[Development and validation of a satisfaction questionnaire in patients with rheumatoid arthritis].

Objective: The aim of this study was to develop and validate a specific tool to assess satisfaction with treatment in patients with rheumatoid arthritis (RA).

Material And Methods: The questionnaire was developed in three stages: firstly, a literature review was performed by experts in developing patient-centered measures; secondly, items selected by 4 experts in RA were assessed for comprehensibility, format and applicability, and thirdly, administration of the questionnaire was evaluated through a personal interview of a group of 14 patients with RA under treatment with infliximab. Validation of the questionnaire was performed in patients with RA who met the ACR criteria, were older than 18 years, and had started treatment with infliximab due to inadequate disease control.

[Childhood circumcision: review of the evidence].

Circumcision is one of the most frequent surgical procedures in children. Because of greater immigration to Spain, health professionals need to know how to interpret new health demands. One of the most important of these is ritual circumcision.

[A validation study of the Spanish versions of the Clinical Anxiety Scale and the Physician Questionnaire for the assessment of anxiety disorders].

Background And Objective: To validate the Spanish versions of both the Clinical Anxiety Scale (CAS) and the Physician Questionnaire (PQ) to assess the severity of symptoms in patients with Anxiety Disorders (AD) treated in ambulatory psychiatric care facilities.

Patients And Method: Observational, prospective and multi-centre study (15 psychiatric facilities included) with a follow-up of 1 to 6 weeks in clinically stable or unstable AD patients. We assessed their convergent validity (with the Hamilton Anxiety Rating Scale as reference), discriminant validity (as compared with the Clinical Global Impression), reliability (internal consistency, test-retest and inter-raters) and sensitivity to change.

Congenital dyserthropoietic anaemia other than type I to III with a peculiar erythroblastic morphology.

Here, we report the case of a child who, since birth, showed persistent macrocytosis and elevated mean corpuscular volume of the erythrocytes. Bone marrow biopsy revealed gross disorganisation of the erythroblastic series both at the light and electron microscopic examination, with complete absence of dysplastic features in the granulocytic and megakaryocytic series. Common causes of macrocytosis were excluded.

[Fungal colonization and/or infection in intensive care units. Multicenter study of 1,562 patients].

Background And Objective: Our objective was to assess the frequency of fungal colonization and/or infection in critically ill patients admitted to intensive care units (ICUs) and to describe the characteristics and risk factors of those patients in whom fungi had been isolated.

Patients And Method: Observational, multicenter study of patients admitted to 64 ICUs on March 23, June 22, and November 16, 1999. In these patients, the presence of fungi was investigated in some biological sample from the day of ICU admission to the day of assessment of fungal infection.

[Spanish adaptation of the Seasonal Pattern Assessment Questionnaire (SPAQ) in the adult and children-adolescent versions].

Introduction: In 1984, Rosenthal et al. described the seasonal affective disorder as a cyclic pattern of depressive episodes appearing in autumn and winter, showing atypical symptoms as hypersomnia, overeating, and carbohydrate craving. They also introduced the self-applied Seasonal Pattern Assessment Questionnaire, which includes a seasonality index.

[Ascites as the sole clinical manifestation in a patient with nodular regenerative hyperplasia].

Nodular regenerative hyperplasia (NRH) of the liver is an infrequent entity that is usually diagnosed after the appearance of clinical signs of portal hypertension such as hepatomegaly, splenomegaly or upper gastrointestinal bleeding due to esophageal varices, which are the most frequently found clinical manifestations in NRH. Ascites is a less frequent finding and has always been described in association with other manifestations of portal hypertension. We describe a new case of NRH with atypical presentation in which ascites was the sole clinical manifestation.

[Recent psychophysical deterioration in the elderly patient: a potentially severe medical emergency. Assessment and attitudes].

An atypical presentation of diseases is common in the elderly patient. Also, a number of conditions in the elderly are commonly associated with deterioration of the functional status, that is, the independence level for daily life activities. This loss of autonomy occasionally calls the physicians attention, masking other symptoms.

[Fiber-optic bronchoscopic biopsy of bronchial smooth muscle. Efficacy of the technique in individuals with normal lung function and patients with COPD].

Background And Objectives: The epithelium and airway smooth muscles of patients with chronic obstructive pulmonary disease (COPD) or bronchial asthma undergo certain structural changes that are probably related to increased expression of inflammatory molecules and cell growth factors. Studying the relation between disease and changes in bronchial smooth muscle is difficult if investigation is restricted to samples from autopsies or thoracotomies. This study was designed to evaluate the probability of obtaining bronchial smooth muscle by endoscopic bronchial biopsy in patients with COPD and from individuals with normal lung function, the relation of disease to bronchial epithelial histology, and the potential usefulness of studying airway muscle remodeling events.

[Medical decisions in patients with chronic obstructive pulmonary disease].

Background: A right information about illness is essential if a patient has to take ethically autonomous medical decisions. We assessed whether a group o patients with chronic obstructive pulmonary disease (COPD) had enough information about their illness to take medical decisions.

Patients And Method: Structured interview about disease knowledge, wills to receive medical information and to take part in medical lesions as well as opinion on advance directives.

[Sexual abuse in children: prevention of sexually transmitted diseases].

When a child suffers from sexual abuse clinical guidelines must be established. There is a risk of infection from the following agents responsible for sexually transmitted diseases: the hepatitis B, hepatitis C and human immunodeficiency viruses, Neisseria gonorrhoeae, Chlamydia trachomatis, syphilis, herpes simplex virus, bacterial vaginosis, papillomavirus, Trichomonas vaginalis and Pediculus pubis. Therefore, a follow-up with periodic serological monitoring for 1year and immunoprophylaxis or chemoprophylaxis for some of these diseases should be started.

[Hyperalphalipoproteinemia: study of a family].

A family with hyperalphalipoproteinemia is described, being exceptional the longevity of some of their members. The proband, a 36 years-old woman with excellent health, showed total cholesterol levels of 6.77 mmol/l, HDL-cholesterol 3.