Síndrome nefrótico secundario a sífilis

El síndrome nefrótico se caracteriza por proteinuria importante, hipoalbuminemia, edema generalizado e hiperlipidemia. Según su etiología se clasifica en primario y secundario, siendo este último raramente encontrado en pediatría, cuyas causas pueden ser múltiples como enfermedades sistémicas, fármacos, neoplasias o enfermedades infecciosas. Se presenta el caso clínico de una adolescente femenina con síndrome nefrótico secundario a sífilis, quien recibió manejo antibiótico apropiado con resolución del cuadro clínico. (provisto por Infomedic International)

Nephrotic syndrome is characterized by significant proteinuria, hypoalbuminemia, generalized edema, and hyperlipidemia. According to its etiology, it is classified as primary and secondary, the latter being rarely found in pediatrics, whose causes can be multiple such as systemic diseases, drugs, neoplasms, or infectious diseases. A clinical case is presented of a female adolescent with nephrotic syndrome secondary to syphilis, who received appropriate antibiotic management with resolution of the clinical condition. (provided by Infomedic International)

Characterization of the European Sea Bass (Dicentrarchus labrax) Gonadal Transcriptome During Sexual Development.

The European sea bass is one of the most important cultured fish in Europe and has a marked sexual growth dimorphism in favor of females. It is a gonochoristic species with polygenic sex determination, where a combination between still undifferentiated genetic factors and environmental temperature determines sex ratios. The molecular mechanisms responsible for gonadal sex differentiation are still unknown. Here, we sampled fish during the gonadal developmental period (110 to 350 days post fertilization, dpf), and performed a comprehensive transcriptomic study by using a species-specific microarray. This analysis uncovered sex-specific gonadal transcriptomic profiles at each stage of development, identifying larger number of differentially expressed genes in ovaries when compared to testis. The expression patterns of 54 reproduction-related genes were analyzed. We found that hsd17ß10 is a reliable marker of early ovarian differentiation. Further, three genes, pdgfb, snx1, and nfy, not previously related to fish sex differentiation, were tightly associated with testis development in the sea bass. Regarding signaling pathways, lysine degradation, bladder cancer, and NOD-like receptor signaling were enriched for ovarian development while eight pathways including basal transcription factors and steroid biosynthesis were enriched for testis development. Analysis of the transcription factor abundance showed an earlier increase in females than in males. Our results show that, although many players in the sex differentiation pathways are conserved among species, there are peculiarities in gene expression worth exploring. The genes identified in this study illustrate the diversity of players involved in fish sex differentiation and can become potential biomarkers for the management of sex ratios in the European sea bass and perhaps other cultured species.

We think you can dance! A pilot randomised controlled trial of dance for nursing home residents with moderate to severe dementia.

OBJECTIVES: To evaluate the feasibility of a dance program for people with moderate to severe dementia living in nursing homeswith regards to recruitment and retention, assessment tools, intervention safety, attendance and engagement. DESIGN: Pilot randomised controlled trial with assessments at weeks 0, 16 and 32. SETTING: A nursing home in Sydney, Australia. INTERVENTIONS: Experienced dance teachers conducted dance groups (intervention) or music appreciation and socialisation groups (control) for 45min, three times a week for 16 weeks. MAIN OUTCOME MEASURES: Descriptive statistics for recruitment and retention, adverse events and attendance and engagement. RESULTS: Recruitment was smooth, attrition was17% over 32 weeks. Engagement during the sessions was high, and no serious falls or behavioural incidents occurred. Average attendance was poorer than anticipated for dance groups (67%) in comparison to music groups (89%). A ceiling effect on the Severe Impairment Battery and the logistical challenges of the Clinical Global Impression of Change meant they may not be optimal tools. CONCLUSIONS: It is feasible to conduct a study of group dance for people with moderate to severe dementia in residential care. Choice of attention control condition should be reconsidered.

