Non-valvular atrial fibrillation in patients on peritoneal dialysis, prevalence, treatment and professionals involved.

Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillars for the prevention of thromboembolic events. However, there are no randomized clinical trials on the risk-benefit profile of oral anticoagulation in patients with chronic kidney disease stage 5 on peritoneal dialysis and there is little evidence in the literature in this population. The objective of our study was to know the prevalence, treatment and professionals involved in the management of atrial fibrillation in peritoneal dialysis patients. For this purpose, we performed a descriptive analysis through a survey sent to different peritoneal dialysis units in Spain. A total of 1,403 patients on peritoneal dialysis were included in the study, of whom 186 (13.2%) had non-valvular atrial fibrillation. In addition, the assessment of the scores of thromboembolic and bleeding risks for the indication of oral anticoagulation was mainly carried out by the cardiologist (60% of the units), as well as its prescription (cardiologist 47% or in consensus with the nephrologist 43%). In summary, patients on peritoneal dialysis have a remarkable prevalence of non-valvular atrial fibrillation. Patients frequently receive oral anticoagulation with vitamin K antagonists, as well as direct oral anticoagulants. The data obtained regarding the scores used for the assessment of thromboembolic and bleeding risk, treatment and involvement by Nephrology indicates that there is a need for training and involvement of the nephrologist in this pathology.

Longitudinal study on the use of dried blood spots for home monitoring in children after kidney transplantation.

The use of DBSs for home monitoring has been limited due to unsatisfactory blood sampling and analytical difficulties. The aim of this longitudinal feasibility trial was to assess the utility of DBS to monitor TAC and Cr at home in transplant recipients. A total of 30 participants (2-21 years, mean±SD, 13.6±5.4 year) were enrolled over 12 months. Eighteen were males. Monthly DBS samples were obtained at home and mailed to the central laboratory for analysis of TAC and Cr. Nineteen patients completed the study, and 216 cards were received in the laboratory from a total of 279 cards expected, with 416/519 (80%) blood spots being suitable for analysis. We found a high correlation between blood TAC and Cr levels by DBS and the clinical laboratory, R2 =.81 and .95, respectively. Fifteen parents and 15 youth completed measures of satisfaction with and preference for DBS testing. All but one parent/caregiver and youth reported satisfaction and preference for this method of testing over laboratory blood draws. We conclude that home DBS monitoring is a feasible method to monitor TAC and Cr in pediatric transplant recipients.

Gestión de incidencias de material sanitario. Comisión de recursos materiales. Hospital Clínic (Barcelona) / Health incident management material

Introducción. Los problemas surgidos con los productos sanitarios aumentan la morbilidad de los pacientes, repercuten en la seguridad de los profesionales y aumentan el gasto sanitario. La Comisión de Recursos Materiales del Hospital Clínic de Barcelona decidió conocer las incidencias relacionadas con estos productos mediante un sistema de notificación de incidentes, entre octubre de 2011 y junio de 2013. Metodología. Estudio descriptivo, retrospectivo. Muestreo no probabilístico, consecutivo de las declaraciones de incidencias. Variables estudiadas: tipo de material, tipo y tiempo de resolución y grado de repercusión. Para el análisis estadístico se utilizó el programa SPSS, versión 20. Resultados. Se recogieron 103 declaraciones de incidencias de 68 artículos, de las cuales el 83.8 % correspondía a material sanitario, y el 16.2 % a no sanitario. El material sanitario repercutió más frecuentemente y de forma grave en los pacientes, frente al no sanitario (p = 0.026). Según la familia del material, las incidencias estaban en relación: el 30.9 %, con «infusión»; el 17.6 %, con «material de cobertura»; el 13.2 %, con «curas», y el 11.8 %, con «ventilación». Las familias de artículos de infusión y ventilación dieron problemas más graves en los pacientes (p = 0.001). Las incidencias con artículos sanitarios se resolvieron en una media de 18.0 ± 28.0 días, y los no sanitarios en una media de 8.4 ± 6.6 días (p = 0.03). Conclusiones. El material sanitario es el que present a mayor número de incidencias, que repercuten de forma grave en la seguridad del paciente. Estas incidencias se resuelven en un periodo de tiempo largo, que puede mejorarse (AU)

