Fiebre Q: 54 nuevos casos de un hospital terciario de Madrid / Q fever: 54 new cases from a tertiary hospital in Madrid

Objetivos. Describir las características epidemiológicas y clínicas de la fiebre Q en una zona urbana de la Comunidad de Madrid. Material y métodos. Estudio observacional retrospectivo de cohorte de los casos diagnosticados de fiebre Q en un único centro desde enero de 2001 hasta diciembre de 2008. El diagnóstico de fiebre Q aguda se realizó mediante la detección de anticuerpos frente a antígenos fase II por técnica de enzyme-linked immunosorbent assay (ELISA) e inmunofluorescencia indirecta (IFI), en base a un título aislado ≥ 1/80 o cuando se demostró seroconversión o serorrefuerzo. El de fiebre Q crónica se realizó mediante anticuerpos frente antígenos fase I positivo si IgG >= 1/800. Resultados. Se diagnosticaron 54 casos de fiebre Q en adultos. Cincuenta y un pacientes con fiebre Q aguda y 3 con fiebre Q crónica. Predominaron los varones de más de 50 años de edad y residentes en medio urbano. La clínica más frecuente fue la neumonía, la insuficiencia renal (33%), la hepatitis y el síndrome febril sin focalidad (25% ambas), con infección concomitante en el 37% de los casos. El seguimiento clínico y serológico en la mayoría de los pacientes fue inadecuado. La doxiciclina fue el tratamiento de mayor respuesta en enfermedad aguda, aunque en 10% con duración inadecuada(AU)

Objectives. To describe the epidemiological and clinical characteristics of Q fever in an urban zone of the Community of Madrid (Spain). Material and methods. An observational, retrospective study was performed of a cohort of cases diagnosed of Q fever within a single center in Madrid from January 2001 to December 2008. The diagnosis of acute Q fever was made by detection of antibodies against phase II antigen by Enzyme-Linked Immunosorbent Assay (ELISA) and indirect immunofluorescence (IFA), based on isolated titer ≥ 1/80 or when they showed seroconversion or seroreinforcement. Chronic Q fever was diagnosed using antibodies against phase I with a positive value if IgG >= 1/800. Results. A total of 54 cases of Q fever in adults were diagnosed; 51 patients had acute Q fever and only 3 chronic. There was a predominance of men over > 50years and from urban areas. The most frequent manifestation was pneumonia (54%), followed by renal failure (33%), hepatitis and fever without focality (25% in both), with concomitant infection in 37% of the cases. The clinical and serological monitoring in most of the patients were inadequate. The best response to treatment was with doxycycline in acute illness, although duration was inadequate in 10%(AU)

[Q fever: 54 new cases from a tertiary hospital in Madrid]. / Fiebre Q: 54 nuevos casos de un hospital terciario de Madrid.

OBJECTIVES: To describe the epidemiological and clinical characteristics of Q fever in an urban zone of the Community of Madrid (Spain). MATERIAL AND METHODS: An observational, retrospective study was performed of a cohort of cases diagnosed of Q fever within a single center in Madrid from January 2001 to December 2008. The diagnosis of acute Q fever was made by detection of antibodies against phase II antigen by Enzyme-Linked Immunosorbent Assay (ELISA) and indirect immunofluorescence (IFA), based on isolated titer ≥ 1/80 or when they showed seroconversion or seroreinforcement. Chronic Q fever was diagnosed using antibodies against phase I with a positive value if IgG ≥ 1/800. RESULTS: A total of 54 cases of Q fever in adults were diagnosed; 51 patients had acute Q fever and only 3 chronic. There was a predominance of men over > 50 years and from urban areas. The most frequent manifestation was pneumonia (54%), followed by renal failure (33%), hepatitis and fever without focality (25% in both), with concomitant infection in 37% of the cases. The clinical and serological monitoring in most of the patients were inadequate. The best response to treatment was with doxycycline in acute illness, although duration was inadequate in 10%.

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[Climate change: new diseases for a new climate?]. / Cambio climático: euronuevas enfermedades para un nuevo clima?

Since the beginning of the 20th century, there has been a progressive increase in the Earth's temperature. This warming of the Earth's surface is largely due to the so-called green house effect that can alter the natural behavior of some natural phenomena such as El Niño. Several articles on climate change have been published recently. Some authors have raised the question of whether these changes could affect human health or even lead to the reappearance of some eradicated diseases. This report focuses on the changes seen in health up to date and their probable causes. Some changes in energy emission levels have been proposed in order to restrain this trend.

