Incidence of anaphylaxis in the city of Alcorcon (Spain): a population-based study.

BACKGROUND: Relatively few studies have examined the incidence of anaphylaxis in the general population. OBJECTIVE: To report the incidence of anaphylaxis among the general population of the city of Alcorcon, Spain, using various public health care databases. METHODS: Episodes of anaphylaxis were recovered using validated alphanumeric strings in different fields of electronic clinical records used in the different public health settings in the city of Alcorcon (primary care, Emergency Department, hospitalized patients and Allergy Outpatient Clinic). Patients with anaphylaxis were tracked across the different clinical settings in Alcorcon. RESULTS: The incidence of anaphylaxis in Alcorcon was 103.37 episodes per 100 000 person-years (total standardized incidence rate of 112.2). There was a peak of 313.58 episodes in the 0-4 years age group and a different distribution of incidence rates (although non-significant) among different age groups between male patients and female patients. In most age groups, incidence tended to be higher for female patients aged over 10 years. Patients were attended at two or more levels in 76.78% of episodes, and a new evaluation was often made at a primary care centre (71.43%), Allergy Outpatient Clinic (75.6%), or both after the episode (58.93%). CONCLUSION AND CLINICAL RELEVANCE: This study revealed a higher rate of anaphylaxis than that in previous studies, although this incidence rate is probably lower than the real incidence rate. Studies exploring potential methodological, genetic and environmental factors accounting for these higher rates of anaphylaxis are required.

[Efficacy of four widely used techniques of the diagnosis of Helicobacter pylori infection in gastric ulcer disease]. / Eficacia de cuatro técnicas de amplio uso para el diagnóstico de la infección por Helicobacter pylori en la enfermedad ulcerosa gástrica.

OBJECTIVE: To study the accuracy of four currently used tests for the diagnostic of Helicobacter pylori infection among gastric ulcer patients with a gold standard as reference which combines several diagnostic methods. MATERIAL AND METHODS: Seventy-three consecutive gastric ulcer patients were prospectively studied. From all patients, three biopsies each were obtained from both antrum and body (two for haematoxylin-eosin staining and one for rapid urease test--Jatrox H.p. Test--. Also, IgG ELISA serology (Helico G) and 13C-urea breath test were performed. According to the gold standard, a patient was considered to be infected with H. pylori when at least two tests were positive; a patient was considered not to be infected with H. pylori when at least three tests were negative. RESULTS: Among gastric ulcer patients, the prevalence of H. pylori infection was 87.6% (95% CI: 78%-93%) with the gold standard as reference. The sensitivity and specificity values were as follows: histology (antrum), 96.8% (89%-99%) and 100% (66%-100%), respectively; histology (body), 98.4% (91%-100%) and 100% (66%-100%); urease test (antrum), 71.8% (60%-81%) and 100% (66%-100%); urease test (body), 96.8% (89%-99%) and 100% (66%-100%); breath test, 100% (94%-100%) and 100% (66%-100%), and serology, 95.3% (87%-98%) and 100% (66%-100%). The sensitivity of the urease test was higher with a body biopsy specimen (McNemar: 15; p < 0.001). CONCLUSIONS: All diagnostic tests (histology, rapid urease test, 13C-urea breath test and serology) are highly accurate for the diagnosis of H. pylori infection among gastric ulcer patients with the exception of the rapid urease test performed with antrum biopsy specimens, where this test displays a lower sensitivity for bacterial detection.

Eficacia de cuatro técnicas de amplio uso para el diagnóstico de la infección por Helicobacter pylori en la enfermedad ulcerosa gástrica / Efficacy of four widely used techniques for the diagnosis of Helicobacter pylori infection in gastric ulcer disease

Objetivo. Estudiar en enfermos con úlcera gástrica la eficacia de cuatro métodos diagnósticos de la infección por Helicobacter pylori de amplio uso en la actualidad, utilizando para ello un 'patrón oro' que combina varias técnicas diagnósticas. Material y métodos. Se estudiaron prospectivamente 73 ulcerosos gástricos consecutivos. En todos los pacientes se obtuvieron tres biopsias del antro y tres del cuerpo (dos para tinción de hematoxilina-eosina y una para la prueba rápida de la ureasa -Jatrox H.p.Test-). Asimismo se realizó una serología ELISA IgG (Helico G) y una prueba del aliento con urea-C13.Según el patrón oro, un paciente estaba infectado cuando dos o más técnicas eran positivas; se consideró ausencia de infección la negatividad de al menos tres de los métodos diagnósticos utilizados. Resultados. La prevalencia de la infección por H. pylori en los pacientes con úlcera gástrica tomando como referencia el patrón oro fue del 87,6 por ciento (IC 95 por ciento: 78 por ciento-93 por ciento). La sensibilidad y especificidad de los métodos diagnósticos fueron las siguientes: histología (antro), 96,8 por ciento (89 por ciento-99 por ciento) y 100 por ciento (66 por ciento-100 por ciento), respectivamente; histología (cuerpo), 98,4 por ciento (91 por ciento-100 por ciento) y 100 por ciento (66 por ciento-100 por ciento); prueba de la ureasa (antro), 71,8 por ciento (60 por ciento-81 por ciento) y 100 por ciento (66 por ciento-100 por ciento); prueba de la ureasa (cuerpo), 96,8 por ciento (89 por ciento-99 por ciento) y 100 por ciento (66 por ciento-100 por ciento); prueba del aliento, 100 por ciento (94 por ciento-100 por ciento) y 100 por ciento (66 por ciento-100 por ciento), y serología, 95,3 por ciento (87 por ciento-98 por ciento) y 100 por ciento (66 por ciento-100 por ciento). La sensibilidad de la prueba de la ureasa fue mayor en el cuerpo gástrico (McNemar: 15; p < 0,001).Conclusiones. Los métodos diagnósticos evaluados (histología, prueba rápida de la ureasa, prueba del aliento con urea-C13 y serología) tienen una elevada eficacia para el diagnóstico de la infección por H. pylori en los pacientes con úlcera gástrica, con la excepción de la prueba rápida de la ureasa realizada en muestras del antro, donde esta técnica es menos sensible para la detección de la bacteria (AU)

