[Nocardia nova brain abscess]. / Absceso cerebral por Nocardia nova.

Nocardia nova is an uncommon pathogen for human beings. We describe an immunocompetent patient who acquired multiple cerebral abscesses. A surgical drainage yielded a sulpha-trimethoprim susceptible N. nova strain. The patient recovered uneventfully after a prolonged treatment with sulpha-trimethoprim.

Evolución de los serotipos, fagotipos y resistencia a antimicrobianos de Salmonella sp en el departamento de salud 02 de la provincia de Castellón, España (2000-2006) / Evolution of serotypes, phagotypes and antibiotic resistance of Salmonella spp in the 02 health district of Castellón, Spain (2000-2006)

Retrospective study of serotypes, phage types and antibiotic resistance of Salmonella spp isolates in the 02 Health District of Castellón, Spain (2000-2006). Strains were serotyped using commercial sera, and they were tested for antimicrobial susceptibility with automated systems. Serotyping confirmation and phage typing were performed by the National Reference Laboratory. A total of 1505 strains were isolated, with 49 different serotypes, being the most frequent Enteritidis. The most common serotype/phage type combination was S. Enteritidis phagetype 1. Of the isolates 81.6 percent were susceptible to amoxicillin/clavulanic acid; 65.2 percent to ampicilin; 99.9 percent to ciprofloxa-cin; 93.4 percent to trimethoprim-sulphametoxazole; and 99.8 percent to cefotaxime. Molecular methods could be useful to complete epidemiologic studies since 25 percent of our isolates showed the same serotype/phage type combination. In our health district antimicrobial resistance in Salmonella is not an important problem.

Descentralización de revisiones en pacientes sometidos a Tratamiento con Anticoagulación Oral (TAO) / Decentralizing review sessions for patients who have undergone an oral anticoagulant treatment

El uso terapéutico de los anticoagulantes orales (ACO) se inició hace más de cincuenta años. En la última década estamos asistiendo a un fuerte incremento de la población sometida a tratamiento con anticoagulación oral (TAO). Un correcto control, independientemente de que sea en el ámbito hospitalario o en atención primaria ha demostrado eficacia en la prevención de complicaciones graves; si a esto unimos la calidad de vida ganada al evitar desplazamientos e incomodidades, es obvio pensar que la descentralización nos beneficia a todos. Existen varios modelos de gestión del TAO. En este estudio se aborda el manejo desde atención primaria, contactando tras el ajuste de dosis y validación por parte del hematólogo del Complejo Hospitalario Torrecárdenas. Como hipótesis se pretende demostrar la posibilidad de descentralizar las revisiones de los pacientes sometidos al mismo, evitando desplazamientos para el control y ajuste de su tratamiento. Se trata de un estudio clínico no aleatorizado con elección del grupo intervención de manera no probabilística a criterio. Duración del mismo: doce meses. Población: pacientes sometidos a anticoagulación oral registrados en la base de datos del servicio de hematología del Complejo Hospitalario Torrecárdenas (Almería). Intervención aplicada: «descentralización del control de coagulación». El espacio muestral es de 38.097 personas. En este trabajo se ha incluido la voz del usuario como parte fundamental de la eficiencia(AU)

Therapeutic use of oral anticoagulants began some fifty years ago. In the past decade, we have witnessed a large increase in the number of people who undergo oral anticoagulant treatment. A correct applied control on these patients, whether that control be carried out in a hospital setting or in a primary health care center, has been demonstrated to be effective in preventing serious complications; this fact taken into account with the improved life quality gained by avoiding displacements and inconveniences makes it obvious to conclude that decentralization benefits all concerned. There are various models available to use to manage oral anticoagulant treatment. In this analysis, the authors deal with the management carried out from a primary health care center, which contacts patients after their dosis has been adjusted and validated by a hematologist at the Torrecárdenas Hospital Complex. As their hypothesis, the authors of this study plan to demonstrate the possibility of decentralizing the reviews of patients undergoing oral anticoagulant treatment, thereby avoiding trips in order to control and adjust their treatment. This is a non-random clinical study whose study group has been chosen by means of a non-probability criteria. This study lasted 12 months. The subjects were chosen from patients undergoing oral anticoagulant treatment registered in the hematology service’s data base at the Torrecárdenas Hospital Complex in Almeria. Applied protocol for being included in this study was decentralization of coagulation. The study sample included 38,097 patients. This study included commentaries by the patients receiving this treatment as a fundamental element to prove its effectiveness(AU)

Impacto de las peticiones de detección de antígeno en orina y su porcentaje de positividad en la incidencia de casos esporádicos de neumonía por Legionella en Castellón / No disponible

Fundamentos: En este trabajo se evalúa el impacto que tiene el número de peticiones de análisis y su porcentaje de positividad sobre la endemia de legionelosis registrada de un área de la provincia de Castellón durante el periodo de implantación de la prueba (2001-2003).Métodos: Se excluyeron las peticiones repetidas y los casos asociados a brotes. Se estimó el incremento de casos esporádicos y del porcentaje de positividad mediante el riesgo relativo, tomando como referencia el primer año. Resultados: Hubo 2.068 peticiones correspondientes a1.819 enfermos. El porcentaje de enfermos positivos fue de 2,3%, sin diferencias significativas entre laboratorios o años. El número de casos esporádicos se incrementó en 9,3 veces (2,8-30,7).Conclusiones: El incremento de casos esporádicos registrados aparece como un artefacto. El aumento de peticiones de análisis incrementan el número de casos diagnosticados como efecto de arrastre, de modo que el aspecto pseudoepidémico del periodo tendría un componente de endemia descubierta cuya magnitud se podría estimar a partir de este indicador. Convendría, por otra parte, conocer los criterios de petición en cada hospital y las características de los enfermos con resultados negativos (AU)

Purpose: This work aims to ascertain the impact of the total number of urine antigen tests performed and the percent of positive results on the endemic level of legionellosis registered in an area of Castellón (Spain)during the period of introduction of this analytic method(2001-2003).Methods: Repeated analysis and outbreak associated cases were excluded from laboratory records. The increment of sporadic cases and percent of positive results were calculated by computing the relative risk (RR) with the first year as reference. Results: There were 2068 test performed from 1819patients.. The percent of positive results was 2.3%, without statistical differences between laboratories and years. The increment of endemic level registered resulted in a RR = 9.3 (2.8-30.7).Conclusions: The rise on registered sporadic cases appears as an artefact. The increment of patients with analysis reveal an endemic component of this pseudoepidemic period whose magnitude can be estimated by this indicator. However, clinical criteria of analytical petitions in each setting and characteristics of patients with negative results should be taken into account (AU)