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This article analyzes instances of misunderstanding between doctor, patient and accompanying person during the history taking of ‘first time’ oncology visits. History taking is a fundamental activity in these visits since it targets useful information for the oncologist to determine the patients’ current and general health status and then arrange the treatment plan most suitable for their cancer. The authors show how this activity involves all participants in the interaction: the oncologist, the patients and their care-givers. The management of this activity is not plain and straightforward: it requires complex negotiations between participants in order for them to find a shared understanding of what information is relevant to the medical history, and what is the purpose of the activity in progress. The analyses help to identify, on one hand, the characteristics of the diseases that patients do not recognize as relevant, and on the other hand, the investigative strategies and communication skills that the doctor uses to track the information. These strategies are discussed as resources to socialize patients to effectively contribute to the present visit and the future ones.

As from the philosophy in Paul Rincoeur’s text, the system sociology of Niklas Luhmann and the biopolitic of Michael Focault, we explore the verdict of the “101/2012” sentence of February 27th; with the objective of identifying subjects and political voids inherent to its jurisdiction. This is, correlative to the temporality that outlines the legality, the ordinance and the amnesty, in the legal reasonings that are exposed in the judgment to resolve the dilemma of principles, duty to investigate and judicial banning of sanctioning. The resolution of the dilemma that favors this last one, makes us come face to face with a paradox of difficult fracture which can be found, according to our point of view, in the constitutional base of the Spanish contemporary state. But this is precisely the point at issue that´s open in the debate set out by this investigation, when framing a question about the function of impunity, precisely from the former identification of its constitutive subjects. Throughout this work, we’ll maintain that the effectiveness of the verdict doesn't reside in the deactivation of the ius punendi but on the activations and/or creations of meaning that unleash from its emergency. For the time being, voids have been effectively activated for the legal and political existence and victims get deactivated; simultaneously allowing us to speculate about the reason of state implied in these operations. This argument would force to restore the problem to the forum affairs from which its been expelled, turrning it into a mere issue of victims and family members, for example, by the Law of the Historical Memory. Consequently, facing the Francoist matter, the investigation responds with this thesis which proposes to go further by situating the verdict as a singularity in a broader network of episodes, in which the victim’s government is an object of domination. From that point of view, the thesis of reason of state gets transformed though this channel into biopolitics, in its conjecture, warning us about its possible absorption/comprehension of the duty of the Spanish contemporary state. The point of issue for the “us” rises as a final reflection: Who or what is the “us” of this biopolitic of vulnerability and victimisation? With this, we possibly find an open road for the matter of state, so prominent in the political conflict of the Spanish contemporary state.

Treball Final de Grau de Podologia, Escola Universitària d'Infermeria, Universitat de Barcelona, curs: 2014-2015, Tutor: Rafael Cuevas Gómez, La disfunció del tendó del tibial posterior (DTTP) és una de les principals causes del peu pla adquirit en l’adult, apareixent de manera progressiva, on hi ha una degeneració crònica del tendó, provocant dolor significatiu i una seqüència patològica durant la marxa provocant incapacitat del pacient en la deambulació. La DTTP pot ser de múltiples causes, sent imprescindible una anamnesis completa i una correcte exploració física per tal d’evitar un diagnòstic erroni. És important realitzar-lo tant precoçment com sigui possible per evitar la progressió del peu pla patològic i poder escollir el tractament conservador més adequat depenent en l’estadi al que es trobi la patologia

We report here an uncommon case of deep infection by Torulopsis incospicua, associated with multibacterial sepsis and complicated by several mycotic aneurysms of hepatic artery, liver graft necrosis, and hepatic acute failure in a liver orthotopic transplant recipient. Two successive emergency liver transplants were needed, but fast relapses of infection and mycotic aneurysms were experienced. The patient died soon after the third liver transplant; disseminated mycosis was demonstrated by post mortem examination. In conclusion, fungal infection should be considered in cases of spontaneous hepatic artery rupture.

Hem llegit amb molt d'interès la carta del Dr. Natal i col.l. referent al nostre article 'Són realment infreqüents les fractures d'ós llarg en menors de dos anys?'. El nostre estudi tenia com objectiu determinar la freqüència diagnòstica de fractures d'ossos llargs en els infants atesos a Urgències i les característiques que presentaven. Com que es tractava d'un estudi retrospectiu, hi ha dades que no es van poder esbrinar perquè no constaven a la història clínica. El que sí que podem confirmar és que no es van diagnosticar maltractaments en cap dels casos.

