Clinical characteristics and type of antithrombotic treatment in a Spanish cohort of elderly patients with atrial fibrillation according to dependency, frailty and cognitive impairment.

BACKGROUND: Available data regarding clinical profile and management of elderly patients with atrial fibrillation (AF) according to dependency, fragility and cognitive impairment are scarce. The objective of the study was to analyze the biodemographic data, clinical profile and antithrombotic treatment according to dependency, fragility and cognitive impairment in elderly AF patients. METHODS: Cross-sectional and multi-center study performed in consecutive AF patients ≥ 75 years treated with oral anticoagulants ≥ 3 months attended in Internal Medicine Departments in Spain. RESULTS: A total of 837 patients (83.0 ± 5.0 years; CHA2DS2-VASc: 5.0 ± 1.4; HAS-BLED: 2.1 ± 0.9) were included. 44.4% of patients had some degree of dependency, 43.3% were fragile, and 32.3% had cognitive impairment. Patients with any of these conditions were older, had a worse clinical profile, with more comorbidities and higher risks of thromboembolic and bleeding events. All these conditions were independently associated among them. Overall, 70.8% of patients were taking vitamin K antagonists, the remaining 29.2% direct oral anticoagulants and 9.7% oral antiplatelets. This distribution was independent of the presence of dependency or fragility, but there was a trend to a higher prescription of vitamin K antagonists in those patients with cognitive impairment (75.2% vs. 68.8%; P = 0.05). CONCLUSIONS: Approximately 32%-44% of elderly anticoagulated AF patients attended have some degree of dependency, fragility and/or cognitive impairment. Patients with any of these conditions are older and have a worse clinical profile. Approximately 71% of patients are taking vitamin K antagonists, regardless dependency or frailty, but with a trend to higher prescription in patients with cognitive impairment.

Localización inusual del hidradenoma papilífero / Unusual location of the papilliform hydradenoma

El hidradenoma papilífero es una tumoración benigna, rara, generalmente localizada en la región vulvar o perineal siendo la región perianal una localización poco frecuente. Su asociación con enfermedades de transmisión sexual y el carcinoma ductal es controvertida; es importante realizar el estudio histopatológico de cualquier tumoración en esta zona. Se reporta el caso de una paciente de 49 años de edad, con un nódulo en la región perianal de 2 años de evolución; el estudio histopatológico confirmó el diagnóstico de hidradenoma papilífero. (AU)

The papilliferous hidradenoma is a benign, rare tumor, usually located in the vulvar or perineal region and the perianal region is a rare site. Its association with sexually transmitted diseases and ductal carcinoma is controversial. It is important to perform the histopathological study of any tumor in this area. The case of a 49-year-old patient with a nodule in the perianal region of 2 years of evolution is reported. The histopathological study confirmed the diagnosis of papilliferous hidradenoma.

HIV vaccine trial willingness among injection and non-injection drug users in two urban centres, Barcelona and San Francisco.

Being able to recruit high-risk volunteers who are also willing to consider future participation in vaccine trials are critical features of vaccine preparedness studies. We described data from two cohorts of injection- and non-injection drug users in Barcelona, Spain [Red Cross centre] and in San Francisco, USA, [UFO-VAX study] at high risk of HIV/HCV infection to assess behaviour risk exposure and willingness to participate in future preventive HIV vaccine trials. We successfully identified drug-using populations that would be eligible for future HIV vaccine efficacy trials, based on reported levels of risk during screening and high levels of willingness to participate. In both groups, Red Cross and UFO-VAX respectively, HCV infection was highly prevalent at baseline (41% and 34%), HIV baseline seroprevalence was 4.2% and 1.5%, and high levels of willingness were seen (83% and 78%).

Pilot study assessing HIV vaccine trial readiness among female sex workers, injection and non-injection drug users, and men who have sex with men in Spain.

The purpose of this study was to assess HIV risk and willingness to participate in HIV vaccine trials in three high risk populations in Spain. Eight hundred and forty-four participants, comprising female sex workers, injection and non-injection drug users (IDUs and NIDUs, respectively), and men who have sex with men were tested for HIV and surveyed for risk and willingness to participate in future preventive HIV vaccine trials. HIV seroprevalence was 3.8% (95% CI: 2-11). HIV infection was associated with transgender identification, IDU in the past year, and sex with an IDU or other drug-using partner. The majority (82%) expressed their willingness to participate in HIV vaccine trials. Substantial sexual and parenteral risk in all groups and concomitant willingness to participate in vaccine trials was found, particularly among women and IDUs. Additional longitudinal cohort studies in Spain are needed to plan future vaccine efficacy trials.

Fitoflagelados potencialmente tóxicos y nocivos de costas del Pacífico mexicano / Potentially toxic and harmful phytoflagellates from the Mexican Pacific coasts

Los fitoflagelados son un grupo heterogéneo de flagelados autotróficos, heterotróficos y mixotróficos, con importancia ecológica para los niveles tróficos en diferentes ecosistemas. Los fitoflagelados en costas del Pacífico mexicano (y en Latinoamérica en términos generales) son virtualmente desconocidos, sólo se tienen pocos registros. El estudio de los fitoflagelados requiere de métodos complicados de recolección y análisis. Esta es, probablemente, la causa de la escasez de conocimiento de este grupo en áreas tropicales y subtropicales. Material recientemente recolectado a lo largo del Pacífico mexicano sirvió para el estudio de fitoflagelados marinos, incluyendo algunos tóxicos y potencialmente tóxicos. Se usaron muestras de plancton filtradas por gravedad y con bomba de vacío utilizando diferentes métodos de fijación y análisis. Se registran aquellas especies presentes o con posibilidad de estarlo que son potencialmente nocivas para el ecosistema marino pertenecientes a los Phyla Euglenophyta, Heterokontophyta y Haptophyta. Estas especies están distribuidas en el plancton, en aguas oceánicas y costeras

