The ROSAS Cohort: A Prospective, Longitudinal Study of Biomarkers for Alzheimer's Disease. Strategy, Methods and Initial Results.

OBJECTIVE: The aims of the Research Of biomarkers in Alzheimer's diseaSe (ROSAS) study were to determine the biofluid and imaging biomarkers permitting an early diagnosis of Alzheimer's disease and better characterisation of cognitive and behavioural course of the pathology. This paper outlines the overall strategy, methodology of the study, baseline characteristics of the population and first longitudinal results from the ROSAS cohort. METHODS: Longitudinal prospective monocentric observational study performed at the Alzheimer's disease Research centre in Toulouse. A total of 387 patients were studied and analyzed in 3 groups: 184 patients with dementia of Alzheimer's type, 96 patients with memory disorders without dementia (Mild Cognitive Impairment) and 107 patients without abnormal memory tests (control group), and were followed up during 4 years. Patient's sociodemographic characteristics, risk factors, medical conditions, previous and current medications, neuropsychological assessment and overall cognitive status were recorded. Blood and urine samples were collected at every year, Magnetic Resonance Imaging were performed at inclusion, after one year of follow-up and at the end of the study. RESULTS: At baseline, three different groups of the cohort differed interestingly in age, level of education, and in percentage of ApoEε4 carriers whereas the history of cardiovascular and endocrine pathologies were similar among the groups. During the follow-up period (3-4 years) 42 mild cognitive impairment patients (43.8%) progressed to dementia, 7 controls progressed into mild cognitive impairment and 1 patient in the control group converted from mild cognitive impairment group to dementia of Alzheimer's type group. During the first year of follow up, the incidence of progression from mild cognitive impairment to dementia of Alzheimer's type was 12.7 per 100, during the second year 33.9 per 100 and 46.7 per 100 for the third year. CONCLUSION: This paper presents the baseline characteristics of the unique French prospective monocenter study in which the natural course of dementia of Alzheimer's type was evaluated. Future analysis of blood and urine samples collection from the ROSAS study will permit to identify possible biofluid biomarkers predicting the early stages of the dementia of Alzheimer's type and risk of progression from Mild Cognitive Impairment to Alzheimer's disease.

Development of a PCR technique specific for Demodex injai in biological specimens.

The identification of Demodex injai as a second Demodex species of dog opened new questions and challenges in the understanding on the Demodex-host relationships. In this paper, we describe the development of a conventional PCR technique based on published genome sequences of D. injai from GenBank that specifically detects DNA from D. injai. This technique amplifies a 238-bp fragment corresponding to a region of the mitochondrial 16S rDNA of D. injai. The PCR was positive in DNA samples obtained from mites identified morphologically as D. injai, which served as positive controls, as well as in samples from three cases of demodicosis associated with proliferation of mites identified as D. injai. Furthermore, the PCR was positive in 2 out of 19 healthy dogs. Samples of Demodex canis and Demodex folliculorum were consistently negative. Skin samples from seven dogs with generalized demodicosis caused by D. canis were all negative in the D. injai-specific PCR, demonstrating that in generalized canine demodicosis, mite proliferation is species-specific. This technique can be a useful tool in the diagnosis and in epidemiologic and pathogenic studies.

Cerebral amyloid angiopathy and microhemorrhages after amyloid beta vaccination: case report and brief review.

