[Constrictive pericarditis and disseminated nocardiosis]. / Péricardite constrictive et la nocardiose disséminée.

Human nocardiosis usually involves the respiratory tract or the skin but may disseminate to virtually any organ, it occurs in immunocompromised hosts as well as individuals with no apparent predisposition. Involvement of the pericardium is uncommon, having been reported infrequently in the past, but mandates a special management. This report describes the first case in Europe of a patient with chronic constrictive pericarditis from nocardia brasiliens, successfully treated with pericardiectomy and appropriate antibiotic therapy.

Germline promoter hypermethylation in BRCA1 and BRCA2 genes is not present in hereditary breast cancer patients

Purpose: Germline promoter hypermethylation of BRCA1 and BRCA2 genes is an alternative event of gene silencing that has not been widely investigated in hereditary breast and ovarian cancer (HBOC) syndrome. Methods: We analyzed germline BRCA promoter hypermethylation in HBOC patients with and without BRCA mutations and control subjects, using a recently developed BRCA methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay. Results: Neither the patients tested nor the control subjects showed germline hypermethylation of the BRCA1 and BRCA2 promoter regions analyzed. Conclusions: Despite the results achieved at somatic levels by other researchers, these were not confirmed in our study at the germline level. Our results show the need to establish more predictive CpG sites in the BRCA promoter regions to optimize the MS-MLPA assay for the detection of germline hypermethylation as an effective pre-screening tool for whole-BRCA genetic analysis in HBOC, because we can not rule out the existence of germline promoter hypermethylation in BRCA

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Germline promoter hypermethylation in BRCA1 and BRCA2 genes is not present in hereditary breast cancer patients.

PURPOSE: Germline promoter hypermethylation of BRCA1 and BRCA2 genes is an alternative event of gene silencing that has not been widely investigated in hereditary breast and ovarian cancer (HBOC) syndrome. METHODS: We analyzed germline BRCA promoter hypermethylation in HBOC patients with and without BRCA mutations and control subjects, using a recently developed BRCA methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay. RESULTS: Neither the patients tested nor the control subjects showed germline hypermethylation of the BRCA1 and BRCA2 promoter regions analyzed. CONCLUSIONS: Despite the results achieved at somatic levels by other researchers, these were not confirmed in our study at the germline level. Our results show the need to establish more predictive CpG sites in the BRCA promoter regions to optimize the MS-MLPA assay for the detection of germline hypermethylation as an effective pre-screening tool for whole-BRCA genetic analysis in HBOC, because we can not rule out the existence of germline promoter hypermethylation in BRCA.

Rendimiento cognitivo y percepción de problemas de memoria en pacientes con dolor crónico: con fibromialgia versus sin fibromialgia / Cognitive performance and memory complaints in chronic pain patients: with fibromyalgia versus without fibromyalgia

Objetivos: 1) Comparar la percepción de problemas de memoria y el rendimiento cognitivo (memoria verbal, atención concentrada, rapidez de procesamiento) en pacientes con y sin diagnóstico de fibromialgia. 2) Comparar estos mismos procesos entre pacientes con fibromialgia primaria y pacientes con fibromialgia concomitante a otras patologías de dolor crónico. Sujetos: Ciento diez pacientes de sexo femenino [21-64 años].Edad 47.6 años. 68 pacientes con fibromialgia [28 fibromialgia primaria, 40 fibromialgia concomitante con otras patologías de dolor] y 42 pacientes con otros diagnósticos de dolor crónico. Material y método: El examen neuropsicológico se realizó de forma individual. Los problemas de memoria se evaluaron con el Cuestionario de Fallos de Memoria en la Vida Cotidiana (MFE), la memoria con el Test de Aprendizaje Verbal (TAVEC), las aptitudes perceptivas y de atención con el Test Toulouse-Piéron (TP) y la rapidez de procesamiento e interferencia con el Test de Colores y Palabras (STROOP). También se aplicó la Escala de Ansiedad y Depresión (HADS). Resultados: No hubo diferencias entre los distintos grupos en duración e intensidad del dolor, nivel de estudios o tipo de ocupación. No se encontraron diferencias significativas entre pacientes con y sin fibromialgia en ninguna de las sub-escalas de los tests TAVEC, TP y STROOP. Tampoco en la sub-escala ansiedad del HADS. Por el contrario, sí hubo diferencias entre pacientes con y sin fibromialgia en percepción de problemas de memoria (MFE-FBM=100,4; MFE-No FBM=77.9;F (1,106)=7,754, p<0,007) y depresión (Dep FBM=9,54; DepNoFBM=6,61; F(1,106)=9,770, p<0.002). Entre pacientes con fibromialgia primaria y fibromialgia concomitante con otras patologías de dolor no hubo ningún tipo de diferencia. La depresión demostró ser una variable relacionada con el rendimiento en memoria verbal y atención concentrada. También con la percepción de problemas de memoria (...) (AU)

