[Nutrition and Metabolism Group of the Spanish Neonatology Society: recommendations and evidence for dietary supplementation with probiotics in very low birth weight infants].

Clinical practice guidelines are an important tool for improving healthcare. In recent years there has been accumulating evidence on the impact of nutritional supplementation with probiotics in the very low birth weight infants. With no uniformity in microorganisms and strains used.

[Treatment hepatitis B reactivation in the transplant].

The indication for liver transplantation for those with hepatitis B virus (HBV) infection represents some 5%-10%, with a declining trend, due in large measure to the efficacy of antiviral drugs. Similarly, the use of nucleoside/nucleotide analogues, with or without specific gamma globulin, has helped prevent HBV infection recurrence. The posttransplantation recurrence of HBV infection can be defined as the reappearance of circulating HBsAg and HBV DNA detectable in 2 measurements.

[Use of ineffective practices in Primary Health Care: professional opinions].

Objective: To estimate the frequency of ineffective practices in Primary Health Care (PHC) based on the opinions of clinical professionals from the sector, and to assess the significance, implications and factors that may be contributing to their continuance.

Material And Methods: An on line survey of opinion from a convenience sample of 575 professionals who had published articles over the last years in Atención Primaria and Semergen medical journals.

Results: A total of 212 professionals replied (37%).

[Amenable mortality as indicator of effectiveness of health care services in Spain before and after transferences].

Objective: To describe the evolution of amenable mortality (MRASS) in Spain and to evaluate differences in trend patterns before and after health care services were transferred to local authorities.

Methods: MRASS was defined from a list of causes of death used in other studies. We analyzed the change in sex-age-standardized death rates of MRASS in two periods: 1999-2001 and 2006-2008, just before, and five years after, the health care transfers were completed.

Quality of life and supportive care for patients with metastatic renal cell carcinoma.

In recent years, a key issue in the management of patients with metastatic renal cell carcinoma (mRCC) has been the assessment of health-related quality of life (HRQoL), particularly following the introduction of targeted therapies that have brought significant improvements in progression-free survival and quality of life in these patients. HRQoL is becoming one of the main factors influencing choice of therapy, and HRQoL experienced during first-line treatment may affect the choice of the second-line therapy. Consequently, several trials have been conducted to evaluate the impact of approved targeted therapies for mRCC on HRQoL, and this measure is being introduced with increasing frequency in the trial design.

Predictive ultrasound factors of lymphatic invasion in rectal cancer: "extra-corporeal" study.

Objective: the accuracy of preoperative endorectal ultrasound in the status evaluation of lymph nodes is around 50-70%, with a lack of eco-morphological patterns of clinical use. Since, accurate local staging is of great value in prognosis and decision-making we decided to analyze the referenced eco-morphological parameters in a try to find a proper predictive tool of clinical help that could improve the accuracy of rectal ultrasound.

Material And Method: the resected specimens of 24 patients that were operated on by radical surgery because rectal cancer, without preoperative radiotherapy were suspended in warm water and ultrasound scanned (360º circular probe with a transducer of 10 Mhz).

Cardiovascular risk in menopausal women and prevalent related co-morbid conditions: facing the post-Women's Health Initiative era.

Objective: To review scientific publications regarding cardiovascular risk during the menopausal years and that related to currently recognized highly prevalent co-morbid factors within this period.

Methods: Citations were selected from a PubMed search and the authors' files according to their clinical and experimental relevance.

Results And Discussion: Although experimental and some observational data have supported the fact that estrogens are beneficial for the female vascular system, these positive actions have been challenged by the results of the Women's Health Initiative trial and the Million Women Study, which demonstrated an increase in cardiovascular risk and related adverse events.

Severe infantile-onset cardiomyopathy associated with a homozygous deletion in desmin.

Desminopathy is a genetically heterogeneous disorder with autosomal dominant pattern of inheritance in most affected families; the age of disease onset is on average 30 years. We studied a patient with a history of recurrent episodes of syncope from infancy who later developed second-degree AV block and restrictive cardiomyopathy; she subsequently suffered several episodes of ventricular tachyarrhythmia requiring implantation of bicameral defibrillator. Neurological examination revealed rapidly progressive bilateral facial weakness, winging of the scapulae, symmetric weakness and atrophy of the trunk muscles, shoulder girdle and distal muscles of both upper and lower extremities.

Vitamin D metabolism and cardiovascular risk factors in postmenopausal women.

Objectives: The purpose of this review is to focus on the association of vitamin D and cardiovascular risk factors in postmenopausal women.

Methods: Review of the relevant literature and results from recent clinical studies as well as critical analysis of published results concerning the association of vitamin D and cardiovascular risk factors in postmenopausal women obtained from both a PubMed and individual searches.

Results And Discussion: Both basic science and clinical studies support the protective role of vitamin D on cardiovascular health, although there are controversial results in the literature.

[Mortality due to heart involvement in the catastrophic antiphospholipid syndrome].

