Gypsy Population With University Studies Is a Key Ethnic Subgroup for the Promotion of Organ Donation Among the Gypsy Population.

INTRODUCTION: The refusal to consider death and the donation and transplantation of organs make Gypsies one of the subpopulation groups with the lowest donation rates in Europe. The approach of this social group implies the support of the most favorable social groups within their own ethnic group. In this sense, the young population with a high level of education is usually the most favorable toward organ donation. OBJECTIVE: To analyze the attitude toward the donation of one's own organs for transplantation among the Gypsy population under 45 years and with secondary or university studies. METHOD: Population under study: The Gypsy population under 45 years old with secondary or university studies who currently reside in Spain. Assessment instrument: The attitude questionnaire for organ donation for transplantation PCID-DTO Ríos. Fieldwork: A random selection based on stratification. Anonymity and self-administered fulfillment. STATISTICS: Student t test and χ2. RESULTS: A total of 44 Gypsy people under 45 years of age were surveyed (mean age 31 ± 8.9 years); 66% were women, and the rest were men. Of these, 20 had university studies, and 24 had secondary or vocational studies. The attitude is favorable toward organ donation in 64% of the respondents, with 80% among university students and 50% among those with secondary or vocational education (P < .005). CONCLUSIONS: The young Gypsy population with university studies has a very favorable attitude toward organ donation. This population subgroup must be key in the promotion of organ donation in the Gypsy population, so the transplant coordinators must request their collaboration in the promotion campaigns of organ donation and transplantation.

Gypsy Population Presents a Favorable Attitude Toward Related Living Donation.

INTRODUCTION: Negative organ donation rates among the Gypsies is much higher than that of any other social group in Spain. However, living donation rates have not been raised much in this social group, despite the existence of several Gypsy patients on the waiting list for transplantation. OBJECTIVE: To analyze the attitude toward related living donation among the Gypsy population who reside in Spain. METHODS: This type of study is an observational sociological study. The study consisted of the adult Gypsy population residing in Spain, and a random sampling of 230 adult gypsies was conducted. Attitude questionnaires for live donation, both hepatic PCID-DVH-Ríos and renal PCID-DVR-Ríos, were used, and random selection was based on stratification. Questionnaires were self-administered and completed anonymously. Student t test, χ2, Fisher, and a logistic regression analysis were used. RESULTS: A sample of 206 Gypsies (52% women) with a mean age of 34 years is obtained. Seventy-two percent (n = 150) would donate an organ to a relative in life, 8% (n = 16) would not donate it, and 20% (n = 41) have doubts. Respondents with a favorable attitude toward living donation presented a more favorable attitude toward cadaveric organ donation (55% vs 0%, P < .001). The attitude toward living kidney donation was more favorable (81% in favor) than toward living liver donation (P < .001). CONCLUSIONS: The Gypsy ethnic group is sensitized to live donor transplantation. The family and cultural roots of Gypsy people could condition this favorable attitude, a fact to be taken into account to sensitize this social group and promote donation campaigns with the aim of increasing donation rates.

Acceptance of the Xenotransplantation of Organs Among the Population of the Spanish Gypsy Ethnic Group.