Aims: 1) To compare memory complaints and cognitive performance (verbal memory, attention and information processing) in chronic pain patients with and without fibromyalgia. 2) To compare those processes in patients with primary fibromyalgia and concomitant fibromyalgia. Subjects: One hundred and ten female patients [21-64 years old].Mean age 47.6 years. 68 patients with fibromyalgia [28 with primary fibromyalgia, 40 with concomitant fibromyalgia] and42 with others chronic pain conditions. Material and methods: Neuropsychological tests were individually performed. Memory complaints were assessed with the Memory Failures in Everyday Memory (MFE), memory with the Verbal Learning Test (TAVEC), attention and perceptual skills with the Toulouse-Piéron Test (TP) and interference with the Stroop Color and Word Test (STROOP). The Hospital Anxiety and Depression Scale (HADS) was also applied. Results: No differences were obtained between groups in duration of pain, pain intensity, educational level and work occupation. Neither difference was obtained between patients with fibromyalgia and without fibromyalgia in TAVEC, TP, STROOP and anxiety scale of the HADS. At the contrary, significant differences were obtained in memory complaints (MFEFBM=100.4; MFE-No FBM=77.9; F (1,106)=7,754, p<0,007) and depression (Dep FBM=9,54; Dep NoFBM=6,61;F (1,106)=9,770, p<0.002). No differences were obtained between patients with primary fibromyalgia and concomitant fibromyalgia. Depression was a significant variable related to performance in verbal memory and attention (...) (AU)

Propuesta de una versión de consenso del Fibromyalgia Impact Questionnaire (FIQ) para la población española / Proposal for a consensus version of the Fibromyalgia Impact Questionnaire (FIQ) for the Spanish population

Objetivo: Lograr una versión actualizada y de consenso del Fibromyalgia Impact Questionnaire (FIQ) para la población española, el Cuestionario de Impacto de la Fibromialgia (CIF). Material y métodos: La confección del CIF se llevó a cabo con participación de todos los grupos de investigadores de las 4 versiones españolas previas del FIQ y teniendo en consideración la reciente versión actualizada del original. Se aplicó el CIF a una muestra de pacientes con fibromialgia para explorar la comprensibilidad de sus ítems y comparar las puntuaciones del cuestionario con 2 índices compuestos: “semiobjetivo” y “subjetivo” de gravedad de la fibromialgia. Se determinaron los correspondientes coeficientes de correlación de Spearman. Resultados: Se exponen las principales modificaciones introducidas en el cuestionario. Algunos pacientes confundieron las respuestas al subítem “j” y al ítem 3, los restantes ítems y subítems no plantearon problemas. Los coeficientes de correlación entre las puntuaciones del CIF y los índices semiobjetivo y subjetivo fueron de 0,57 y 0,76, respectivamente (p < 0,001). Conclusión: Se propone el CIF como versión española actualizada y de consenso del FIQ (AU)