Introduction. The problems encountered with medical devices increase patient morbidity, affect safety professionals and increase health spending. The Material Resources Committee of the Hospital Clínic of Barcelona decided to understand the implications associated with these products through a system of incident reporting from October 2011 to June 2013. Methodology. A descriptive retrospective study. No probabilistic statements consecutive occurrences sampling. Variables studied: type of material, type and time resolution and degree of impact. For statistical analysis SPSS version 20 software was used. Results. 103 incident statements of 68 items, of which 83.8 % were medical supplies and 16.2 % for non-health were collected. The medical supplies impacted more frequently and severely in patients compared to non-health (p = 0.026). According to the family of the material, the incidents were related: 30.9 %, to «infusión»; 17.6 %, to «cover material»; 13.2 %, to «cures». And 11.8 %, to «ventilation». Families of infusion and ventilation items got more serious problems in patients (p = 0.001). Incidences sanitary items were resolved in an average of 18.0 ± 28.0 days and non-health at an average of 8 4 ± 6.6 days (p = 0.03). Conclusions. The medical equipment is the one with most incidents, severely impacting on patient safety. These incidents are resolved over a long period of time, that could be improved (AU)

[HEALTH INCIDENT MANAGEMENT MATERIAL]. / Gestión de incidencias de material sanitario. COMISIÓN DE RECURSOS MATERIALES. HOSPITAL CLÍNIC (BARCELONA).

INTRODUCTION: The problems encountered with medical device increase patient morbidity, affect safety professionals and in crease health spending. The Material Resources Committee a the Hospital Clinic of Barcelona decided to understand the im plications associated with these products through a system o incident reporting from October2011 to June2013. METHODOLOGY: A descriptive retrospective study. No probabi listic statements consecutive occurrences sampling. Variable studied: type of material, type and time resolution and degre, of impact. For statistical analysis SPSS version 20 software wa used. RESULTS: 103 incident statements of 68 items, of which 83.8% were medical supplies and 16.2% for non-health were collected. The medical supplies impacted more frequently and severely in patients compared to non-health (p = 0.026). According to the family of the material, the incidents were related: 30.9%, to "infusión"; 17.6 %, to "cover material"; 13.2 %, to "cures" and 11.8 %, to "ventilation". Families of infusion and ventilation items got more serious problems in patients (p = 0.001). Incidences sanitary items were resolved in an average of 18.0 ± 28.0 days and non-health at an average of 8 4 ± 6.6 days (p = 0.03). CONCLUSIONS: The medical equipment is the one with most incidents, severely impacting on patient safety. These incidents ar resolved over a long period of time that could be imoroved.

Tacrolimus pharmacokinetics in Hispanic children after kidney transplantation.

Ethnic differences in drug pharmacokinetics are well recognized including that for tacrolimus (TAC) in adult subjects. However, similar knowledge among pediatric populations is missing. Our limited retrospective study compares steady-state pharmacokinetics of TAC in Hispanic versus non-Hispanic children. Serial blood samples were collected and whole blood concentrations of TAC were measured using radioimmunoassay. Compared with non-Hispanic children, Hispanic children had lower measures of drug exposure (maximum drug concentration [Cmax] and area under the drug concentration-time curve [AUC0-∞]), higher volume of distribution, and faster clearance. Interestingly, only in Hispanic children, significant correlations were found between body weight and clearance, age and volume of distribution, and Schwartz estimated glomerular filtration rate and half-life. In conclusion, our study suggests that ethnic differences exist between Hispanic and non-Hispanic children in TAC PK, and based on our preliminary findings, either a higher or more frequent TAC dosing may be required for effective immunosuppression therapy in Hispanic children.

Análisis prospectivo de la colonización de catéteres centrales y sus factores relacionados / Prospective analysis of central venous catheter colonization and related factors

