[Prevalence of nosocomial urinary infection. Alternatives to bladder catheterization]. / Prevalencia de infección urinaria nosocomial. Medidas alternativas al cateterismo vesical.

BACKGROUND: The detection of a high percentage of nosocomial urinary infection (NUI) associated with vesical catheterization (VC) and the frequent use of VC in patients with urinary incontinence, led us to implant a prevention programme which included the introduction of absorbent diapers as a alternative to vesical catheterization in incontinent patients. MATERIAL AND METHODS: After actualization and introduction of VC preventive measures and the introduction of absorbent diapers, regular determinations were made of the prevalence of NUI with analysis of the variations using the chi 2 test for trends. The prevalence of urinary incontinence and the efficacy of the diapers were also measured. RESULTS: The prevalence of NUI associated with VC showed a significant decrease, from 27.5% to 3% (p = 0.004). Between 6% and 11% of the patients admitted to the medical service had urinary incontinence. After introduction of the diapers as part of health care assistance programme, the use of VC in patients with urinary incontinence is rare. CONCLUSIONS: 1) The prevention programme allowed a significant reduction in the prevalence of NUI associated with VC. 2) The use of absorbent diapers to care for patients with urinary incontinence probably contributed to reducing the prevalence of NUI. It was well accepted by the nursing staff and iatrogeny associated with their use was scarce.

POEMS syndrome and multiple angioproliferative lesions mimicking generalized histiocytomas.

A case of POEMS syndrome and Castleman's multicentric disease is reported. Multiple long-standing cutaneous lesions, histologically similar to histiocytomas, were the initial manifestation of POEMS syndrome. A high incidence of angiomatous lesions associated with POEMS syndrome has already been established. To our knowledge, this report is the first report to associate multiple angioproliferative lesions mimicking generalized histiocytomas with POEMS syndrome.