Catastrophic antiphospolipid syndrome (CAPS) is extremely rare antiphospolipid syndrome (APS) variety associated to higher mortality. When heart involvement appears has worsening pronostic. We reported a CAPS case, possibily afterward sting wasp triggering, with acute heart failure during evolution.

Chronic bronchitis and acute infections as new risk factors for ischemic stroke and the lack of protection offered by the influenza vaccination.

Background And Purpose: Acute and chronic infections may play a role in promoting complications of atherosclerotic disease. We evaluated the importance of acute infections and chronic bronchitis (CB; as a chronic inflammatory state) in several subtypes of ischemic stroke, and we investigated whether the influenza vaccination was independently associated with a reduced likelihood of stroke.

Methods: A case-control study was performed on 393 consecutive ischemic stroke patients and 393 control subjects matched for age, sex and time of year.

[Mycological view of dermatophytes in humans.].

Dermatophytes are a group of closely related fungi that have the capacity to invade keratinized tissue (skin, hair, and nails) of humans and animals to produce an infection, dermatophytosis, commonly referred to as ringworm. Dermatophytoses are common of world wide: in the United States, Microsporum audouinii and Microsporum canis, once the major agents of tinea capitis, have been superseded by Trichophyton tonsurans. Since the 1950s, T.

Clinical experiences with drospirenone: from reproductive to postmenopausal years.

Objective: To review the scientific publications concerning the clinical use of drospirenone (DRSP) as the progestin in combined oral contraceptives (OCs), and as hormone treatment for menopause.

Methods: This is a retrospective study of published information concerning DRSP retrieved from both a PubMed and a personal search.

Results And Discussion: DRSP is a progestin with antimineralocorticoid and antiandrogenic activities that confer special clinical relevance.

[Ulcerative pancolitis predicts the need for colectomy: study of an incident cohort of patients with ulcerative colitis in Aragón (Spain)].

Introduction: Population-based studies show pancolitis as the only risk factor for colectomy in patients with ulcerative colitis (UC).

Aim: To evaluate surgical need, its etiology and characteristics, and the distinct clinical variables that act as risk and/or protective factors for the indication for surgery in an incident cohort of patients with UC in Aragón.

Patients And Method: Based on the results of a population-based, prospective study reporting the incidence of inflammatory bowel disease in Aragón, 168 patients with a diagnosis of UC were included in the present study.

[Frostbite of the upper and lower limbs in an expert mountain climber: the value of bone scan in the prediction of amputation level].

A 38 year old man was admitted to our hospital 10 days after suffering a frostbite injury in hands and feet while practicing mountain climbing, at 8,100 meters of altitude, while he was trying to reach the top of the K2 mountain. A 99mTc-MDP bone scan performed in aseptic conditions showed: in hands: absence of bone uptake in the 3rd phalanx and distal portion of 2nd phalanx of the 5th finger of the left hand, and multiple areas of increased uptake in the distal portion of both hands. In feet: uptake decreases in the 2nd phalanx of the first toe of the left foot, and absence of bone uptake in the 3rd phalanx of the 2nd toe of the left foot, and in 2nd phalanx of the 1st toe and 3rd phalanx of the 2nd, 3rd and 4th toes of the right foot.

[Pure lower motoneurone syndrome in a series of six patients].

Introduction: Lower motoneurone syndromes (SMNI) have been defined by their clinical pattern, anomalies in nerve conduction and the presence of antiglycolipid antibodies. The possible response to immunotherapy is another characteristic which makes these syndromes interesting.

Patients And Methods: We studied the clinical and electrophysiological data, clinical progress and response to treatment of a series of six patients, with a pure lower motoneurone syndrome, with a follow up period of between 5 and 13 years.

[Adrenal gland pseudocyst: 2 cases manifesting with acute abdominal pain and shock].

Objective: To describe two cases of adrenal pseudocyst that presented as acute abdomen and shock.

Methods: Two cases of adrenal pseudocyst are presented: one patient was a 69-year-old woman who presented with shock and pain in the left hypochondrium and the other was a 23-year-old woman who complained of dizziness and pain in the left hypochondrium.

Results: US and CT evaluation showed a heterogeneous cystic mass.

[Multinational European project and multicenter Spanish study of quality improvement of assistance on consultation-liaison psychiatry in general hospital: clinical profile in Spain].

Background: In the frame of the European study on quality assurance in consultation liaison psychiatry and psychosomatics (supported by the BIOMED 1 program), the clinical <> of consultation-liaison psychiatry units pertaining to six Spanish general hospitals is analyzed.

Patients And Method: A sample of 3. 608 consecutive patients referred to the consultation-liaison psychiatry units of five public general hospitals (Clínico of Zaragoza, Clínico of Barcelona, General of Alicante, Ramón y Cajal of Madrid, Princesa of Madrid) and one private gynecological hospital (Dexeus of Barcelona) was studied.

[Acute transverse myelitis secondary to hepatitis B vaccination].

Introduction: Acute transverse myelitis is an inflammatory disorder. The pathogenesis is unclear, but the probable mechanism involves an autoimmune phenomenon. Possible causes included multiple sclerosis and parainfectious and postvaccinal events.