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Resumen: Introducción: La neuropatía hereditaria con parálisis sensible a la presión (NHPP) es una alteración autosómica dominante, con episodios recurrentes de mononeuropatía en nervios susceptibles de compresión típicos, con características neurofisiológicas comunes. Sin embargo, se han comunicado otras presentaciones clínicas y neurofisiológicas. Métodos: Análisis de características clínicas y neurofisiológicas en una revisión retrospectiva de 20 pacientes con NHPP confirmados genéticamente, de los cuales, 16 se estudiaron en nuestro servicio entre los años 1996 y 2016. Resultados: Además de las características típicas de la NHPP, encontramos formas atípicas como síntomas sensitivos recurrentes posicionales en 3 pacientes, polineuropatía sensitivo motora crónica en uno y mononeuropatía no evolutiva en otro. Dos pacientes empezaron en edad temprana, uno a los 7 años, con lesión del ciático poplíteo externo y otro al nacer, con afectación de plexo braquial. Las principales alteraciones de la conducción nerviosa que se encontraron fueron: la disminución de la velocidad de conducción sensitiva con rangos del 84% en el sural y 94% en el mediano y peroneo superficial, descenso de la velocidad de conducción motora del nervio cubital a través del codo en el 97% y el incremento de la latencia distal motora del nervio mediano y ciático poplíteo externo en el 74%. Conclusión: De acuerdo con los resultados, confirmamos la variabilidad clínica de la NHPP y encontramos los hallazgos más frecuentes en la conducción nerviosa, la disminución generalizada de la velocidad de conducción sensitiva, además de la afectación motora principalmente en lugares susceptibles de compresión, y detectamos los casos típicos, atípicos y asintomáticos de esta en entidad. Abstract: Introduction: Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant disorder, typically presenting with recurrent episodes of mononeuropathy in nerves susceptible to compression, with similar neurophysiological characteristics. However, other clinical and neurophysiological presentations have been reported. Methods: We retrospectively analysed the clinical and neurophysiological characteristics of 20 patients with genetically confirmed HNPP. Sixteen patients were studied in our department between 1996 and 2016. Results: In addition to the typical characteristics of HNPP, we found atypical forms including recurrent positional sensory symptoms in 3 patients, chronic sensorimotor polyneuropathy in one, and non-progressive mononeuropathy in one. Onset was early in 2 patients: one at the age of 7 years, with common peroneal nerve injury, and another at birth, with brachial plexus involvement. By frequency, the main pathological findings in the nerve conduction study were: decreased sensory nerve conduction velocity in the sural (84%) and the median and superficial peroneal nerves (94%); decreased motor nerve conduction velocity in the ulnar nerve through the elbow (97%), and increased motor distal latency of the median and deep peroneal nerves (74%). Conclusion: Our results confirm the clinical variability of HNPP, with the most frequent nerve conduction study findings being the generalised decrease in sensory nerve conduction velocity, in addition to motor involvement, mainly in locations susceptible to nerve compression. The nerve conduction study can detect typical, atypical, and asymptomatic cases of HNPP.

