[Shigella spp. infections in Getafe Hospital between 2001 and 2006]. / Infección por Shigella spp. en el Hospital de Getafe entre 2001 y 2006.

INTRODUCTION: Shigella spp. is a bacterium that frequently causes diarrhoea in underdeveloped countries, but not so much in Spain, where it has been published that its incidence has decreased in the last few years. OBJECTIVE: The aim of this study has been to asses changes in the epidemiology of Shigella spp. infection over the last 5 years in children of Getafe, as well as the subspecies of Shigella spp. that cause illness in this area (area 10, Madrid), the need for hospitalisation, the complications and the treatment. METHOD: A retrospective study was carried out, based on a review of the medical charts of children less than fifteen years old and had a diagnosis of Shigella spp. infection during 2000-2006. They were identified through the Getafe Hospital Microbiology Service. RESULTS: Nineteen patients were identified, of which only four needed to be hospitalised. There were no differences between males and females. The Shigella spp. subspecies identified were S. sonnei and S. flexneri. The most frequent symptoms were vomiting, abdominal pain, diarrhoea, and fever. Only one had dehydration as a complication. The treatment was symptomatic, except in the four hospitalised patients, who required fluid therapy and antibiotics. The outcome was good in all patients. CONCLUSION: In this study, there appears to be an increase in the Shigella spp. incidence over the last few years in Area 10 of Madrid. Due to the fact that Shigella spp. is not a frequent bacterium in Spain, there are not enough studies on it, therefore it would be of interest to carry out prospective studies, in order to confirm this increase in incidence.

Infección por Shigella spp. en el Hospital de Getafe entre 2001 y 2006 / Shigella spp. infections in Getafe Hospital between 2001 and 2006

Introducción: Shigella spp. es un patógeno que produce gastroenteritis aguda de forma frecuente en países en desarrollo, pero no tan habitual en España, donde se ha publicado que está disminuyendo su incidencia en los últimos años Objetivo: El objetivo de este estudio fue determinar cambios en la epidemiología de Shigella spp. en los últimos 5 años en la población infantil de Getafe, así como el tipo de Shigella spp. que produce enfermedad en el área 10 de Madrid (área que depende de nuestro hospital), la necesidad de ingreso, sus complicaciones y tratamiento. Método: Se llevó a cabo un estudio descriptivo, retrospectivo, basado en revisión de historias clínicas de los pacientes, menores de 15 años, afectados por shigellosis entre los años 2001 y 2006, que fueron identificados a partir del Servicio de Microbiología del Hospital Universitario de Getafe. Resultados: Se identificaron 19 pacientes, de los cuales sólo 4 precisaron ingreso. Las subespecies de Shigella spp. identificadas fueron S. sonnei y S. flexneri. La clínica más frecuente fue diarrea, que se acompañaba de vómitos, dolor abdominal tipo cólico y fiebre elevada. Sólo uno de los pacientes presentó deshidratación hiponatrémica como complicación. El tratamiento fue sintomático, salvo en los pacientes ingresados en los que se pautó fluidoterapia intravenosa y antibioterapia, con resolución de la enfermedad. Conclusión: En el estudio realizado parece existir un aumento de la incidencia de Shigella spp. en los últimos años en el área 10 de Madrid. Al no ser un patógeno frecuente en España, no existen muchos estudios, con lo que sería interesante realizar estudios prospectivos para confirmar este aumento de incidencia (AU)

