[Health-related quality of life in patients recovered from COVID-19]. / Calidad de vida relacionada con la salud en pacientes recuperados de COVID-19.

INTRODUCTION: The presence of symptoms after acute SARS-CoV-2 infection is frequent and has an impact on patients' quality of life. The aim of this study is to assess the health-related quality of life of COVID-19 survivors and to ascertain which factors are related to worse results. METHODS: An observational, cross-sectional study has been performed, using, a telephone survey that was administered to all patients with COVID-19 from the first pandemic wave in our healthcare area 10months after the acute infection. Patients with dementia and nursing home residents were excluded. Health-related quality of life was assessed using the EQ-5D instrument and its índices EQ-VAS and EQ-Health Index. RESULTS: 443 answers were collected. Mean age was 54±16 and 38.4% of patients were male. The most affected domain was anxiety/depression (23.9% of patients) and mobility (16.5%). Mean global EQ-VAS score was 75.8±18.7, and mean EQ-Health Index was 0.884±0.174. Both VAS and Health Index scores were lower in females, patients older than 65 years, patients with comorbidities, and those who needed hospital admission during the acute infection. VAS scores in our sample were lower than in the general Spanish population, but similar to the scores in our region prior to the pandemic. Female sex, hospital admission, and a lower educational status were independently associated to lower EQ-Health Index scoring. CONCLUSION: While health self-perception is affected after COVID-19, this might not be directly related to the infection. There exist profiles of patients more prone to a worse quality of life in which interventions may be considered.

Edema pulmonar fatal en paciente con meningitis por enterovirus / No disponible

No disponible

[Pyogenic liver abscess: changes in etiology, diagnosis and treatment over 18 years]. / Absceso hepático piógeno: cambios en la etiología, diagnóstico y tratamiento a lo largo de 18 años.

BACKGROUND: There are no detailed studies in our country on the impact of modern imaging techniques on diagnosis, treatment and prognosis of pyogenic liver abscesses. MATERIAL AND METHODS: All patients with the diagnosis of PLA from 1981 to 1998 were included in the study. The study was divided in two periods: 1981 to 1989 and 1990 to 1998. RESULTS: Compared with the first time period, the following was observed from 1990 to 1998: the mean age was higher (52 versus 65 years, p = 0.006), infections with identified source increased (33% versus 74%, p = 0.003), diagnosis was earlier (13 versus 3 days, p = 0.0002), modern imaging techniques were used more frequently (17% versus 96%, p = 0.002), the proportion of recovered microorganisms increased (53% versus 88%, p = 0.002), as well as use of percutaneous drainage (0% versus 37%, p = 0.002) and the prognosis was better (mortality rate 40% versus 10%, p = 0.01). CONCLUSIONS: Relevant changes were observed among patients in our hospital in the nineties regarding epidemiology, management and prognosis of PLAs. Part of these changes are due to a higher use of new imaging techniques.

[Clinical profile and prognosis of bacteremia in patients with cirrhosis based on the Child-Pugh classification]. / Perfil clínico y pronóstico de las bacteriemias en pacientes cirróticos de acuerdo con la clasificación de Child-Pugh.

The characteristics of 70 cases of bacteremia in cirrhotic patients were studied according to the Child-Pugh classification as severity marker of liver involvement. Factors influencing on prognosis were determined. For a comparative analysis, 1,006 cases of bacteremia in non-cirrhotic patients were included. Sixteen patients corresponded to group A, 23 to group B and 31 to group C in the Child-Pugh classification. Patients in group A had a predominance of extra-enteric microorganisms, mainly Staphylococcus aureus (37.5%; p = 0.02), well-defined source (urinary tract, respiratory tract, skin) and good prognosis (mortality rate 6.2%). In contrast, patients in group C had a high recovery rate of Escherichia coli (41.9%) and pneumococcus (19.3%), undetermined source (51.6%; p = 0.05), ascites (83.9%), with or without concomitant peritonitis (41.1%; p = 0.03) and poor prognosis (mortality rate 48.3%; p = 0.008). The characteristics of patients in group B were similar to those of patients in group C but prognosis was as in patients in group A. The immediate mortality rate in the studied patients was 26%. The parameter which best predicted survival in the multivariate analysis was the Child-Pugh classification.

[Bacteremia in the elderly. Clinical features and prognostic factors]. / Bacteriemia en ancianos. Aspectos clínicos y factores pronósticos.

BACKGROUND: The analysis of the most relevant characteristics and prognostic factors in elderly patients with bacteremia. PATIENTS AND METHODS: For the period 1989-1993 a prospective study of all significant bacteremias in adult patients admitted to a General Hospital was performed. Patients were visited until their death or during at least 50 days. The most relevant findings in elderly patients (over 65 years old) are described. Overall survival probabilities were obtained by Kaplan-Merner analysis. Cox proportional models were used to examine hazards of dying. RESULTS: Of the 1,128 bacteremias studied, 603 (53.9%) were in elderly patients. In this group, the increasing age was related with higher frequency of urinary (p = 0.02) and biliary (p = 0.001) sources of infection and lower frequency of underlying neoplasia (p = 0.06), immunosuppression (p = 0.0000) and development of septic shock (p = 0.02). These differences are higher in patients over 85. Among older patients the survival probability in the day 21 after diagnosis was 0.71 (95% CI 0.66-0.74), significantly lower to the probability in younger patients (p = 0.0001). In the elderly patients, the worse prognestic was associated to shock (RR = 8; 95% CI 5.8-11), indeterminated source of infection (RR = 3.6; 95% CI 2.2-5.8), underlying neoplasia (RR = 1.7; 95% CI 1.3-2.4), neutropania (RR = 1.5; 95% CI 1.1-2.1) nosocomial acquisition (RR = 1.3; 95% CI 1.0-3.1) and inappropriate treatment (RR = 1.2; 95% CI 1.0-3.2), but age was not an independent contributor. CONCLUSIONS: We found differences between the clinical characteristics and the prognosis of bactermia in elderly and younger patients. Among elder patients, those over 85 years old constitute a particular group with well defined characteristics.

[Neurologic manifestations of polycythemia vera. Analysis of 24 cases and review of the literature]. / Manifestaciones neurológicas de la policitemia vera. Análisis de 24 casos y revisión de la literatura.

Neurological symptoms (NS) of 33 patients diagnosed as suffering from polycythemia vera (PV) are described. 24 of them (73%) had NS at some point in their evolution, the most frequent being related to blood hyperviscosity (headache 51%, dizziness 36%, paresthesias 30%, sight alterations 21%). 5 patients had ictus (15%) and there were no bleeding symptoms in the nervous system. There were no significant differences (p greater than 0.05) in age, sex; hematocrit, platelet or volume of packed red cells, between patients with NS and those without NS. A complete remission of NS was obtained reducing the hematocrit, except in ictus patients. We did not find mortality, as a result of NS.