[The availability in Spanish public hospitals of resources for diagnosing and treating sleep apnea-hypopnea syndrome].

Introduction And Objective: Sleep apnea-hypopnea syndrome is associated with an overall deterioration in the patients health and affects between 1 and 2 million people in Spain. The objective of the present study was to evaluate the diagnostic and therapeutic resources available in Spain for dealing with this problem in terms of both infrastructure and human resources.

Methods: We selected 461 general hospitals, 457 (99.

[Inguinal silicotic adenopathy: presentation of a case].

Silicosis is a sistemic occupational disease, including in the group of pneumoconiosis, because is resulting from the inhalation of microscopic particles of crystalline silica, which deposition and histologic changes take place in lung tissue. A 30 year-old male, construction worker who presented many mediastinal, abdominal and groinal adenopathies without lung damaged. A groinal adenophaty biopsy showed the presence of numerous noncaseating granulomas containing scattered polarizable particles compatible with silica.

[Management of myocardial infarction in Spain in the year 2000. The PRIAMHO II study].

Introduction And Objectives: Hospital registries are useful tools to measure the degree of implementation of new treatments and clinical practice guidelines.

Patients And Method: The hospital registry described here was developed in the prospective PRIAMHO II study, which involved a random selection of Spanish hospitals with a coronary intensive care unit and external quality control. This study investigated patients admitted to the coronary care unit with acute myocardial infarction.

Immunohistochemical prognostic index for breast cancer in young women.

Aims: Women under 35 years of age comprise a small proportion of patients with breast cancer, but determining their prognosis can be difficult. This prospective, multivariate study looked at several factors with the aim of obtaining a useful index to evaluate the prognosis of these women.

Methods: In total, 108 patients below 35 years of age affected by invasive ductal carcinoma without distant metastasis were studied.

[Validation study of a polygraphic screening device (BREAS SC20) in the diagnosis of sleep apnea-hypopnea syndrome].

Objective: To validate the BREAS SC20 (Breas Medical AB, Mölnlyke, Sweden) polygraphic screening device, comparing it with conventional polysomnography (PSG), in the diagnosis of sleep apnea-hypopnea syndrome. A validity study of the diagnostic test was carried out at the sleep clinic of a tertiary hospital.

Patients And Methods: Seventy patients clinically suspected of sleep apnea-hypopnea syndrome and treated at the sleep laboratory of the Hospital Txagorritxu, Vitoria, Spain, from November, 2001 until August, 2002 were consecutively enrolled in the study.

[New recommendations and perspectives for the control of tuberculosis].

This report summarises the ATC/CDC recommendations on the diagnosis and treatment of latent tuberculosis infection. Based on the sensitivity and specificity of the tuberculin skin test and the prevalence of TB in different groups, 3 cut-off levels have been proposed for defining a positive tuberculin reaction: > or =5 mm, >/=10 mm and > or =15 mm of induration. Treatment can be carried out mainly with Isoniazid, but there are alternatives such as Rifampin plus Pyrazinamide in the following cases: when Isoniazid-resistant M.

[Treatment of congestive heart failure in the setting of hospital at home. Study of 158 patients].

Background And Objective: Hospital at Home might become a suitable alternative to traditional hospital admissions for several exacerbated chronic diseases. Congestive heart failure represents an important workload at the hospital level. In this study we present the results of our experience with congestive heart failure patients attended in Hospital at Home regimen during the period 1999-2001.

Comparison of a cardiorespiratory device versus polysomnography for diagnosis of sleep apnoea.

This study assessed the accuracy of a cardiorespiratory monitoring device versus polysomnography for the diagnosis of suspected sleep apnoea/hypoponea syndrome (SAS). A total of 86 patients (89% male, mean age 52 yrs) that had been referred to a sleep laboratory with a clinical diagnosis of SAS underwent cardiorespiratory polygraphy in an unattended mode using an ambulatory device (MERLIN). Analysis was carried out both automatically and manually.