After the interruption of the international multicenter Phase 2 clinical trial with active immunotherapy based on synthetic Abeta42 (AN1792), few reports about the neuropathological findings in those patients and those from the Phase 1 clinical trial were published. These reports described some pathological similarities among the patients such as a reduction in the burden of amyloid plaques, the reactions of microglia/macrophages and the persistence of neurofibrillary tangles and neuropil threads. In addition, a lymphocytic inflammatory infiltrate as well as white matter lesions were present in some cases with meningoencephalitis. In both animal models of vaccination, as well as some vaccinated patient samples, there appears to be a correlation between vaccination and hemorrhages. Subsequently, two series reports concerning 8 patients from the Phase 1 initial trial showed that immunization with Abeta42 seemed to result in clearance of amyloid plaques, but did not prevent progressive neurodegeneration and that it increased vessel wall amyloid angiopathy as well as cortical microhemorrhages. Recent clinical data gave further encouraging results regarding vaccination in humans demonstrating that long term follow-up of patients from the second clinical trial revealed reduced functional decline, at least, in antibody responders. Here we describe a patient diagnosed with Alzheimer's disease who also participated in the Phase 2 clinical trial. A neuropathological examination confirmed Alzheimer's disease without meningoencephalitis and revealed a severe amyloid angiopathy with frequent microhemorrhages, the decrease of amyloid load being difficult to ascertain. Our results are in agreement with previous studies and confirm the presence of severe amyloid angiopathy after vaccination. The latter may be a transient phenomenon depending on the degree of immune response and the pathological stage of the disease when the patient underwent treatment. In addition, our vaccinated case also demonstrated microhemorrhages and microinfarcts which were already noticed to occur with a higher density in immunized Alzheimer's disease patients.

Dermatosis profesionales. Adaptación transcultural del cuestionario Nordic Occupational Skin Questionnaire (NOSQ-2002) del inglés al castellano y al catalán / Occupational Dermatoses. Cross-Cultural Adaptation of the Nordic Occupational Skin Questionnaire (NOSQ-2002) from English to Spanish and Catalan

Antecedentes. El eccema de las manos y la urticaria son dermatosis profesionales muy frecuentes. El cuestionario NOSQ (Nordic Occupational Skin Questionnaire) fue creado en inglés como herramienta imprescindible para la investigación de enfermedades cutáneas de origen laboral. La versión corta del cuestionario es útil para el rastreo y la versión larga es una herramienta de investigación de los factores de riesgo. Objetivo. Adaptación transcultural de la versión larga del cuestionario NOSQ al castellano y al catalán para garantizarla claridad en la comprensión, la corrección semántica y la equivalencia respecto a la versión original. Métodos. Principios de buena práctica de la International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Metodología en 4 fases basada en la traducción directa consensuada, la retrotraducción y las entrevistas cognitivas. Resultados. Tras la traducción directa e independiente del cuestionario, el Grupo de Trabajo Español emitió una primera versión que fue sometida a entrevistas cognitivas. Se modificaron 39 cuestiones (68 %) en la versión castellana y 27 (47 %) en la versión catalana. Los cambios consistieron en la adición de ejemplos para mejorarla comprensión, la reformulación de instrucciones, el cambio al uso de un formato directo de pregunta y la adición de ciertas definiciones. La retrotraducción fue valorada por los autores originales, incorporándose 7 cambios en la versión castellana y 2 en la catalana. La tercera versión consensuada fue sometida a un segundo turno de entrevistas cognitivas. Se emitió posteriormente la versión definitiva. Conclusión. Las versiones en castellano y catalán del cuestionario NOSQ-2002 están disponibles en www.ami.dk/NOSQ y www.arbejdsmiljoforskning.dk (AU)

Background. Eczema of the hands and urticaria are very common occupational dermatoses. The Nordic Occupational Skin Questionnaire (NOSQ-2002), developed in English, is an essential tool for the study of occupational skin diseases. The short version of the questionnaire is useful for screening and the long version is used to study risk factors. Objective. The aim of this study was to culturally adapt the long version of the NOSQ to Spanish and Catalan and to ensure comprehension, semantic validity, and equivalence with the original. Methods. The principles of the International Society for Pharmacoeconomics and Outcomes Research for good research practices were applied. A 4-phase method was used, with direct, revised translation, back translation, and cognitive interviews. Results. After direct translation, a first version was issued bythe Spanish Working Group. This version was evaluated in cognitive interviews. Modifications were made to 39 questions (68 %) in the Spanish version and 27 questions (47 %) in the Catalan version. Changes included addition of examples to improve understanding, reformulation of instructions, change to use of a direct question format, and addition of certain definitions. The back translation was evaluated by the original authors, leading to a further 7 changes in the Spanish version and 2 in the Catalan version. The third consensus version underwent a second round of cognitive interviews, after which the definitive version in each language was issued. Conclusion. Spanish and Catalan versions of the NOSQ-2002 questionnaire are available at www.ami.dk/NOSQ and www.arbejdsmiljoforskning.dk (AU)