OBJECTIVES: To determine the incidence of computed tomography (CT) identifiable Randall plaques in a CT explored population; to determine the clinical relevance of this radiological finding by a 7-year follow-up; to determine a cut point to identify a population with high risk of developing calcium stone disease (SD). MATERIALS AND METHODS: Retrospective study of all patients explored by abdominal CT in our center between January and March 2005. INCLUSION CRITERIA: age 30-60 years and no SD. Papillae attenuation was measured on nonenhanced CT in Hounsfield units (HU) and the mean of all papillae was calculated. Patients were re-evaluated after 7 years to identify calcium stone formers. Anamnesis and already available CT, ultrasound, kidney, ureter, and bladder radiograph (KUB) or intravenous urography (IVU) images performed as part of their follow-up were used. In patients with no follow-up, ultrasound and KUB were to be performed. Pearson correlation, Student t-test, and the receiver operator curve were used for statistical analysis. RESULTS: A total of 362 patients fulfilled the inclusion criteria and were analyzed; 12 developed calcium SD after 7 years. A significant difference was encountered between the papillae attenuation of stone formers (SF) versus non-SF (47.2HU vs. 35.5HU, p=0.001). There was good correlation between papillae attenuation and the possibility of developing SD (R=0.87). An optimal cut point of 43HU with a sensitivity of 81% and specificity of 97%, area under the curve 0.91, separated SF and non-SF. CONCLUSION: Patients with high papillae density have a higher risk of developing SD. A cut point of 43HU could accurately be used to identify a high-risk population.

Fonament. Les fractures són habituals entre les lesions no intencionades de la infància, però es creu que són poc fre- qüents en lactants. Objectiu. Determinar la freqüència diagnòstica i les caracte- rístiques de les fractures produides en nens menors de 2 anys. Mètode. Estudi retrospectiu de les consultes d'infants menors de 2 anys diagnosticats de fractura d'os llarg a urgències. Resultats. S'inclouen 258 consultes (prevalença 0,2%), el 25,2% de les quals corresponen a infants de menys d'1 any. Es van diagnosticar 293 fractures (35 infants en pre- sentaven dues). L'os més fracturat va ser el radi (en menors d'1 any, el fèmur), i la fractura en rodet, el tipus més ha- bitual. En 196 consultes (76%) se n'especifica la causa, i les més freqüents són caigudes i traumatismes. El 15,1% dels pacients van necessitar ingressar. Conclusions. Les fractures d'os llarg, tot i que són poc fre- qüents en lactants, presenten una morbiditat elevada. És important fer una anamnesi exhaustiva per esclarir-ne la causa i poder aplicar mesures preventives

RESUM Fonament. Durant l'adolescència es passa de ser una persona dependent de l'estructura familiar a ser independent, capaç de prendre decisions sobre la salut. Objectiu. Valorar la informació que els adolescents són capaços d'aportar per si mateixos en la consulta mèdica i conèixer la preferència en l'acompanyament de la visita. Mètode. Estudi prospectiu (1/1/2010 - 31/12/2011) basat en enquestes a adolescents (12-18 anys) que consulten a urgències i que inclouen preguntes dirigides a conèixer la seva autonomia en l'entrevista clínica. També es valora la preferència de fer la visita mèdica sol o acompanyat. Resultats. S'inclouen 279 adolescents (51,3% dones; edat mitjana 14,5 anys; 22,2% immigrants). En el 93,9% s'objectiva coincidència entre les respostes dels adolescents i les dels seus acompanyants en simptomatologia referida; en el 89,6% en la durada de la clínica i en el 71,7% en el tractament fet prèviament a la consulta. Es considera el 78,9% dels adolescents autònoms. El 51,6% prefereixen estar acompanyats durant la visita. No s'observen diferències significatives en autonomia i preferència d'acompa- nyament segons sexe, edat i origen del pacient. Conclusions. La majoria dels adolescents són capaços de respondre una anamnesi completa i fiable sense el suport d'un adult. La meitat dels adolescents prefereixen estar acompanyats durant la visita mèdica.