Estudio transversal comparativo de las fórmulas CKD-EPI y MDRD-4 a partir de la historia clínica informatizada de Atención Primaria de Barcelona / A comparative, cross-sectional study of the CKD-EPI and MDRD-4 equations from the Primary Care computerized clinical history of Barcelona

Antecedentes: La prevalencia de enfermedad renal crónica (ERC) en España supera el 7%. Su diagnóstico precoz puede ayudar a frenar la evolución. En Atención Primaria (AP) se calcula el filtrado glomerular estimado (FGe) mediante fórmulas basadas en la creatinina plasmática(CrP).Objetivos: Comparar los FG e según las fórmulas MDRD-4 y CKD-EPI a partir de la historia clínica informatizada (HCI) y la clasificación de ERC en una población de AP. Material y métodos: Estudio transversal. Se incluyó a pacientes de 20-99 años, asignados a centros de AP de Barcelona, con CrP entre julio de 2008 y junio de 2010. Se obtuvieron losdatos de la HCI. Se calculó el FGe mediante CKD-EPI y MDRD-4.Resultados: Se estudió a un total de 447.140 personas: 58,7% mujeres, 56,6 (DE 18,8) años. El 32,5% con diagnóstico de hipertensión arterial, 11% con diabetes mellitus y 9,3% con enfermedad cardiovascular asociada. La CrP media fue 0,89 (0,28) mg/dL, FGe por MDRD-4 de 80,59(21,04) mL/min/1,73 m2y por CKD-EPI de 85,03 (21,13) mL/min/1,73 m2. La CKD-EPI, respecto a MDRD-4, clasificó el 2,3% de los pacientes en estadios menos avanzados de ERC, el 96,8% en el mismo y el 0,9% en más avanzados. El índice kappa fue de 0,87. En números absolutos clasificó en estadios 3b-4-5 (posible derivación a nefrología) a 958 pacientes más, con 691 personas >69 años en estadio 3b.Conclusiones: Utilizar una u otra fórmula puede variar el FGe. La CKD-EPI tiende a clasificar enestadios más avanzados en > 69 años. El uso de cada fórmula puede hacer cambiar el número y tipo de derivaciones a nefrología

Background: The prevalence of chronic kidney disease (CKD) in Spain is higher than 7%. Its early diagnóstico can help to delay its progression. Glomerular filtration rate (GFR) based on serum creatinine (SC) is calculated in primary care (PC) to identify CKD. Objectives: To compare GFR by MDRD-4 and CKD-EPI equations obtained from clinical records(CR) and to compare the classification of CKD in a primary care population. Material and methods: A cross-sectional study was performed, including patients 20-99 years old, assigned to primary care centers of Barcelona, with a SC recorded between July 2008 and June 2010. Data were obtained from the CRs. GFR was calculated from MDRD-4 and CKD-EPI equations. Results: A total of 447,140 persons were studied (58.7% females, 56.6 [SD 18.8] years old).Of these 32.5% were diagnosed of hypertension, 11.0% diabetes and 9.3% had some associated cardiovascular disease. SC 0.89 (0.28) mg/dL (78.7 [SD 24.8] mol/L), GFR being 80.59(21.04) mL/min/1.73 m2by MDRD-4, and 85.03 (21.13) mL/min/1.73 m2by CKD-EPI. CKD-EPI compared to MDRD-4 classified 2.3% of patients in less advanced stages of CKD, 96.8% in the same stage and 0.9% in more advanced stages. Kappa coefficient: 0.87. In absolute numbers, CKD-EPI classified in 3b-4-5 stages (candidates for referral to nephrology) 958 patients more,691 of them being patients > 69 years old and stage 3b.Conclusions: Using one equation or another could vary the estimation of GFR. CKD-EPI tends to classify patients older than 69 into more advanced stages. Each equation can change the number and type of referral to nephrology (AU)

El filtrado glomerular reducido según las fórmulas de Cockcroft-Gault y MDRD no siempre predice la morbimortalidad cardiovascular en los pacientes hipertensos atendidos en atención primaria / Decreased glomerular filtration rate using the Cockgroft-Gaultand MDRD formulas does not always predict cardiovascular morbidity and mortality in hypertensive primary care patients