INTRODUCTION: Organ refusal rates among Gypsies is much higher than that of any other social group in Spain. However, their attitude toward new therapies related to transplantation, such as the xenotransplantation, is not known. This is especially important in countries such as Spain, where there are research and development units for xenotransplantation. OBJECTIVE: To analyze the attitude toward xenotransplantation among the Gypsy population living in Spain. METHOD: Type of study: Observational sociological study. Population under study: Adult Gypsy population currently residing in Spain. SAMPLE: A random sampling of 230 adult Gypsies. Assessment instrument: A validated attitude questionnaire for xenotransplantation-PCID-XenoTx Ríos. Fieldwork: Random selection based on stratification. Anonymity and self-administered fulfillment. STATISTICS: Student t test, χ2, Fisher, and a logistic regression analysis. RESULTS: A sample of 206 Gypsies was obtained. Forty-five percent (n = 93) would accept a solid organ xenotransplantation if they needed it, and the results were similar to those currently obtained with human organs; 24% (n = 49) have doubts, and 31% (n = 64) would not accept the xenotransplantation. If the results were worse than with human organs, only 9% would accept the xenotransplantation (n = 19). Respondents with a favorable attitude toward xenotransplantation presented a more favorable attitude toward cadaveric organ donation (55% vs 34%, P = .01). CONCLUSIONS: Gypsies do not present a very favorable attitude toward xenotransplantation, especially compared with other Spanish population groups. A favorable sensitivity is presented by the population group in favor of it to cadaveric organ donation, which could be used to sensitize this social group and promote donation campaigns with the aim of increasing donation rates.

Approach of Social Groups With Little Sensitization to Organ Donation: Pilot Study in the Gypsy Population to Assess the Best Approach to Determine the Attitude Toward Organ Donation for Transplantation.

BACKGROUND: There are social groups with very low donation rates, and action is needed to try to reverse this situation. The goal of this study was to determine which approach is the best to use with the gypsy population in Spain to determine their attitude toward organ donation. METHODS: The study population screened was the adult gypsy population resident in Spain. An attitude questionnaire regarding organ donation for transplant ("PCID-DTO Ríos: Questionnaire of "Proyecto Colaborativo Internacional Donante" about Organ Donation and Transplant [developed by Dr. Ríos]") was used as the assessment instrument. In 3 gypsy towns, the patriarch was contacted, who agreed to the questionnaire and to inform the others of our presence. Two forms of action were valued: (1) a direct approach (n = 100), with personal interview; and (2) an alternative approach (n = 200), which involved leaving the questionnaire in a meeting point of the town and collecting the questionnaires at the end of the meeting. The completion was anonymous and self-administered. RESULTS: The completion level of the study was anecdotal in both groups. The direct approach presented several problems: (1) null participation to complete the questionnaire (only 12 questionnaires were collected); (2) the attempt to generate empathy and request re-evaluation generated in 78% of the cases a hostile environment; and (3) the male population presented a harder and more aggressive attitude. With the alternative approach, only 10 of the 200 questionnaires left were retrieved, 9 of them blank or painted. CONCLUSIONS: The approach of the gypsy population is complex; because of their hostile and unfavorable attitude, a more global approach is needed, with the collaboration of people of their own ethnic group.

Miointimoma: un raro tumor de pene / Myointimoma: A Rare Tumor of the Penis

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Eritema exudativo multiforme perinévico / Exudative Erythema Multiforme Around Nevi

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No disponible

Itraconazole versus griseofulvin in the treatment of tinea capitis: a double-blind randomized study in children.

BACKGROUND: Tinea capitis is a fungal infection in which topical therapy is often unsuccessful. Griseofulvin has been considered to be a first-line therapy. Other antifungal agents are the azole derivatives. Among these, itraconazole was compared with griseofulvin in children in a double-blind study. PATIENTS AND METHODS: Thirty-four children and one adult with clinical signs and symptoms of tinea capitis and with positive culture and microscopy for dermatophytes have been included in a double-blind comparison between itraconazole, 100 mg daily, and ultramicronized griseofulvin, 500 mg daily. Both drugs were given for 6 consecutive weeks. The final evaluation was made 8 weeks after the end of treatment to allow the hairs to regrow. Seventeen itraconazole- and 15 griseofulvin-treated patients received the complete 6-week treatment course. Fifteen of these 17 itraconazole patients and 14 of the 15 griseofulvin patients had infections caused by Microsporum canis. Fifteen of 17 patients were cured by itraconazole (88%) and 15 of 17 patients by griseofulvin (88%). One of the patients who discontinued griseofulvin therapy after 4 weeks was clinically and mycologically cured. Two of the original 17 griseofulvin patients discontinued therapy because of vomiting. None of the itraconazole-treated children experienced side effects. CONCLUSIONS: Itraconazole is the first azole derivate that matches griseofulvin for the treatment of tinea capitis in children. The drug also appears to be better tolerated than griseofulvin.