Predictive value of P53, BCL-2, and BAX in advanced head and neck carcinoma.

Because the apoptotic process appears to be involved in the response-to-treatment of chemotherapy and radiotherapy, we investigated the prognostic value of the expression of three apoptosis-associated genes (p53, Bax, and Bcl-2) in tumor biopsies from patients with locally advanced head and neck carcinoma. Using specific monoclonal antibodies, immunohistochemical staining for p53, Bax, and Bcl-2 was performed on tumor material from 43 patients before their scheduled adjuvant chemoradiotherapy. Results indicated that the response to treatment was 83.

[Low grade astroblastoma: pathological and magnetic resonance findings].

Introduction: The astroblastoma is an uncommon type of glial tumour. It accounts for less than 1% of all tumours of the central nervous system. It originates in the tanicytes, ependymal cells present in the embryo and usually seen in adolescents and young adults.

Tuberculin skin testing in intravenous drug users: differences between HIV-seropositive and HIV-seronegative subjects.

The prevalence of tuberculin skin test reactions among intravenous drug abusers and differences in tuberculin skin test positivity between HIV-seropositive and HIV-seronegative subjects were evaluated in a cross-sectional study of 1131 subjects. They were recruited from a therapeutic community, from those who attended the centre for the treatment of drug addiction and from those who visited for any reason an acute tertiary-care hospital in Vitoria-Gasteiz, Basque Country (Spain). All subjects underwent skin testing with purified protein derivative (PPD) tuberculin and testing for HIV antibodies.

Lower malfunction rate with self-locating catheters.

Objective: We analyzed malfunction rates (obstruction, omental wrapping, displacement) and catheter survival for self-locating catheters as compared with other Tenckhoff catheter designs.

Patients And Methods: We conducted our survey at two centers, prospectively studying all self-locating catheters implanted from May 1997 to October 2000 and used for peritoneal dialysis (PD). Tenckhoff catheters of other designs used previously in our units were used as the control group.

[Management of myocardial infarction in Spain (1995-99). Data from the registry of the Ischaemic Heart Disease Working Group (RISCI) of the Spanish Society of Cardiology].

Introduction And Objectives: Limited information is available on how patients with myocardial infarction are treated in Spain. In order to make up for this deficiency, in October 1994, the Ischaemic Heart Disease Working Group of the Spanish Society of Cardiology initiated a myocardial infarction registry, which is currently active.

Methods: Patients are recruited from hospitals with intensive coronary care facilities.

Effectiveness of continuous positive airway pressure in mild sleep apnea-hypopnea syndrome.

The aim of this trial was to evaluate the effectiveness of continuous positive airway pressure (CPAP) in patients with mild sleep apnea- hypopnea syndrome (SAHS). One hundred forty-two consecutive patients with mild SAHS (apnea-hypopnea index 10-30, without severe sleepiness) were randomly assigned to receive conservative treatment (CT)-sleep hygiene and weight loss-(65 patients) or CT plus CPAP (77 patients), and 125 patients (86% males, age: 54 +/- 9 yr, BMI: 29 +/- 4 kg/m(2), AHI: 20 +/- 6, ESS: 12 +/- 4) completed the follow-up. The following outcomes were assessed at inclusion and after 3 and 6 mo of treatment: sleepiness (Epworth scale, multiple sleep latency test [MSLT]), other symptoms related to SAHS, cognitive function, and perceived health status (Functional Outcomes of Sleep Questionnaire [FOSQ], Nottingham Health profile).

Remitting seronegative symmetrical synovitis with pitting edema associated with subcutaneous Streptobacillus moniliformis abscess.

We describe an 84-year-old woman who developed remitting seronegative symmetrical synovitis with pitting edema (RS3PE) associated with a subcutaneous abscess of the hand due to Streptobacillus moniliformis. Polyarthritis and edema were relieved after therapy with corticosteroids. We review the association of RS3PE to different rheumatologic, neoplastic, or infectious diseases.