Introduction: Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant disorder, typically presenting with recurrent episodes of mononeuropathy in nerves susceptible to compression, with similar neurophysiological characteristics. However, other clinical and neurophysiological presentations have been reported. Methods: We retrospectively analysed the clinical and neurophysiological characteristics of 20 patients with genetically confirmed HNPP. Sixteen patients were studied in our department between 1996 and 2016. Results: In addition to the typical characteristics of HNPP, we found atypical forms including recurrent positional sensory symptoms in 3 patients, chronic sensorimotor polyneuropathy in one, and non-progressive mononeuropathy in one. Onset was early in 2 patients: one at the age of 7 years, with common peroneal nerve injury, and another at birth, with brachial plexus involvement. By frequency, the main pathological findings in the nerve conduction study were: decreased sensory nerve conduction velocity in the sural (84%) and the median and superficial peroneal nerves (94%); decreased motor nerve conduction velocity in the ulnar nerve through the elbow (97%), and increased motor distal latency of the median and deep peroneal nerves (74%). Conclusion: Our results confirm the clinical variability of HNPP, with the most frequent nerve conduction study findings being the generalised decrease in sensory nerve conduction velocity, in addition to motor involvement, mainly in locations susceptible to nerve compression. The nerve conduction study can detect typical, atypical, and asymptomatic cases of HNPP. Resumen: Introducción: La neuropatía hereditaria con parálisis sensible a la presión (NHPP) es una alteración autosómica dominante, con episodios recurrentes de mononeuropatía en nervios susceptibles de compresión típicos, con características neurofisiológicas comunes. Sin embargo, se han comunicado otras presentaciones clínicas y neurofisiológicas. Métodos: Análisis de características clínicas y neurofisiológicas en una revisión retrospectiva de 20 pacientes con NHPP confirmados genéticamente, de los cuales, 16 se estudiaron en nuestro servicio entre los años 1996 y 2016. Resultados: Además de las características típicas de la NHPP, encontramos formas atípicas como síntomas sensitivos recurrentes posicionales en 3 pacientes, polineuropatía sensitivo motora crónica en uno y mononeuropatía no evolutiva en otro. Dos pacientes empezaron en edad temprana, uno a los 7 años, con lesión del ciático poplíteo externo y otro al nacer, con afectación de plexo braquial. Las principales alteraciones de la conducción nerviosa que se encontraron fueron: la disminución de la velocidad de conducción sensitiva con rangos del 84% en el sural y 94% en el mediano y peroneo superficial, descenso de la velocidad de conducción motora del nervio cubital a través del codo en el 97% y el incremento de la latencia distal motora del nervio mediano y ciático poplíteo externo en el 74%. Conclusión: De acuerdo con los resultados, confirmamos la variabilidad clínica de la NHPP y encontramos los hallazgos más frecuentes en la conducción nerviosa, la disminución generalizada de la velocidad de conducción sensitiva, además de la afectación motora principalmente en lugares susceptibles de compresión, y detectamos los casos típicos, atípicos y asintomáticos de esta en entidad.

OBJECTIVES: The present study aims to describe the clinical, electrocardiographic, and echocardiographic cardiological findings in a group of patients with oral clefts. METHODS: This is a prospective cross-sectional study on 70 children (age range from 13 days to 19 years) with oral clefts who attended the multidisciplinary program of a university hospital from March 2013 to September 2014. The patients were evaluated by a pediatric cardiologist and underwent detailed anamnesis, physical examination, electrocardiogram, and echocardiogram. RESULTS: Sixty percent of the patients were male; 55.7% presented with cleft lip and palate, and 40.0% presented with health complaints. Comorbidities were found in 44.3%. Relevant pregnancy, neonatal, family and personal antecedents were present in 55.7%, 27.1%, 67.2%, and 24.3% of the patients, respectively. Regarding the antecedents, 15.2% of the patients presented with a cardiac murmur, 49.0% with a familial risk of developing plurimetabolic syndrome, and 6% with family antecedents of rheumatic fever. Electrocardiographic evaluation showed one case of atrioventricular block. Echocardiograms were abnormal in 35.7% of the exams, including 5 cases of mitral valve prolapse — one of which was diagnosed with rheumatic heart disease. CONCLUSION: The finding of a family risk of developing plurimetabolic syndrome and a diagnosis of rheumatic heart disease indicates that patients with oral clefts may be more prone to developing acquired heart disease. Thus, our findings highlight the importance of anamnesis and methodological triangulation (clinical-electrocardiographic-echocardiographic) in the investigation of patients with oral clefts and emphasize that cardiological follow-up to evaluate acquired and/or rhythm heart diseases is necessary. This strategy permits comorbidity prevention and individualized planned treatment.