Invasive aspergillosis (IA) is increasingly recognized in the intensive care unit (ICU), and new risk factors associated with respiratory colonization or infection by Aspergillus spp. include steroid treatment and chronic lung obstructive disease [1, 2]. In a review of 289 autopsies in the ICU, IA was the leading cause of Goldman class I discrepancy (a missed major diagnosis with major impact on patient management and survival) [3]. The epidemiology of IA indicates an increasing number of infections in immunosuppressed patients/individuals undergoing transplantation of bone marrow, hematopoietic stem cells, or organ transplantations, and those receiving intensive chemotherapy or other immunosuppressive treatments. A broad group of patients who are admitted to ICU also have some form of immunosupppression and may be susceptible to invasive mould infections. For various reasons, figures about the true incidence of IA in ICU are difficult to generate. The most important reason is the difficulty encountered in making a definite diagnosis of IA (lack of sensitivity and specificity with regard to culture and radiology) [4]. Recently, galactomannan (GM) in bronchoalveolar lavage (BAL) fluid appears to be a promising tool for early diagnosis in non-neutropenic critically ill patients and has been associated in proven cases with sensitivity and specificity of 88 and 87%, respectively [5]. Pseudomembranous and obstructive Aspergillus tracheobronchitis are still considered to have a fatal outcome and have been reported in a wide variety of patients [6]. There has been only one report in a patient with diabetes which was treated by deoxycholate amphotericin B (AmB) and subsequent addition of oral itraconazole [7]. In this paper, we report a pseudomembranous and obstructive tracheobronchitis in a diabetic patient successfully treated with caspofungin and AmB.

Il volume è il frutto di un’articolata ricerca che non si configura come semplice storia di una scuola quanto piuttosto come storia di un luogo, di un edificio e di una politica pubblica. Il luogo e l'edificio appartengono all'epoca aurea del municipalismo di inizi secolo con l' avvio, a Cesena, di un coraggioso programma di modernizzazione urbana e civile che portò alla costruzione di un nuovo e "moderno ospedale ". La politica pubblica è quella è quella che ha connotato la destinazione d'uso della struttura dall'originaria vocazione sanitaria a quella formativa. Il contributo partendo dalle recenti ricerche sui documenti relativi alla costruzione dell'ex Ospedale Bufalini, opera dell'ing. Emilio Speroni, nonché dalle recenti acquisizioni sulla consistenza materiale della fabbrica dovute ad una attento rilievo critico del complesso, affronta alcuni aspetti relativi l'insegnamento del "Restauro architettonico". Il progetto di restauro è da tempo riconosciuto come atto fondato sulla consapevolezza dell’unicità dell’oggetto che si ha di fronte e non certo come operazione frutto di astratte categorie operative o di approssimate abitudini esecutive. Lo scritto si sofferma pertanto sul tema dell’educazione a quello che è stato definito “il tempo dilatato dell’ascolto. Ascoltare la permanenza vuole dire imparare a concentrarsi soprattutto sui dettagli, per comprendere meglio la ricchezza e l’importanza testimoniale anche di manufatti umili e, proprio per questo, più a rischio di conservazione (“non si tratta di vedere o sentire cose diverse, si tratta di guardare ed ascoltare in modo diverso” A. Conan Doyle). Ulteriori riflessioni riguardano il termine "manutenzione" sul quale molto è stato scritto anche se, contrariamente a quanto si crede, questo termine non assume significati univoci specie nella pratica comune: J. Ruskin sottolineava la diffusa abitudine, diffusa allora come ora, di lasciare andare in rovina un monumento per poi realizzarne un lucroso ed appariscente intervento. Le note si concludono infine con alcune considerazioni su cosa vuol significare lavorare al contorno di una permanenza (e qualche volta forse “oltre il restauro) e sulla opportunità di assumere quest’ultima come punto di partenza di cui ne riconosce le incredibili potenzialità anche per il progetto del nuovo.

No abstract available

Queremos agradecer a los compañeros de la Asociación Madrileña de Podólogos y en especial a los Miembros de la Junta Directiva, la invitación para asistir como profe­sores en este 1. r Curso de Ortopodología, así como a to­dos los compañeros de la Escuela de Podología de la Uni­versidad de Barcelona por su presencia en este trabajo. Al preparar esta clase, creímos necesario retroceder un poco hacia la exploración clínica del paciente, puesto que al instaurar un tratamiento ortopodológico, debíamos ex­plicar cuáles eran los parámetros en los cuales basamos nuestro criterio profesional.