Update on bacterial pathogens: virulence and resistance.

The present article is an update of the literature on bacterial pathogens. Recognizing the interest and scientific and public health importance of infections produced by bacterial pathogens with new virulence mechanisms and/or new mechanisms of resistance to antimicrobial agents, a multidisciplinary group of Spanish physicians and microbiologists organized a joint session and revised the most important papers produced in the field during 2006. Each article was analyzed and discussed by one of the members of the panel.

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Objective: To report the results of a survey directed at medical and nursing staff as a method of improving the quality of procedures, in accordance with standard ISO 9001:2000.

Method: Cross-sectional study using a self-administered questionnaire. A sample size of 405 was calculated as 405, for nurses and 337 for medical staff, assuming an overall percentage of satisfaction of 80%, with a precision of 3.

[Surgical complications in salvage surgery of patients with head and neck carcinomas treated with concomitant chemoradiotherapy (CCR)].

Introduction: One way of treating head and neck carcinomas is using concomitant chemoradiotherapy (CCR). In this study we will try to evaluate the incidence of complications in rescue surgery after CCR.

Material And Method: We have studied data from 103 patients diagnosed as having stage III or IV squamous head and neck carcinoma between 1997 and 2005.

[Hereditary hyperferritinemia cataracts syndrome in a Spanish family caused by the A40G mutation (Paris) in the L-ferritin (FTL) gene associated with the mutation H63D in the HFE gene].

Background And Objective: The cataract-associated increase in serum ferritin without any other data of iron overload is known since 1995 as hyperferritinemia-cataract syndrome (HHCS). More than 100 families have been described all around the world with this syndrome and more than 30 mutations in the L-ferritin (FTL) gene. We introduce a family from Madrid (Spain), with the disease phenotype and a genotype with the A40G mutation, named Paris, and besides carrier of the H63D mutation of the HFE gene.

[Intraoperative therapeutic intensification techniques in locally advanced abdominal sarcomas].

Introduction: Sarcomas are rare tumors that develop from mesenchymal cells. Their management is difficult due to their changing histology, location, and behavior. In this article, we discuss the use of two intraoperative therapeutic intensification techniques, intraoperative radiotherapy (IORT) and hyperthermic intraoperative intraperitoneal chemotherapy (HIIC), in the treatment of locally advanced abdominal sarcomas and peritoneal sarcomatosis.

[Video-polysomnography in preterm infants with birth weight under 1,800 g].

Introduction: Neonatal video-polysomnography (VPSG) in preterm infants is indicated to rule out sleep-related respiratory disturbances before discharge from neonatal units and to study neonatal sleep patterns and associated pathologic conditions.

Objective: To study the presence of apnea, hypopnea, and periodic breathing in preterm infants with low birth weight (< 1,800 g) and to describe their cardio-respiratory variability, electroencephalogram (EEG) abnormalities, and brain maturity in connection with sleep stages.

Method: We performed a cross-sectional, descriptive study through review of the clinical histories of preterm infants with a birth weight < 1,800 g who had undergone VPSG (2001-2003).

[Transdermal iontophoresis with dexamethasone and verapamil for Peyronie's disease].

Objectives: To evaluate the effects of transdermal iontophoresis with verapamil and dexamethasone in patients with Peyronie's disease of less than one year of evolution.

Material And Methods: We have treated ten patients twice a week during six consecutive weeks using iontophoresis with a Miniphysionizer dispositive. This device generates a 2mA electric current during 20 min which triggers the transdermal penetration of medication.

[Study of energy expenditure in anorexia nervosa: agreement between indirect calorimatry and several equations].

Unlabelled: Nutritional management is essential in anorexia nervosa (AN), although nutrient replenishment must be done progressively to prevent the occurrence of re-alimentation syndrome.

Objective: to compare resting enengy expenditure (REE) by means of indirect calorimetry and by different equations in AN female patients.

Material And Methods: we studied 21 women admitted for AN (DSM-IV), mean age 17 years (SD 5.

Current situation in the development of a preventive HIV vaccine.

The uncontrolled progression of the aids epidemic has made the development of an efficacious human immunodeficiency virus (HIV) vaccine a major objective of scientific research. No effective preventive vaccine against HIV is currently available and sterilizing immunity has not yet been achieved in animal models. This review analyses the major challenges in developing an aids vaccine, in particular the mechanisms involved in viral escape from the immune response, and summarizes the results obtained with the different prototypes of therapeutic and preventive vaccines.

[Malignant tumours of the external auditory canal and of the middle ear].

Objectives: To review our experience and results in the treatment of a low incidence pathology such as the malignant ear tumors.