Value of limited necropsy in HIV-positive patients.

We performed limited autopsy with histological examination of tissue cores obtained percutaneously using the Tru-Cut needle and the Jamshidi trocar in 150 adult HIV-positive patients. Data were compared retrospectively with the antemortem clinical diagnosis. Eighty-one percent of the patients were male, and 78% were intravenous drug users.

Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr.

The prevalence and related clinical features of obstructive sleep apnea-hypopnea (OSAH) in the general population were estimated in a two-phase cross-sectional study. The first phase, completed by 2,148 subjects (76.9%), included a home survey, blood pressure, and a portable respiratory recording, whereas in the second, subjects with suspected OSAH (n = 442) and a subgroup of those with normal results (n = 305) were invited to undergo polysomnography (555 accepted).

Prevention of intraocular pressure elevations during hemodialysis.

Intraocular pressure (IOP) may rise during hemodialysis sessions in predisposed patients because of a rapid drop in osmolality at the blood compartment. A patient with diabetes had painful ocular episodes during hemodialysis that were associated with an IOP increase. We modified the dialysis parameters to prevent a rapid decrease in osmolality by creating conductivity and ultrafiltration profiles and adding a colloid solution at the beginning of the procedure.

[Rh (D) alloimmunization and pregnancy. Analysis of the causes after prophylaxis introduction].

Purpose: Prenatal and postnatal prophylaxis of the Rh (D) haemolytic disease of the newborn have clearly reduced the number of cases but still there are alloimmunizations.

Patients And Methods: All cases detected in our Hospital in the last 24 years have been reviewed and possible causes analyzed.

Results: From a total of 10,332 deliveries in Rh (D) negative women we have detected 114 anti-D in 86 women.

[The clinical management guidelines of the Sociedad Española de Cardiología in acute myocardial infarct].

In the recent years, new possibilities have emerged in the diagnosis and management of acute myocardial infarction with ST segment elevation and its complications. Moreover, a deep transformation has taken place in the health care system organization, particularly in aspects related to care of patients presenting non-traumatic chest pain, both in pre-hospital and hospital areas. All these issues warrant a consensus document in Spain dealing with the role that these important changes should play in the whole management of myocardial infarction patients.

Beekeeper' arthropathy.

Objective: To describe the clinical, analytical, and radiological features of an observed arthropathy affecting beekeepers.

Methods: Prospective study of 34 patients (32 male, 2 female), mean age 42 years (range 16 to 66 years), evaluated for the presence of acute or chronic arthritis related to beekeeping. All patients were working and living in the same village, Fuenlabrada de los Montes (1300 habitants), where there is a census of 180 beekeepers.

Acute pancreatitis: evaluation of the prognostic criteria of the latest Balthazar tomographic classification.

The use of prognostic criteria to detect potentially acute pancreatitis can allow us to select patients most in need of special attention. Of the many possible criteria, we used Ranson's clinical analytic criteria and Balthazar's tomographic criteria, and compared them to the latest criteria of Balthazar, in which pancreatic necrosis figures as the principal prognostic factor. Tomographic evaluation of pancreatic necrosis was shown to be the best prognostic marker in acute pancreatitis, with the greatest sensitivity and specificity of all methods used with one-hundred consecutive patients admitted with acute pancreatitis.

Use of intrauterine contraceptive devices in nulliparous women: personal experience over a 12-year period.

Objective: To evaluate the use of intrauterine contraceptive devices (IUDs) in nulliparous women compared to their use in parous women.

Methods: A comparative cross-sectional study was carried out to determine the reasons for removal of IUDs inserted between 1985 and 1996 in a sample of 227 nulliparous women and 2080 parous women. The statistical analysis was performed using the chi 2 test; the differences were considered to be significant when p < 0.