[Clinical and biological markers of secondary uveitis: results of a discriminant analysis]. / Marcadores clinicobiológicos de uveítis secundaria: resultados de un análisis discriminante.

BACKGROUND: The association of uveitis and systemic disease is well known. Patients suffering from uveitis often undergo a extensive battery of tests in order to detect underlying disease, but the efficiency of such screening is uncertain. The aim of this study was to investigate useful clinical data for recognizing secondary uveitis. PATIENTS AND METHODS: We conducted a prospective analysis of 115 patients with uveitis of unknown etiology. All of them were included in an extensive protocol study. Four groups were considered: specific ocular disease (SOD), idiopathic uveitis, HLA-B27 associated uveitis without arthritis (HLA-B27-AU) and secondary uveitis. Groups were compared by analysis of variance for continuous variables, and chi 2 test or Student's t-test for discrete variables. A stepwise multiple discriminant analysis was performed for ranking the variables in order of their usefulness for distinguishing idiopathic and secondary uveitis. RESULTS: We diagnosed 11 SOD (9.6%), 54 idiopathic uveitis (47%), 6 HLA-B27-AU (5.2%) and 41 secondary uveitis (35.7%). The discriminant analysis showed that age, an elevated erythrocyte sedimentation rate, presence of cutaneous lesion, joint pain and genital ulcers are the strongest predictors of secondary uveitis. This model classification functions detected 92.5% of idiopathic uveitis and 72% of secondary uveitis. The global percentage of patients with a correct diagnosis was 84.6%. CONCLUSIONS: Anamnesis, physical examination and basic laboratory tests are sufficient tools for the diagnostic approach of the majority of patients with uveitis. Subsequent diagnostic procedures must be planned in each patient to confirm a specific disease.

[Varicella complicated by pericarditis and pneumonia]. / Varicela complicada con pericarditis y neumonía.

Varicella is a highly infectious disease mainly affecting young children under 14 years of age, and being generally mild. In adults immunodeficient children and neonates exposed in utero, the illness tends to be more severe with higher incidence of complications. The type of complication is linked to the age: in children, bacterial infection of skin lesions and acute cerebellar ataxia are more frequent while lower respiratory tract infection, Reye syndrome and encephalitis are less common. Varicella pneumonia is found typically in adult patients and diffuse encephalitis which course is worse than children could be less frequently. Acute pericarditis is an exceptional complication with a benign course, but only if myocarditis or pericardial effusion are not concurrent. It usually appears in teenagers and young adults; only a few times, it has been linked to other complications as pneumonia or arthritis. We report a varicella case in an adult patient who suffered from pneumonia and pericarditis, both of them were benign.

[What do the internal medicine residents of Anadalusia think of their specialty? Survey results]. / Qué opinan los residentes de medicina interna de Andalucía de su especialidad? Resultados de una encuesta.

BACKGROUND: To know the opinion of andalusian Internal Medicine (IM) residents about different subjects of their specialty, and their biomedical investigation activities. PATIENTS AND METHODS: A questionnaire with codified answers, facilitated to 64 IM residents of Andalusia. RESULTS: 69% of residents referred that IM was the specialty they wished to adhere at first choice. A 61% of residents would advice choosing IM as specialty to physicians with the exams for becoming a resident just passed. Best merit of IM for 89% of people was the global sight of the patient, and worst one for 37.5% was its tendency to fragmentation. 47% of residents consider that the role of the specialty will grow in the future. CONCLUSIONS: Our questionnaire reflects some of the contradictions that IM as a specialty is living, and probably show the rely of future internists to some future propositions about the specialty.

[Prostatic vasculitis, an unusual onset of panarteritis nodosa: presentation of 2 cases]. / Vasculitis prostática, una forma de inicio inusual de la panarteritis nodosa: presentación de dos casos.

Prostatic involvement in nodose panarteritis is considered as exceptional, especially as the onset of the disease. We discuss two cases which made their debut with fever, weight loss and urinary symptomatology, simulating a prostatic neoplasia. The pathology study of the ressected prostatic sample showed in both cases a necrotizing vasculitis which yielded the diagnosis of nodose panarteritis, and to establish the specific treatment with steroids an immunosuppressants.

¿Qué opinan los residentes de Medicina Interna de Andalucía de su especialidad? Resultados de una encuesta / What do andalusian internal medicine residents thing abort their speciality?: results of a questionnaire

Objetivos: Valorar la opinión de residentes de medicina interna (MI) de Andalucía sobre diferentes aspectos de su especialidad, así como sus actividades de investigación biomédica. Material y métodos: Encuesta con respuestas codificadas a 64 residentes de MI de Andalucía. Resultados: Un 69% de los residentes confesó que la MI era la especialidad que deseaban realizar como primera opción. Un 61 porciento aconsejaría elegir la MI como especialidad a un médico que ahora aprobara el examen de médico interno residente. La principal virtud de la MI para un 89% de los encuestados es la visión global del enfermo y para un 37,5 porciento su tendencia a la fragmentación el principal defecto. Un 47% de los residentes consideran que la presencia de la especialidad aumentará en el futuro. Conclusiones: Nuestra encuesta refleja algunas de las contradicciones que está viviendo la especialidad de MI y probablemente señala el apoyo de los futuros internistas a algunas propuestas de futuro sobre la especialidad (AU)