Cost and Mortality Analysis of an Intermediate Respiratory Care Unit. Is It Really Efficient and Safe?

Introduction: Historically, it has been assumed that Intermediate Respiratory Care Units (IRCU) were efficient, because they saved costs by reducing the number of admissions to intensive care units (ICU), and effective, because they specialized in respiratory diseases.

Methods: The number of IRCU admissions and mortality rate, historically and in 2016, were evaluated. For 2016, the grouped Related Diagnostic Groups (DRGs) were also described, and the savings achieved under all budgetary headings by avoiding UCI stays were calculated.

Frailty in patients over 65 years of age admitted to Intensive Care Units (FRAIL-ICU).

Objective: To estimate the prevalence of frailty in patients admitted to the Intensive Care Unit (ICU) and its impact upon ICU mortality at 1 and 6 months.

Design: A prospective observational cohort study was carried out.

Setting: Spanish ICU.

Importance of carbon dioxide in the critical patient: Implications at the cellular and clinical levels.

Important recent insights have emerged regarding the cellular and molecular role of carbon dioxide (CO) and the effects of hypercapnia. The latter may have beneficial effects in patients with acute lung injury, affording reductions in pulmonary inflammation, lessened oxidative alveolar damage, and the regulation of innate immunity and host defenses by inhibiting the expression of inflammatory cytokines. However, other studies suggest that CO can have deleterious effects upon the lung, reducing alveolar wound repair in lung injury, decreasing the rate of reabsorption of alveolar fluid, and inhibiting alveolar cell proliferation.

Mesenteric-portal axis thrombosis and deep venous thrombosis in a patient with inferior vena cava agenesis.

Splenoportal axis thrombosis not associated with cirrhosis or neoplasms has a prevalence lower than 5 per 10,000 people. An etiologic factor responsible for portal thrombosis is finally identified in most cases, usually systemic thrombogenic factors or predisposing local factors. However, despite a detailed study of all etiologic factors, up to 30% of cases are eventually considered as idiopathic in origin.

[What would you do in front of a patient with a Horner syndrome?].

Horner's syndrome (HS) occurs when there is disruption to the oculosympathetic pathway. Its features include eyelid ptosis, miosis and anhidrosis. The aetiology of this syndrome is varied and includes tumours, trauma, vascular disease and iatrogenic.

Anterior tibial tubercle osteotomy using cerclage wire fixation in total knee replacement: a modification of the usual technique.

Anterior tibial tubercle (ATT) osteotomy facilitates exposure in knee arthroplasty. However, it is not without complications. We have introduced some technical modifications that reduce the surgical aggression by designing a short osteotomy that does not invade the intramedullary canal, and synthesizing it with three cerclage wires with a particular layout that increases the solidity of the system.

Safety and Tolerability of Alveolar Type II Cell Transplantation in Idiopathic Pulmonary Fibrosis.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease with limited response to currently available therapies. Alveolar type II (ATII) cells act as progenitor cells in the adult lung, contributing to alveolar repair during pulmonary injury. However, in IPF, ATII cells die and are replaced by fibroblasts and myofibroblasts.

A Bayesian cost-effectiveness analysis of a telemedicine-based strategy for the management of sleep apnoea: a multicentre randomised controlled trial.

Background: Compliance with continuous positive airway pressure (CPAP) therapy is essential in patients with obstructive sleep apnoea (OSA), but adequate control is not always possible. This is clinically important because CPAP can reverse the morbidity and mortality associated with OSA. Telemedicine, with support provided via a web platform and video conferences, could represent a cost-effective alternative to standard care management.

Impact of inappropriate lymphadenectomy on lung metastasectomy for patients with metastatic colorectal cancer.

Purpose: To evaluate the characteristics of lymph node assessment in the Spanish Colorectal Metastasectomy Registry (GECMP-CCR) and to analyze and compare the survival of patients with pathological absence or presence of lymph node metastases (LNM) with the survival of those with uncertain lymph node status (uLNs).

Methods: A total of 522 patients with lung metastases from colorectal carcinoma were prospectively registered from 2008 to 2010. To confirm the pathologic absence of LNM, systematic nodal dissection or systematic sampling was required, or the lymph node status was coded as uncertain.

Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis.

Previous studies have suggested a benefit for patients with plaque psoriasis when omega-3 fatty acids are added to topical treatment. This study evaluated the efficacy of a nutritional complement rich in omega-3 fatty acids in patients with mild or moderate plaque psoriasis. Thirty patients were recruited, 15 of whom were given topical treatment with tacalcitol, forming the control group.

Guidelines on the Use of Methotrexate in Psoriasis.

Psoriasis, a chronic multifactorial inflammatory disease that develops in genetically predisposed individuals, affects approximately 1.5% of the Spanish population. This disease has a negative impact on patients' quality of life, and long-term therapy is often required to control the symptoms.

[Bullous scabies responding to ivermectin therapy].

Bullous scabies is a rare disease that is usually diagnosed in elderly patients. The clinical, histological, and immunological findings are identical to bullous pemphigoid. In a review of the literature, we found reports of 24 cases.

[Amicrobial pustulosis of the folds: report of a new case and review of literature].

Amicrobial pustulosis of the folds is a rare disorder characterized by a recurrent sterile pustular rash mainly affecting the skinfolds, scalp, and periorificial regions such as around the external auditory meatus. Few cases have been reported in the literature, most of them occurring women and all of them associated with some immunological disorder, the most common being lupus erythematosus. We present a new case of amicrobial pustulosis of the folds in a woman; the only immunologic abnormality detected was an elevation of immunoglobulin E.

[Sedation with sevoflurane for magnetic resonance imaging in pediatrics: retrospective study of 5864 cases].

Objective: To evaluate the use of sevoflurane for sedating pediatric patients undergoing magnetic resonance imaging studies.

Material And Methods: Data were extracted retrospectively from the records of 5864 pediatric patients (aged 0-18 years) who had undergone magnetic resonance imaging studies in our hospital from 1999 to 2004. Sevoflurane was usually administered at high concentrations of up to 7% on induction; after 2 minutes the concentration was reduced.

[Enteral supplements: dietary supplements or substitutes?].

Objective: To assess the use of oral nutritional supplements analyzing the reason for prescription and its implication in caloric-protein intake.

Setting: study performed at a university hospital of 350 beds with medical and surgical specialties. SUBJECTS, PATIENTS: Patients inclusion was done by selecting all starting oral nutritional supplement prescription.

[Acneiform eruption secondary to cetuximab].

C225 (cetuximab) is a monoclonal antibody that targets the epidermal growth factor receptor (EGF-R). It is used for the treatment of solid malignant tumors in advanced stages. It works against tumors by inhibiting cell proliferation, angiogenesis and the formation of metastases, as well as by promoting cell apoptosis.