[Occupational dermatoses. Cross-cultural adaptation of the Nordic Occupational Skin Questionnaire (NOSQ-2002) from English to Spanish and Catalan]. / Dermatosis profesionales. Adaptación transcultural del cuestionario Nordic Occupational Skin Questionnaire (NOSQ-2002) del inglés al castellano y al catalán.

BACKGROUND: Eczema of the hands and urticaria are very common occupational dermatoses. The Nordic Occupational Skin Questionnaire (NOSQ-2002), developed in English, is an essential tool for the study of occupational skin diseases. The short version of the questionnaire is useful for screening and the long version is used to study risk factors. OBJECTIVE. The aim of this study was to culturally adapt the long version of the NOSQ to Spanish and Catalan and to ensure comprehension, semantic validity, and equivalence with the original. METHODS: The principles of the International Society for Pharmacoeconomics and Outcomes Research for good research practices were applied. A 4-phase method was used, with direct, revised translation, back translation, and cognitive interviews. RESULTS: After direct translation, a first version was issued by the Spanish Working Group. This version was evaluated in cognitive interviews. Modifications were made to 39 questions (68 %) in the Spanish version and 27 questions (47 %) in the Catalan version. Changes included addition of examples to improve understanding, reformulation of instructions, change to use of a direct question format, and addition of certain definitions. The back translation was evaluated by the original authors, leading to a further 7 changes in the Spanish version and 2 in the Catalan version. The third consensus version underwent a second round of cognitive interviews, after which the definitive version in each language was issued. CONCLUSION. Spanish and Catalan versions of the NOSQ-2002 questionnaire are available at www.ami.dk/NOSQ and www.arbejdsmiljoforskning.dk.

Quiste pigmentado del rafe medio escrotal en un niño / Pigmented Cyst of the Median Raphe of the Scrotum in a Boy

No disponible

No disponible

Descriptive analysis of clinical factors affecting terminally ill cancer patients.

GOALS OF WORK: To make a descriptive analysis of clinical and laboratories parameters in advanced neoplastic patients. MATERIALS AND METHODS: We interviewed 406 terminally ill cancer patients to study demographic and neoplastic data, 24 graded symptoms, 21 analytical parameters and scales to evaluate general condition, quality of life and independence in daily activities. MAIN RESULTS: An average of 9.3 symptoms per patient were detected and median survival was 26.5 days. Most frequent symptoms were asthenia (96.8%), anorexia (94.8%), weight loss (88.1%) and pain (80.5%). Principal laboratory abnormalities were high blood sedimentation rate (96%), high cytolysis and cholestasis enzyme levels (50-77%), anemia (81.5%), low protein (66%) and low albumin levels (67%). Symptom prevalence was different according to age, gender, primary tumour, location of metastasis, laboratory parameters, performance status, quality of life or independence in daily-living activities. CONCLUSIONS: We should know more frequent symptoms affecting terminal cancer patients and any factor contributing to it to provide more comfort in the final phases of life.

Utility of prophylactic antibiotics in pediatric adenoidectomy.