Objective: To obtain an updated FIQ consensus version for patients in Spain, the Cuestionario de Impacto de la Fibromialgia (CIF). Material and methods: The CIF elaboration was carried out with the participation of all the groups of researchers in the 4 previous FIQ Spanish versions, and taking into account the recent updated version of the original FIQ. The CIF was completed by a sample of fibromialgia patients to explore how comprensible its items are and to compare its global score with 2 fibromialgia composite severity indexes, one semi-objective and one subjective. The corresponding Spearman correlation coefficients were determined. Results: The main modifications introduced in the questionnaire are shown. Some patients were confused in their responses to subitem “j” and item 3, but not with regard to the remaining items or subitems. Correlation coeficients between the CIF and the semi-objective and subjective fibromialgia severity indexes were 0.57 and 0.76 respectively (P< 001). Conclusion: The CIF is proposed as an updated Spanish version of the FIQ (AU)

[Proposal for a consensus version of the Fibromyalgia Impact Questionnaire (FIQ) for the Spanish population]. / Propuesta de una versión de consenso del Fibromyalgia Impact Questionnaire (FIQ) para la población española.

OBJECTIVE: To obtain an updated FIQ consensus version for patients in Spain, the Cuestionario de Impacto de la Fibromialgia (CIF). MATERIAL AND METHODS: The CIF elaboration was carried out with the participation of all the groups of researchers in the 4 previous FIQ Spanish versions, and taking into account the recent updated version of the original FIQ. The CIF was completed by a sample of fibromialgia patients to explore how comprensible its items are and to compare its global score with 2 fibromialgia composite severity indexes, one semi-objective and one subjective. The corresponding Spearman correlation coefficients were determined RESULTS: The main modifications introduced in the questionnaire are shown. Some patients were confused in their responses to subitem "j" and item 3, but not with regard to the remaining items or subitems. Correlation coeficients between the CIF and the semi-objective and subjective fibromialgia severity indexes were 0.57 and 0.76 respectively (P<001). CONCLUSION: The CIF is proposed as an updated Spanish version of the FIQ.

[Experience with 25-gauge transconjunctival vitrectomy compared to a 20-gauge system. Analysis of 132 cases]. / Etude comparative de la vitrectomie transconjonctivale sans suture à 25-gauges avec celle à 20-gauges. A propos de 132 interventions.

PURPOSE: The transconjunctival sutureless vitrectomy (TSV 25) is a new technique showing substantial progress. METHODS: A prospective study of 66 eyes of 66 patients who underwent surgical procedures using the transconjunctival standard vitrectomy system (TSV 25), between June 2004 and June 2005. The results were compared with the results in an equivalent population (66 patients) that underwent vitrectomy with a standard 20-gauge system. RESULTS: The most important differences between groups were 1) shorter surgical time in the 25-gauge vitrectomy group than in the 20-gauge group, with a mean time of 28.15+/-5.50 min for group 1 and 44.15+/-5.64 min for group 2 (p<0.001) and 2) lower mean postoperative intraocular tension in the first group of patients: in this group, the intraocular tension before surgery was a mean of 16.27+/-1.76 mmHg, decreasing to 12.17+/-1.36 mmHg, with a posterior increase to normal values of 15.06+/-1.66 mmHg at 7 days after surgery and a mean of 16.10+/-1.51 mmHg at 15 days. This decrease was not observed in the group of patients who underwent 20-gauge vitrectomy surgery. The other postoperative complications were similar in both groups except for four cases of anterior proliferation and two cases of fibrinous uveitis in group 2. CONCLUSION: The transconjunctival sutureless system (TSV 25) decreases surgical time and postoperative inflammation, with optimal postoperative patient comfort, but currently the accurate selection of patients remains important.

[Combined surgery for lens extraction, vitrectomy, and implantation in the diabetic patient using phacoemulsification versus phacofragmentation]. / Chirurgie combinée phacoexérèse, vitrectomie et implantation chez le patient diabétique avec phacoémulsification versus phacophragmentation.

