[Morbidity in hospital admission for stroke]. / Morbilidad por hospitalización en el ictus.

INTRODUCTION: In spite of advances in the prevention and treatment of ischemic vascular disease, this continues to be one of the main causes of disablement and prolonged hospitalization in developed countries. Also, hospitalization itself leads to complications which have a negative effect on the morbi-mortality of these patients during the time spent in hospital. OBJECTIVE: We decided to study the effect of systemic complications during the period of hospital stay, on the functional recovery of patients which ictusl. MATERIAL AND METHODS: A prospective study was made of 47 patients admitted to our unit for neurological deficit of more than 24 hours evolution and of cerebrovascular aetiology. Functional recovery was evaluated by means of the index of Barthel on discharge and after a period of 3 months with respect to the degree of neurological involvement (Canadian scale on admission), glycemia on admission, time spent in hospital and the occurrence of systemic complications in hospital. RESULTS: These were no differences between the groups of patients with and without systemic complications regarding age, glycemia and Canadian scale on admission. Nor wes there any difference between the groups regarding the number of patients with significant deterioration of their neurological condition (decrease > 20% in the EC). Functional recovery on hospital discharge was worse in the group with systemic complications (IB: 43.05 +/- 34.1: as compared with IB: 72.8 +/- 22.7 in the group without complications). This difference persisted after 3 months. CONCLUSIONS: Systemic complications related to hospitalization have a negative effect on the functional recovery of patient with ictus and also prolong the time spent in hospital.

[Clinical forms and prognostic criteria in alcoholic hepatitis]. / Formas clínicas y criterios pronósticos en la hepatitis alcohólica.

The biological and clinical features and prognostic factors of 65 patients affected by alcoholic hepatitis were studied. All patients had an ethanol intake higher than 80 gr/day during at least 3 years. 22 patients were female and 43 male with a mean age of 45 +/- 11.7 years. 19 had acute hepatitis (29.2%), 2 had acute hepatic insufficiency (3%), one had acute cholestasis (1.5%), 14 had chronic hepatopathy (21.5%). 29 patients had the diagnosis (44.6%) confirmed by histologic analysis. All patients had liver enlargement, 25 had jaundice and 4 had fever. The hepatic biopsies showed steatosis in 53 cases, centrilobular sclerosis in 32 cases and cirrhosis in 19.8 patients developed hepatic encephalopathy, 3 had renal insufficiency, and 4 died. The levels of albumin (P = 0.0043), total bilirubin (P = 0.0003), prothrombin (P = 0.0001) and the development of hepatic encephalopathy or/and renal insufficiency were the parameters to define the group of patients with bad evolution, the IgA also being significant. The low mortality of our studied (6.1%) can be justified by the diagnosis at non-symptomatic stage. We recommend a liver biopsy in all patients with chronic alcoholism and liver enlargement, or biologic markers suggesting alcoholic hepatopathy.

[Myasthenia gravis and treatment with intravenous immunoglobulins. Reply]. / Miastenia grave y tratamiento con inmunoglobulinas por via intravenosa. Replica.

Miastenia grave y tratamiento con inmunoglobulinas por via intravenosa. Replica.