OBJECTIVE: To determine the utility of prophylactic antibiotics in non-risk pediatric patients undergoing adenoidectomy. METHODS: We performed a prospective, controlled, randomized, and double-blind study on patients under 14 years of age, scheduled for adenoidectomy who accomplished the following criteria: absence of immunosuppressive and/or cardiovascular risk factors, no antimicrobial therapy for at least 15 days prior to operation, and no fever 1 week before surgery. Venous blood samples for culture were obtained at 30s and 20 min after the curettage of adenoidal tissue. Likewise, immediate and delayed complications were registered in all cases. The usefulness of prophylaxis was analyzed according to three major standpoints: bacteremia, immediate complications, and delayed complications. RESULTS: One-hundred one patients fulfilled the inclusion criteria and were included in the study. Fifty-one children received prophylaxis and the remainder did not. In the non-prophylactic group incidence of bacteremia at 30s was significantly higher than in the prophylactic group (32.7% versus 4.0%) (p<0.001). Neither bacteremia at 20 min, nor immediate or delayed complications showed statistical differences between both treatment groups. CONCLUSIONS: Preoperative antimicrobial prophylaxis in pediatric adenoidectomy did not offer advantages preventing complications in non-risk patients. Only bacteremia that occurs 30s after the curettage of adenoid tissue is reduced with the employment of prophylactic antibiotics.

Neurological complications following functional neck dissection.

A retrospective study was done to assess the incidence and factors associated with neurological complications in patients who have undergone a functional neck dissection (FND). Four hundred forty-two epidermoid cancer patients operated on from January 1984 to December 2002 were included in the study. Clinical parameters, neurological sequelae, and other complications were evaluated in all cases. The incidence of neural damage was calculated on the nerves at risk (n =714). Paralysis of the 11th nerve occurred in 12 cases (1.68%). A lesion of the marginal branch of the 7th cranial nerve was observed in nine cases (1.26%). Bernard-Horner's syndrome and hypoglossal nerve paralysis were noted in four and three cases (0.56 and 0.42%), respectively. Thus, the incidence of neurological sequelae after FND is low. Neurological complications were not associated with either clinical parameters or non-neurological complications (P >0.05). None of the factors studied can predict the appearance of neural problems in the postoperative period.

Bacteremia following pediatric adenoidectomy.

OBJECTIVE: Adenoidectomy is frequently performed in children. The goals of this work were to determine the incidence of bacteremia during the adenoidectomy, to identify the microorganisms implicated, and to analyze the possible association of bacteremia with postoperative complications. METHODS: One hundred pediatric patients operated of adenoidectomy without preoperative antibiotic prophylaxis were prospectively included in this study. They had no immunosuppressive and/or cardiovascular risk factors, no antimicrobial therapy for at least 15 days prior to operation, and no fever 1 week before surgery. Venous blood samples were obtained 30 s and 20 min after the curettage of adenoidal tissue. RESULTS: The 33 and 14% of the samples were positive at 30 s and 20 min. The organism more commonly isolated was the streptococcus viridans. Bacteremia was only related to postoperative acute otitis media (p=0.012). CONCLUSIONS: Bacteremia exists after pediatric adenoidectomy, although it seldom correlates with clinical signs or symptoms. Postoperative acute otitis media is the only complication related to postsurgical bacteremia.

Efectos del ultrasonido externo sobre el adipocito en la liposucción / Effects of external ultrasound on fat tissue in liposuction

Se ha desarrollado un método de liposucción asistida con ultrasonido externo, aplicado directamente sobre la piel, sin embargo no existe en la literatura un estudio formal que describa los cambios provocados en las diferentes estructuras y tejidos con la aplicación de diferentes intensidades de ultrasonido externo por períodos variables. Ante la inexistencia de una guía científica para el uso del ultrasonido externo en la lipoescultura, este estudio se desarrollo para conocer sus efectos, así como los parámetros capaces de producir la destrucción selectiva de las células de grasa, facilitando su extracción por aspiración y que sean seguros para no lesionar los tejidos adyacentes. Se utilizaron diez cerdos machos de raza criolla, en los cuales se aplicó el ultrasonido externo y se observaron los cambios macroscópicos del tejido graso bajo visión directa a través de una fibra óptica; simultáneamente se tomaron biopsias a diferentes intensidades y a diferentes periodos de tiempo, quefueron analizadas histológicamente, con lo que se demostró que el ultrasonido externo no produce los fenómenos de licuefacción grasa y microcavitación. Las quemaduras producidas en la piel se presentan solo cuando el transductor se mantiene en un halo igual a su diámetro durante un minuto o más; mientras se realice un movimiento continúo del transductor que sobrepase el diámetro de éste, la aplicación del ultrasonido externo es segura hasta periodos de 20 minutos (AU)

