[Eugenics' extension in the Spanish health care system through the prenatal diagnosis].

The wide implantation of strategies of sifted or prenatal selection close to laws that protect the destruction of the human life before the childbirth in the whole world, they are giving place to an increasing number of eugenic abortions. In Spain, the law 2/2010 of the sexual and reproductive health and voluntary interruption of pregnancy there has supposed the liberalization of the eugenic abortion without term limit. In we make concrete, the sanitary national and international policies of prenatal selection of Down's Syndrome, which they chase to facilitate the total or partial destruction before the childbirth of this human group, submitting it to a few particular conditions of existence during his prenatal life in those who will be an object of a series of technologies of selection, they might be qualified of genocidal policies if we consider the definition of genocide given by United Nations.

Drug-related hepatotoxicity and hepatic failure following combined androgen blockade.

Androgen deprivation therapy has been the mainstay of treatment for metastatic prostate cancer and of less advanced cancers as neoadjuvant and adjuvant treatment. Abnormal liver function test, in particular elevated transaminases, is an adverse reaction more frequently noticed during androgen deprivation therapy with antiandrogen. We report the case of a patient with acute hepatic failure associated with the use of bicalutamide.

Hepatic involvement in a teenager with type 1 diabetes and poor metabolic control.

There are several manifestations of hepaticinvolvement in diabetes but the most frequent is non-alcoholic steatohepatitis. Acquired hepatic glycogenosis is characterized by intrahepatocyte glycogen accumulation in poorly controlled type 1 diabetes under treatment with high doses of insulin. We report the case of a diabetic teenager with progressive elevation of liver enzymes associated with poor metabolic control.

[Polypoid cystitis associated with glandular cystic cystitis].

Objective: Polypoid cystitis and intestinal metaplasia are well-known lesions of the bladder.

Methods: We report the case of one patient with both lesions identified synchronically in the bladder.

Results: Although these lesions are not neoplastic, there are evidences supporting a possible degeneration of the metaplastic epithelium to adenocarcinoma.

[The Herbst triad: finger clubbing, hypoproteinemia and iron deficiency anemia associated with gastroesophageal reflux].

Gastroesophageal reflux with hiatal hernia has been associated with unusual presentations, including rumination syndrome, Sandifer syndrome (reflux esophagitis, iron deficiency anemia and head cocking) and the Herbst triad (iron deficiency anemia, hypoproteinemia and finger clubbing). We report a new case of this rare disease. Lack of awareness of gastroesophageal reflux as a possible cause of these striking symptoms could lead to complications and delayed surgery.

[Patient autonomy and information and clinical documentation-related rights within the context of Spanish Law 41/2002].

Law 41/2002 Regulating Patient Autonomy and Health Documentation and Information-Related Rights and Obligations regulates matters which the General Health Law of 1986 had fallen short in its attempt to regulate, such as the right to health information, informed consent, health documentation, clinical records and other clinical information. This Law likewise classifies the ways in which capabilities may be limited and attributes physicians with authority over the evaluation thereof. In keeping with the Oviedo Convention on Human Rights and Biomedicine, this study includes the guiding principles of the new bioethics, such as an individual's right to privacy of the health-related information, living wills (or advance medical directives), the patient's right to antonomy and to take part in the decision-making process, the refusal of treatment or teenagers being of legal age for health-related decision-making purposes.

Prognosis and clinical evaluation of infection caused by Rhodococcus equi in HIV-infected patients: a multicenter study of 67 cases.

Objective: To assess the clinical characteristics and the factors that influenced the prognosis of patients with HIV and infection caused by Rhodococcus equi.

Design: Observational, multicenter study in 29 Spanish general hospitals.

Setting: These hospitals comprised a total of 20,250 beds for acute patients and served a population of 9,716,880 inhabitants.

Prognostic evaluation of bacteremia and fungemia in patients with acquired immunodeficiency syndrome.

The incidence of bacterial infections in general and of bacteremia in particular is high among patients with acquired immunodeficiency syndrome (AIDS). The factors influencing the prognosis of bacteremia in these patients are not well known. In order to better define those factors associated with a poor prognosis, all episodes of bacteremia or fungemia in patients with AIDS who were hospitalized in four general hospitals between 1 September 1987 and 31 December 1996 were studied prospectively.

[Centrofacial necrosis secondary to cocaine use].

We report the medical case of a 40-year-old man with a history of years of cocaine abuse. He was admitted to our hospital for a septic process and purulent rhinorrhea. The clinical examination and craniofacial computed tomography revealed severe necrosis of the nasal septum, maxillary sinus, ethmoidal sinus, sphenoidal sinus and soft palate.

[Characterization of major ambulatory surgery in a basic general hospital].