Objetivo. Conocer la incidencia de colonización de los catéteres venosos centrales (CVC) en las unidades de hospitalización del Institut de Malalties Digestives i Metaboliques (IMDiM) del Hospital Clínic de Barcelona con intención de reducir el riesgo de infección. Método. Estudio descriptivo, prospectivo y longitudinal, de 4 meses de duración. Fueron objeto de estudio los pacientes ingresados en las unidades del IMDiM, portadores de CVC (n = 230). Al retirar el catéter, se procedía al cultivo de la punta del mismo, realizándose 2 hemocultivos si el paciente presentaba fiebre. Se creó una base de datos. Se analizó con SPSS versión 11.0. Las variables se compararon mediante prueba de χ2, test de la t de Student y se realizó un análisis multivariante mediante la regresión logística de Cox, considerándose significativa una p igual o inferior a 0,05. Resultados. El cultivo de punta de catéter fue positivo en el 45,2%, con una tasa de bacteriemia relacionada con catéter, clínicamente significativa de 2,9 ‰ días de catéter. La probabilidad de contaminación de punta de catéter fue del 25% a los 10 días de colocación. Realizado el análisis multivariado, observamos que el tipo de catéter, el cambio de apósito y la infección bacteriana de las llaves, fueron las 3 variables independientes asociadas a un mayor riesgo de infección. Conclusiones. Estos resultados sugieren que: 1) se debería revisar y actualizar el protocolo de inserción y mantenimiento de catéteres; 2) valorar la permanencia de éstos a partir del 10.º día, y 3) seleccionar adecuadamente el tipo de catéter que se va a colocar, utilizar el de menor número de luces necesario, así como disminuir el número de cambios de apósito(AU)

Objective: To evaluate the incidence of central venous catheter (CVC) colonization in inpatient units of the Institut de Malalties Digestives i Metabòliques (IMDiM) of Hospital Clinic (Barcelona, Spain) with a view to reducing the risk of infection. Method: A 4-month descriptive, prospective and longitudinal study was performed. A total of 230 patients admitted to the IMDiM with CVC were included during the study period. At catheter removal, the tip was cultured and, if the patient had fever, two blood cultures were also obtained. A data base was created. Data were analyzed using SPSS v.11.0. Variables were compared with the Chi-square and Student’s t-tests and a multivariate analys is was performed using Cox logistic regression. Avalue of P<0.05was considered significant. Results: Catheter tip culture was positive in 45.2%. The rate of catheter-related blood stream infections was 2.9 % catheter-days, which was clinically significant. The probability of catheter tip contamination 10 days after placement was 25%. Multivariateanalysis revealed that the independent variables associated with a higher risk of infection were catheter type, changes of dressing, and infected bacterial stopcocks. Conclusions: These results suggestthat: 1) the protocol for catheter insertion and care should be reviewed and up dated, 2 catheter removal should be considered after the 10th day, 3) the appropriate type of catheter should be selected, the catheter with the lowest number of lumens should be used, and changes of catheter dressing should be reduced(AU)

[Prospective analysis of central venous catheter colonization and related factors]. / Análisis prospectivo de la colonización de catéteres centrales y sus factores relacionados.

OBJECTIVE: To evaluate the incidence of central venous catheter (CVC) colonization in inpatient units of the Institut de Malalties Digestives i Metabòliques (IMDiM) of Hospital Clinic (Barcelona, Spain) with a view to reducing the risk of infection. METHOD: A 4-month descriptive, prospective and longitudinal study was performed. A total of 230 patients admitted to the IMDiM with CVC were included during the study period. At catheter removal, the tip was cultured and, if the patient had fever, two blood cultures were also obtained. A database was created. Data were analyzed using SPSS v.11.0. Variables were compared with the Chi-square and Student's t-tests and a multivariate analysis was performed using Cox logistic regression. A value of P<0.05 was considered significant. RESULTS: Catheter tip culture was positive in 45.2%. The rate of catheter-related bloodstream infections was 2.9 per thousand catheter-days, which was clinically significant. The probability of catheter tip contamination 10 days after placement was 25%. Multivariate analysis revealed that the independent variables associated with a higher risk of infection were catheter type, changes of dressing, and infected bacterial stopcocks. CONCLUSIONS: These results suggest that: 1) the protocol for catheter insertion and care should be reviewed and updated, 2) catheter removal should be considered after the 10th day, 3) the appropriate type of catheter should be selected, the catheter with the lowest number of lumens should be used, and changes of catheter dressing should be reduced.

Fabrication of macroporous carbonate apatite foam by hydrothermal conversion of alpha-tricalcium phosphate in carbonate solutions.

Bone consists of a mineral phase (carbonate apatite) and an organic phase (principally collagen). Cancellous bone is characterized by interconnecting porosity necessary for tissue ingrowth and nourishment of bone cells. The purpose of the present study was to fabricate macroporous carbonate apatite (CAP) blocks with interconnecting porosity as potential bone substitute biomaterials by hydrothermal conversion of alpha-TCP foam in carbonate solution. The fabrication of the macroporous CAP was accomplished in two steps: (1) preparation of alpha-TCP foams using polyurethane foams as templates, and (2) hydrothermal conversion at 200 degrees C of alpha-TCP foam in the presence of ammonium carbonate solutions of different concentrations. The maximum carbonate content of the resultant CAP foam was approximately 7.4 wt %. The mean porosity of the CAP foam was as high as 93 vol %. The macroporous CAP blocks or granules prepared in this manner has properties similar to that of bone in mineral composition and in having interconnecting macroporosity necessary for osteoconductivity and tissue ingrowth. On the basis of composition and interconnecting macroporosity, the CAP foam materials could be ideal biomaterials for bone repair and as scaffolds for tissue engineering.

