[Nutritional assessment at the time of hospital-admission: study initiation among different methodologies].

Background And Objectives: The elevated prevalence figures of hyponutrition in hospitalized patients--near 40%--is an issue of concern. This allows deducing that early identification of malnourished, or at risk for hyponutrition, patients by means of effective nutritional assessment methods may represent an essential tool for nutritional planning. The aim of this study was applying to a same group of patients different nutritional assessment methods (objective and subjective) at the time of hospital admission in order to assess the degree of effectiveness for its clinical application.

[Idiopathic cholestasis associated with bloody diarrhea as the first manifestation of Hodgkin's lymphoma].

Jaundice in Hodgkin's disease occurs in 3-13% of the cases reported in the medical literature and can be due to several causes. Cholestatic jaundice associated with ductopenia may be a consequence of an associated paraneoplastic process and can occur several months before the development of Hodgkin's disease. When there is a finding of jaundice of unknown etiology associated with ductopenia, the possible existence of Hodgkin's disease should be investigated.

Cytologic aspect of brown tumor of hyperparathyroidism. Report of a case affecting the hard palate.

The cytologic and histologic findings of one brown tumor (BT) of hyperparathyroidism located in the hard palate, at first misdiagnosed as peripheral giant-cell granuloma, are described. Poor communication between cytopathologist and ear nose and throat specialist was responsible for the error. The overriding cytologic finding was the presence of numerous multinucleated giant cells (MGCs) of the osteoclastic type.

[Diagnostic cost-effectiveness of the skin biopsy in inflammatory diseases of the skin].

Introduction: Inflammatory skin diseases are a very heterogeneous and extensive group of entities whose clinical and pathological diagnosis is difficult. In cases where the clinical diagnosis is doubtful, the histopathological study of one or more lesions can be of great help. The aim of our work is to compare the effectiveness of the histopathological diagnosis in inflammatory skin lesions according to the department performing the biopsy.

[Use of extra-hospital emergency systems in the treatment of acute stroke in the region of Murcia. Possible repercussions on the urgent care of stroke patients].

Aim: To examine the use of extra-hospital emergency systems in the urgent care of stroke patients in our region and their influence on the time required to reach hospital, the time needed to perform an urgent computerised axial tomography (CAT) scan and the delay in receiving attention from the specialist.

Patients And Methods: Samples were collected from 232 stroke patients out of the total number admitted to our hospitals. Data about the stroke were collected prospectively, and included the arrival time, the time required to perform the CAT scan and the time the specialist devoted to attending the patient.

[Usefulness of clinical profiling and exercise testing in the prognostic assessment of patients admitted with chest pain but without high-risk criteria].

Introduction And Objectives: Few data are available on the outcome of patients admitted to hospital with suspected acute coronary syndrome who have no high-risk factors and who undergo exercise testing before discharge. Our objectives were to investigate outcomes in this group of patients and to determine whether clinical history-taking or exercise testing can help to predict outcome.

Patients And Method: The study population comprised 449 patients admitted to hospital with chest pain suggestive of acute coronary syndrome.

[Dobutamine stress echocardiography in patients with stable chronic angina and a low- or medium-risk on exercise testing: usefulness for assessing long-term prognosis].

Introduction And Objectives: The ability of stress echocardiography to provide prognostic information that supplements that obtainable from clinical data and exercise electrocardiography is still controversial. Our aim was to determine whether dobutamine stress echocardiography provides additional information on long-term prognosis after conventional exercise testing has indicated that a patient with chronic stable angina has a low or intermediate risk of a cardiac event.

Patients And Method: The study included consecutive patients with stable angina who were not found to be at high risk on a previous exercise test.

Pitfalls and infrequent findings in fine-needle aspiration of the prostate gland.

