[The non-mydriatic camera as a screening method in diabetics in Tarragona]. / Resultados de la implantación de la càmara no midriática como método de screening en pacientes diabéticos en Tarragona.

OBJECTIVE: The aim of the study is to present the results of the first year of using a non-mydriatic fundus camera. We performed an evaluation of its usefulness and problems. METHODS: During the first year of using the non-mydriatic fundus camera we evaluated 3,272 type II diabetic patients who were not being controlled in the hospital. RESULTS: The diabetic retinopathy was observed in 164 patients (5.01%), the mild form in 70 patients (2.14%). Diabetic macular oedema was observed in 41 patients (1.25%). In 119 patients (3.63%) the retinography could not be interpreted and were referred to the hospital; 113 patients also were referred due to other pathologies; the largest group of these patients had age-related macular disease or age-related macular degeneration (42 patients). Finally, 458 patients (13.99%) required mydriatic eye-drops. CONCLUSIONS: The non-mydriatic fundus camera is a useful technique for assessing the presence of diabetic retinopathy, particularly in patients with poor ophthalmic control. This technique may enable us to diagnose these patients who need laser treatment.

Resultados de la implantación de la càmara no midriática como método de screening en pacientes diabéticos en Tarragona / The non-mydriatic camera as a screening method in diabetics in Tarragona

ObjetivoPresentar los resultados tras el primer año de funcionamiento de la cámara no midriática en nuestra área, evaluando su utilidad y los problemas que hemos observado.MétodosDurante el periodo de un año se han revisado 3.272 pacientes diabéticos tipo 2 mediante la cámara no midiátrica; estos pacientes no estaban siendo sometidos a controles periódicos en nuestro centro en razón a su patología ocular.ResultadosLa retinopatía diabética se observó en 164 pacientes (5,01%), la forma leve en 70 pacientes (2,14%). El edema macular diabético se apreció en 41 pacientes un 1,25%. En 119 (3,63%) pacientes no se pudo interpretar la imagen debiendo ser referidos a las consultas de oftalmología, además se derivaron 113 pacientes sin retinopatía diabética, de estos la mayoría (42 pacientes) presentaban lesiones en el área macular sospechosas de maculopatía o degeneración macular asociada a la edad. Finalmente en 458 (13,99%) pacientes se precisó la instilación de colirio midriático.ConclusionesPodemos extraer que el screening mediante cámara no midiátrica, es altamente útil para poder acceder a una gran parte de la población diabética, en especial aquella que acude con escasa frecuencia al oftalmólogo, permitiéndonos diagnosticar un número importante de pacientes susceptibles de tratamiento láser para evitar su ceguera(AU)

ObjectiveThe aim of the study is to present the results of the first year of using a non-mydriatic fundus camera. We performed an evaluation of its usefulness and problems.MethodsDuring the first year of using the non-mydriatic fundus camera we evaluated 3,272 type II diabetic patients who were not being controlled in the hospital.ResultsThe diabetic retinopathy was observed in 164 patients (5.01%), the mild form in 70 patients (2.14%). Diabetic macular oedema was observed in 41 patients (1.25%). In 119 patients (3.63%) the retinography could not be interpreted and were referred to the hospital; 113 patients also were referred due to other pathologies; the largest group of these patients had age-related macular disease or age-related macular degeneration (42 patients). Finally, 458 patients (13.99%) required mydriatic eye-drops.ConclusionsThe non-mydriatic fundus camera is a useful technique for assessing the presence of diabetic retinopathy, particularly in patients with poor ophthalmic control. This technique may enable us to diagnose these patients who need laser treatment(AU)

Prevalence of Trichinella spp. in North Spain wild fauna and new variety of Trichinella britovi identification.

Trichinella spiralis and Trichinella britovi live in apparent sympatry among wild fauna of the Iberian Peninsula. In the present study 105 Trichinella isolates from wild mammals were typed by inter-sequence simple repeat PCR (ISSR-PCR). All isolates identified as T. spiralis were indistinguishable from the ISS48 reference strain. Among those belonging to T. britovi, four variations were clearly distinguishable; two of them, ISS11 C-76 and ISS86 MON, had been previously detected while the ISS2 reference strain and Trichinella Rioja 3, (MVUL/SP/02/R3) had not been reported before. The newly distinguished genotype of T. britovi was analyzed by ISSR-PCR, multiplex-PCR, UARR sequencing, and single larva cross-breeding with the other T. britovi genotypes including Trichinella T8 (ISS49). Among all of them, the ISS11 and ISS2 isolates were found to be the most frequent. The uniformity found within T. spiralis isolates is consistent with its recent introduction in Iberian Peninsula, whereas the presence of four variations within T. britovi suggests that this species is an endemic species. Orographical diversity of the West-End of Eurasian Region could act to preserve population diversity observed within T. britovi.

