Semi-automatic measuring of arteriovenous relation as a possible silent brain infarction risk index in hypertensive patients. / Medición semiautomática de la relación arteriovenosa retiniana como posible marcador de riesgo de infarto cerebral silente en pacientes hipertensos.

OBJECTIVE: To evaluate the usefulness of a semiautomatic measuring system of arteriovenous relation (RAV) from retinographic images of hypertensive patients in assessing their cardiovascular risk and silent brain ischemia (ICS) detection. METHODS: Semi-automatic measurement of arterial and venous width were performed with the aid of Imedos software and conventional fundus examination from the analysis of retinal images belonging to the 976 patients integrated in the cohort Investigating Silent Strokes in Hypertensives: a magnetic resonance imaging study (ISSYS), group of hypertensive patients. All patients have been subjected to a cranial magnetic resonance imaging (RMN) to assess the presence or absence of brain silent infarct. RESULTS: Retinal images of 768 patients were studied. Among the clinical findings observed, association with ICS was only detected in patients with microaneurysms (OR 2.50; 95% CI: 1.05-5.98) or altered RAV (<0.666) (OR: 4.22; 95% CI: 2.56-6.96). In multivariate logistic regression analysis adjusted by age and sex, only altered RAV continued demonstrating as a risk factor (OR: 3.70; 95% CI: 2.21-6.18). CONCLUSIONS: The results show that the semiautomatic analysis of the retinal vasculature from retinal images has the potential to be considered as an important vascular risk factor in hypertensive population.

Association between fibromyalgia and psychiatric disorders in systemic lupus erythematosus.

OBJECTIVES: Systemic lupus erythematosus (SLE) is an autoimmune disease that may affect many organs, with musculoskeletal symptoms being the most common. Fibromyalgia (FM) is frequent in SLE patients. Psychiatric disorders such as anxiety and depression are also present in many SLE patients. The aim of our study is to determine the relationship between FM and psychiatric symptoms (PS), both anxious (AS) and depressive (DS), and its impact on health status in SLE patients. METHODS: In a total of 84 SLE patients we studied the presence of both FM and PS using specific questionnaires (Hamilton). We also evaluated health status and SLE disease activity by both the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and serological markers. Patients performed the Short Form 12 (SF-12) questionnaire as a quality of life measure. Qualitative variables were compared using Pearson's chi-square test and Fisher's exact test, and Student's t-test was used for quantitative variables. The Mann-Whitney U-test was applied if a normal distribution was not observed. RESULTS: Thirty patients were diagnosed with FM (35.7%), 16 had clinical signs DS (19%) and 30 had clinical signs AS (35.7%). We found a statistically significant association between FM and AS (p<0.001), and between FM and DS (p<0.001). Higher SF-12 physical component and mental component scores were observed in FM group compared to non-FM group (p<0.001). We have not found any associations between SLE activity and FM and PS. CONCLUSIONS: There is a high prevalence of FM in SLE patients, and a strong association with DS and AS. FM contributes to worsening health status in SLE patients. SLE activity has little or no impact either on psychiatric symptoms or FM.

Estudio clínico epidemiológico de las neumonías por ®Mycoplasma» en un hospital general de Barcelona / Clinical and epidemiological study of Mycoplasma pneumoniae in a general hospital in Barcelona, Spain

Introducción: Mycoplasma pneumoniae es una de las causas más frecuentes de neumonía en la infancia. Objetivos: Estudiar los casos de neumonía por M. pneumoniae en un hospital de Barcelona en menores de 15 años, para conocer las características epidemiológicas, clínicas, radiológicas y analíticas, así como determinar si hay diferencias entre menores y mayores de 5 años y en casos de coinfección. Material y métodos: Se realizó un estudio retrospectivo, revisando las historias clínicas de los menores de 15 años que entre los años 2000 y 2006 fueron atendidos en el Hospital delMar de Barcelona y cuya IgM para Mycoplasma fue positiva. Posteriormente se realizó un análisis estadístico mediante el programa SPSS. Resultados: Se diagnosticaron 63 neumonías por Mycoplasma,35 en niñas y 28 en niños. La media de edad fue de 5,9años, y el 46% eran menores de 5 años. Hubo un mayor número de casos durante los años 2002 y 2004, sin observar ningún predominio estacional. Las manifestaciones clínicas más frecuentes fueron fiebre (n= 57) y tos (n= 53), además de faringitis o vómitos; la gran mayoría de los casos presentaban un buen estado general. La auscultación pulmonar fue patológica en 57casos, predominando la unilateralidad y los crepitantes. La alteración radiológica estuvo presente en 59 casos, mayoritariamente unilateral. Los resultados analíticos no presentaron alteraciones significativas. Se pautó tratamiento de forma empírica con penicilina o macrólidos antes de conocer la etiología. Se encontraron 16 coinfecciones con adenovirus, 6 con Chlamydiapneumoniae y uno con enterovirus. Conclusiones: Mycoplasma debe considerarse como un agente causal de neumonías en la infancia. Destacan la dificultad del diagnóstico diferencial con otras neumonías, la similitud clínica entre mayores y menores de 5 años y el elevado porcentaje de coinfección (AU)

Introduction: Mycoplasma pneumoniae is one of the main causes of pneumonia in children. Objectives: To study cases of pneumonia caused by Mycoplasma pneumoniae in children less than 15 years of age in a hospital in Barcelona, to establish the epidemiological, clinical, radiological and analytic characteristics. Another aim was to establish whether there are differences between children under and over 5 years of age and in cases of coinfections. Methods: A retrospective study was carried out in which the authors reviewed the clinical histories of children under 15years of age who, from 2000 to 2006, were brought to the Hospital del Mar in Barcelona and who were positive for Mycoplasma IgM. The statistical analysis of the findings was performed using a SPSS software package. Results: Sixty-three cases of mycoplasma pneumonia were diagnosed, 35 in girls and 28 in boys. The mean age was 5.9years, and 46% were less than 5 years old. There was a higher incidence during 2002 and 2004, but there was no seasonal prevalence. The most common clinical manifestations were fever(n=57) and cough (n=53), as well as pharyngitis or vomiting, while the great majority of the children were in good general health. Abnormal lung sounds were detected on auscultation in 57cases; in the majority they were unilateral and involved crackles. Radiographic changes, mainly unilateral, were observed in59 cases. The results of laboratory analyses revealed no significant alterations. Treatment consisted of penicillin or macrolides. There were 16 cases of coinfection with Adenovirus, six with Chlamydia pneumoniae and one with Enterovirus. Conclusions: Mycoplasma should be considered as the possible causal agent of pediatric pneumonia. The difficulty in the differential diagnosis with respect to other types of pneumonia, the clinical similarities of this disease in children under and over 5 years of age and the substantial incidence of coinfections are stressed (AU)