[Analysis of withdrawal from noninvasive mechanical ventilation in patients with obesity-hypoventilation syndrome. Medium term results].

Objective: To evaluate the possibility of cessation of noninvasive mechanical ventilation or noninvasive positive pressure ventilation (NPPV) treatment in patients with obesity-hypoventilation syndrome (OHS).

Material And Methods: A study was carried out on 22 OHS patients who had received NPPV for a minimum of 1 year. Prior to evaluation of the cessation of ventilatory support, all patients underwent the following tests: diurnal and nocturnal arterial blood gases, nocturnal oximetry, nocturnal cardiorespiratory polygraphy, and lung function tests.

[Reliability of chronic obstructive pulmonary disease diagnosis by primary care physicians and pneumologists in Spain. Predictive factors].

Objective: The aims of this study were to assess the methods used by primary care physicians and pneumologists to diagnose chronic obstructive pulmonary disease (COPD) in Spain, and to analyze the factors affecting correct diagnosis of the disease.

Material And Methods: This observational, descriptive, cross-sectional and multicenter study enrolled a stratified randomized sample from each Spanish region from the practices of primary care physicians and pneumologists.

Results: Five hundred sixty-eight (63.

[Drug treatment of chronic obstructive pulmonary disease on two levels of patient care: degree of compliance with recommended protocols].

Objective: The aims of this study were to identify the drug treatment protocols applied by primary care physicians or pneumologists for patients with stable chronic obstructive pulmonary disease (COPD) in Spain, to determine the agreement between prescription practices and current recommendations and to assess differences between the two levels of patient care.

Patients And Methods: The study was observational, descriptive and multicenter. A stratified random sample of patients treated by family physicians or pneumologists was taken for every region in Spain.

[Comparison of echocardiographic studies made with new portable devices to conventional studies].

Objectives: The latest development in echocardiography is the hand-held ultrasound device. Previous studies have shown that portable ultrasound devices detect major cardiovascular pathology better than the physical examination, but their diagnostic accuracy is still not known. The purpose of this study was to compare the results of examinations made with portable devices to those obtained with higher-scale platforms.

[Complete immune and clinical recovery after highly active antiretroviral therapy in advanced vertically HIV-1 infected children].

Background And Objective: The aim of this study was to evaluate the ability of long-term highly active antiretroviral therapy (HAART) to fully reconstitute the immune system in children with severe AIDS.

Patient And Method: Lymphoproliferative responses (LPR) were evaluated by incorporation of [3H]-thymidine. Cytokine production in culture (IFN- gamma, IL-5) was quantified using commercially available specific ELISA assays.

[Risk stratification using combined ECG, clinical, and biochemical assessment in patients with chest pain without ST-segment elevation. How long should we wait? ].

Introduction: We use clinical, ECG, and biochemical data to stratify risk in patients with chest pain without ST segment elevation. However, the prognostic performance of these studies in relation to time from onset of symptoms is unknown.

Patients And Method: In a single-center, prospective study, 321 consecutive patients who had been admitted in the emergency room with a suspected acute coronary syndrome without ST segment elevation were included in the study.

[Different approach in high-cardiovascular-risk women, compared to men: a multidisciplinary study-Spain].

Background And Objective: There is a broad range of cardiovascular high-risk patients, who might benefit from general and pharmacological interventions. The aim of the study was to evaluate the differences in the characteristics of CV risk in women with respect to men, and if there are differences in the treatment between men and women.

Patients And Method: We collected the data from CV high-risk patients from Cardiology, Internal Medicine, Neurology, Endocrinology and Primary Care.

[Octreotide treatment of post surgical chylothorax].

Chylothorax is an infrequent complication of cardiac surgery in children. Most patients respond to a low-fat diet or to parenteral nutrition, but pleuroperitoneal drainage or thoracic duct ligature is sometimes required. We present the case of a 3-year-old girl with Down syndrome and complex atrioventricular canal defect who presented chylothorax 22 days after the Glenn procedure with bidirectional pulmonary-cava fistula.

[Severe hypernatremia: survival without neurologic sequelae].

Hypernatremia is an electrolyte disturbance most frequently caused by excess water loss and less frequently by increased sodium intake. The few reported cases of severe hypernatremia (> 190 mEq/l) had an adverse outcome with high mortality and/or severe neurologic sequelae. The first case was a 7-year-old girl with renal failure undergoing continuous venovenous hemodiafiltration therapy who presented hypernatremia (216 mEq/l) after incorrect preparation of dialysis fluid.

Trigeminal nucleus caudalis dorsal root entry zone radiofrequency thermocoagulation for invalidating facial pain.

Introduction: Facial pain syndromes occasionally result in desperate clinical settings completely unresponsive to any known therapy. Trigeminal nucleus caudalis dorsal root entry zone (DREZ) lesion is reported to be of benefit in such cases. In 1982 Nashold performed the first DREZ caudalis lesion in a patient with anaesthesia dolorosa.

[Effects of prone position, inhaled nitric oxide and surfactant in children with hypoxemic pulmonary disease].

Objective: To analyze the therapeutic response to prone position, inhaled nitric oxide (NO) and surfactant in children with hypoxemic pulmonary disease.

