Epidemiological study of Clostridium difficile infection in critical patients admitted to the Intensive Care Unit.

Unlabelled: Data on the epidemiology of infections caused by Clostridium difficile (CDI) in critically ill patients are scarce and center on studies with a limited time framework and/or epidemic outbreaks.

Objective: To describe the characteristics and risk factors of critically ill patients admitted to the ICU with CDI, as well as the treatments used for the control of such infections.

Material And Methods: A retrospective study was made of patients included in the ENVIN-ICU registry with CDI in 2012.

[Consensus statement: recommendations for the management of metabolic bone disease in human immunodeficiency virus patients].

Objective: To provide practical recommendations for the evaluation and treatment of metabolic bone disease in human immunodeficiency virus (HIV) patients.

Participants: Members of scientific societies related to bone metabolism and HIV: Grupo de Estudio de Sida (GeSIDA), Sociedad Española de Endocrinología y Nutrición (SEEN), Sociedad Española de Investigación Ósea y del Metabolismo Mineral (SEIOMM), and Sociedad Española de Fractura Osteoporótica (SEFRAOS).

Methods: A systematic search was carried out in PubMed, and papers in English and Spanish with a publication date before 28 May 2013 were included.

Whole-exome sequencing in splenic marginal zone lymphoma reveals mutations in genes involved in marginal zone differentiation.

Splenic marginal zone lymphoma (SMZL) is a B-cell neoplasm whose molecular pathogenesis remains fundamentally unexplained, requiring more precise diagnostic markers. Previous molecular studies have revealed 7q loss and mutations of nuclear factor κB (NF-κB), B-cell receptor (BCR) and Notch signalling genes. We performed whole-exome sequencing in a series of SMZL cases.

[Polyalkylimide filler in human immunodeficiency virus-associated facial lipodystrophy: ophthalmic complications].

Case Report: A 54 year old male, who consulted for acute inflammatory palpebral edema. The patient has HIV infection (on antiretroviral treatment) and an associated facial lipodystrophy that was filled with polyalkylimide in both frontotemporal regions one year before. MRI revealed subcutaneous abscesses in the filled areas, which led to preseptal cellulitis.

[Practical considerations for high resolution anoscopy in patients infected with human immunodeficiency virus].

Anal cancer is uncommon in the general population, however its incidence is increasing significantly in certain risk groups, mainly in men who have sex with men, and particularly those infected with human immunodeficiency virus. High resolution anoscopy technique is currently considered the standard in the diagnosis of anal intraepithelial neoplasia, but at present there is no agreed standard method between health areas. High resolution anoscopy is an affordable technique that can be critical in the screening of anal carcinoma and its precursor lesions, but is not without difficulties.

[Initial antiretroviral treatment in human immunodeficiency virus-infected patients in Spain: Decisions made in relation to particular immunovirological characteristics (PERFIL-es study)].

Introduction: The purpose of Perfil-es study was to identify the proportion of patients starting ARV treatment based on NNRTIs or PI/r, and to identify the variables involved in the therapeutic decision-making in standard clinical practice.

Methods: An observational retrospective study performed in 65 Spanish hospitals.

Results: Was a total of 1,687 starts: 53% with NNRTI-based regimen and 42% with PI/r, and of the 642 patients analyzed, 72% had a CD4 count<350 cells/μl.

[Epilepsy in the temporal lobe: déjà vu in Primary Care].

Epilepsy is a common disease in the general population. 10% of the population will present a seizure throughout his life, although only 1% will have an epileptic condition. We can divide the generalized epilepsy and focal.

Adverse events during the titration phase of interferon-beta in remitting-relapsing multiple sclerosis are not predicted by body mass index nor by pharmacodynamic biomarkers.

Background: This study aimed to correlate body mass index or biomarkers with the frequency of common adverse events (AEs) with subcutaneous IFN β-1a during treatment titration in patients with relapsing-remitting multiple sclerosis previously naïve to IFN β.

Methods: Eighty-four patients (66.3% females) were followed up during 8 weeks, 25.

Relationship between volume and survival in closed intensive care units is weak and apparent only in mechanically ventilated patients.

Background: Recent studies have found an association between increased volume and increased intensive care unit (ICU) survival; however, this association might not hold true in ICUs with permanent intensivist coverage. Our objective was to determine whether ICU volume correlates with survival in the Spanish healthcare system.

Methods: Post hoc analysis of a prospective study of all patients admitted to 29 ICUs during 3 months.

[Anaemia as a cause of haemodynamic angina in a patient with chronic ischaemic heart disease].

Ischaemic heart disease is the leading cause of mortality and morbidity and one of the primary causes of morbidity in Spain. The variability in the clinical presentation of this condition at both primary care and emergency services level requires a careful history and a thorough physical examination. In the case presented, the main symptoms of angina and dyspnea reported in the anamnesis, and the obvious pallor in the physical examination, were the key data to identify anaemia as a cause of angina.