Epithelial inclusion cysts (EIC) are a rare ocular disease and its physiopathology is not well-known. They consist on growths of ocular surface epithelial cells inside the anterior segment of the eye in the form of a cyst. To date several cases have been published in the literature, none of them related to glaucoma surgery. We describe two cases of EIC after glaucoma devices implantation. An 86 year-old male patient with primary open angle glaucoma develop an EIC in right eye three years after removal of PRESERFLO™ MicroShunt (Santen, Osaka, Japan) and a 9 year-old female patient with glaucoma secondary to uveitis for juvenile idiopathic arthritis develops an EIC under the tube of an Ahmed valve implant during postoperative period. EIC develop after ocular penetrating wounds and an inflammatory stimulus. They are benign proliferations, follow-up is necessary to detect space complications early, so less mutilating surgery is needed for removal., (Copyright © 2024 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: The effectiveness of the Enhanced Recovery After Surgery (ERAS) protocols in gastric cancer surgery remains controversial., Methods: Multicentre prospective cohort study of adult patients undergoing surgery for gastric cancer. Adherence with 22 individual components of ERAS pathways were assessed in all patients, regardless of whether they were treated in a self-designed ERAS centre. Each centre had a three-month recruitment period between October 2019 and September 2020. The primary outcome was moderate-to-severe postoperative complications within 30 days after surgery. Secondary outcomes were overall postoperative complications, adherence to the ERAS pathway, 30 day-mortality and hospital length of stay (LOS)., Results: A total of 743 patients in 72 Spanish hospitals were included, 211 of them (28.4 %) from self-declared ERAS centres. A total of 245 patients (33 %) experienced postoperative complications, graded as moderate-to-severe complications in 172 patients (23.1 %). There were no differences in the incidence of moderate-to-severe complications (22.3% vs. 23.5%; OR, 0.92 (95% CI, 0.59 to 1.41); P = 0.068), or overall postoperative complications between the self-declared ERAS and non-ERAS groups (33.6% vs. 32.7%; OR, 1.05 (95 % CI, 0.70 to 1.56); P = 0.825). The overall rate of adherence to the ERAS pathway was 52% [IQR 45 to 60]. There were no differences in postoperative outcomes between higher (Q1, > 60 %) and lower (Q4, ≤ 45 %) ERAS adherence quartiles., Conclusions: Neither the partial application of perioperative ERAS measures nor treatment in self-designated ERAS centres improved postoperative outcomes in patients undergoing gastric surgery for cancer., Trial Registration: ClinicalTrials.gov Identifier NCT03865810., (Copyright © 2023 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

