uruguay: identification of two novel intimin variants (muB and xiR/beta2B).

A total of 71 enteropathogenic Escherichia coli (EPEC) strains isolated from children with diarrhoea in Montevideo, Uruguay, were characterized in this study. PCR showed that 57 isolates carried eae and bfp genes (typical EPEC strains), and 14 possessed only the eae gene (atypical EPEC strains). These EPEC strains belonged to 21 O : H serotypes, including eight novel serotypes not previously reported among human EPEC in other studies.

[Benign paroxysmal positional vertigo of the horizontal canal: A multicenter study].

Objective: BPPV localized in the horizontal semicircular canal is an infrequent entity. Nowadays there are controversies about the different treatments available. The objective of this study is to present our results.

[Association of pheochromocytoma with contralateral nonfunctioning adrenal adenoma].

A 52-year-old woman complaining of abdominal pain, headaches and palpitations was admitted to our hospital for investigation of a bilateral adrenal tumor. Bilateral adrenalectomy was subsequently performed. The definitive diagnosis was right pheochromocytoma and left adrenocortical adenoma.

[Small bowel obstruction due to metastatic lobular carcinoma of the breast].

Although breast cancer most frequently metastasizes to the bone, lung, pleura, liver, adrenal glands and brain, it can also affect other organs such as the small bowel and ovaries, especially if the type of cancer is infiltrating and lobular. We present a case of metastases to the small bowel and ovaries from pleomorphic type infiltrating lobular breast carcinoma presenting as intestinal obstruction. Barium transit study revealed a stenosis in the jejunum and another in the terminal ileum at the ileocecal valve area.