Antecedentes: El deterioro de la función renal se ha asociado con un incremento de la morbimortalidad cardiovascular. El objetivo del estudio fue analizar la asociación del filtrado glomerular (FG) basal, según las fórmulas de Cockcroft-Gault y MDRD, con la incidencia de eventos cardiovasculares (ECV) en una cohorte de personas hipertensas seguida durante 12 años. Métodos: Estudio prospectivo de una muestra aleatoria de 223 hipertensos libres de ECV atendidos en un centro de atención primaria urbano. Se estimó el FG mediante ambas fórmulas. Se consideró ECV la aparición de cardiopatía isquémica, insuficiencia cardíaca, accidente cerebrovascular, vasculopatía periférica o muerte por ECV. Se analizaron los datos mediante el método actuarial y modelos de regresión de Cox. Resultados: La mediana de tiempo de seguimiento fue de 10,7 años (rango intercuartílico,6,5-12,1). El seguimiento fue completo en 191 participantes (85,7%). La supervivencia acumulada fue del 64,7% (intervalo de confianza [IC] del 95%: 57,9-71,6%). La tasa media de incidencia de ECV durante todo el período de seguimiento fue de 3,6 (IC del 95%, 2,7-4,4%) por 100 personas hipertensas/año. El modelo multivariable final mostró que las variables con mayor poder predictivo de ECV en la población de estudio fueron la diabetes y la estimación del FG >60ml/min/1,73 m2mediante fórmula MDRD. Conclusiones: Se observó una relación entre la aparición de ECV y los valores de FG estimados por la fórmula MDRD al inicio del seguimiento superiores a 60 ml/min/1,73 m2, inversa a la eserada. La estimación del FG mediante fórmula de Cockcroft-Gault no se asoció con el riesgo cardiovascular (AU)

Background: Renal function decrease is associated with cardiovascular morbidity and mortality. The aim was to analyze the association of cardiovascular morbidity and mortality with baseline glomerular filtration rate (GFR), according Cockcroft-Gault and MDRD formulas, with incidence of major adverse cardiovascular events (MACEs) in a cohort of hypertensive individuals followed for 12 years. Methods: We performed a prospective study of a random sample of 223 hypertensive patients free of MACEs followed in an urban Primary Care Center. GFR was estimated using both formulas. MACEs were considered the onset of ischemic heart disease, heart failure, stroke, peripheral vascular disease or cardiovascular death. Data were analyzed using the life-table method and Cox regression modeling. Results: Follow-up median was 10.7 (interquartile range, 6.5-12.1) years. Follow-up was complete in 191 participants (85.7%). The cumulative survival was 64.7% (95%Confidence Interval (CI) 57.9%-71.6%). The incidence of MACEs during the follow-up period was 3.6 (95% CI, 2.7-4.4) per 100 subject-years. The final multivariable model showed that the most predictive variables of MACEs in the study population were the presence of diabetes and the estimation of GFR >60 ml/min/1.73 m2by MDRD equation. Conclusions: There was a relationship between the occurrence of MACEs and MDRD formula estimated GFR above60 ml/min/1.73 m2at study entry, inversely to what expected. C-G formula estimated GFR by was not associated with cardiovascular risk (AU)

[Decreased glomerular filtration rate using the Cockckroft-Gault and MDRD formulas does not always predict cardiovascular morbidity and mortality in hypertensive primary care patients]. / El filtrado glomerular reducido según las fórmulas de Cockcroft-Gault y MDRD no siempre predice la morbimortalidad cardiovascular en los pacientes hipertensos atendidos en atención primaria.

BACKGROUND: A decrease in renal function is associated with cardiovascular morbidity and mortality. The aim of this study was to analyse the association of cardiovascular morbidity and mortality with baseline glomerular filtration rate (GFR), calculated according to the Cockcroft-Gault and MDRD formulas, with the incidence of major adverse cardiovascular events (MACEs) in a cohort of hypertensive individuals followed for 12 years. METHOD: We performed a prospective study of a random sample of 223 hypertensive patients free of MACEs, who were followed in an urban Primary Care Centre. GFR was estimated using both formulas. MACEs were considered as the onset of ischaemic heart disease, heart failure, heart attacks, peripheral vascular disease or cardiovascular death. Data were analysed using the life-table method and Cox regression modeling. RESULTS: The median follow-up was 10.7 (interquartile range, 6.5-12.1) years. Follow-up was completed in 191 participants (85.7%). The cumulative survival was 64.7% (95% Confidence Interval (CI), 57.9-71.6). The incidence of MACEs during the follow-up period was 3.6 (95% CI, 2.7-4.4) per 100 subject-years. The final multivariable model showed that the most predictive variables of MACEs in the study population were the presence of diabetes mellitus and the estimation of GFR ≥60 ml/min/1.73 m2 by MDRD equation. CONCLUSIONS: There was a relationship between the occurrence of MACEs and an estimated GFR by MDRD above 60 ml/min/1.73 m2 at study entry, inversely to what was expected. GFR estimated by the C-G formula was not associated with cardiovascular risk.