In diabetes mellitus (DM) patients retinal complications were typically considered part of a vascular process. Recent research suggests that retinal degeneration in DM might also be caused by a neuropathy that could precede microvascular alterations. The present work reviews the currently available bibliography about neurodegeneration in patients with type 2 DM (DM2) without diabetic retinopathy (DR). In patients with non-severe, early DM2 without DR and good metabolic control visual function parameters show early abnormalities that precede clinical DR (in which we diagnose with a conventional ophthalmological examination). Using optical coherence tomography (OCT) technology, a reduction in macular and peripapillary thickness has been observed in different studies. Recent researches suggest that systemic complications (especially ischaemia) and a possible microvascular alteration eventually contributes to retinal neurodegeneration, which opens the door to new studies that include new techniques for evaluating the microvascularization of the retinal layers., (Copyright © 2022 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: The COVID-19 pandemic led Spain to order a state of alert with the cessation of non-essential activities on 14 March 2020, and to implement public health interventions (such as home confinement) and other health recommendations to prevent the spread of the SARS-CoV-2 virus (hand washing and the obligation to wear face-masks). These factors could have influenced the rate of viral conjunctivitis., Method: In this retrospective, noninterventional, descriptive study, the incidence of viral conjunctivitis in an emergency department of a national hospital is compared over two distinct time periods: pre-COVID (13 March-30 September 2019, one year before the start of the pandemic) and COVID (13 March-30 September 2020)., Results: In the first period there were 436 cases of conjunctivitis, of which 168 (38.5%) were confirmed cases of viral conjunctivitis 168 (38.5%), while in the second period there were 121 recorded cases, of which the most frequent were allergic and traumatic (23 cases; 19% each group), bacterial (15 cases; 12.3%) and viral (15 cases; 12.3%). The diagnosis of viral conjunctivitis is the one that suffered the most significant relative reduction (48.5%), while other types of conjunctivitis hardly changed their relative frequency between these two periods of time., Conclusions: Viral conjunctivitis is the most frequent infectious disease of the eye and has a transmission rate similar to that of coronavirus, so the measures implemented could positively affect its incidence., (Copyright © 2021 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Scarce information is available on the resources to deal with the Sexually Transmitted Infections (STIs), both in the clinic and in the laboratory. The objective is to describe and know the reality of the clinics and laboratories that treat these infections in Spain., Methods: Cross-sectional observational study with data collection through a survey aimed at the members of the GEITS Group., Results: Responses were obtained from 24 centers (response rate 38.1%) belonging to 10 Autonomous Communities. Regarding STI consultations, 38% require that the patient present a health card to provide assistance, and 31.8% only provide it by referral from another doctor. The 52.4% perform diagnostic methods in the care center. Regarding laboratories, 18.2% do not offer immediate response diagnostic tests, although 100% have PCR against Neisseria gonorrhoeae and Chlamydia trachomatis, 47.8% against Mycoplasma genitalium and 65% detect lymphogranuloma venereum genotypes. All laboratories continue to perform culture and gonococcal sensitivity techniques, and 20% perform molecular methods for detection of MG antimicrobial resistance., Conclusion: There is great variability in the provision of human and material resources both in the clinics and in the laboratories that attend STIs. In a significant number of centers there are limitations for patient access. Although laboratories have molecular biology technologies, not all of them offer immediate response tests. All laboratories detect N. gonorrhoeae infection by PCR and also by culture, which allows sensitivity testing in all centers., (Copyright © 2020 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Scarce information is available on the resources to deal with the Sexually Transmitted Infections (STIs), both in the clinic and in the laboratory. The objective is to describe and know the reality of the clinics and laboratories that treat these infections in Spain., Methods: Cross-sectional observational study with data collection through a survey aimed at the members of the GEITS Group., Results: Responses were obtained from 24 centers (response rate 38.1%) belonging to 10Autonomous Communities. Regarding STI consultations, 38% require that the patient present a health card to provide assistance, and 31.8% only provide it by referral from another doctor. The 52.4% perform diagnostic methods in the care center. Regarding laboratories, 18.2% do not offer immediate response diagnostic tests, although 100% have PCR against Neisseria gonorrhoeae and Chlamydia trachomatis, 47.8% against Mycoplasma genitalium and 65% detect lymphogranuloma venereum genotypes. All laboratories continue to perform culture and gonococcal sensitivity techniques, and 20% perform molecular methods for detection of MG antimicrobial resistance., Conclusion: There is great variability in the provision of human and material resources both in the clinics and in the laboratories that attend STIs. In a significant number of centers there are limitations for patient access. Although laboratories have molecular biology technologies, not all of them offer immediate response tests. All laboratories detect N.gonorrhoeae infection by PCR and also by culture, which allows sensitivity testing in all centers., (Copyright © 2020 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: In 2010, the AIDS Study Group (Grupo de Estudio del SIDA [GESIDA]) developed 66 quality care indicators. The aim of this study is to determine which of these indicators are associated with mortality and hospital admission, and to perform a preliminary assessment of a prediction rule for mortality and hospital admission in patients on treatment and follow-up., Methods: A retrospective cohort study was conducted in the Hospital Universitario Son Espases (Palma de Mallorca, Spain). Eligible participants were patients with human immunodeficiency syndrome≥18 years old who began follow-up in the Infectious Disease Section between 1 January 2000 and 31 December 2012. A descriptive analysis was performed to evaluate anthropometric variables, and a logistic regression analysis to assess the association between GESIDA indicators and mortality/admission. The mortality probability model was built using logistic regression., Results: A total of 1,944 adults were eligible (median age: 37 years old, 78.8% male). In the multivariate analysis, the quality of care indicators associated with mortality in the follow-up patient group were the items 7, 16 and 20, and in the group of patients on treatment were 7, 16, 20, 35, and 38. The quality of care indicators associated with hospital admissions in the follow-up patients group were the same as those in the mortality analysis, plus number 31. In the treatment group the associated quality of care indicators were items 7, 16, 20, 35, 38, and 40., Conclusions: Some GeSIDA quality of care indicators were associated with mortality and/or hospital admissions. These indicators are associated with delayed diagnosis, regular monitoring, prevention of infections, and control of comorbidities., (Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)