The seroprevalence of human infection with Rickettsia slovaca, in an area of northern Spain.

An epidemiological survey was undertaken to explore human exposure to Rickettsia slovaca in two provinces of northern Spain. When IFAT were used to test 200 members of the general population for antibodies to rickettsiae of the spotted-fever group, six (3.3%) were found positive, presumably, since Dermacentor is one of the most common genera of human-biting tick in the study area, for antibodies to R. slovaca. Thirty-one (16.9%) of an additional 183 subjects who presented shortly after being bitten by ticks were also found seropositive. The difference in seroprevalence between the general and the tick-bitten populations was significant. Subject gender had no influence on seroprevalence in either population, although, in the tick-bitten group, age and occupation did have a significant influence on the prevalence recorded. Immunoblotting was used to confirm the presence of antibodies in the five subjects, all from the tick-bitten group, found to have acute infections. Three D. marginatus ticks obtained from three of these acute cases were found PCR-positive for R. slovaca DNA.

Epidemiological study of Rickettsia typhi infection in two provinces of the north of Spain: analysis of sera from the general population and sheep.

Data relating to Rickettsia typhi infection in Spain are scarce. A serological survey of 383 serum samples (184 males, 199 females) from the general population and 120 sera from sheep were studied by immunofluorescence assay (IFA). The human serum samples were collected from the general population of Palencia and Burgos provinces, and sheep serum samples were collected from Palencia province. Of the 383 human serum samples studied, 29 were positive for antibodies against R. typhi (7.5%) No statistical differences were found according to age, sex, origin (rural vs. urban) or geographic distribution, but a significant difference was observed related to occupation. In addition, 69 serums were found positives for R. typhi in sheep samples (57.5%). Our results indicated the circulation of R. typhi infectious for humans and sheep in Palencia and Burgos provinces. This study indicates that sheep may be infected with R. typhi, and that animals can, therefore be used as indicators of the presence of this organism.

Percutaneous transluminal angioplasty as best treatment in stenosis of vascular access for hemodialysis.

We show the results of treatment with percutaneous transluminal angioplasty on 38 occasions for vascular access for hemodialysis. Our study includes 22 patients with A-V internal fistulas (Cimino type), 1 autologous saphenous vein shunt and 7 synthetic polytetrafluoro-ethylene shunts. Twenty patients have had a follow-up period over 24 months. Four patients required a second and 2 of them a third transluminal dilatation. Only on two occasions were complications related to the technique. The microscopic findings of the venous wall after percutaneous transluminal angioplasty are shown.

[Visceral leishmaniasis in childhood (author's transl)]. / El Kala-azar en la infancia. Estudio en la provincia de Sevilla.

Authors present six cases of kala-azar in children under six years of age observed in the province of Seville, during a three year period. Ethiologic, clinical, evolutive and therapeutic aspects of this illness are analized. Two of the patients presented jaundice, in which a liver-spleen scan was performed and nothing else but the hepato-splenomegaly was found, as it was described in a previous case. Importance of visualizing leishmanias by bone marrow puncture for a true diagnosis is remarked.

[Melitococcal hepatic encephalopathy]. / Encéphalopathie hépatique mélitococcique.

A 5 year old child with brucellosis is described who developed severe liver disease with neuropsychiatric signs and electroencephalographic changes.

[Favism (study of 8 families)]. / Favismo (Estudio de ocho familias).

This paper presents ten cases of total glucose-6-phosphate dehydrogenase (G-6-PD) deficiency in individuals with hemolytic crisis after exposure to products of the fava been ("Vicia faba"). Three other cases of total G-6-PD deficiency and eleven partial deficit cases of the enzyme, without associated hemolysis were detected in a total of forty individuals belonging to eight families of the province of Seville examinated for G-6-PD levels. Important differences were noted in the G-6-PD enzyme dosage taken during the crisis and six and twelve months after. This fact was interpreted as a secondary effect to the elimination of the enzymopenic cells because of hemolysis. Data suggests the existence of a relatively stable form of G-6-PD that could explain the dissociation between the incidence of deficit in G-6-PD level in the general population and the reduced casuist of favism reported in our literature.

[Familial erythrophagocytic lymphohistiocytosis (author's transl)]. / Linfohistiocitosis eritrofagocítica familiar.

A four-year old boy with familial erythrophagocytic lymphohistiocytosis is reported. The clinical picture was that of prolonged fever, hepato and splenomegaly, adenopathies and, in the terminal state, bleeding tendency and sligth jaundice. The laboratory data showed anemia, leucopenia and abnormal coagulation studies compatibles with disseminated intravascular clotting. The differential diagnosis with malignant histiocytosis is attempted from a histological point of view.