Situación epidemiológica de la hidatidosis en los centros hospitalarios del sistema público de salud de Extremadura (2003-2012) / Epidemiological update of hydatid disease in hospitals in the public health system of Extremadura (2003-2012)

INTRODUCCIÓN: La hidatidosis humana es una zoonosis con distribución cosmopolita. Todavía constituye un importante problema de salud pública en muchas regiones del mundo, incluida la cuenca mediterránea. La situación epidemiológica actual no es conocida en ciertas regiones de España. El objetivo de este trabajo es renovar los datos epidemiológicos de la hidatidosis en pacientes hospitalizados en el sistema público de salud de Extremadura. MÉTODOS: Estudio descriptivo longitudinal y retrospectivo de pacientes hospitalizados con diagnóstico de hidatidosis (códigos CIE 122.0-122.9) en centros sanitarios del sistema público de salud de Extremadura durante el periodo 2003-2012. RESULTADOS: Se incluyeron 876 pacientes con diagnóstico de hidatidosis; 536 (61%) fueron varones, con una edad media de 65,5 ± 17,8; 19 casos (2,2%) fueron menores de 19 años: 17 (89,47%) casos entre los años 2003-2007 versus 2 casos entre 2008-2012 (OR = 7,83; IC 95%: 1,79-34,11; p = 0,001). Un total de 141 (16,0%) eran menores de 45 años. El diagnóstico primario fue más frecuente en menores de 45 años y el diagnóstico secundario más frecuente en mayores de 70 años (p < 0,05). La tasa de incidencia fue mayor a través del registro de pacientes hospitalizados (8,02 casos por 105 personas-año) respecto al sistema de declaración obligatoria de enfermedades (1,88 casos por 105 personas-año), p < 0,05. CONCLUSIÓN: En Extremadura la hidatidosis es todavía frecuente, con una clara disminución en el número de casos pediátricos. El número de casos obtenidos mediante los registros de pacientes hospitalizados respecto al sistema de notificación de enfermedades de Extremadura sugieren la necesidad de modificaciones que mejoren la vigilancia y el control de la hidatidosis

INTRODUCTION: Echinococcosis is a zoonotic infection with a worldwide distribution, and is still an important health problem in many areas of the world, including the Mediterranean basin. At present the epidemiological situation is unclear in certain regions of Spain. The aim of this study was to update the epidemiological situation in Extremadura through an analysis of hospitalised patients in the public health system diagnosed with hydatid disease. METHODS: A longitudinal retrospective study was conducted between 2003 and 2012 on hospitalised patients with a diagnosis of hydatidosis (ICD 122.0-122.9) in hospitals of the public health service of Extremadura. RESULTS: During the period of study, 876 patients were diagnosed with hydatid disease. Of these 536 (61%) of cases were male, with a mean age of 65.53 ± 17.8 years. More importantly, 19 (2.2%) of patients were 19 years old, with 17 cases between 2003-2007 versus 2 cases between 2008-2012 (OR = 7.83; 95% CI: 1.79-34.11; P = .001). A total of 141 (16.0%) were younger than 45 years. The primary diagnosis was most frequently reported in the younger population < 45 years, whereas the secondary diagnosis was usually found in the elderly population > 70 years (P < .05). The incidence rate of hydatid disease obtained from Hospital Discharge Records (HDRs) was significantly higher compared to the incidence that was declared in the Notifiable Disease System of Extremadura (8.02 cases per 105 person-years vs. 1.88 cases per 105 person-years [P < .05]). CONCLUSION: In Extremadura hydatid disease is still frequent. With a clear decrease in the number of paediatric cases. The number of cases obtained from HDRs regarding Notification System Diseases Extremadura suggests the need for modifications to improve surveillance and control of hydatid disease

[Epidemiological update of hydatid disease in hospitals in the public health system of Extremadura (2003-2012)]. / Situación epidemiológica de la hidatidosis en los centros hospitalarios del sistema público de salud de Extremadura (2003-2012).