Background: Surgical treatment of gallbladder cancer is still controversial. The extent of the radical surgery and its therapeutic efficacy continue to be debated., Objective: Analyze the efficacy of radical resection in patients with incidental gallbladder cancer evaluating the presence of residual disease in the resection specimen and analyzing the associated factors of survival., Methods: A retrospective analysis of patients with incidental GC between June 1999 and June 2010 was performed. Incidental (I) tumors were included. Data covering demographic features, clinical characteristics, local pathological stage, histological features and factors for long term survival were analyzed. p< 0.05 were considered significant., Results: A total of 28 patients: 78,6% females. Median age 56 years. All treated by resection of segments 4b/5 and lymphadenectomy. Histological examination revealed residual disease in 42% (37% liver), residual disease was related to tumoral (T) stage (p 0,001). Patients with residual disease presented a DSS and DFS of 10 and 6.5 months respectively vs 56 months in those without residual disease (p 0,001). Variables associated with survival were T stage (P .006), TNM stage (P<.001), and residual disease in the resected specimen (P<.001)., Conclusions: Aggressive re-resection of incidental GC offers the only chance for cure but its efficacy depends on the extent of the disease found at the time of repeated surgery and in the deferred pathological study., (Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.)

Background and Objective: To describe an unusual clinical presentation of puerperal meningitis by Streptococcus agalactiae (S. agalactiae)., Patient and Method: We report a case of puerperal meningitis for S. agalactiae, a rare form of infection in a healthy puerperal and with an atypical presentation., Results: We deeply report the clinical case, the procedures performed to exclude other diseases and management differences. It is compared with meningitis cases reported in the literature, and as in these, we opt for and early diagnosis and a rapid onset of antibiotic treatment., Conclusion: Meningitis caused by S. agalactiae is not a frequent complication in the postpartum period, that requires early diagnosis and treatment of which depends the patient's prognosis., (Copyright © 2013 Elsevier España, S.L. All rights reserved.)

Objective: To experimentally study the behaviour of 4 types of monofilament with 3 knotting techniques, very often used in surgery, employing mechanical tests., Material and Methods: Four 4/0 monofilaments were chosen, two of nylon, and the other two of polypropylene. Three types of knot designs were made with each thread. The first design (D-S-S) consisted of a double half-knot (D) followed by one single (S) in the opposite direction, a third S in turn in the opposite direction. The configuration of the second design was D-S-D, and the third, S-S-D. A mechanical fracture test was performed by stretching the thread at a rate of 4N/s, the force and deformation being recorded at intervals of 100 ms., Results: There was a decrease in the force and deformation in the tests on threads with knots compared to threads without knots. In all cases the rupture of the thread occurred in the knot area, presumably due to damage caused to the thread during the knotting process. The D-S-D knot had the greatest resistance with polypropylene threads, and S-S-D provided the greatest resistance with nylon threads, Conclusions: Polypropylene threads, with D-S-D knots, should be more indicated to suture tissues that have to support great forces and with little deformation of the suture (e.g., tendons). Nylon threads, with S-S-D knots, would be better indicated for tissues that have to support smaller forces and that require greater elasticity (e.g., skin)., (Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.)