INTRODUCTION: In diabetic patients, we often need to perform cataract and pars plana vitrectomy. Two different techniques are currently valid: 1) phacoemulsification and pars plana vitrectomy and 2)pars plana lensectomy and posterior vitrectomy. METHODS: Retrospective study of two different groups of type 2 diabetic patients: those receiving 1) phacoemulsification and pars plana vitrectomy or 2) pars plana lensectomy and posterior vitrectomy. RESULTS: On statistical analysis there were no differences in complications between the two groups. The effect on visual acuity was similar in both groups. DISCUSSION: The association of cataract surgery and posterior vitrectomy is a valid technique for treating diabetic retinopathy complications. In the present study, the complications of the two techniques were similar, the most important concerning only anterior chamber opening in the first group. CONCLUSION: The two techniques of cataract extraction and pars plana vitrectomy at the same time have no differences in their results and are valid for treatment of diabetic patients.

Bovine lactoferrin for Helicobacter pylori eradication: an open, randomized, multicentre study.

BACKGROUND: Cure rates for eradication of Helicobacter pylori appear to be decreasing, thus more effective therapies must be identified. AIM: To evaluate the efficacy of bovine lactoferrin in the treatment of H. pylori infection. METHODS: In a multicentered prospective study, 402 (mean age 52.4, range 19-84 years) H. pylori-positive patients were assigned to one of three regimens: group A - esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. for 7 days; group B - lactoferrin 200 mg b.d. for 7 days followed by the same schedule of group A; group C - esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. plus lactoferrin 200 mg b.d. for 7 days. RESULTS: Of the 402 patients, 389 completed the study. Six patients were discontinued due to side effects, one patient in group B died and six patients were lost to follow up. The eradication rate (intention-to-treat analysis) was 77% in group A (105/136), 73% in group B (97/132) and 90% in group C (120/134) (chi(2)-test P < 0.01). The incidence of side effects was 9.5% in group A, 9% in group B and 8.2% in group C (chi(2)-test P = 0.1). CONCLUSION: This study demonstrates that bovine lactoferrin is an effective adjuvant to 7-day triple therapy for eradication of H. pylori infection.

[Diffuse retinal pigment epitheliopathy and corticoid ointment topical treatment in a patient with psoriasis]. / Epithéliopathie pigmentaire rétinienne diffuse et traitement topique avec pommade à base de corticostéroïdes dans un cas de psoriasis.

Central serous chorioretinopathy has three patterns: the first or typical form with one or several points of diffusion; the second, diffuse retinal pigment epitheliopathy; and the third, the bullous form of serous chorioretinopathy. The authors present a case of a 55-year-old male presenting with diffuse retinal pigment epitheliopathy and topical treatment of psoriasis, with a 9-year history of corticoid ointment use, associated with cyclosporine over the last year. The topical treatment was discontinued and the patient recovered his vision, with a final visual acuity of 5/10 in the right eye and 4/10 in the left eye.

[The health costs of alcoholism]. / Costes sanitarios del alcoholismo.

OBJECTIVE: To evaluate the economic effect in terms of health costs of alcohol abuse in Spain. DESIGN: The most up-to-date available, secondary sources of information were used. The period for the costs calculation was a natural year, with the prices adjusted to pesetas in 1996. The focus was based on the prevalence of cases per period. All the information referred to the whole of Spain. SETTING: Health costs were broken down into out-patient attendance, hospital emergencies, admissions, treatment at special centres and other health expenditure. MEASUREMENTS AND MAIN RESULTS: The total health cost attributable to alcoholism was 177,084 million pesetas, broken down as follows: a) cost of hospital admissions: 93,644 million pesetas (52.88%); b) cost of out-patient attendance: 34,600 million (19.53%); c) cost of treatment at special centres: 18,029 million (10.18%); d) cost of hospital emergencies: 10,481 million (5.91%); and e) other health expenditure: 20,330 million pesetas (11.48%). CONCLUSIONS: The figures arrived at do not cover the total cost of alcohol abuse, since a conservative approach was adopted. They stand as a minimum of the expenditure in our country. Some are direct costs on health authorities, whereas others can be managed as a cost-opportunity problem.

Seasonality of marriages in Spanish and French parishes in the Cerdanya valley, eastern Pyrenees.