Based on the experience accumulated over two decades and in more than 7,000 transrectal fine-needle aspirations (FNAs) of the prostate gland, several benign and malignant unusual cytologic findings are described. Infrequent benign cytologic findings and possible pitfalls are atrophic prostatic epithelium, squamous metaplasia, transitional cells, granulomatous prostatitis, seminal vesicle epithelium, ganglion cells, lubricant artifacts, and treatment effects. Infrequent variants of carcinoma are foamy-cell carcinoma, prostatic duct adenocarcinoma, mucinous adenocarcinoma, transitional-cell carcinoma, small-cell carcinoma, squamous-cell carcinoma of the prostate, metastatic solid tumor within the prostate, and mesenchymal tumors.

The continuing role of fine-needle aspiration of the prostate gland into the 21st century: a tribute to Torsten Löwhagen.

A brief review of the history of transrectal fine-needle aspiration (FNA) of the prostate gland is reported in this article; the authors'experience of FNA during the last 20 yr is described also. Despite the worldwide acceptance of the thin-needle core approach, the use of transrectal FNA of palpable abnormalities of the prostate still is advocated because it is cheaper, faster, easier to perform, and results in lower morbidity than any other technique so far developed. High sensitivity, specificity, and efficacy account for its reliability.

[Fibrillary and immunotactoid glomerulonephritis: report of a case and review of the literature].

We describe the case of a 67 year-old female with nephrotic syndrome and rapidly progressive renal failure. The nephropathy was characterized by deposits of randomly oriented fibrils with a diameter of about 18-20 nm on electron microscopy. Immunofluorescence microscopy was performed and there was no staining for immunoglobulins and complement.

[Change of EPO treatment from subcutaneous epoetin to intravenous epoetin or darbepoetin alpha].

This prospective, two-arm, clinical trial assesses the effectiveness in maintaining the levels of haemoglobin (Hb) between 11 and 13 g/d1 and the safety of changing the administration route (from subcutaneous to intravenous) of epoetin (rHuEPO) alpha at equidose versus a changeover to darbepoetin alpha, taking the exact equivalence in peptide mass between the two as referent in patients with chronic renal insufficiency (CRI) in haemodialysis. A total of 112 patients previously treated with epoetin and no dose modification during the 8 weeks prior to the study and stable levels of Hb were included. Of these, 92.

Diagnostic limitations in testicular cytopathology: to what extent is fine-needle aspiration reliable for the diagnosis of epidermoid cyst of the testis?

This article describes the cytologic and histologic findings of a epidermoid cyst of the testis diagnosed by means of fine-needle aspiration (FNA) cytology. The gross and cytologic features are creamy aspirate, squamous cells, squamae, and fragments of granulomatous tissue. The cytologic features are fairly typical and similar to those observed in cutaneous epidermoid cysts; however, in this setting, the differential diagnosis should be carried out mainly with teratoma and dermoid cysts.

[Treatment of renal anemia with darbepoetin alfa administered once every other week in predialysis patients with chronic kidney disease and previously treated with epoetin alfa].

Darbepoetin alfa is an erythropoiesis-stimulating glycoprotein with up to 3 times longer half-life than recombinant human erythropoietin (rHuEPO) in humans. The aim of this study was to assess the efficacy and safety of darbepoetin alfa given once every other week as treatment of anemia in predialysis patients with chronic renal failure (CRF) previously treated with once-weekly epoetin alfa. A total of 42 CRF patients were included, all of whom had previously been treated with epoetin alfa and showed stable hemoglobin (Hb) levels without dose changes during the last 8 weeks prior to enrolment in this study.

Fine-needle aspiration of apocrine hidrocystoma--a potential mimic of papillary neoplasms metastasizing to the skin.

We report the cytologic features of a histologically confirmed apocrine hidrocystoma as seen in fine-needle aspirates. The main cytologic features were the presence of sparse pseudopapillae with mild to moderate atypia in a background of an amorphous navy blue material reminiscent of that seen in aspirates of colloid nodules of the thyroid gland. The pseudopapillae were mistaken for malignant metastatic deposits.

[Aetiological diagnosis of cerebral infarction in a county hospital].

Introduction: Cerebral infarction (CI) can be classified aetiologically in several different ways using explicit diagnostic criteria. However, the extent to which these diagnostic criteria are actually implemented in clinical practice is unknown. Aims.

[Collagenous colitis and small intestinal villous atrophy: manifestations of the same disorder?].