Hepatitis C virus is an important public health threat, not only because of the high prevalence of this infection in western and third world countries, but also because of the high rate of resistance to the available antiviral therapy that consists on the use of pegylated interferon plus ribavirin. Currently, new forms of therapy are being developed based on a more precise knowledge of the structure and function of the viral proteins and of the strategies used by the virus to escape the immune and interferon systems. The new therapeutic approaches aim at different objectives: a) the inhibition of viral replication by blocking the viral protease and/or replicase; b) the use of other types of interferon with more potent antiviral effect, c) the induction of a specific anti-viral immune response by means of immunomodulatory compounds or therapeutic vaccination, d) the blockade of "de novo" infection of other cells with neutralizing antibodies, e) the induction of a antiviral state in the liver by transferring to this organ the gene of interferon and/or immunostimulating cytokines.

Objectives: To describe the management of the geriatric hospital home assessment team to support at primary care in the need of health of geriatric patients., Design: Prospective observational study., Setting: 5-North health district from Madrid., Participants and Methods: All patients evaluated at home and the coordination activities between primary care and hospital geriatric service, developed by the geriatric assessment team between january 1997 at december 1999. Inquiry to primary care physicians about the usefulness of geriatric hospital home assessment team., Main Results: 524 patients was assisted at home by the geriatric assessment team to request primary care (58.4% at all patients attended), 83.24 +/- 7.21 years old (68.1% females), with pluripathology (4.02 +/- 1.86 diagnostics) and polypharmacy (4.95 +/- 2.8), moderate-severe functional disability (Barthel Index < 60 at 65% and Red Cross functional disability > 2 at 74.4%) and frequently cognitive impairment (41.2% with Pfeiffer > 5). The main reasons of primary care to consult was functional impairment (28.4%), medical process assessment (16.2%), geriatric assessment (13.2%), skin ulcers (13.2%) and behavioral disorders (10.8%). 865 telephone call and 178 meeting in health center of primary care for consultation or medical management or for coordinating medical management was attended. 62% of primary care physician inquired to answer back. The belief of 100% answers was about de usefulness of the geriatric assessment team activity, mainly because their specialization on geriatric care (76.7%) and their responsibility of the hospital resources (65.1%)., Conclusions: The activity of geriatric hospital home assessment team is useful as support of primary care on assessment and management geriatric patients in the community and coordinate hospital and primary care to resolve health problems in this population.

Background: A high prevalence of osteoporosis has been described in patients before and after cardiac transplantation. But clinical factors involved in previous bone loss in this condition are not well known. The purpose has been to study bone mineral density (BMD) in patients subject to cardiac transplantation, analyzing clinical and biochemical factors related to bone mass in these patients., Patients and Methods: We have studied lumbar and hip BMD in 51 patients candidates to cardiac transplantation, evaluating the functional grade of the cardiopathy, time of evolution of the disease, and antropometric and biochemical markers of bone turnover. BMD was measured using a dual X ray densitometer., Results: A significant decrease in bone mass at lumbar and hip sites was found in patients with regard to normal population. A high prevalence of osteoporosis was found (27.4%). Time of evolution of the disease prior to transplantation was found to be the most important predictive variable in bone loss at trabecular bone (lumbar spine). No modifications were found in blood routine parameters, mineral studies and in serum intact PTH. Resorption bone markers were increased and formation markers were normal, suggesting a elevated turnover osteoporosis. Patients with osteoporosis had less BMI that patients without, indicating a protective effect of body mass. Patients with osteoporosis also had a greater time of evolution of the disease., Conclusions: There is a decreased bone mass in lumbar spine and hip and a higher prevalence of osteoporosis in patients with cardiac failure before cardiac transplantation. Time of waiting for cardiac transplantation has been an important factor found in the development of metabolic bone disease in these patients.