Association of HLA-DRB3*0202 and serum IgG antibodies to Chlamydia pneumoniae with essential hypertension in a highly homogeneous population from Majorca (Balearic Islands, Spain).

Separate studies investigating the relationship of essential hypertension (EH) with the HLA system and with Chlamydia pneumoniae (C. pneumoniae) infection have given conflicting results. Our aim was to clarify these relationships and determine whether the HLA system and C. pneumoniae infection interact with respect to the risk for EH. An association study (110 essential hypertensives and 107 controls) was conducted in a highly homogeneous population in the Balearic Island of Majorca (Spain). Molecular typing of HLA-B and HLA-DRB and quantification of serum levels of IgG antibodies to C. pneumoniae (sIgGa-Cp) were determined. Student's t-test, chi(2)-statistics, logistic regression analysis, and general linear model ANOVA were used for statistical analysis. The results showed that EH was related with HLA-DRB3*0202 in the whole study population, and with levels of sIgGa-Cp>63.5 BU/ml in the group of individuals with sIgGa-Cp>30 BU/ml (OR (95% CI) adjusted for obesity, familial history of EH and diabetes=2.06 (1.07-3.97), P=0.03, and =4.60 (1.06-19.90), P=0.04, respectively). The association between EH and sIgGa-Cp was observed in the DRB3*0202(+) individuals, but not in the DRB3*0202(-) subgroup (OR (95% CI)=11.14 (1.92-64.54), P=0.004, and =0.98 (0.22-4.43), P=0.64, respectively (P of the Mantel-Haenszel test for homogeneity of OR=0.06)). In our population, EH was positively associated with HLA-DRB3*0202 and with high levels of sIgGa-Cp. Moreover, a significant interaction of DRB3*0202 on the effect of sIgGa-Cp was observed, as the association of EH with these antibodies depended on the presence of DRB*0202.

[Angiotensinogen gene T174M polymorphism: opposite relationships with essential hypertension and obesity in a homogeneous population from Majorca (Baleric Islands, Spain)]. / Polimorfismo T174M del gen del angiotensinógeno: relaciones opuestas con la hipertensión arterial esencial y con la obesidad en una población homogénea de Mallorca (Islas Baleares).

Numerous association studies have been performed to evaluate the relationship between the angiotensinogen gene and the essential hypertension, but their results are conflicting. The conflicting results may be explained by methodological reasons, particularly genetic differences in the population samples, phenotypic differences in the hypertensive populations analyzed, lack of appropriate control for other hypertension risk factors in some studies, or limited statistical power among many studies. Furthermore, hypertension is a public health issue of great relevance in Baleric Islands (Spain). For these reasons we performed an association study about the relationship between the M235T, T174M and G-6A diallelic polymorphisms of the angiotensinogen gene and hypertension in a population from Majorca (Balearic Islands), in which a considerable homogeneity with respect to ethnicity and environmental factors could be documented. This population was composed of 109 patients and 107 controls. Alleles of the angiotensinogen gene were determined by PCR and restriction site polymorphism analysis. The different genotypes were tested for association with dependent variables by univariate and multivariate logistic regression analysis. In the univariate analysis we found no evidence of association between the angiotensinogen gene genotypes and hypertension. This lack of association was independent of obesity, familial history of hypertension and diabetes for the genotypes of the polymorphisms M235T and G-6A; however, in the multivariate analysis the T174T174 genotype showed an almost significant positive association with hypertension [OR = 2.76 (95% confidence interval: 1.00-7.65, p = 0.05)]. The T174T174 genotype also showed a significant negative association with obesity [OR = 0.41 (95% confidence interval: 0.18-0.90, p = 0.03)] that remained after adjustment by sex, hypertension and diabetes [OR = 0.26 (95% confidence interval: 0.10-0.65, p = 0.004)]. Our results: a) are in contrast with the results from most previous studies that found a relationship of the T174M polymorphism with hypertension, as in those studies the M174 allele was responsible for the association; b) emphasize the need for rigorous control for obsesity in the studies of association between the angiotensinogen gene and hypertension; c) underscore the importance and the utility of using concrete populations to carry out studies on the genetic dissection of hypertension.

