[Epidemic outbreak of 81 cases of brucellosis following the consumption of fresh cheese without pasteurization]. / Estudio de un brote epidémico de 81 casos de brucelosis consecutivo al consumo de queso fresco sin pasteurizar.

BACKGROUND: In spite of the great effort that has been made in recent years in Castilla-La Mancha to control brucelosis, a lack of awareness on the part of producers and consumers leads to major epidemic outbreak, such as the one described below. METHODS: A description of the outbreak is described and a study is conducted of cases and controls to determine the factors which are responsible for the epidemic. Unadjusted and adjusted Odds Ratios (O.R.) are obtained together with their confidence intervals, for the main epidemiological factors studied. RESULTS: A total of 81 cases of brucelosis were recorded in a period of 25 weeks. All the cases occurred in the same borough or were in some way linked to it. In the case and controls study no differences were found with regard to age, sex, contact with livestock or the consumption of pasteurised milk or cheese. A strong link was established between the illness and the consumption of home-made cottage cheese prepared by a small-scale producer in the borough, (O.R. = 311.9; C.I. = 95% = 41.48-12735)., whose livestock turned out to be infected with Brucella Mellitensis. CONCLUSIONS: This outbreak showed that in Spain, there is a risk of contracting brucelosis by consuming non-pasteurised dairy products, particularly cheese, when these are not subjected to the normal sanitary and health controls. The benefits of epidemiological research in the search for cases and determining the factors responsible for the outbreak are also demonstrated. An intensification of controls, the cleansing of the herds and flocks and health education in general, are suitable instruments for controlling this zoonosis in Spain.

[Noninvasive diagnosis of Takayasu's arteritis]. / Diagnóstico de la arteritis de Takayasu mediante técnicas no invasivas.

OBJECTIVES: Takayasu arteritis is a chronic inflammatory obliterative disease of the great vessels that mainly affects the aorta and its primary branches. In its early phase, the clinical presentation and laboratory tests are nonspecific, so accurate diagnosis frequently depends on imaging studies. The aim of this study was to review the main features of Takayasu's arteritis and the usefulness of different noninvasive imaging techniques in the early diagnosis and follow-up of this entity. MATERIAL AND METHODS: We included 12 patients diagnosed with Takayasu's arteritis at our center. We retrospectively reviewed the different imaging studies (color Doppler US, multislice CT, and magnetic resonance) employed in each case. RESULTS: The abdominal aorta and its main branches (renal arteries, superior mesenteric artery, and celiac trunk) were involved in 8 of the 12 patients studied. This involvement was detected as increased velocities in Doppler US that were suggestive of stenosis and was later confirmed on CT angiography and MR angiography. In four patients, CT angiography and MRI angiography demonstrated diffuse and homogeneous vessel wall thickening; in two patients, these techniques also showed enhancement of the thickened walls after contrast administration that suggested active inflammatory disease. Another frequent finding was supra-aortic trunk involvement, which was seen in six cases. CONCLUSION: Noninvasive imaging techniques are fundamental in the early diagnosis of patients with Takayasu's arteritis. CT angiography and MR angiography provide additional information about the inflammatory activity of the disease.

Diagnóstico de la arteritis de Takayasu mediante técnicas no invasivas / Noninvasive diagnosis of Takayasu´s arteritis

Objetivos: La arteritis de Takayasu es una enfermedad crónica, inflamatoria y obliterativa de los grandes vasos, con predilección por la aorta y sus ramas principales. La frecuente inespecificidad clínica y analítica hace que el diagnóstico final dependa, en gran medida, de los estudios de imagen. Este trabajo pretende revisar las manifestaciones de esta enfermedad, así como la utilidad de las distintas pruebas de imagen no invasivas en el diagnóstico y seguimiento de estos pacientes. Material y métodos: Se incluyen 12 pacientes diagnosticados de arteritis de Takayasu en nuestro centro, y se revisan retrospectivamente los distintos estudios de imagen realizados: ecografía Doppler color, tomografía computarizada (TC) multicorte y resonancia magnética (RM).Resultados: En 8 de los 12 pacientes revisados se detectó como alteración fundamental la afectación de la aorta abdominal y sus ramas principales (arterias renales, arteria mesentérica superior y tronco celíaco). Dicha afectación se detectó como un aumento de las velocidades en el estudio Doppler-color sugestivo de estenosis, que se confirmó con angio-TC y angio-RM. En 4 casos la angio-TC y la angio-RM mostraron engrosamiento difuso y homogéneo de la pared, en 2 de ellos se apreció captación de contraste, como signo sugestivo de inflamación activa. Otra manifestación frecuente fue la afectación de troncos supraaórticos, que se objetivó en 6 pacientes. Conclusión: Las técnicas de imagen no invasivas son fundamentales en el diagnóstico inicial de los pacientes con enfermedad de Takayasu. La angiografía por TC y RM aporta datos adicionales al ser una herramienta útil para valorar la actividad inflamatoria del proceso (AU)

Objectives: Takayasu arteritis is a chronic inflammatory obliterative disease of the great vessels that mainly affects the aorta and its primary branches. In its early phase, the clinical presentation and laboratory tests are nonspecific, so accurate diagnosis frequently depends on imaging studies. The aim of this study was to review the main features of Takayasu's arteritis and the usefulness of different noninvasive imaging techniques in the early diagnosis and follow-up of this entity. Material and methods: We included 12 patients diagnosed with Takayasu's arteritis at our center. We retrospectively reviewed the different imaging studies (color Doppler US, multislice CT, and magnetic resonance) employed in each case. Results: The abdominal aorta and its main branches (renal arteries, superior mesenteric artery, and celiac trunk) were involved in 8 of the 12 patients studied. This involvement was detected as increased velocities in Doppler US that were suggestive of stenosis and was later confirmed on CT angiography and MR angiography. In four patients, CT angiography and MRI angiography demonstrated diffuse and homogeneous vessel wall thickening; in two patients, these techniques also showed enhancement of the thickened walls after contrast administration that suggested active inflammatory disease. Another frequent finding was supra-aortic trunk involvement, which was seen in six cases. Conclusion: Noninvasive imaging techniques are fundamental in the early diagnosis of patients with Takayasu's arteritis. CT angiography and MR angiography provide additional information about the inflammatory activity of the disease (AU)

Degeneración walleriana del haz corticoespinal tras hematoma cerebral espontáneo / No disponible

No disponible