Respiratory muscle pressures in non-CF bronchiectasis: repeatability and reliability.

BACKGROUND: Respiratory muscle strength is used diagnostically in clinical practice and as an outcome measure in clinical trials in various chronic lung diseases. There is limited data on its repeatability in people with non-CF bronchiectasis. The aim of the present study was to assess the repeatability of maximal inspiratory (P( I)max) and expiratory pressures (P(E)max) in a group of patients with stable, moderate-to-severe non-CF bronchiectasis. METHODS: Twenty participants with stable moderate-to-severe non-CF bronchiectasis were recruited. Respiratory muscle strength measurements (three maximal inspiratory and expiratory pressures) were made on 2 separate days. A standard protocol was used, including practice tests, before obtaining three technically acceptable and reproducible readings with a difference of 10% or less between values. CLINICAL TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT00487149. RESULTS: The mean (SD) age of the non-CF bronchiectasis group was 63 (9) years. Maximal inspiratory pressures were repeatable with mean (SD) for highest P(I)max, Test 1 and Test 2, 75.90 (20) and 79.40 (19) cmH(2)O, and limits of agreement (mean difference +/- 2SD) -3.50 +/- 20 cmH(2)O, (p = 0.14). Maximal expiratory pressures differed significantly with mean (SD) for highest P(E)max, Test 1 and Test 2, 102.25 (27) and 112.30 (32) cmH(2)O, and limits of agreement (mean difference +/- 2SD) -10.10 +/- 35 cmH(2)O, (p = 0.02). The intraclass correlation coefficient (95% CI) for highest P(I)max and P(E)max was 0.93 (95% CI 0.82 to 0.97) and 0.90 (95% CI 0.76 to 0.96), respectively. CONCLUSION: Maximal inspiratory pressure measurements were repeatable during a period of clinical stability in moderate-to-severe non-CF bronchiectasis, suggesting this may be a useful outcome measure in non-CF bronchiectasis. Once a baseline has been established, a second visit is not required. P(E)max was not a repeatable measure and further study is necessary to ascertain how much practice testing is required to obtain an accurate value.

Physical training for cystic fibrosis.

BACKGROUND: Physical training may form an important part of the care package for people with cystic fibrosis. OBJECTIVES: To determine whether a prescribed regimen of physical training produces improvement or prevents deterioration in physiological and clinical outcomes in cystic fibrosis compared to no training. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of the most recent search: September 2007. SELECTION CRITERIA: All randomised and quasi-randomised controlled clinical trials in which a prescribed regimen of physical training is compared to no physical training in people with cystic fibrosis. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies for inclusion, assessed methodological quality and extracted data. MAIN RESULTS: Of the 26 studies identified, seven studies which included 231 participants, met the inclusion criteria. This review does provide some limited evidence from both short- and long-term studies that aerobic or anaerobic physical training has a positive effect on primary outcomes (exercise capacity, strength and lung function) but improvements are not consistent between studies. AUTHORS' CONCLUSIONS: Conclusions about the efficacy of physical training in cystic fibrosis are limited by the small size, short duration and incomplete reporting of most of the studies included in this review. Physical training is already part of the care package offered to most people with cystic fibrosis and there is a lack of evidence to actively discourage this. The benefits obtained from including physical training in a package of care may be influenced by the type of training programme. Further research is needed to assess comprehensively the benefits of exercise programmes in people with cystic fibrosis and the relative benefits of the addition of aerobic versus anaerobic versus a combination of both types of physical training to the care of people with cystic fibrosis.

Non-invasive ventilation for cystic fibrosis.