Prospective evaluation of a dot-blot enzyme immunoassay (Directigen RSV) for the antigenic detection of respiratory syncytial virus from nasopharyngeal aspirates of paediatric patients.

This study investigated the efficacy of a commercial enzyme immunoassay (Directigen RSV, ColorPAC) in comparison with the shell vial culture method (using Hep-2 cells) for the detection of respiratory syncytial virus (RSV) in nasopharyngeal aspirates from children with bronchiolitis. During the period 1995-2002, 4950 samples were examined. RSV was detected in 1660 (33.5%) samples, with a sensitivity of 80.9%, a specificity of 97.5%, a positive predictive value of 93.8%, a negative predictive value of 91.6%, and a testing efficiency value of 92.2% compared with shell vial culture. In 83 (5%) samples, the ColorPAC was positive and the shell vial assay was negative. Of these, 71 (85.6%) were false-negative by cell culture. The true false-positive results obtained by ColorPAC represented only 0.7% of all RSV-positive samples. In general, no statistically significant differences were detected between the different months and epidemic periods studied. Compared with ColorPAC, the shell vial culture method displayed a sensitivity of 95.8% and a specificity of 100%. Overall, the ColorPAC assay was an acceptable, simple and rapid method for the antigenic detection of RSV in paediatric respiratory samples.

Características clínicas y epidemiológicas de los pacientes infectados por el virus influenza B/Hong Kong/330/2001 en las Islas Baleares (2002-2003) / clinical and epidemiological characteristics of patients infected by influenza B/Hong Kong/330/2001 virus in Balearic Islands (2002-2003)

Se revisan las características clínicas y epidemiológicas de los niños infectados por el virus influenza B/Hong Kong/330/01 (IB) en la temporada epidémica 2002-2003 y se compara con los diagnosticados en dos temporadas previas. Todas las muestras fueron sometidas a la detección antigénica y al cultivo viral (línea celular MDCK). Sólo se pudo realizar el seguimiento en 40 (87 por ciento) niños infectados por el virus IB. De los casos estudiados, 24 (60 por ciento) eran niños y 16 (40 por ciento) niñas. La edad media fue de 4,6 años (rango 27 días-15 años). Quince niños (37,5 por ciento) fueron considerados inmunodeprimidos. Se detectó fiebre en el 92,5 por ciento, síntomas respiratorios en el 85 por ciento, manifestaciones neurológicas en el 15 por ciento, exantemas en el 12,5 por ciento y síntomas musculares en el 12,5 por ciento. Los diagnósticos clínicos defintivos fueron: infección del tracto respiratorio superior 40 por ciento, neumonía 20 por ciento, fiebre y exantema 7,5 por ciento, otitis aguda media 7,5 por ciento, miositis 5 por ciento, bronquiolitis 2,5 por ciento y poliartralgias 2,5 por ciento. Se observó un posible caso, no confirmado, de encefalopatía asociado a infección por el virus IB. Un paciente oncológico (2,5 por ciento) falleció de una neumonía asociada al virus IB. Ninguno de los pacientes había sido vacunado frente a los virus gripales. De acuerdo con los datos obtenidos los niños infectados por el virus influenza B/Hong Kong/330/01 poseerían una edad media de 4,6 años y presentarían un síndrome febril con patología respiratoria y/o manifestaciones clínicas atípicas que requieren ingreso hospitalario (AU)

[Silent ischemic heart disease in patient with Wegener's necrotizing glomerulonephritis]. / Cardiopatía isquémica silente en paciente con glomerulonefritis necrotizante por enfermedad de Wegener.

Wegener's granulomatosis is a necrotizing vasculitis disorder that usually presents with clinical involvement of the upper and lower respiratory tract in association with renal disease. Although Wegener's granulomatosis can affect other systems, such as the eye, skin, joints, muscle, nerves, gastrointestinal tract and heart, cardiac involvement is traditionally believed to be rare, even though coronary vasculitis can be demonstrated at postmortem examination. We report a patient who has both respiratory and renal involvement who died unexpectedly following a silent myocardial infarct after a period of clinical improve induced by treatment with cyclophosphamide and prednisone.