Introduction: Shigella spp. is a bacterium that frequently causes diarrhoea in underdeveloped countries, but not so much in Spain, where it has been published that its incidence has decreased in the last few years. Objective: The aim of this study has been to asses changes in the epidemiology of Shigella spp. infection over the last 5 years in children of Getafe, as well as the subspecies of Shigella spp. that cause illness in this area (area 10, Madrid), the need for hospitalisation, the complications and the treatment. Method: A retrospective study was carried out, based on a review of the medical charts of children less than fifteen years old and had a diagnosis of Shigella spp. infection during 2000-2006. They were identified through the Getafe Hospital Microbiology Service. Results: Nineteen patients were identified, of which only four needed to be hospitalised. There were no differences between males and females. The Shigella spp. subspecies identified were S. sonnei and S. flexneri. The most frequent symptoms were vomiting, abdominal pain, diarrhoea, and fever. Only one had dehydration as a complication. The treatment was symptomatic, except in the four hospitalised patients, who required fluid therapy and antibiotics. The outcome was good in all patients. Conclusion: In this study, there appears to be an increase in the Shigella spp. incidence over the last few years in Area 10 of Madrid. Due to the fact that Shigella spp. is not a frequent bacterium in Spain, there are not enough studies on it, therefore it would be of interest to carry out prospective studies, in order to confirm this increase in incidence (AU)

Bloqueo ciático a nivel de la fosa poplítea. Comparación entre dos abordajes / Sciaticblockade at the level of the popliteal fossa. Comparison between two approaches

Objetivos:Valorar las ventajas e inconvenientes, tanto desde elpunto de vista médico como del paciente, del bloqueo delnervio ciático a nivel del hueco poplíteo comparando la víaposterior y la lateral.Material y métodos:Se realizó un estudio prospectivo en 66 pacientes ASAI-II, propuestos para cirugía ortopédica del pie. Los pacientesfueron distribuidos de forma aleatoria en dos grupos,grupo A (33 pacientes): abordaje posterior y grupo B (33pacientes): abordaje lateral. El anestésico local utilizado fuemepivacaína 1,5% (20 ml). Todos los pacientes fueron premedicadoscon midazolan 2 mg, i.v. Se estudiaron los siguientes parámetros: edad, peso, altura,sexo, dificultad por parte del anestesiólogo para encontrarlas referencias anatómicas del punto de entrada (alta,media, baja), número de pases de la aguja hastaencontrar el nervio, tiempo desde el momento de la punciónhasta la localización del nervio, disconfort del pacientedurante la punción (en una escala visual analógica de 0 a10), tolerancia del paciente al decúbito prono, satisfacciónglobal del paciente (mala, regular, buena, muy buena, excelente)y complicaciones derivadas de la técnica.Resultados:No se encontraron diferencias significativas entre losdos grupos en cuanto a las características demográficas, dificultadanatómica y satisfacción global del paciente. El bloqueopor vía lateral presenta mayor número de pases,tiempo de ejecución, disconfort del paciente y un riesgomayor de punción arterial. Sólo dos de los pacientes estudiadospresentaron algún grado de dificultad para posicionarseen decúbito prono.Conclusiones:La vía posterior es de elección en este bloqueo y la víalateral es una alternativa a tener en cuenta en ciertos pacientes

Objectives:To assess the benefits and drawbacks, both for thephysician and for the patient, of the blockade of the sciaticnerve at the level of the popliteal fossa comparing the rearand the lateral approach.Material and methods:A prospective study was performed on 66 patients ASAI-II that were candidates for orthopedic foot surgery. Patientswere randomized to two groups: group A (33 patients)in which the rear approach would be used andgroup B (33 patients) in which the lateral approach wouldbe used. The local anesthetic used was mepivacaine 1.5%(20 ml). All the patients received prior medication with midazolam2 mg, i.v.The following parameters were determined: age,weight, height, gender, difficulty for the anesthesiologist tofind the anatomical references of the entrance point (high,medium, low), number of needle punctures before locatingthe nerve, time elapsed till the puncture to the location ofthe nerve, discomfort of the patient during the puncture(rated in a visual analogical scale from 0 to 10), toleranceof the patient to prone and supine position, global patientsatisfaction (poor, regular, good, very good, excellent) andcomplications associated to the technique.Results:No significant differences were found between the twogroups in terms of demographic characteristics, anatomicaldifficulty and global patient satisfaction. Blockade performedthrough the lateral approach results in a greaternumber of punctures, a longer procedure, greater discomfortfor the patient and a higher risk of arterial puncture.Only two of the patients studied had some difficulty withthe prone and supine position.Conclusions:The rear route is preferable for this procedure, althoughthe lateral route is an alternative that has to be consideredin some patients