La experiencia de implantación del nuevo Registro de Atención Sanitaria Especializada y la transición a la CIE10 en los hospitales españoles. Proceso y resultados esperados / No disponible

No disponible

Timing of DVT prophylaxis and risk of postoperative knee prosthesis infection.

This multicenter prospective study was performed to determine risk factors for knee prosthesis infection and the effect of timing doses of prophylactic low-molecular-weight heparins (LMWH) related to time of surgery on the risk of knee prosthesis infection. A total of 5496 consecutive patients who underwent total knee arthroplasty from 2005 to 2006 in 13 orthopedic centers were prospectively followed up for 6 months, and the incidence of knee prosthesis infection was recorded. A case control study was nested in the cohort. Case patients were matched to uninfected (control) patients, and the timing of perioperative LMWH was recorded as the main risk factor. Fifty patients developed postoperative knee prosthesis infection during the follow-up period, yielding an incidence of prosthesis infection of 0.91% (95% CI, 0.68%-1.20%). Forty-four patients were matched to 106 controls. Case patients received the first LMWH dose ±12 hours from the start of surgery more frequently than their control counterparts (odds ratio, 1.5; 95% CI, 0.73-3.0). After adjusting by main risk factors, no statistical association was found between close perioperative timing of LMWH and risk of prosthesis infection. Diabetes mellitus (adjusted odds ratio, 3.2; 95% CI, 1.2-8.8) and wound hematoma (adjusted odds ratio, 4.2; 95% CI, 1.1-16.5) were found to be independent risk factors for prosthesis infection.

Genomewide scan and fine-mapping linkage studies in four European samples with bipolar affective disorder suggest a new susceptibility locus on chromosome 1p35-p36 and provides further evidence of loci on chromosome 4q31 and 6q24.

We present the findings of a large linkage study of bipolar affective disorder (BPAD) that involved genomewide analysis of 52 families (448 genotyped individuals) of Spanish, Romany, and Bulgarian descent and further fine mapping of the 1p34-p36, 4q28-q31, and 6q15-q24 regions. An additional sample of 56 German families (280 individuals) was included for this fine-mapping step. The highest nonparametric linkage scores obtained in the fine mapping were 5.49 for 4q31 and 4.87 for 6q24 in the Romany families and 3.97 for 1p35-p36 in the Spanish sample. MOD-score (LOD scores maximized over genetic model parameters) analysis provided significant evidence of linkage to 4q31 and at least borderline significance for the 1p and 6q regions. On the basis of these results and previous positive research findings, 4q31 and 6q24 should now be considered confirmed BPAD susceptibility loci, and 1p35-p36 is proposed as a new putative locus that requires confirmation in replication studies.

Ayudas técnicas para la deambulación en geriatría / Deambulation technical devices in geriatric

La incapacidad que supone la alteración de la deambulación en el anciano representa una importante limitación de su independencia funcional. El proceso del envejecimiento, sumado en ocasiones a procesos patológicos, impiden al sujeto caminar y desplazarse con normalidad. Esta deficiencia se puede suplir con un conjunto de ayudas técnicas que permiten al individuo restablecer un patrón de marcha correcto y eficiente. Revisamos los aspectos más relevantes expuestos en la literatura al respecto, analizando las principales opciones disponibles y presentando sus indicaciones primordiales (AU)

[Study of electrocardiographic alterations during the acute phase of intracerebral hemorrhage and their prognostic implications]. / Estudio de las alteraciones electrocardiográficas durante la fase aguda de una hemorragia intraparenquimatosa y sus implicaciones pronósticas.

The electrocardiographic abnormalities occurring with acute central nervous system disease were known phenomenon. In this study, we have done a descriptive study of 100 patients with intracranial haemorrhage (ICH) compared with a control group and the changes associated a worse prognostic. We have observed that the incidence of abnormalities electrocardiographic were most frequent in the patients with ICH (p < 0.05). The incidence of abnormalities in the pattern electrocardiographic was the 70% and the incidence of arrhythmias was the 56%. We have also observed that the presence of Q wave, QTc > or = 0.44 sec and the atrial fibrillations means a worse prognostic. We conclude that the incidence of abnormalities electrocardiographic in the ICH is elevate an the presence of Q wave, QTc > or = 0.44 an the atrial fibrillations means a worse prognostic.

[Epidemiological study of nosocomial meningitis in neurological patients]. / Estudio epidemiólogico de la meningitis nosocomial en el enfermo neurológico.

We realized a retrospective study of all the patients who developed a nosocomial meningitis after to admitted to the Intensive Care Unit of our hospital, during the last five years. Nosocomial meningitis was found in 3.29% of the neurologic patients. The most frequent causes of the meningitis was the external ventricular drainage (14.8%), post-neurosurgical (0.8%) and head injury (0.0007%). The causative bacterias were stafilococo, S. pneumoniae, K. pneunomiae and P. aeruginosa. The mortality was of the 39.06%.