Establecimiento de la probabilidad etiológica en las bronquiolitis víricas de la población lactante / Establishment of the etiologic probability in viral bronchiolitis presented in infant population

Se presenta un estudio prospectivo (enero 1995-diciembre 2001) destinado al establecimiento de la probabilidad etiológica en las bronquiolitis víricas que afectan a la población lactante < 2 años). Durante este período de tiempo se han analizado 6.072 muestras, de las cuales 2.152 (35,4 por ciento) fueron positivas. El virus respiratorio sincitial (VRS) ha sido el más aislado en este estudio (76,6 por ciento), seguido de los virus gripales (10,9 por ciento), virus de la parainfluenza (7,3 por ciento) y adenovirus (5,1 por ciento). El estudio epidemiológico ha demostrado el predominio del VRS y virus gripales en los meses invernales (diciembre-marzo), lo cual ha determinado que estos virus sean los responsables del porcentaje más elevado de bronquiolitis en este período (probabilidad etiológica). Destaca el adelantamiento de las epidemias causadas por el VRS al mes de diciembre a partir del período 1998-1999. Los virus gripales se presentan preferentemente entre enero y marzo y las bronquiolitis que producen son clínicamente indistinguibles de las causadas por el VRS. Se ha observado un incremento significativo del número de casos de bronquiolitis causadas por el virus gripal tipo A (influenza A) en los últimos años. El virus de la parainfluenza ha predominado en los meses de primavera y verano, siendo el virus que muestra la máxima probabilidad etiológica desde mayo hasta septiembre. La mayoría (88 por ciento) de las infecciones por el virus parainfluenza lo han sido por el serotipo 3. Los adenovirus se han presentado a lo largo del año con un cierto predominio en los meses invernales. Se ha detectado un incremento significativo en el aislamiento de estos virus en los últimos años. El conocimiento de la distribución y presentación epidemiológica de los virus respiratorios permite establecer la probabilidad etiológica de las bronquiolitis víricas en los lactantes en cada mes del año y elaborar los protocolos de diagnóstico y actuación hospitalaria más adecuados frente a cada uno de ellos. (AU)

Protección del orificio de salida del Catéter en las actividades acuáticas / Protection of the catheter output in water sports

No disponible

[Persistence of the left superior vena cava discovered during the implantation of a hemodialysis catheter]. / Persistencia de la vena cava superior izquierda descubierta durante la implantación de catéter para hemodiálisis.

A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. It is a persistent remnant of the left anterior cardinal vein that usually disappears in early embryological development as a result of compression between the left atrium and the hilum of the left lung. If it is not associated with other congenital cardiac anomalies it is usually asymptomatic but has important clinical implications in some situations. In this article, we describe a patient with bilateral SVC identified on a chest radiograph by a haemodialysis central venous catheter passing through it.

Evaluation of different continuous cell lines in the isolation of mumps virus by the shell vial method from clinical samples.

AIMS: To compare prospectively the efficacy of the Vero, LLC-MK2, MDCK, Hep-2, and MRC-5 cell lines in the isolation of the mumps virus from clinical samples by means of the shell vial method. METHODS: During an epidemic outbreak of parotiditis 48 clinical samples (saliva swabs and CSF) were studied. Two vials of the Vero, LLC-MK2, MDCK, MRC-5, and Hep-2 cell lines were inoculated with 0.2 ml of the samples by the shell vial assay. The vials were incubated at 36 degrees C for two and five days. The vials were then fixed with acetone at -20 degrees C for 10 minutes and stained by a monoclonal antibody against mumps virus by means of an indirect immunofluorescence assay. RESULTS: The mumps virus was isolated from 36 samples. The Vero and LLC-MK2 cell lines showed a 100% isolation capacity, MDCK showed 77.7%, MRC-5 showed 44.4%, and Hep-2 showed 22.2%. The Vero and LLC-MK2 lines were significantly different to the other cell lines (p < 0.001). The sensitivity for the Vero and LLC-MK2 lines at two and five days of incubation was identical (100%). The values obtained in the study of the quantitative isolation capacity (positive isolation with > 5 infectious foci) were 94.4% for Vero, 97.2% for LLC-MK2, 5.5% for MDCK, 5.5% for Hep-2, and 0% for MRC-5. CONCLUSIONS: The Vero and LLC-MK2 cell lines are equally efficient at two and five days incubation for the isolation of the mumps virus from clinical samples, and the use of the shell vial method considerably shortens the time of aetiological diagnosis with higher specificity.