Experience with amorolfine in the treatment of dermatomycoses.

In a double-blind randomized comparative study, 75 patients were treated with amorolfine cream 0.125, 0.25 or 0.5%. At the end of treatment clinical cure rates of 80, 76 and 84%, respectively, and mycological cures of 72, 64 and 76% were obtained. At 2 months posttherapy follow-up relapse rates were 0, 12 and 12%, respectively. There was no significant difference between the three groups in terms of clinical and mycological response, duration of treatment or tolerance. In a double-blind parallel study, 40 patients were treated topically with either 0.5% amorolfine cream or 1% bifonazole cream. The percentages of combined clinical and mycological cures were 83.3 and 78.95%, respectively. There was no significant difference in terms of tolerance and clinical and mycological cure rates. All treatments were applied once daily. Posttreatment MIC values did not indicate development of resistance to either amorolfine or bifonazole.

A comparative double-blind study of terbinafine (Lamisil) and griseofulvin in tinea corporis and tinea cruris.

In a double-blind randomized study, 92 patients with culturally proven tinea corporis and/or tinea cruris were treated orally with either terbinafine (Lamisil) (125 mg b.i.d.) or griseofulvin (500 mg b.i.d.) for up to 6 weeks. The two groups of patients and distribution of the target lesions were similar, but the analysis of the clinical scores showed that the terbinafine group had slightly higher mean scores at baseline (P = 0.186). At the end of therapy the proportion of patients with negative microscopy and culture was 78% in the terbinafine group and 83% in the griseofulvin-treated group. At the assessment 8 weeks after the end of therapy the percentages of terbinafine- and griseofulvin-treated patients with negative mycology were 93 and 95%, respectively. There were three relapses after mycological cure in the griseofulvin group (8%) and two in the terbinafine group (4%). Griseofulvin-treated patients were treated for shorter periods than terbinafine-treated patients (i.e. 58% compared to 26% received only 2-4 weeks of therapy). In terms of overall effectiveness, there were no significant differences between the two treatments. Thirty-seven terbinafine patients (77%) compared to 36 griseofulvin patients (82%) had overall effective therapy. Eight terbinafine patients (16%) compared to 10 griseofulvin patients (20%) experienced at least one adverse event. Five patients in the terbinafine group and six in the griseofulvin group had to stop the treatment due to headaches or gastrointestinal disorders. One terbinafine patient had an elevation of liver function tests after 6 weeks of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in fungal ultrastructure after short-course ciclopiroxolamine therapy in pityriasis versicolor.

The clinical outcome and the effects on morphogenesis and cell ultrastructure induced by a 1% ciclopiroxolamine solution in six patients with proven pityriasis versicolor were studied. Treatment regimens consisting of a once-daily application for 1 day, 2 days (Days 1 and 4) or 3 days (Days 1, 4 and 8). Clinical evaluation, scanning (SEM) and transmission electron microscopy (TEM) were performed on skin scrapings before treatment, and at 3, 7, 15 and 21 days after the start of therapy. SEM techniques have shown severe changes in the surface ultrastructure of yeasts and hyphae of Pityrosporum spp. (Malassezia furfur) 15 days after the start of therapy. TEM techniques showed extensive internal disruption, mainly severe necrosis of the cytoplasm, 3 and 7 days after the start of treatment. However, KOH direct microscopy showed apparently normal morphology of Pityrosporum spp. (Malassezia furfur) at all assessment points. The final clinical cure in all the patients was achieved 21 days after the start of therapy.

A clinical double-blind trial comparing amorolfine cream 0.5% (RO-14-4767) with bifonazole cream 1% in the treatment of dermatomycoses.

