[Severe acquired aplastic anemia: historical outcome of patients treated by allogeneic bone marrow transplantation from matched sibling donors. A study by the Spanish Group for Bone Marrow Transplantation in Children (GETMON)]. / Aplasia medular grave adquirida: evolución histórica de los resultados obtenidos con trasplante de progenitores hematopoyéticos de donante familiar. Estudio del Grupo Español para el Trasplante de Médula Osea en Niños (GETMON).

INTRODUCTION: Allogeneic haematopoietic stem-cell transplantation is the treatment of choice for acquired aplastic anaemia in children. Experience with this approach from Spanish Working Party for Bone Marrow Transplantation in Children in two sequential time periods (1982-1990 and 1991-2004) is reported. PATIENTS AND METHODS: Sixty two consecutive patients with a median age of 10 years were transplanted; 18 in the 1982-1990 period and 44 in the 1991-2004 period. Conditioning regimen consisted mainly of irradiation and cyclophosphamide in the first period (72 % of patients) and cyclophosphamide +/- anti-thymocyte globulin (62 %) in the second. Graft versus host disease prophylaxis consisted of cyclosporine in most patients (57/62). RESULTS: Fifty one patients are alive and disease-free at a median follow-up of 127 months. Five years probability of event-free survival is 82 %. The survival increased from 61 % to 91 % during the two time periods. Eleven patients died from graft failure or rejection (3), acute or chronic graft versus host disease and infection (4) or multi-organ failure (4). Univariate analysis identified two significant prognostic factors: interval diagnostic/transplant and time period of transplant (for both p = 0.03). CONCLUSIONS: This experience corroborates that allogeneic haematopoietic stem-cell transplantation is the best treatment for severe acquired aplastic anaemia, with a current disease-free survival of 90 % of patients.

[Prevalence and risk factors for pressure ulcers]. / Prevalencia y factores de riesgo de úlceras por presión.

OBJECTIVES: To study prevalence of pressure ulcers among functionally impaired patients in the community and evaluate risk factors associated with the development of pressure ulcers in these patients.Design. Cross-sectional, observational study. SETTING: Community dwellers served by the Primary Health Care Area of Rincón de la Victoria in Málaga.Participants. All patients included in the <> (n=178). METHODS: A questionnaire was developed to ascertain demographic and health characteristics. Risk factors were evaluated with the Modified Norton Scale. The outcome variable of interest was presence or absence of pressure ulcers, their location and grade. The denominator used for the calculation of the prevalence was the total of evaluated patients. Results. Prevalence of pressure ulcers in our Basic Health Area was 12.9%. The most important sociodemographic characteristic associated with the presence of pressure ulcers in these patients was the educational attainment of the caregiver. Health varaibles of the patient were also associated with the risk of developing ulcers. CONCLUSIONS: Results indicate the need of diagnostic protocols with standardised instruments and prevention plans to reduce pressure ulcers in the community. Longitudinal studies are needed to evaluate interventions in this area.

Prevalencia y factores de riesgo de úlceras por presión / Prevalence and risk factors for pressure ulcers

Objetivo. Conocer la prevalencia de úlceras por presión (UPP) en pacientes incapacitados de una Zona Básica de Salud (ZBS) y caracterizar los factores de riesgo asociados a su aparición. Diseño. Estudio transversal observacional. Emplazamiento. ZBS Rincón de la Victoria (Málaga). Participantes. Pacientes incluidos en el Programa de Incapacitados (n = 178), de la ZBS, residentes en su domicilio o en una residencia geriátrica. Mediciones. Cuestionario específico con variables sociodemográficas y de salud. Para la valoración de factores de riesgo asociados con la formación de UPP, se utilizó la Escala de Norton Modificada (ENM). La variable resultado de interés fue la presencia o ausencia de UPP, localización y grado. El denominador para el cálculo de la prevalencia ha sido el total de pacientes valorados. Resultados. La prevalencia fue del 12,9 per cent. La característica sociodemográfica más significativa asociada con la presencia de úlceras en estos pacientes fue el nivel de instrucción del cuidador. Se constata asociación de determinadas variables del estado de salud del paciente con aparición de UPP. Conclusiones. Los resultados alertan a la necesidad de la realización de protocolos diagnósticos y de intervención comunitaria para reducir la presentación de UPP en pacientes incapacitados que viven en la comunidad (AU)