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Introduction The term descending necrotising mediastinitis (DNM) refers to an infection that begins in the oropharyngeal region and spreads through the fascial planes into the mediastinum. This study aims to estimate the incidence of DNM in our centre, the epidemiology and clinical features of the disease and to evaluate prognostic factors influencing mortality. Patients and methods We performed a retrospective study on 43 consecutive patients diagnosed at the Hospital Universitari Vall d’Hebron in Barcelona from January 1996 to December 2006. We performed a descriptive study and a bivariate and a multivariate analysis of variables collected. Results Overall mortality was 21%, but when we subdivided the study into two periods (1996–2000 and 2001–2006) it shows a significant decrease (40% versus 4.3%). Risk factors identified in the bivariate analysis were: diagnosis period 1996–2000, diabetes mellitus, comorbidity, number of surgeries, left lateral surgery, postoperative morbidity and septic shock. In multivariate analysis, only the presence of septic shock proved to be an independent predictor of mortality. Conclusions DNM is a disease of low incidence and should be suspected clinically and confirmed immediately with a computed tomography (CT). Multidisciplinary and early treatment has allowed us to reduce mortality by 40% in the first initial period to 4.3% today.

The objective of this review is to present an overview of some of the most commonly consumed artisanal Mexican cheeses, as well as those cheeses that show potential for a protected designation of origin. A description is given for each of these cheeses, including information on their distinguishing characteristics that makes some of them potential candidates for achieving a protected designation of origin status. This distinction could help to expand their frontiers and allow them to become better known and appreciated in other parts of the world. Due to the scarcity of scientific studies concerning artisanal Mexican cheeses, which would ultimately aid in the standardization of manufacturing processes and in the establishment of regulations related to their production, more than 40 varieties of artisanal cheese are in danger of disappearing. To preserve these cheeses, it is necessary to address this challenge by working jointly with government, artisanal cheesemaking organizations, industry, academics, and commercial partners on the implementation of strategies to protect and preserve their artisanal means of production. With sufficient information, official Mexican regulations could be established that would encompass and regulate the manufacture of Mexican artisanal cheeses. Finally, as many Mexican artisanal cheeses are produced from raw milk, more scientific studies are required to show the role of the lactic acid bacteria and their antagonistic effect on pathogenic microorganisms during aging following cheese making.