In a double-blind parallel study, 40 patients with dermatomycoses (one cutaneous candidosis and 39 dermatophyte infections) were treated topically with amorolfine (RO-14-4767) cream (0.5%), a new antifungal compound, or with bifonazole cream (1%). The treatment was applied once daily and was continued until 1 week after resolution of the symptoms, the maximum duration of treatment was limited to 6 weeks. Assessment of results was based on both clinical and mycological parameters. The percentages of amorolfine- and bifonazole-treated patients who were clinically and mycologically cured were 83.33% and 78.95%, respectively. Two patients treated with amorolfine and one patient treated with bifonazole were withdrawn from the trial because of side-effects. There was no significant difference between the two creams in clinical and mycological cure rates and tolerance.

A clinical and mycological assessment of tioconazole solution in the treatment of superficial dermatomycoses.

The efficacy, acceptability, and tolerability of tioconazole solution (1%) in a pump spray were evaluated in an open-label trial in 26 patients with dermatophytosis, superficial candidiasis, and tinea versicolor. Medication was applied twice daily for 30 consecutive days. Eighteen patients had dermatophyte lesions: four patients had tinea pedis interdigitalis (one of these also had tinea cruris), and 14 patients had tinea corporis. Of these, four patients did not respond to treatment and were considered therapeutic failures and ten were carriers and remained so one month after therapy. Five patients were clinically and mycologically cured at the end of therapy and did not relapse one month after therapy. All of the eight remaining patients were clinically and mycologically cured at the end of treatment and one month later: these included seven patients with tinea versicolor and one with anal candidiasis.

[Treatment of interdigital tinea pedis using a solution of 1:100 bifonazole (Bay h 4502)]. / Tratamiento de Tinea pedis interdigitalis con solución de bifonazol al 1 por 100 (Bay h 4502).

An open mycologically controlled trial was undertaken to evaluate the efficacy, acceptability and tolerance of bifonazole 1% solution for the treatment of patients with Tinea pedis interdigitalis. The solution of bifonazole was applied once daily for three consecutive weeks. Only patients with positive direct microscopy of scrapings and positive culture (dermatophytes) were included in the trial. Assessments were performed one week after start of therapy, and three days, two weeks and six weeks after therapy end. Twenty-three patients were evaluated (17 males and six females), the average age was 33.6 years (seventeen-sixty-five years) years. In 1 case T. rubrum var. granulare was the infecting organism, in 11 cases T. rubrum and finally 11 cases were due to T., mentagrophytes var interdigitale. Twenty patients were clinically and mycologically cured at the end of treatment and there were no relapses two weeks and six weeks later. One patient (T. rubrum) was cured clinically, but had positive direct microscopy and negative cultures after treatment. This finding persisted two and six weeks after therapy end, but there was no clinical relapse. Two patients (T. mentagrophytes var. interdigitale y T. rubrum var. granulare) did not respond to therapy. One patient had mild irritation (burning and reddening) but was able to finish treatment. All the patients found the medication acceptable and easy to apply.

Topical ketoconazole (2% dermatological cream) for the treatment of superficial dermatomycoses.

A total of 48 patients with superficial dermatomycoses took part in an open trial to study the efficacy, acceptability and tolerance of topical ketoconazole (2% dermatological cream) applied twice daily. Forty patients (23 women and 17 men) were available for review upon completion of therapy. After 30 days of therapy, 11 patients were cured clinically and mycologically and 5 patients were cured clinically but had positive mycological findings. One of the patients in this group relapsed one month later. After 60 days of treatment, 22 patients were clinically and mycologically cured. Two patients did not respond to treatment. Only 2 patients in this group relapsed one month later.

Scytalidium hyalinum infection diagnosed in Spain.

Scytalidium hyalinum infection of the soles and toe webs was diagnosed in a 40-year-old male immigrant to Spain from Equatorial Guinea. Short courses of therapy with oral ketoconazole (Nizoral) 400 mg day-1 and topical clotrimazole (Canesten) failed to improve the condition.