The phytoflagellates are a heterogeneous group of autotrophic, heterotrophic and mixothrophic flagellates of trophic importance in several ecosystems. As in the rest of Latin America, the phytoflagellates that occur in the Mexican Pacific coasts are virtually unknown except for a few records. Their study require complicated collection and analysis methods, a probable cause for the scarce knowledge of this group in tropical and subtropical areas. Material recently collected from various localities along the Mexican Pacific coasts was used to study phytoflagellates, including toxic and potentially toxic species. Plankton samples were treated by gravity and pump filtration, using different methods for fixation and analysis. The phyla Euglenophyta, Heterokontophyta and Haptophyta were found. They occur as plankton in oceanic and shallow coastal waters

[Potentially toxic and harmful phytoflagellates from the Mexican Pacific coasts]. / Fitoflagelados potencialmente tóxicos y nocivos de costas del Pacífico Mexicano.

The phytoflagellates are a heterogeneous group of autotrophic, heterotrophic and mixothrophic flagellates of trophic importance in several ecosystems. As in the rest of Latin America, the phytoflagellates that occur in the Mexican Pacific coasts are virtually unknown except for a few records. Their study require complicated collection and analysis methods, a probable cause for the scarce knowledge of this group in tropical and subtropical areas. Material recently collected from various localities along the Mexican Pacific coasts was used to study phytoflagellates, including toxic and potentially toxic species. Plankton samples were treated by gravity and pump filtration, using different methods for fixation and analysis. The phyla Euglenophyta, Heterokontophyta and Haptophyta were found. They occur as plankton in oceanic and shallow coastal waters.

Manejo actual de la candidiásis sistémica neonatal con fluconazol: informe de dos casos / Current management of sistemic candidiasis with fluconazole in newborn: report of two cases

Presentamos dos casos de recién nacidos prematuros con muy bajo peso al nacer, que requirieron manejo especial en la unidad de cuidados intensivos, con ventilación mecánica, antibióticos de amplio espectro, monitoreo invasivo que desarrollaron candidiasis sistémica. Se les trató con Fluconazole a dosis convencional aprobada por la Administración Federal de Drogas y Alimentos (FDA) de los Estados Unidos, con excelentes resultados y sin reacciones secundarias. Este enfoque de manejo ofrece una buena alternativa en el tratamiento de ésta patología.

Indometacina endovenosa en el cierre del conducto arterioso persistente en recién nacidos / Endovenous indomethacin in the closure of patent ductus arteriosus in newborn

Se presenta un caso de una paciente recién nacida prematura, con retardo en el crecimiento intrauterino, quien despúes de 19 días de vida inició falla para crecer y apneas secundarias a la persistencia de conducto arterioso, la cual se resolvió luego del empleo de indometacina por vía endovenosa. La presente es la primera comunicación escrita en nuestro país del empleo de indometacina endovenosa, para lograr el cierre del conducto arterioso persistente

Fistula salival y mediastinitis: complicación fatal post plastia esofágica. Reporte de un caso / Salival fistula and mediastinitis: fatal complication post esophageal plasty

Se presenta un caso de una paciente femenina con diagnostico de atresia esofagica IIIA; operada a las 11 horas de vida y cuya evolucion se complico con una fistula salival, mediastinitis y choque septico. Se manejó conservadoramente con ayuno, nutricion parenteral y antimicrobianos. La respuesta a dicho manejo fué admirable, la fístula cerró y el esófago se conservó sin evidencia de estenosis

Experiencia Madre Canguro / Kangaroo mother experience

Se evaluó los resultados del manejo de recién nacidos pretérmino y detérmino con peso al nacer menor de 2000 gramos con os métodos de alimentación: Tradicional y Madre Canguro (10 recién nacidos en cada grupo): Los niños manejados con el método Madre Canguro tuvieron mayor incremento ponderal y menor estancia hospitalaria, a pesar de tener menor peso promedio al nacer y un grado mayor de prematuridad, demostrándose así la efectividad del método Madre Canguro

Utilidad de la correlación entre los hallazgos anormales en el examen físico y la escala clínica de Yale como criterio de hospitalización para lactantes febriles / Correlatión utility between the abnormal findings in the physical examination and the Yale clinical scale as hospitalization's criteria for febriles infants

Se efectuó un estudio prospectivo en 64 niños con edades comprendidas entre 1 y 24 meses durante el tiempo transcurrido entre el 1 de Octubre y el 30 de Noviembre de 1989, se demostró que en uestro medio existe una importante interacción entre el aspecto de un niño febril y los datos anormales de la exploración física, que tienen un valor predictivo en el tipo de manejo que el paciente puede requirir

Utilidad de una correlación entre hallazgos anormales en el exámen físico y la escala clínica de Yale como criterio de hospitalización para lactantes febriles / Correlation utility between the abnormal findings in the physical examination and the Yale clinical scale as hospitalization`s criterio for febriles infants

Se efectuó un estudio prospectivo en 64 niños con edades comprendidas entre 1 y 24 meses durante el tiempo trascurrido entre el 1 de octubre y el 30 de noviembre de 1989, se demostró que en nuestro medio existe una importante interacción entre el aspecto de un niño febril y los datos anormales de la exploración física, que tienen un valor predictivo en el tipo de manejo que elpaciente puede requerir