We describe the case of a 64-year-old woman with a previous diagnosis of celiac sprue and no clinical or histological response to gluten withdrawal. The patient presented a history of longstanding recurrent watery diarrhea and was found to have collagenous colitis after further investigation of her diarrhea. Immunological study was incompatible with celiac disease and no other cause of villous atrophy was found.

[Primary ciliary dyskinesia, presentation of an atypical case].

Primay ciliary dyskinesia is a rare autosomal recessive disorder, characterized by abnormal ciliary structure and function and chronic lung, sinus and middle ear disease. A 45-year-old man with a history of recurrent respiratory infections, which was developped in the adult age, and was presented with moderate clinical involvement, and spermatic hypomotility in seminogram. Diagnosis and differential diagnosis was based on the typical clinical picture and the electron microscopical demonstration of ultrastructural abnormalities.

The exercise test that indicates a low risk of events. Differences in prognostic significance between patients with chronic stable angina and patients with unstable angina.

Objectives: The objective of this prospective study was to determine the differences in the prognostic significance of an exercise test (ET) that indicates a low risk of events (low-risk exercise test [LRET]) between patients with unstable angina (UA) and those with chronic stable angina (CSA).

Background: It is not known whether the prognostic significance of an LRET is influenced by the disease; that is the reason for performing exercise testing.

Methods: All patients not presenting with high-risk criteria were submitted to a prognostic ET.

[Diagnosis of apical hypertrophic cardiomyopathy using contrast echocardiography].

Apical hypertrophic cardiomyopathy is a disease with clear electrocardiographic and echocardiographic characteristics. However, poor visualization of apical endocardial border is a limiting factor to diagnose apical hypertrophic cardiomyopathy by echocardiography. We present a case report of a patient with a characteristic electrocardiogram but poor apical endocardial border delineation.

[Fever of central origin during stroke].

Introduction: Fever appears in a fourth of stroke, approximately. Its origins, (the most of them are infectious) are unknown in a minority of the cases. Some hypotheses indicate that central mechanisms like hypothalamic lesions or segregation of endogenous pyrogens may be implicated.

[Prognostic significance of the implantation of a temporary pacemaker in patients with acute myocardial infarction].

Objective: Indication of temporary pacemakers in patients during acute myocardial infarction was widely studied in the pre-thrombolytic era without having determined whether the generalization of fibrinolysis might have changed the overall incidence and significance of temporary pacemakers. Our aim was to determine the incidence and the prognostic significance of insertion of temporary pacemakers in patients with acute myocardial infarction.

Patients And Methods: In a study involving 1,239 patients consecutively admitted to hospital with acute myocardial infarction we studied clinical characteristics and prognosis depending on temporary pacemaker insertion or not.

Prognostic significance of bundle-branch block in acute myocardial infarction: the importance of location and time of appearance.

Background: The presence of bundle-branch block (BBB) is associated with high mortality rates and is considered an important predictor of poor outcome in patients with acute myocardial infarction (AMI).

Hypothesis: The objective of this study was to assess the prognostic significance of BBB in patients with AMI depending on its form of presentation.

Methods: A multicenter prospective 1-year follow-up study involving 1,239 consecutive patients diagnosed with AMI was performed.

[Kinesigenic paroxysmal choreoathetosis: contribution of SPECT].

We report two unrelated patients affected of kinesigenic paroxysmal choreoathetosis (CPC), during a symptomatic period. Routine complementary exams were normal. The 99mTc-HMPAO cerebral SPECT showed hyperactivation in the basal ganglia opposite to the choreoathetosic symptoms and reduced untake in the near parietal and subcortical zones in one case.

[Leiomyoma of the bladder].

Objective: To present an additional case of leiomyoma of the bladder, a rare tumor that is frequently discovered incidentally, and to review the few cases reported in the Spanish literature, with special reference to the clinical aspects, complementary tests and treatment.

Methods: A case of leiomyoma of the bladder in a patient who had come to deliver after a full-term pregnancy is presented. Routine physical examination on admission revealed a tumor in the anterior aspect of the vagina.