Objective: To determine whether tobacco consumption affects the prevalence of asthmatic symptoms. The European Asthma Study Questionnaire was used., Design: Cross-sectional descriptive study., Setting: Guadalajara Health Area., Patients: Sample of 3000 people between 20 and 44 living in Guadalajara., Interventions: None., Measurements and Main Results: Measuring instrument was the European Asthma Study Questionnaire, to which two items on tobacco dependency were added. All the symptoms except asthma attack changed in function of the amount of tobacco consumed. Sibilant noises varied from 8.3% in non-smokers (NS), to 17.5% in light smokers (LS), 28.7% in moderate smokers (MS) and 42.6% in heavy smokers (HS). Night cough also increased in parallel with consumption: 14.1% in NS, 23.2% in LS, 41.2% in HS. Nocturnal thoracic pressure (14.7%), attacks of breathlessness (12.3%) and being considered to have asthma symptoms (14.2%) were more common in heavy smokers. Non-smokers had greater prevalence of sibilant noise with breathlessness (NS 57.7%, LS 39.2%, MS 30.4%, HS 34.5%) and without an associated cold (NS 45.2%, LS 20.3%, MS 23.4%, HS 29.9%), and used asthma treatments more often (NS 3.5%, LS 1.7%, MS 1.5%, HS 1%)., Conclusions: The studies using this questionnaire should include additional questions on the tobacco history of the participants, since it seems that tobacco smoking and its amount may affect findings.

The objective of this study was to determine the prevalence of asthma-related symptoms in the Guadalajara Health Area, using the methods prescribed by the first phase of the European Asthma Study (EAS). A transversal descriptive study by self-administered questionnaire in a population of 2,968 subjects aged 20 to 44 years old assigned to the Guadalajara Health Area was performed. The study took place between September 1995 and February 1996. We received 2,435 responses (81.2% of the sample). Each symptom was studied in relation to sex, age, domicile and smoking and the results were compared to data from other Spanish health areas participating in the EAS. Significant differences were found between our results and those of other Spanish health areas. Subjects reporting asthma symptoms accounted for 8.6% (C.I. 7.5% to 9.8%) of the sample. Presence of asthma was related to place of residence but not to age or sex.

We have retrospectively studied 89 episodes of spontaneous bacterial peritonitis (SBP) attended at our service with the purpose of analyzing clinical features, microbiologic data and possible etiopathogenic factors, treatment and course. The most frequent symptoms were ascites, abdominal pain and fever. Only 3.3% of episodes were asymptomatic. Twenty-four episodes (26.96%) resulted in death of the patient and only the presence of septic shock and prothrombin time lower than 35% statistically correlated with a higher mortality (100% and 53.8%, respectively, p less than 0.01) of the possible factors analyzed. The culture of ascitic fluid (AF) was positive in 52.8% of the episodes and there were no clinical or time course differences between these cases and those who presented negative culture. The isolated microorganisms were the usual ones in this condition, outstanding 37.5% of gram-positive cocci in monomicrobial SBP. Treatment was initiated within the first 12 hours from admittance in 76.4% of cases, between 12 and 72 hours in 12.3% and after 72 hours in 11.2%. Cefotaxime was given to 47.1% of episodes and 52.9% of patients received ampicillin or cefoxitin plus aminoglycoside; the mortality was lower with the first schedule (11.9% versus 40.4%, p less than 0.01).

The neutrophilic dermatosis are a group of cutaneous diseases that share similar clinical and histopathologic features. They frequently occur in association with other diseases, particularly idiopathic inflammatory bowel disease. We present herein three cases of neutrophilic dermatosis and inflammatory bowel disease. We emphasize the atypical cutaneous findings and we discuss their nosologic situation.