BACKGROUND: Non-invasive ventilation (NIV) may be a means to temporarily reverse or slow the progression of respiratory failure in cystic fibrosis (CF). OBJECTIVES: To compare the effect of NIV versus no NIV in people with CF. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings. We searched the reference lists of each trial for additional publications possibly containing other trials. Most recent search: October 2006. SELECTION CRITERIA: Randomised controlled trials comparing a form of pressure preset or volume preset NIV to no NIV in people with acute or chronic respiratory failure in CF. DATA COLLECTION AND ANALYSIS: Three reviewers independently assessed trials for inclusion criteria and methodological quality, and extracted data. MAIN RESULTS: Fifteen trials were identified; seven trials met the inclusion criteria with a total of 106 participants. Six trials evaluated single treatment sessions only and one evaluated a six-week intervention. Four trials (79 participants) evaluated NIV for airway clearance compared with an alternative chest physiotherapy method and showed that airway clearance may be easier with NIV and people with CF may prefer it. We were unable to find any evidence that NIV increases sputum expectoration, but it did improve some lung function parameters.Three trials (27 participants) evaluated NIV for overnight ventilatory support. Lung function and nocturnal transcutaneous carbon dioxide were evaluated within two trials. Due to the small numbers of participants and statistical issues, there were discrepancies in the results between the RevMan and the original trial analyses. No clear differences were found between NIV compared with oxygen or room air except for exercise performance, which significantly improved with NIV compared to room air over six weeks. AUTHORS' CONCLUSIONS: Non-invasive ventilation may be a useful adjunct to other airway clearance techniques, particularly in people with CF who have difficulty expectorating sputum. Non-invasive ventilation, when used in addition to oxygen, may improve gas exchange during sleep to a greater extent than oxygen therapy alone in moderate to severe disease. These benefits of NIV have largely been demonstrated in single treatment sessions with small numbers of participants. The impact of this therapy on pulmonary exacerbations and disease progression remain unclear. There is a need for long-term randomised controlled trials which are adequately powered to determine the clinical effects of non-invasive ventilation in CF airway clearance and exercise.

Species connectivities and reaction mechanisms from neutral response experiments.

We develop a new method for obtaining connectivity data for nonlinear reaction networks, based on linear response experiments. In our approach the linear response is not the result of an approximation procedure but is due to the appropriate design of the response experiments, that is (1) they are carried out with the preservation of constant values for the total (labeled plus unlabeled) input and output fluxes and (2) the labeled compounds obey a neutrality condition (i.e., they have practically the same kinetic and transport properties as the unlabeled compounds). Under these circumstances the linear response equations hold even though the kinetics of the process is highly nonlinear. On the basis of this linear response law, we develop a method for evaluating reaction connectivities in biochemical networks from stationary response experiments. Given a system in a stationary regime, a pulse of a labeled species is introduced (with conservation of the total flux) and then the response of all the species of the network is recorded. The mechanistic information is contained in a connectivity matrix, K, which can be evaluated from the response data by means of differential as well as integral methods. The approach does not require any prior knowledge of the reaction mechanism. We carried out a numerical study of the method, based on a two-step procedure. Starting from a known reaction mechanism, we generated response data sets, to which we add noise; then, we use the noisy data sets for retrieving the connectivity matrix. The calculations were done with two programs written in Mathematica: the urea cycle and the upper part of glycolysis are used as sample biochemical networks. Given enough computer power, there are no limitations concerning the number of species involved in the response experiments; on current desktop systems processing responses of teens of species would take a few hours. The method is limited by the occurrence of experimental errors: if experimental errors in the evaluation of fluxes are larger than 10%, the method may fail to reproduce the correct values of some elements of the connectivity matrix.

Consequences of imperfect mixing the Gray-Scott model.

We study an autocatalytic reaction-diffusion scheme, the Gray-Scott model, when the mixing processes do not homogenize the reactants. Starting from the master equation, we derive the resulting coupled, nonlinear, stochastic partial differential equations that rigorously include the spatiotemporal fluctuations resulting from the interplay between the reaction and mixing processes. The fields are complex and depend on correlated complex noise terms. We implement a method to solve for these complex fields numerically and extract accurate information about the system evolution and stationary states under different mixing regimes. Through this example, we show how the reaction-induced fluctuations interact with the temporal nonlinearities, leading to results that differ significantly from the mean-field (perfectly mixed) approach. This procedure can be applied to an arbitrary nonlinear reaction diffusion scheme.

[Elimination of measles plan in the Valencia community: epidemiological surveillance in 2003]. / Plan de eliminación del sarampión en la Comunidad Valenciana: vigilancia epidemiológica en el año 2003.

