Distribution and Outcomes of a Phenotype-Based Approach to Guide COPD Management: Results from the CHAIN Cohort.

Rationale: The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes.

Objective: We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes.

Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort.

Background: Asthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult.

Methods: To identify patients with ACOS, a cohort of well-characterized patients with COPD and up to 1 year of follow-up was analyzed.

Prognostic implications of the standardized study of resection margins in pancreatic cancers.

Introduction: Involvement of surgical resection margins is a fundamental prognostic factor in pancreatic oncological surgery. However, there is a lack of standardized histopathology definition. The aims of this study are to investigate the real rate of R1 resections when surgical specimens are evaluated according to a standardized protocol and to study its survival implications.

Clinical application of the COPD assessment test: longitudinal data from the COPD History Assessment in Spain (CHAIN) cohort.

Objective: The COPD Assessment Test (CAT) has been proposed for assessing health status in COPD, but little is known about its longitudinal changes. The objective of this study was to evaluate 1-year CAT variability in patients with stable COPD and to relate its variations to changes in other disease markers.

Methods: We evaluated the following variables in smokers with and without COPD at baseline and after 1 year: CAT score, age, sex, smoking status, pack-year history, BMI, modified Medical Research Council (mMRC) scale, 6-min walk distance (6MWD), lung function, BODE (BMI, obstruction, dyspnea, exercise capacity) index, hospital admissions, Hospital and Depression Scale, and the Charlson comorbidity index.

[Cost and outcome of hip's arthroplasty nosocomial infection. Case and control study].

Case-control study for evaluation of cost and outcome of nosocomial surgical site infection in primary hip arthroplasty during a period of 5 years. Mean hospitalization time in the orthopedic service was 54 days for cases, and 13 days for control (p<0.05).

[Malignant infarct of the middle cerebral artery in a patient with bacterial meningitis].

The mortality of acute bacterial meningitis (BM) has remained stable in the last decades in spite of the use of new antibiotics, probably due to vascular complications. We report a 68-year-old woman with BM who had a malignant infarction of left middle cerebral artery territory 72 hours after admission to the hospital. The patient experienced a bad evolution and died four days after admission.

Prenatally diagnosed choledochal cysts: observation or early surgery?

The incidence of subhepatic cysts later confirmed as choledochal cyst has changed with the use of prenatal ultrasonography. A new group has emerged: the neonatal patient with an antenatal diagnosis. Optimal timing for cyst excision depends on variables such as gestational age, weight, associated conditions, biochemical liver alterations, development of complications, and the sonographic surveillance of size.

["Papanicolaou." Outmoded, isn't it?].

The quality of cytopathology services in the United States has recently come under public scrutiny. While numerous studies have demonstrated remarkable success of the PAPANICOLAOU test in the reduction of cervical cancer, problems that include inadequacies in obtaining the sample, processing the sample screening and interpretation based on the PAPANICOLAOU Classification have been questioned. The recommendations of expert consultants attending a workshop sponsored by the Division of Cancer Prevention and Control, National Institutes regarding utilization of the Pap Smear have been made and published as the Bethesda System.

Interatrial conduction block with retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmias: influence of preventive antiarrhythmic treatment.

Patients with advanced interatrial conduction block with retrograde activation to the left atrium present a high incidence of supraventricular tachyarrhythmias. We report the value of preventive antiarrhythmic treatment in these patients.

Apolipoprotein E phenotypes, lipoprotein composition, and xanthelasmas.

The different types of serum lipoproteins, including apolipoprotein E phenotypes, were measured in 50 patients with xanthelasma. Half of them were found to be hyperlipemic. The normolipemic and hyperlipemic groups with xanthelasma were compared with two control groups (one a group of normolipemic patients and another a group of hyperlipemic patients without xanthelasma) selected as homogeneously as possible with regard to age, sex, degree of obesity, and hyperlipemic phenotype.

Porokeratotic eccrine ostial and dermal duct nevus.

We report 2 cases of congenital porokeratotic eccrine nevus in a 5-year-old girl and a 7-year-old boy. The clinical manifestations were those of nevus comedonicus palmaris. The histologic picture consisted of comedo-like dilatations and cornoid lamellae involving the eccrine ostia and ducts.

[Chronic mucocutaneous candidiasis].

Chronic mucocutaneous candidiasis is a chronic infection of mucoses, nails and skin due to Candida sp., that does not respond to standard treatment. We report on three patients with chronic mucocutaneous candidiasis in association with iron deficiency, IgA deficiency in one patient and adult onset in another.

[Multiple hamartoma syndrome].

We describe the clinicopathological features of multiple hamartoma and neoplasia syndrome (Cowden's syndrome) in a 58 year-old man and in a 56 year-old woman. The typical mucocutaneous lesions of this disorder were present in both cases. Visceral hamartomas involving thyroid and gastrointestinal system (polyposis) were present in both patients.

[Electrophysiologic characteristics of the transplanted heart].

The electrophysiologic characteristics of the denervated human heart were assessed in 20 cardiac transplants recipient from the Cardiology Department, at the Hospital of San Pablo, Barcelona, Spain. We studied the donor and the recipient sinus node function at rest and exercise test. Holter recording of 24 hours was performed in a few cases.