Needle washing increases the diagnostic yield of fine needle aspiration biopsy of the thyroid gland.

Background And Objective: Nodular thyroid disease is a common condition in our clinical practice, and fine needle aspiration biopsy (FNAB) is the diagnostic procedure of choice. Its main limitation is the number of non-diagnostic samples. Since the Bethesda criteria were implemented in 2007 (a consensus document on the morphologic criteria and diagnostic terminology for interpretation of thyroid cytological samples), a higher prevalence of non-diagnostic FNAB was shown.

Myringoplasties in children: our results.

Introduction And Objectives: Myringoplasty, one of the most frequent surgical techniques in otology, is the repair of tympanic membrane when the ear has only a perforation without any ossicular damage. The main objective of our work was to study the outcome of myringoplasty in patients less than 15 years of age. We also reviewed the existence of prognostic factors, such as Eustachian tube functionality, surgical technique and the hearing outcome after surgery.

[Propranolol: Treatment of capillary hemangioma with orbital involvement].

Clinical Case: A 2-months-old girl had a fast growth hemangioma in the left side of the face, that involved upper eyelid and superior and external portion of the orbit, covering her visual axis and pushing the eye and lateral rectus muscle. We gave oral propranolol as treatment and we noticed a fast and constant hemangioma reduction and resolution of orbital and palpebral component.

Discussion: According to previous researches, propranolol seems to be an effective and safe drug to treat capillary hemangioma.

Interobserver reproducibility of a grading system for chromophobe renal cell carcinoma.

Objectives: To evaluate interobserver reproducibility of a grading system proposed by Paner et al. for chromophobe renal cell carcinoma.

Material And Methods: After selecting 23 cases of chromophobe renal cell carcinoma from the Xeral-Cíes Hospital, Meixoeiro Hospital and POVISA Hospital from the last 15 years, an informative meeting on the Paner et al.

[Vacuum assisted closure in open abdomen and deferred closure: experience in 23 patients].

Introduction: We analyse our experience and the results obtained with the use of vacuum assisted closure (VAC(®), KCI Clinic Spain SL) in the management of open abdomen.

Material And Methods: We retrospectively reviewed the laparostomies performed between June 2006 and March 2011 using VAC(®) treatment in the Hospital Xeral-Cíes, Vigo.

Results: We included 23 consecutive patients (18 males and 5 females) on whom the VAC(®) was used in the open abdomen due to different indications (abdominal trauma, peritonitis, pancreatitis, ischaemic disease or abdominal compartmental syndrome).

Nephrogenic adenoma: an immunohistochemical analysis using biotin-free methods.

Nephrogenic adenoma (NA) has been considered as a metaplastic process of the urothelium. It has been suggested that this lesion is of renal tubular cell origin or differentiation. Immunohistochemical studies of NA emphasize its staining with α-methylacyl-coenzyme A racemase (AMACR), and prostatic adenocarcinoma may be a possible differential diagnosis.

Neonatal ascites and oligohydramnios: the role of kidney.

Posterior urethral valve pathologies are the most frequent childhood obstructive uropathy reported, and we infer their presence on diagnosing foetal ascites and oligohydramnios. Early action is vital to determine the long-term development and the degree of impairment of renal function. We report a newborn male 34 weeks of gestation with a prenatal diagnosis of foetal ascites, fluid on the loose in renal fossa and oligohydramnios.

[Efficacy and toxicity of erlotinib in non-small cell lung cancer treatment].

Objective: To evaluate the efficacy and toxicity of erlotinib in patients with non-small cell lung cancer.

Method: Patients were selected from an outpatients' dispensing database. The time period selected was from January 2008 to January 2010.

[Extramedullary plasmacytoma of the larynx. A case report].

Extramedullary plasmacytoma of the larynx and localized laryngeal amyloidosis are two entities that are extremely rare in children. We report the case of an 11-year-old child presenting with progressive dysphonia, with a diagnosis of extramedullary plasmacytoma and localized laryngeal amyloidosis. The treatment he received and subsequent follow-up were compared with the few cases found in the literature.

Analysis of pharmacodynamic interaction of sevoflurane and propofol on Bispectral Index during general anaesthesia using a response surface model.

Background: Propofol and sevoflurane act on the GABA(A) receptor, modulating the function of this receptor in an additive manner. The pharmacodynamic interaction of both drugs considering their effect on EEG activity analysed by the bispectral index (BIS) was identified as additive, but this has not been studied in a clinical setting. The objective of this study was to analyse the pharmacodynamic interaction of propofol and sevoflurane on BIS using a surface response model in patients undergoing general anaesthesia with i.