[Matematical modeling of antibiotic resistance: perspectives from a meta-analysys]. / Modelos matemáticos en el estudio de la resistencia a los antimicrobianos. Perspectivas a partir de un metaanálisis.

The antibiotic resistance is one of the greatest challenges of the international health community. The study of antibiotic resistance must be a multidisciplinary task and, in this sense, the main goal of this work is to analyze the role that Mathematical Modeling can play in this scenario. A qualitative and cuantitative analysis of the works published in the scientific literature is done by means of a search in the most important databases: MEDLINE, SCOPUS and ISI Web of Science. Consequently, there are few papers related to our topic but the existing works have been published in high-quality and impact international journals. Moreover, we can state that mathematical models are a very important and useful tool to analyze and study both the treatments protocols for resistance prevention and the assesment of control strategies in hospital environtment, or the prediction of the evolution of diseases due to resistant strains.

Shock séptico por mionecrosis primaria del psoas / Septic shock due to primary myonecrosis of psoas

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Miocardiopatía periparto en paciente consumidora de cocaína / Peripartum cardiomyopathy in a cocaine user

Presentamos un caso de insuficiencia cardíaca a las 48 h de una cesárea en una mujer de 23 años adicta a la cocaína por vía inhalada. La paciente presentó un cuadro súbito de edema agudo de pulmón cardiogénico asociado con cambios electrocardiográficos y ecocardiográficos con una recuperación posterior de la función ventricular tras tratamiento médico de la insuficiencia cardíaca y con evolución posterior favorable (AU)

[Rombencephalitis due to Listeria monocytogenes. Probable usefulness of dexamethasone associated with antibiotic treatment]. / Rombencefalitis por Listeria monocytogenes. Probable utilidad de la dexametasona asociada al tratamiento antibiótico.

INTRODUCTION: Infection of the central nervous system by Listeria monocytogenes appears in most cases as acute meningitis which is indistinguishable from other types of acute meningitis. Rombencephalitis is a rare form of neurolisteriosis, localized to the brainstem. The initial non specific symptoms may make early diagnosis difficult. CASE REPORT: We describe the clinical case of a previously healthy woman who had L. monocytogenes infection localized to the brainstem. Her initial symptoms were fever and headache followed by signs of brainstem involvement, deterioration of consciousness and severe respiratory insufficiency which made mechanical ventilation necessary. Study of the cerebrospinal fluid showed lymphocytic pleocytosis, raised protein and normal glucose levels. L. monocytogenes was isolated on blood culture. Cranial computerized tomography was normal and magnetic resonance showed a right pontobulbar lesion. After receiving specific antibiotic treatment the infectious condition improved. However, the neurological symptoms started to improve when dexamethasone was added to the antibiotic treatment twelve days later. The patient was discharged from hospital with slight neurological sequelas. CONCLUSION: In a febrile patient with signs of brainstem involvement, neurolisteriosis should be suspected and ampicillin and gentamycin added to the treatment. The possibility of acute respiratory arrest occurring makes it necessary to monitor these patients closely. The association of dexamethasone to the antibiotic treatment may be useful in some cases of rombencephalitis due to L. monocytogenes.

Rombencefalitis por Listeria monocytogenes. Probable utilidad de la dexametasona asociada al tratamiento antibiótico / Rombencephalitis due to Listeria monocytogenes. Probable usefulness of dexamethasone associated with antibiotic treatment

Introducción. La infección del sistema nervioso central por Listeria monocytogenes se manifiesta en la mayoría de los casos como una meningitis aguda indistinguible de otras meningitis bacterianas. La rombencefalitis es una forma rara de neurolisteriosis que se localiza en el tronco cerebral y cuyos síntomas iniciales son inespecíficos y pueden dificultar el diagnóstico precoz. Caso clínico. Se presenta el caso clínico de una mujer previamente sana que sufrió una infección en el tronco cerebral provocada por L. monocytogenes. Los síntomas iniciales fueron fiebre y cefalea, seguidos de signos de afectación del tronco cerebral, disminución del nivel de conciencia e insuficiencia respiratoria grave que necesitó ventilación mecánica. El estudio del líquido cefalorraquídeo mostró pleocitosis linfocitaria, hiperproteinorraquia y glucorraquia normal. Se aisló L. monocytogenes en el hemocultivo. La tomografía computarizada fue normal y el estudio con resonancia magnética mostró una lesión pontobulbar derecha. Tras recibir tratamiento antibiótico específico mejoró el cuadro infeccioso, pero la sintomatología neurológica comenzó a mejorar recién cuando doce días más tarde se añadió dexametasona al tratamiento antibiótico. La paciente recibió el alta hospitalaria con secuelas neurológicas leves. Conclusiones. Ante un paciente con cuadro febril y síntomas de afectación del tronco cerebral se debería sospechar neurolisteriosis e incluir ampicilina y gentamicina en el tratamiento. La posibilidad de que ocurra una parada respiratoria aguda aconseja mantener en estrecha vigilancia al paciente. La asociación de dexametasona al tratamiento antibiótico podría ser útil en algunos casos de rombencefalitis por L. monocytogenes (AU)

[Acute eosinophilic pneumonia in a pregnant woman]. / Neumonía eosinófila aguda en gestante.

Acute eosinophilic pneumonia is a recently described pulmonary phenomenon involving rapidly progressing respiratory insufficiency. Although it can appear at any age, it has never been reported during pregnancy and its impact on gestation is therefore unknown. We describe the clinical signs and course of disease in this first report of acute eosinophilic pneumonia in a pregnant woman. We emphasize the diagnostic utility of bronchoalveolar lavage, the resolution of symptoms without corticoid treatment and, mainly, the absence of adverse repercussions of the disease on pregnancy.

[Septic shock and multiple organ failure caused by Mycobacterium tuberculosis]. / Shock séptico y fallo multiorgánico por Mycobacterium tuberculosis.

We report a case of death from septic shock with multiorganic failure of tuberculosis origin. We described, the pathogenic mechanism of the sepsis and respiratory distress due to Mycobacterium tuberculosis. Another aspect of interest was the hemodynamic demonstration of septic shock due to M. tuberculosis.