INTRODUCTION: Echinococcosis is a zoonotic infection with a worldwide distribution, and is still an important health problem in many areas of the world, including the Mediterranean basin. At present the epidemiological situation is unclear in certain regions of Spain. The aim of this study was to update the epidemiological situation in Extremadura through an analysis of hospitalised patients in the public health system diagnosed with hydatid disease. METHODS: A longitudinal retrospective study was conducted between 2003 and 2012 on hospitalised patients with a diagnosis of hydatidosis (ICD 122.0-122.9) in hospitals of the public health service of Extremadura. RESULTS: During the period of study, 876 patients were diagnosed with hydatid disease. Of these 536 (61%) of cases were male, with a mean age of 65.53±17.8 years. More importantly, 19 (2.2%) of patients were 19 years old, with 17 cases between 2003-2007 versus 2 cases between 2008-2012 (OR=7.83; 95%CI: 1.79-34.11; P=.001). A total of 141 (16.0%) were younger than 45 years. The primary diagnosis was most frequently reported in the younger population <45 years, whereas the secondary diagnosis was usually found in the elderly population >70 years (P<.05). The incidence rate of hydatid disease obtained from Hospital Discharge Records (HDRs) was significantly higher compared to the incidence that was declared in the Notifiable Disease System of Extremadura (8.02 cases per 10(5) person-years vs. 1.88 cases per 10(5) person-years [P<.05]). CONCLUSION: In Extremadura hydatid disease is still frequent. With a clear decrease in the number of paediatric cases. The number of cases obtained from HDRs regarding Notification System Diseases Extremadura suggests the need for modifications to improve surveillance and control of hydatid disease.

Sarcoma de Kaposi clásico en el pie: presentación de 2 casos no relacionados con VIH / The classic Kaposi´s sarcoma in feet: two cases not related to HIV

La infección por el virus de la inmunodeficiencia humana (VIH) ha aumentado la incidencia de pacientes con sarcoma dc Kaposi, de forma que la presencia del Kaposi junto con la demostración de la infección se considera criterio de SIDA. Previamente a la aparición del SIDA existía el sarcoma de Kaposi, afectando otras localizaciones diferentes y en un grupo poblacional diferente. Se presentan dos casos de pacientes no VIII con lesiones cutáneas de Sarcoma de Kaposi en su Variante clásica, con lesiones que afectan a los pies (AU)

Human immunodcficiencyvirus (HIV) infection has increased the incidence of patients with Kaposi’s sarcoma so patients with this disease associated to infection is considered AIDS. Previous to the discovery of this syndrome, Kaposi’s appears in patients on different locations and different population group. We present two cases of Kaposi’s syndrome in not HIV patients with lesions located in both feet (AU)

[Contributions of the ambulatory blood pressure monitoring to the values measured at the medical office]. / Aportaciones de la monitorización ambulatoria a la presión arterial casual.

OBJECTIVE: To communicate our experience with this technique centred in the definition of the patterns and the peculiar characteristics of the rising pattern. METHODS: During a four year period, the ambulatory blood pressure monitoring was obtained in 500 hypertensive patients with difficult to control blood pressure or of recent detection, following the guide of the Cardiorisk project. RESULTS: The most frequent pattern observed was non-dipper (46.6%). The pulse pressures obtained by ambulatory and office blood pressure monitoring kept a correlation that serve as guide to the office blood pressure measurements. The level of control by ambulatory monitoring blood pressure is only discretely superior to the office blood pressure if the cases of white coat and masked hypertension are considered. The rising pattern is associated to a major vascular risk. CONCLUSIONS: An increased vascular risk is noticed in the rising pattern with respect to other patterns. The morphology of different atypical patterns was also presented. The help of the ambulatory blood pressure monitoring along with one taken in the office determined a great aid to interpret the huge variability of the arterial pressure.

Espondilodiscitis por Enterococcus faecalis: análisis de un caso / Spondylodiscitis due to Enterococcus faecalis: a case report

Un varón de 85 años ingresó en nuestro hospital para valoración de lumbalgia invalidante de 2 meses de evolución. Tenía antecedentes de lumbalgia recidivante, hepatopatía crónica por el virus C de la hepatitis y diabetes mellitus tipo 2. Se observó por técnicas de imagen afección vertebral y discal, y en el cultivo del material aspirado a nivel discal creció Enterococcus faecalis, que también fue demostrado en hemocultivos, con idénticas características fenotípicas. Tras 6 semanas de tratamiento parenteral, corsé y fisioterapia experimentó progresiva mejoría, y se lo siguió ambulatoriamente. Se comenta la rareza de E. faecalis como agente etiológico de la espondilodiscitis, lo que condiciona actitudes terapéuticas basadas en las orientaciones microbiológicas aplicadas a otras formas más frecuentes de etiología piógena y según antibiograma

An 85-year-old man was admitted to our hospital for evaluation of disabling low back pain with onset 2 months previously. The patient had a history of recurrent lower back pain, hepatitis C virus infection and type 2 diabetes. Imaging techniques showed vertebral and discal involvement. Culture of the aspirated discal specimen revealed Enterococcus faecalis, which was also found in blood cultures, with the same phenotypic characters. After 6 weeks of parenteral antibiotics, bracing and physical therapy, the patient progressively improved and was followed-up on an outpatient basis. E. faecalis is a rare cause of spondylodiscitis, which may lead to this etiological agent being overlooked in favor of other more frequent etiologic agents