Patients And Methods: We studied the effect of prone position, NO, and surfactant in critically ill children with acute hypoxemic pulmonary disease unresponsive to conventional therapy. We analyzed PaO2, SatO2, the PaO2/FiO2 ratio, oxygenation index and PaCO2 before and after each treatment, as well as the subsequent clinical course.

[Characterization of de novo malignancies in liver transplantation].

Introduction: The incidence of de novo malignancies after liver transplantation varies from 3-15%, and is greater than that in the general population. Immunosuppression may play a significant role in the development of most of these tumors.

Objective: To evaluate the incidence and clinical features of de novo tumors in liver transplant recipients in our center as well as to assess survival.

[Responses to antiretroviral treatments in vertically HIV-1-infected children].

Background And Objective: Our goal was to determine the probability of achieving a fall-off of viral load (VL) and an increase of CD4+T-lymphocytes by 36 months from the initiation of antiretroviral therapy (ART) in a cohort of HIV-infected children according to their baseline data.

Patients And Method: This was retrospective multicenter observational study of virologic and immunologic markers in 128 HIV-1-vertically infected children on ART: 55 HIV-infected children on combination therapy (CT), and 73 HIV-infected children on highly active antiretroviral therapy (HAART). Viral load (VL) was quantified using a standard molecular assay.

[Prognostic value of the pediatric index of mortality (PIM) score and lactate values in critically-ill children].

Objective: To analyze and compare the prognostic value of the pediatric index of mortality (PIM) score and lactate values on admission to a pediatric intensive care unit (PICU).

Patients And Methods: We performed a prospective study of 500 consecutive children: 237 girls (47.4 %) and 263 boys (52.

[Antiphospholipid antibodies evolving into connective tissue disease: follow-up study of women with recurrent misscarriage].

Background And Objective: The aim of this study was to evaluate the clinical and immunologic profile, the rate of progression to connective tissue disease and the possible predictors of evolution in patients with antiphospholipid antibodies and abortions.

Patients And Method: In a prospective follow-up study, we determined the prevalence of antiphospholipid antibodies as well as other autoimmune abnormalities and the evolution to connective tissue disease in 200 women with unexplained recurrent abortions. IgG and IgM anticardiolipin antibodies were determined by ELISA and the lupus anticoagulant was determined by means of coagulometric tests.

[Safety and usefulness of transesophageal echocardiography in the acute phase of myocardial infarction].

Introduction And Objectives: The usefulness and safety of transesophageal echocardiography have been assessed in other studies but there is no report in which these factors have been evaluated in the acute phase of myocardial infarction. Patients and method. Transesophageal echocardiography was performed 56 times in 55 patients in the first week after a myocardial infarction.

[Galantamine: a novel cholinergic agent for Alzheimer's disease].

Galantamine has been recently approved for the symptomatic treatment of Alzheimer's disease (AD). Apart from inhibiting acetylcholinesterase, galantamine modulates the nicotinic receptors, although the clinical significance of this action remains uncertain. Through a broad research program, it has been shown that galantamine produces a cognitive, functional and behavioral benefit in patients with either mild or moderate AD.

[Dominant autosomal cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). A review].

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a familial condition caused by a mutation of the Notch3 gen in chromosome 19. Accumulation of osmiophilic granular material (GOM) on the middle layer of small and medium-sized cerebral arteries leads to progressive narrowing of the blood vessels. As a result, clinical findings include migraine, cerebrovascular ischemic events, vascular dementia and a number of neuropsychiatric disorders associated to an extensive leukoencephalopathy readily shown by MRI studies.

[Extracorporeal membrane oxygenation: indications and recommendations on when to refer patients to a specialized unit].

Extracorporeal membrane oxygenation (ECMO) is a highly complex technique of extracorporeal support that has been available in Spain since 1997 and is now provided by three centres. This article aims to detail the guidelines and indications for neonatal and pediatric ECMO in severe cardiorespiratory failure and to provide information on when to contact the referral centres when treating patients who may need this treatment.

[Coinfection with chlamydia and mycoplasma. Incidence in our environment].

Objectives: To investigate the presence Mycoplasma pneumoniae and Chlamydia pneumoniae and to determine their importance as the cause of community-acquired pneumonia in childhood.

Material And Methods: We performed a retrospective descriptive study of all the patients aged less than 15 years old diagnosed with community-acquired pneumonia due to M. pneumoniae in the pediatric emergency department of our hospital between May 1998 and May 2000.

[Idiopathic cholestasis associated with progressive ductopenia in two patients with hodgkin's disease].

Introduction: Jaundice in Hodgkin's disease can be due to several causes. Ductal lesions and ductopenia, which we describe below, have rarely been reported.

Case Report: We describe 2 cases of idiopathic cholestasis associated with Hodgkin's disease in which duction lesions and ductopenia were found.

[Different immune profiles according to the immunological and clinical progression in vertically HIV-infected children].

Background: Our goal was to evaluate immunologic profile differences of HIV-infected children on antiretroviral treatment (ART). PATIENTS AND METHODDS: We studied 23 HIV-vertically infected children: a) N-A1 group: 10 HIV-infected children in A1 category; b) N-B2 group: 6 HIV-infected children in B2 category, and c) N-C3 group: 7 HIV-infected children in C3 category. We also studied 13 healthy age-matched HIV-negative children as controls.