Retrospective analysis of risk factors and prognosis in non-ventilated patients with nosocomial pneumonia.

Although nosocomial pneumonia in non-ventilated patients continues to be frequent and have high mortality rates, knowledge of the associated risk and prognostic factors is still limited. This retrospective study was designed to analyze epidemiological characteristics, risk and prognostic factors in patients with nosocomial pneumonia admitted to a hospital internal medicine department. Data on epidemiological, clinical and microbiological factors as well as diagnosis and clinical course were obtained from the medical records of 104 patients diagnosed with nosocomial pneumonia, according to Centers for Disease Control criteria, and from 104 control subjects. The incidence of nosocomial pneumonia was 18.8 per 1000 admissions. Risk factors significantly associated with contracting the disease were female sex, hospital stay longer than 14 days, other admission in the previous month and use of antibiotics during the previous six weeks. The most frequent underlying diseases were cardiorespiratory in nature (59.4%). Prognostic factors significantly associated with increased mortality were serious underlying disease, initially critical clinical status, severe and moderate respiratory insufficiency and bilateral radiological signs. More epidemiological data are needed to improve the diagnosis, treatment and prevention of nosocomial pneumonia.

[Non-specific digestive ulcers and Behçet's disease]. / Ulceras digestivas inespecíficas y enfermedad de Behçet.

We present a 56-year-old patient with episodes of recurrent abdominal pain and constitutional syndrome, whose evolution was complicated by mucous ulcers in mouth, esophagus, anus and ileocecal valve, as well as occasional aphthae in scrotum. All these clinical signs are compatible with a Behçet's disease with relevant digestive manifestations.

[Usefulness of captopril as monotherapy and combination therapy in the treatment of arterial hypertension]. / Utilidad del captopril como monoterapia y en terapia de combinación en el tratamiento de la hipertensión arterial.

The efficacy and tolerance of captopril was prospectively studied as monotherapy for blood hypertension (BH), as well as combined modality with thiazides diuretic and nifedipine as a third drug. 95 cases of BH were followed up for a period of 6 months. 43.15% of the patients who received monotherapy with captopril were controlled (diastolic BP less than 95 mmHg). Those patients who had a diuretic added showed a response of 71.75% and those administered 3 drugs showed a response of 81.25%. The decrease of BH was significant in all groups (p less than 0.01). There was a significant correlation (p less than 0.01) between the response to monotherapy and severity of BH (mild BH 67.50% and severe BH 35.20%). 6.5% of patients abandoned the treatment because of secondary effects. No alterations were noted in the blood test. Monotherapy with captopril is effective in control of mild and moderate BH. In resistant patients, the addition of a diuretic and nifedipine retard as a third drug is useful and well-tolerated in any type of BH severity.