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Chronic recurrent multifocal osteomyelitis is a rare disease of unknown etiology that mainly affects children. We present a retrospective review of the medical records of five patients with a diagnosis of chronic recurrent multifocal osteomyelitis in an infectious diseases clinic at a tertiary center. We describe the epidemiological, clinical and radiological features, laboratory, microbiological and histological findings, treatment, course and prognosis in these patients. There is no specific treatment for chronic recurrent multifocal osteomyelitis. There are new treatment options such the combination of azithromycin and calcitonin in children without clinical improvement with non-steroidal anti-inflammatory drugs.

Introduction: Since the introduction of zidovudine, perinatal transmission (PT) of HIV-1 has markedly decreased, although a transmission rate of zero has still not been achieved. The present study describes the trend in PT over 13 years, as well as changes in medical-surgical management and their influence on PT., Patients and Methods: We performed a prospective cohort study of all HIV-1-infected mother-infant pairs born between January 1987 and December 1999 in Hospital 12 Octubre in Madrid. Univariate analysis was performed to determine the relationship between possible risk factors and PT., Results: A total of 290 mothers and 291 children were included. Thirty-eight children were infected, 28 of these before 1994 (PT rate: 13 %). There were no cases of infection when the full ACTG 076 protocol was implemented. Factors significantly associated with a higher transmission rate were prolonged rupture of membranes and nonelective caesarean section. The main protective factor was antiretroviral therapy., Conclusions: PT markedly decreased after the introduction of the ACTG 076 protocol. In the last 13 years, maternal age and maternal infection due to heterosexual transmission have increased. Other changes observed were modifications in obstetric interventions and the generalized use of zidovudine and antiretroviral therapy during pregnancy.

Myiasis is caused by infestation of the skin by the larvae of flies. This entity has specific epidemiological characteristics. Although it is highly unusual in our environment, imported cases can be found because of increased traveling and immigration. The usual clinical manifestations are subcutaneous abscesses, where the larvae develop. Differential diagnosis includes common disorders such as cellulitis and furunculosis, but knowledge of this entity makes diagnosis and treatment simple. We describe the life cycle of the human botfly and the typical clinical presentation and management of this entity. We also highlight the increasing importance of greater awareness of imported diseases.

Background It has been known for many years that the risk of sudden infant death syndrome (SIDS) is reduced by the supine sleeping position. Campaigns are required to increase awareness of this finding among all those involved in childcare (parents, relatives, kindergarten staff, health professionals etc.).ObjectiveTo determine knowledge of the best sleeping position among health professionals (physicians and nurses) and the parents of healthy neonates.Material and methodThe study was performed in a tertiary maternity hospital. A voluntary, anonymous questionnaire containing an item on the best sleeping position for neonates was distributed. The influence of parental age, occupation, education, and previous children was analyzed.ResultsThe side position was the most frequent answer among parents both in the first questionnaire (50.9 %) and in the second (46.8 %). Health professionals preferred the supine position (63.3 %). Parents who gave the right answer had a higher mean age, were more likely to work outside the home and to be better educated. The existence of previous children did not influence the answer.ConclusionsIn some maternity hospitals, parents still believe the side sleeping position to be best for their children. To provide an example in maternity wards, all health professionals should accept the supine position as the best for preventing SIDS.