Background: Outpatient surgery initially came into being and further developed as a result of the progressive increase in the demand and in hospital expenses. Although it has afforded the possibility of lowering the cost per procedure and of improving the efficiency of the hospitals by maintaining the degrees of patient satisfaction and safety, it has also made it necessary to question the customary activity indicators. This had led us to assess the outpatient surgery units of the recently-opened Algeciras Hospital based on the customary system of payment in other countries, the Related Diagnostic Groups (RDG's).

[Acute respiratory failure as the presentation of amyotrophic lateral sclerosis. Apropos a case].

We report the case of a 61-year-old man with amyotrophic lateral sclerosis presenting with respiratory failure requiring long-term mechanical ventilation. Diagnostic difficulties are discussed along with the circumstances that give rise to suspicion of neuromuscular disease in a context of respiratory failure of unknown cause. The patient is at present in stable condition after 6 months of domiciliary mechanical ventilation.

Severe paronychia due to zidovudine-induced neutropenia in a neonate.

We describe the case of an HIV-perinatally exposed child who was treated with zidovudine prophylaxis for reduction of perinatal transmission. At 4 weeks of age, he developed severe paronychia of the great toes as a result of Candida albicans and Escherichia coli. At that time, laboratory tests showed anemia and neutropenia.

[Postoperative complications in a case of iatrogenic hypothyroidism induced by diet drugs].

Oral thyroid preparations, which were first administered in 1892 to treat myxedema, are the oldest effective endocrine medications. Since thyroxin became available, such drugs have been dispensed without a physician's prescription and have come to be mistakenly referred to as "diet pills". Self-prescription of such products can cause changes in thyroid function, with systemic repercussions.

[Late p53 mutation in head and neck oncogenesis].

p53 mutation are currently recognized as the commonest genetic event in human tumors. In this paper are studied, through immunochemistry, the p53 protein expression of 25 carriers from squamous cell carcinoma of the larynx and hypopharynx as well in the non tumoral mucosa of the larynx removed and corresponding metastases. Because of the great overexpression of this protein among tumors and its metastases, aside with the low expression in normal far-off mucous membranes of the studied growths, the AA.

[Expression of proto-oncogene bcl-2 in squamous cell carcinoma of the larynx].

Apoptosis, or programmed cell death, is responsible for deleting cells in normal tissues to maintain homeostasis after DNA damage. Apoptosis has several physiological inhibitors, one of the most important being the proto-oncogene bcl-2. An immunohistochemical study was made of bcl-2 expression in 25 squamous cell carcinomas of the larynx, in laryngeal mucosa distant from the primary neoplasm, and in lymph node metastases.

[Changes in heroin administration route and frequency of human immunodeficiency virus infection].

Background: Self-administration of drugs by different intravenous routes may induce a reduction in the organic complications of drug addiction (DA). The aim of this study was to evaluate the changes in the way of drug administration in a series of DA individuals in the province of Cádiz, Spain, and the evolution of the frequency of infection by the human immunodeficiency virus (HIV) in these patients.

Methods: The reports of all the drug users from the province of Cádiz admitted to the Detoxication Unit of the Hospital Punta de Europa in Algeciras, from January, 1989 to July, 1993 were reviewed.

Prospective evaluation of a two-week course of intravenous antibiotics in intravenous drug addicts with infective endocarditis. Grupo de Estudio de Enfermedades Infecciosas de la Provincia de Cádiz.

In a prospective study, a two-week course of antibiotics (cloxacillin 2 g/4 h plus amikacin 7.5 mg/kg/12 h) was evaluated in the therapy of right-sided infective endocarditis in intravenous drug users (IVDU). All IVDU admitted to hospital during the study period who fulfilled the strict criteria for diagnosis of infective endocarditis were analysed.

[Nutritional management of acute infectious diarrhea of mild and moderate intensity].

In childhood, acute infectious diarrhea remains one of the most important causes of mortality (due to dehydration) and morbidity (due to malnutrition). Whilst, the introduction of solutions for oral rehydration have meant a therapeutic advance of extraordinary importance to meet the objective of avoiding or correcting the dehydration, the nutritional management of the child with acute diarrhea remains a subject of great controversy. Evidence that suggests that the mild or moderate forms of the illness do not cause functional or anatomic alterations in the gastrointestinal apparatus of the severity or duration described in the more severe forms of diarrhea, makes necessary a new therapeutic focus which, together with the rehydration, takes into account the nutritional aspect.

[The contribution of "La España Médica" (1856-1866) to the introduction of anesthesiology in Spain].

The aim of this study was to analyse the contribution of "La España Médica " (1856-1866) to the introduction of anesthesiology in Spain. Thirty-seven articles on anesthesiology were published, with 19 articles (51.35%) being originals from spanish authors and 18 (48.