[Calmette-Guerin bacillus in the prophylaxis of superficial bladder tumors. Our experience and our doubts]. / Bacilo de Calmette-Guerin en la profilaxis de los tumores superficiales de vejiga. Nuestra experiencia y nuestras dudas.

OBJECTIVE: This study was conducted to determine the efficacy of our BCG dose and schedule for prophylactic therapy in superficial bladder tumors. METHODS: Following complete TUR, 81 mg intravesical BCG were administered weekly for six weeks and for nightly another six times. The patients were evaluated every three months by cytology, cystoscopy and routine analysis. RESULTS: 21/25 patients completed the treatment. At 15.5 months median follow-up, 18/21 (85.7%) were disease-free, 2/21 (9.5%) had recurrence and 1/21 (4.7%) showed disease progression. CONCLUSIONS: BCG is the most effective prophylactic therapy for superficial bladder tumors currently available. The ideal dose, treatment schedule and its mechanism of action are as yet unknown.

[Bladder schistosomiasis: report of 2 new cases with different anatomoclinical features and review of the literature]. / Esquistosomiasis vesical: aportación de dos nuevos casos con presentaciones anatomo-clínicas diferentes y revisión de la literatura.

This paper reports two cases of vesical schistosomiasis in two black patients treated in this Service over the last three years. A description is made of the different anatomo-clinical presentations of these two cases, commenting on the characteristics of this disease, its pathogenesis, diagnosis and treatment, and stressing the slight increase in its frequency in our environment as a consequence of the increased migratory movements of people from endemic regions into our country.

[Immunoprophylaxis of superficial tumors of the bladder with interferon alfa-2b. Our experience]. / Inmunoprofilaxis de los tumores superficiales de vejiga con interferon alfa 2b. Nuestra experiencia.

OBJECTIVE: The present study was conducted to determine the usefulness of prophylactic therapy with alpha 2b interferon for superficial bladder tumors. METHOD: Following complete TUR, alpha 2b infereron was administered to 36 patients at a dose of 50 million IU weekly for 3 months and monthly for 9 months. Patients were evaluated every 3 months on the basis of their clinical and analytical data and the cystoscopic findings. RESULTS: Twenty-six patients completed treatment and were evaluable. The follow up and disease-free period was 25.70 months. Recurrence was observed in 38.4% of the patients and tumor progression in 3.8%. CONCLUSIONS: Alpha 2b interferon is useful in the prevention of tumor recurrence. Its utility is similar to that of other drugs currently used.

[The role of vascular radiology in the diagnosis of "suspicious" images of the upper urinary tract]. / Papel de la radiología vascular en el diagnóstico de las imágenes "sospechosas" del tracto urinario superior.

Accurate diagnosis of "suspect" lesions from the Upper Urinary Tract (U.U.T.) is of major significance for implementing an appropriate treatment. There are many diseases and situations which may condition the occurrence of a suspect image, i.e., of a repletion defect of the U.U.T., in the U.I.V., the vascular imprints being just one of them. This paper contributes two cases where the suspect lesion was due to this cause and vascular radiology was decisive to reach a diagnosis.

[Endometrial carcinoma of the prostate. Report of a case]. / Carcinoma endometroide de próstata. A propósito de un caso.

Endometrial Carcinoma is an uncommon intraductal prostatic tumour, the origin (either from prostatic epithelium or Müellerian) and management (traditional hormonal therapy vs. progestagens) of which has been the subject of vigorous debate. Currently and with the help of the immunohistochemical techniques its origin has finally been confirmed as being prostatic, thus justifying the use of the traditional hormonal therapy applied in prostate acinous carcinoma. The paper contributes one case of Endometrial Carcinoma confirmed by immunohistochemical techniques, as well as a review of the main landmarks in the study of these tumours.

[Prophylaxis in prostatic surgery with aztreonam. Our experience]. / Profilaxis en cirugía prostática con Aztreonam. Nuestra experiencia.

Aztreonam is a monobactam antibiotic with a very specific spectrum of action for gram-negative aerobic bacteria. Since these bacteria are responsible for most of the urinary tract infections, we conducted a study to determine its efficacy in the prophylaxis and treatment of infections in prostate surgery, one of the most common procedures performed in our field. Thirty-two patients received 1 gm Aztreonam at the time of anesthetic induction and q 8 h thereafter to a total dose of 3 gm. Cultures were performed before and 72 h after surgery. Twenty-eight patients had no complications and a sterile urine culture or less than 10,000 colonies, 2 developed wound infection from Staph, aureus and 1 had more than 100,000 colonies of Enterococci in urine. The foregoing findings indicate that Aztreonam is useful for prophylaxis and treatment of urinary tract infections in prostate surgery.