Search

Introduction: Ganser syndrome is a rare medical disorder situated between hysterical etiopathogenesis and psychosis, factitious disorders and organic lesions which results in a difficult diagnosis. It is listed in DSM VI as a dissociative disorder whose main symptom is approximate answers, other accompanying symptoms appearing in Ganser: clouding of consciousness, somatic conversion symptoms and hallucinations. Psychopathologically explains a mental state of escape from a situation difficult to being tolerated. Organically appears in pathologies involving the frontal lobes Objectives: We present a case of a XX year old man who suddenly develops a depressive disorder with no apparent cause. Initially he was a professionally developed man. Famous archaeologist. University professor. Guitarist in a musical group. He deteriorated through the years, appearing dementia data with auditive hallucinations and resistant headache. He begins to have difficulty speaking correctly, with paraphasias and short answers, continually repeating "I don't know", Short-term amnesia and bed-chair life Methods: It was impossible to perform both the Mini-Mental State Examination test and the fototest because the patient refused claiming to be very nervous. The CT and MRI showed a slight temporary atrophy and vascular age changes. Subsequently, PET was performed without notable findings. Antidepressant and anxiolytic treatment was introduced without success as well as treatment for dementia and antipsychotic treatment. Results: The headache was improved. The rest of the symptoms did not disappear Conclusions: Ganser syndrome is a psychiatric condition that is difficult to diagnose and treat. [ABSTRACT FROM AUTHOR]

Copyright of Diaeta is the property of Asociacion Argentina de Dietistas & Nutricionistas Dietistas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We aimed to evaluate the impact of Staphylococcus aureus phenotype (vancomycin MIC) and genotype (agr group, clonal complex CC) on the prognosis and clinical characteristics of infective endocarditis (IE)., Methods: We performed a multicentre, longitudinal, prospective, observational study (June 2013 to March 2016) in 15 Spanish hospitals. Two hundred and thirteen consecutive adults (≥18 years) with a definite diagnosis of S. aureus IE were included. Primary outcome was death during hospital stay. Main secondary end points were persistent bacteraemia, sepsis/septic shock, peripheral embolism and osteoarticular involvement., Results: Overall in-hospital mortality was 37% (n = 72). Independent risk factors for death were age-adjusted Charlson co-morbidity index (OR 1.20; 95% CI 1.08-1.34), congestive heart failure (OR 3.60; 95% CI 1.72-7.50), symptomatic central nervous system complication (OR 3.17; 95% CI 1.41-7.11) and severe sepsis/septic shock (OR 4.41; 95% CI 2.18-8.96). In the subgroup of methicillin-susceptible S. aureus IE (n = 173), independent risk factors for death were the age-adjusted Charlson co-morbidity index (OR 1.17; 95% CI 1.03-1.31), congestive heart failure (OR 3.39; 95% CI 1.51-7.64), new conduction abnormality (OR 4.42; 95% CI 1.27-15.34), severe sepsis/septic shock (OR 5.76; 95% CI 2.57-12.89) and agr group III (OR 0.27; 0.10-0.75). Vancomycin MIC ≥1.5 mg/L was not independently associated with death during hospital nor was it related to secondary end points. No other genotype variables were independently associated with in-hospital death., Conclusions: This is the first prospective study to assess the impact of S. aureus phenotype and genotype. Phenotype and genotype provided no additional predictive value beyond conventional clinical characteristics. No evidence was found to justify therapeutic decisions based on vancomycin MIC for either methicillin-resistant or methicillin-susceptible S. aureus., (Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Background: Infective endocarditis (IE) caused by anaerobic bacteria is a rare and poorly characterized disease. Most data reported in the literature are from case reports [1-3]. Therefore, we assessed the situation of anaerobic IE (AIE) in Spain using the database of the Spanish Collaboration on Endocarditis (GAMES)., Methods: We performed a prospective study from 2008 to 2016 in 26 Spanish centers. We included 2491 consecutive cases of definite IE (Duke criteria)., Results: Anaerobic bacteria caused 22 cases (0.9%) of definite IE. Median age was 66 years (IQR, 56-73), and 19 (86.4%) patients were men. Most patients (14 [63.6%]) had prosthetic valve IE and all episodes were left-sided: aortic valves, 12 (54.5%); and mitral valves, 8 (36.4%). The most common pathogens were Propionibacterium acnes (14 [63.6%]), Lactobacillus spp (3 [13.63%]), and Clostridium spp. (2 [9.0%]), and the infection was mainly odontogenic. Fifteen of the 22 patients (68.2%) underwent cardiac surgery. Mortality was 18.2% during admission and 5.5% after 1 year of follow-up. When patients with AIE were compared with the rest of the cohort, we found that although those with AIE had a similar age and Charlson comorbidity index, they were more likely to have community-acquired IE (86.4% vs. 60.9%, p = 0.01), have undergone cardiac surgery (68.2% vs 48.7% p = 0.06), and have had lower mortality rates during admission (18.2% vs. 27.3%)., Conclusion: IE due to anaerobic bacteria is an uncommon disease that affects mainly prosthetic valves and frequently requires surgery. Otherwise, there are no major differences between AIE and IE caused by other microorganisms., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

This research refers to the case study of a patient, a male college student, who was given psychotherapeutic care. Initially, the patient self-referral to the Mental Health area, which is a service permanently offered by the Autonomous University of the State of Mexico, through the Research Center in Medical Sciences (CICMED). The process of the case allowed analyzing the administrative procedure that operates in the CICMED and the process between this and the educational establishment in which the patient studied.