Las células intersticiales de Cajal: otra contribución a la medicina moderna / Interstitial cells of Cajal: another contribution to modern medicine

Las aportaciones de Santiago Ramón y Cajal a lamedicina moderna son innumerables. Este grancientífico y humanista, un hombre adelantado a sutiempo, habló por primera vez de conceptos comola angiogénesis, que representa uno de los camposmás novedosos hoy en día para la oncología,además de realizar investigaciones experimentalessobre la degeneración y regeneración del sistemanervioso mediante las cuales sentó las basesmorfofuncionales de la neurociencia actual. En estecaso, hemos querido recordar la relevancia deldescubrimiento de las llamadas «célulasintersticiales» de Cajal, que han sido involucradasen múltiples procesos y enfermedades digestivasque aquí recogemos, y, sobre todo, su recienterelación con los tumores del estromagastrointestinal con las implicaciones terapéuticasque esto podría traer consigo

The contributions of Santiago Ramon y Cajal toModern medicine are innumerable. This largescientist and humanist, a man ahead of his time,spoke for the first time such concepts asangiogenesis, which represents one of the mostinnovative fields for oncology today, in addition toconducting experimental research on thedegeneration and regeneration of the nervoussystem by which laid the foundationmorphofunctional of neuroscience today. In thiscase, we wanted to remember the significance ofthe discovery of so-called «interstitial cells ofCajal», which have been involved in multipleprocesses and digestive diseases we collect, andespecially his recent relationship withgastrointestinal stromal tumors with thetherapeutic implications this could bring

[Periodic familial fever]. / Fiebre periódica hereditaria.

The familial periodic fevers are Known as autoinflammatory syndromes. It is important in clinical practice to recognize these uncommon illnesses characterized by recurrent bouts of unspecific systemic symptoms associated to elevation of acute phase reactants without autoantibodies or underlying infection. The clinical suspicion supported on the molecular diagnosis represents a new perspective in relation to treatment and prognosis of these patients.

Fiebre periódica hereditaria / Periodic fever familial

Las enfermedades que se incluyen dentro del grupo de fiebres periódicas hereditarias forman parte del nuevo concepto de fenómeno “autoinflamatorio”.El conocimiento de esta entidad permite reconocer en la práctica clínica este grupo de enfermedades infrecuentes que se caracterizan por manifestaciones sistémicas inespecíficas recurrentes asociadas a elevación de reactantes de fase aguda con estudio de autoinmunidad negativo y sin evidencia de infección subyacente. La sospecha clínica apoyada en los avances de las técnicas de diagnóstico molecular permite dar al paciente una nueva perspectiva en cuanto al pronóstico y tratamiento

The familial periodic fevers are Known as autoinflammatory syndromes. It is important in clinical practice to recognize these uncommon illnesses characterized by recurrent bouts of unspecific systemic symptoms associated to elevation of acute phase reactants without autoantibodies or underlying infection. The clinical suspicion supported on the molecular diagnosis represents a new perspective in relation to treatment and prognosis of these patients

[Interstitial cells of Cajal: another contribution to modern medicine]. / Las células intersticiales de Cajal: otra contribución a la medicina moderna.

The contributions of Santiago Ramon y Cajal to Modern medicine are innumerable. This large scientist and humanist, a man ahead of his time, spoke for the first time such concepts as angiogenesis, which represents one of the most innovative fields for oncology today, in addition to conducting experimental research on the degeneration and regeneration of the nervous system by which laid the foundation morphofunctional of neuroscience today. In this case, we wanted to remember the significance of the discovery of so-called <>, which have been involved in multiple processes and digestive diseases we collect, and especially his recent relationship with gastrointestinal stromal tumors with the therapeutic implications this could bring.

[The spectrum of familial Mediterranean fever]. / El espectro de la fiebre mediterránea familiar.

Familial mediterranean fever (FMF) is a disease whose importance in recent years is reappearing thanks to the advances in molecular genetics. The diagnosis is established by symptoms, presence of inflammatory episodes of fever and serositis, family background and genetic study. Identification of the most prevalent mutations of the MEFV gene may confirm atypical or incomplete forms of FMS that are difficult to recognize based on the classical major and minor criteria. Knowledge of this more extensive clinical spectrum makes it possible to have a new diagnostic and therapeutic perspective based on the treatment of colchicine and secondary prevention of AA amyloidosis.

The role of endothelial progenitor cells and statins in endothelial function: a review.

Endothelial dysfunction, a well recognized marker of cardiovascular risk, is an early event in arteriosclerosis process. Diabetes mellitus, hypertension and dyslipidemia, known risk factors for coronary disease have been associated with endothelial dysfunction, which improves after the control of these factors. Statins have additional benefits on endothelial function not related to decreasing cholesterol levels, known as pleiotropic effects. Most recently it has been reported the effect of statins promoting bone marrow-derived mononuclear cells. These cells are positive for CD34 and KDR superficial markers of endothelial cellular lineage, which is consistent with the hypothesis that they constitute the endothelial progenitor cells. Circulating endothelial progenitor cells are involved in the repair process of the endothelium after endothelial-cell injury in myocardial ischemia, angina and other stressful situations. Recent studies have demonstrated an inverse relationship between the EPC count in peripheral blood and risk of developing a cardiovascular event. In addition, circulating EPC correlates with the presence of endothelial dysfunction and could play a role as a surrogate biologic marker in vascular function. The effect of statins on endothelial progenitor cells might contribute to improve endothelial function leading to a decrease in vascular risk, independently of their impact on LDL cholesterol. In this paper, we review the role of statins in EPC mobilization, its effect in endothelial function restoration and the relevance of this finding in cardiovascular risk. We also review future therapeutic implications.

Perspectiva histórica de la clasificación de las vasculitis / Historical perspective on the classification of vasculitis

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