[Usefulness of transesophageal echocardiography in the detection of embolic risk in a case of Staphylococcus aureus endocarditis]. / Utilidad de la ecocardiografía transesofágica en la detección del riesgo embólico en un caso de endocarditis por Staphylococcus aureus.

Embolism is very frequently found in patients with infective endocarditis (IE), fundamentally in cerebral arteries. An early diagnosis and possible complications seem to be related to morbidity and mortality. Echocardiography has a considerable function in early diagnosis, and, also, when we evaluate the risk of major cerebral embolism. However there is no agreement in the second aspect: for some authors echocardiography only slightly aids, but others consider it of great value in identifying high-risk patients. We describe a patient who suffers infective endocarditis by Staphylococcus aureus with significant neurological complications in its evaluation. Vegetation was disclosed by transesophageal echocardiography (TEE), whereas transthoracic echocardiography (TTE) was unable to do so. This is why we underline the role of TEE in the diagnosis and description of vegetation features (size, mobility and implantation) which seem to be linked to the risk of cerebral complications.

[Promotion of mother-infant health: a comparative study of legislation of pregnancy protection]. / Promoción de la salud maternoinfantil: estudio comparativo de la legislación para la protección del embarazo.

OBJECTIVE: To describe the legislative measures aimed at protecting working women during pregnancy, which exist in France, Italy, the United Kingdom and Spain. DESIGN: The aspects studied were employment protection and modifications in work conditions for the pregnant woman. Existing Spanish legislation, the third Programme of Community Action for Equal Opportunities and some relevant scientific articles were reviewed. MEASUREMENTS AND MAIN RESULTS: Regarding protection of pregnant women from dismissal, legislation is more explicit in France and Italy, where protection covers the whole of the pregnancy, extending in France until 4 weeks after the end of the period off-work for the birth and in Italy until the child is one year old. Likewise, both in France and Italy, there is a long list of jobs which a pregnant woman is not allowed to do, with the possibility of a change of post if necessary. In Spain there is a Health at Work draft law, where measures relating to this question have been assembled. CONCLUSION: In general, the legislation referring to the protection of pregnant women at work is not widely known and leaves without protection those women in a more vulnerable work situation. Health professionals could support the equality and health of working women by informing them adequately of their rights.

Semen characteristics and diabetes mellitus: significance of insulin in male infertility.

A study was made of semen quality and serum hormonal profiles (FSH, LH, prolactin, testosterone) of patients with type I diabetes mellitus. Semen parameters and levels of prolactin and testosterone were significantly altered in the diabetic state. The concentration of insulin in serum and seminal plasma and the serum levels of FSH, LH, and testosterone were measured in 80 men classified in the following groups: fertile subjects, infertile normoglycemic subjects, subjects with carbohydrate intolerance, and excretory and secretory azoospermic subjects. In all groups, seminal insulin concentrations were higher than those obtained in serum. The hormone appears to freely cross the blood-testis barrier, there to be concentrated in the semen. The levels of insulin in serum and seminal plasma did not correlate with semen parameters and are not suitable markers of seminal quality. For unknown reasons, the concentrations of insulin in seminal plasma were lower in the subjects suffering from carbohydrate intolerance.