The Cerdanya valley in the eastern Pyrenees has a physical unity into which a political frontier has been imposed to divide it. The social and cultural repercussions of this Franco-Spanish border have created obstacles to marriage which are not due to topography. Choice of month of marriage is under cultural control and the study of seasonality in marriages recorded in the registers of all the Cerdan parishes on both sides of the border demonstrated differences over time and between French and Spanish sectors. It is suggested that these changes demonstrate the process of distancing of the two populations. Cluster and correspondence analysis showed progressive differentiation of the seasonality patterns of the French and Spanish Cerdans despite the geographic unity of the valley. Sociocultural factors are presumed responsible.

PIP: The Cerdanya valley in the eastern Pyrenees is defined by a relatively flat valley floor of 950-1300 m surrounded by peaks up to 2900 m high. The local population could therefore easily be defined as being those people who live within the valley's natural topographical boundaries. The area held allegiance to different states until the 1659 Treaty of the Pyrenees created a division between village zones. A more precise demarcation was defined in the 1866-68 Treaty of Bayonne. A common identity nonetheless continued among the people of the valley given the absence of any physical barriers between them. Development, tourism, and out-migration during the 20th century have since transformed the Cerdanya. Analysis of marriage records in the valley found a decrease over time in the frequency of trans-frontier marriages, suggesting an increase in the significance of the frontier. Contemporary cultural differences in food habits have also been shown. The authors used parish record data on the seasonality of French and Spanish marriages in the Cerdanya to investigate whether there was greater social cohesion among the people of the Cerdanya 60-70 years ago. The study found the choice of month of marriage to be culturally determined and differences over time and between French and Spanish sectors in the seasonality of marriages. These changes suggest the distancing of the two populations.

Corneal topography, ultrasound biomicroscopy, and scatterometry.

This paper presents a review of corneal topography, including history, literature, physics and technology, data analysis, and recent advances in the field. Clinical applications are also discussed and include contact lens fitting, diagnosis of keratoconus, and refractive surgery.

[Intravitreal ganciclovir in cytomegalovirus retinitis in AIDS]. / Ganciclovir intravítreo en la retinitis por citomegalovirus en SIDA.

A retrospective study was made of 26 patients with AIDS who initially presented with retinitis as the only clinical manifestation of cytomegalovirus infection (39 eyes). Sixty-five induction or re-induction therapeutic courses were administered with intravitreal ganciclovir. The efficiency rate of therapy was 93.8%. Thirty-eight maintenance therapeutic courses (200 micrograms/week) were evaluated. The non-compliance rate was 23%. Bilateral retinitis occurred in 44.4% of cases. The systemic administration of therapy had to be substituted for the intravitreal administration in 32% of patients during the clinical course of their conditions. The mean survival rate was 9.5 months. Both retinal detachment and vitreal hemorrhage occurred in 5% of patients. When retinitis is the first clinical manifestation of cytomegalovirus infection, therapy with intravitreal ganciclovir is efficacious to inactivate lesions. Although bilateral retinitis and extraocular dissemination are common, the mean survival rate is high.

Cerdanya: mountain valley, genetic highway.

In this paper the records of 7844 marriages in the parishes of French and Spanish sectors of the Cerdanya Valley have been analysed. The Cerdanya is an eastern Pyrenean valley, today divided by the Franco-Spanish border, but once united within Catalonia. The results have been reported on the one hand on a small scale using local place names, and on the other hand on a wider scale across France and Spain, because interest lies both in the geographic range from which some marital partners have come and in the relative proportions of brides and grooms from the French and Spanish parts of Cerdanya and from adjacent districts. Both mountains and the Franco-Spanish border are shown to have reduced the likelihood of marriage. Inaccessible mountain barriers appear to have been a greater obstacle to marital movement than the border. Adjacent districts and local provinces have provided a greater proportion of brides and grooms than more distant ones, but thereafter frequencies from the further regions do not decrease with greater distance. More marital partners have moved from Spain to France than vice-versa, and mobility of grooms exceeded mobility of brides. Results are relevant to genetics and the current European interest in nationality and ethnicity.

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.