Methods: The study reviewed 36 patients with malignant tumors of the EAC and middle ear treated between 1977 and 2000 in our hospital, excluding cancer of the pinna, metastatic tumours and sarcomas. It was used the staging system proposed by the M.

HIV-infected children with moderate/severe immune-suppression: changes in the immune system after highly active antiretroviral therapy.

The objective of this study was to monitor the changes in the immune system of HIV-infected children with moderate or severe immunodeficiency after highly active antiretroviral therapy (HAART), comprising a follow-up study in 14 HIV-infected children on HAART at two time points separated approximately by 11.8 +/- 0.4 (9.

[Subcutaneous panniculitis at a third level hospital retrospective study of 113 cases].

Introduction: The panniculitides or hypodermitis are a wide and heterogeneous group of diseases characterized by the presence of subcutaneous inflammatory nodules located generally in low limbs.

Objectives: Show the clinicopathologic characteristics of the cases diagnosed as panniculitis for a 5 years period; their epidemiology, etiopathogenic factors, evolution and treatment.

Material And Methods: A retrospective study of 113 patients diagnosed as panniculitis by histopathologic report of cutaneous biopsy since 1997 to 2001 were performed.

[Non-fluoroscopic electroanatomical mapping (CARTO system) in the ablation of atrial tachycardias].

Introduction And Objectives: The recent introduction of navigation systems has made substantial improvements in cardiac electrophysiological mapping. We present our experience with non-fluoroscopic electroanatomical mapping in patients with atrial tachycardias.

Patients And Method: We studied 24 consecutive patients with atrial tachycardias (10 of whom had undergone previous radiofrequency ablation which failed).

[Subsets of CD8+ T cells in longterm asymptomatic vertically HIV-1 infected children].

Background And Objective: HIV-infection has distinct patterns of disease progression with heterogeneous manifestations. We analyzed the subsets of CD8+ T cells in a group of long term asymptomatic (LTA) HIV-1-infected children who had stable CD4+ T cell counts (> 600/l).

Patients And Methods: Cross-sectional study in HIV-1-vertically infected children older than 7 years who were rated into two groups according to the clinical and immunological classification: a) LTA: 7 asymptomatic HIV-1-infected children in A1, and b) rapid progressor (PR): 14 age-matched C3 HIV-1-infected children.

[Image techniques for the evaluation and clinical decision making of patients with stroke].

The clinical relevance of cardiac embolism a potential cause of stroke is progressively increasing, mainly due to the recent progress in diagnostic imaging. In the present paper, we update and review the state of the art of the different etiologies currently accepted of a cardiac source of stroke. Furthermore, we review the clinical role of different image techniques, emphasizing the doubts and realities of each particular approximation.

[Interventional radiology, angioplasty and TIPS in Budd-Chiari syndrome].

Introduction: Budd-Chiari syndrome consists of complete or partial obstruction of the hepatic veins. Many treatment options are available; new interventional radiology techniques may play an important role as an alternative to surgical shunting.

Patients And Method: Of 11 patients diagnosed with Budd-Chiari syndrome, 7 were treated with percutaneous balloon angioplasty or transjugular intrahepatic portosystemic shunt (TIPS) (2 and 5 patients, respectively).

[Acute pancreatitis with fluid collections complicated with cutaneous fistula].

The presence of acute fluid collections is an habitual event in an acute pancreatitis, generally followed by a favourable outcome. We present a case about an ancient woman suffering from an acute necrotizing pancreatitis with tense fluid collections that produced espontaneously several cutaneous fistula. We find no report on literature about this uncommon complication.

[Transpyloric enteral nutrition in critically-ill children (II): complications].

Objective: To study tolerance to transpyloric enteral nutrition (TEN) and the incidence of secondary complications in critically-ill children.

Patients And Methods: We performed a prospective, observational study between 1994 and 2002 of all critically-ill children admitted to our pediatric intensive care unit who received TEN. Tolerance and complications were analyzed.

[Transpyloric enteral nutrition in critically-ill children (I): technic and indications].

Objective: To study the utility and efficacy of transpyloric enteral nutrition (TEN) in critically-ill children by analyzing the factors that determine enteral tolerance.

Patients And Methods: We performed a prospective, observational study between 1994 and 2002 of all critically-ill children admitted to our pediatric intensive care unit who received TEN. The indications for enteral nutrition, type of nutrition and its duration were studied.

[Liver failure due to mushroom poisoning: clinical course and new treatment perspectives].

Mushroom poisoning, mainly due to the Amanita genus, is an infrequent cause of liver failure in our environment. However, because of its high morbidity and mortality, it constitutes a medical emergency. The characteristic initial symptoms of vomiting, abdominal pain, and diarrhea are nonspecific and may be confused with gastroenteritis.