AIMS: Describing the clinical and epidemiological characteristics of the suspicions of measles notified in the CV during the year 2003 and evaluating the system of surveillance. DESIGN: Cross-sectional, descriptive study. SETTING: Community of Valencia (CV), Spain. PARTICIPANTS: Cases of suspected measles notified in 2003. MAIN MEASUREMENTS: Description of the data collected in the questionnaires (including names) of the Plan to Eliminate Measles of the CV, and obtaining of quality indicators for this plan and those proposed in the national action plan. RESULTS: From 43 notified suspicions, 11 (25.6%) were confirmed, 29 (67.4%) discarded, and 3 (7%) compatible. The rate of effect was 0.33 of 105. From 11 confirmed cases, 10 belonged to two outbreaks (one familiar and an other one communitary) and one was an isolated and imported case. 80% of areas of health were declared. The majority of the suspicions and all the cases were given in the first half of the year. Five cases were given in cohorts of age not submitted to the program of vaccination (minors of 15 months and major of 20 years), and 2 cases might have been avoidable in agreement with the program (6 and 12-year-old children not vaccinated). 40 samples of whey and 33 of urine were collect within the recommended periods. The majority of quality indicators were over the recommended ones (80%). CONCLUSIONS: In year 2003 no case of measles has taken place from autochthonous virus in the CV.

Plan de eliminación del sarampión en la Comunidad Valenciana: vigilancia epidemiológica en el año 2003 / Elimination of measles plan in the Valencia Community: epidemiological surveillance in 2003

Objetivo. Describir las características clínicas y epidemiológicas de los casos de sospecha de sarampión notificados en la Comunidad Valenciana durante el año 2003 y evaluar el sistema de vigilancia. Diseño. Estudio descriptivo, transversal. Emplazamiento. Comunidad Valenciana (CV). Participantes. Casos de sospecha de sarampión notificadas en 2003. Mediciones principales. Descripción de los datos recogidos en las encuestas nominales del Plan de Eliminación del Sarampión de la CV y obtención de indicadores de calidad de éste y los propuestos desde el plan de acción a escala nacional. Resultados. De 43 sospechas notificadas, se confirmó el 25,6%, se descartó el 67,4% y fue compatible el 7%. La tasa de incidencia fue de 0,33 por 105 habitantes. De los 11 casos confirmados, 10 correspondían a 2 brotes (uno familiar y otro comunitario) y uno fue un caso aislado e importado. El 80% de las áreas de salud notificó sospechas de sarampión. La mayoría de sospechas y casos se dio en la primera mitad del año. Cinco casos pertenecían a grupos de edad no incluidos en el programa de vacunación (menores de 15 meses y mayores de 20 años) y 2 casos podrían haberse evitado (niños de 6 y 12 años no vacunados). Se recogieron 40 muestras de suero y 33 de orina. La mayoría de los indicadores de calidad se cumplió por encima de los valores recomendados (80%). Conclusiones. Durante 2003 no se declaró ningún caso de sarampión por virus autóctonos en la CV

Aims. Describing the clinical and epidemiological characteristics of the suspicions of measles notified in the CV during the year 2003 and evaluating the system of surveillance. Design. Cross-sectional, descriptive study. Setting. Community of Valencia (CV), Spain. Participants. Cases of suspected measles notified in 2003. Main measurements. Description of the data collected in the questionnaires (including names) of the Plan to Eliminate Measles of the CV, and obtaining of quality indicators for this plan and those proposed in the national action plan. Results. From 43 notified suspicions, 11 (25.6%) were confirmed, 29 (67.4%) discarded, and 3 (7%) compatible. The rate of effect was 0.33 of 105. From 11 confirmed cases, 10 belonged to two outbreaks (one familiar and an other one communitary) and one was an isolated and imported case. 80% of areas of health were declared. The majority of the suspicions and all the cases were given in the first half of the year. Five cases were given in cohorts of age not submitted to the program of vaccination (minors of 15 months and major of 20 years), and 2 cases might have been avoidable in agreement with the program (6 and 12-year-old children not vaccinated). 40 samples of whey and 33 of urine were collect within the recommended periods. The majority of quality indicators were over the recommended ones (80%). Conclusions. In year 2003 no case of measles has taken place from autochthonous virus in the CV