Liposuction method assisted with external ultrasound has been developed, applied directly on the skin, however it doesn’t exist in the literature a formal report that describes the provoked changes to the different structures and tissues and the application in different intensities of external ultrasound, per variables periods. There is not any scientific guide for the use of the external ultrasound in the liposculpturing. This study tries to know the effects of this energy, as well as the parameters that are able to produce the selective destruction of the cells of fat to facilitate its extraction by aspiration and all that in a so safe way that we don’t injure the adjacent tissues. Ten creole race male pigs were used, in which the external ultrasound was applied and the macroscopic changes of the fatty low direct vision were observed through an optic fiber; we took simultaneously biopsies to different intensities and periods of time. It was demonstrated that the external ultrasound does not produce the phenomenons of fatty liquefaction and acoustic cavitation. The burns on skin are presented when the transducer stays in a halo similar to its diameter for one minute or more; while the transducer is moving on a diameter bigger than its surface, the external ultrasound application is safe until for 20 minutes (AU)

Valoración clínica integral del prognatismo y su tratamiento con avance maxilar (Le Fort I) / Clinical evaluation of prognathism and his treatment with maxillary advancement (Le Fort I)

Desde hace décadas el tratamiento habitual del prognatismo es la retrusión mandibular. Clásicamente nos apoyamos en la cefalometría para confirmar el diagnóstico y realizar predicciones preoperatorias que guian el plan quirúrgico y lograr una oclusión normal mediante la retrusión mandibular. Sin embargo, en algunos pacientes el estudio clínico sugiere hipoplasia del tercio medio de la cara y para su tratamiento se deben realizar avances del maxilar para mejorar la apariencia facial y la oclusión. La cirugía ortognática ha evolucionado en sus indicaciones y técnicas, y por lo tanto en sus objetivos. Inicialmente el objetivo primordial era la corrección de la oclusión, mientras que actualmente domina es la estética facial, sin olvidar la corrección oclusal. Debido a que los resultados de la expansión de los tejidos blandos son más predecibles que los de la contracción, preferimos realizar un avance maxilar con osteotomías tipo LeFort I para tener una contribución estética más previsible de los tejidos blandos. Analizamos el resultado de 16 pacientes con medidas cefalométricas de prognatismo, pero con evidencia clínica de hipoplasia en el tercio medio facial. Todos los pacientes fueron intervenidos mediante avance maxilar por osteotomías tipo LeFort I, que en algunas ocasiones se combinan con retroposición mandibular, mentoplastía u otro procedimiento sobre la mandíbula en caso de deformidad importante de la misma(AU)

By decades, the classic and traditional treatment of congenital prognathism has been the surgical mandibular retrusion. For many years we have used cephalometric values to make the diagnosis and the preoperative predictions that would give us the surgical plan for the treatment of this pathology which consistent in a mandibular retrusion to achieve normal occlusion. In some of our patients we have seen that the cephalometric analysis present signs of prognathism values even though the clinical study and the external appearance tended to look-like a hypoplasia of the facial medial third instead. Techniques and indications for ortognatig surgery have been evolutioned, and obviously the treatment goals. The primary objective was the occlusion’s correction, but now the most important thing is the facial esthetics, obviously not forgetting the oclusal correction. The results of the tissue expansion are more predictable than contraction outcomes, we rather to perform a maxillary advancement with LeFort I osteotomy to predict the soft-tissue changes. The present study evaluates the result of 16 patients with cephalometric confirmation of prognathism, even though the clinical study and the external appearance tended to look-like a hypoplasia of the facial medial third. All of them received surgical correction through maxillary advancement with LeFort I osteotomy, sometimes was also used mandibular retrusion, chin surgery, or another surgical procedure in the mandible in case of mandibular deformity (AU)

[Does clustering exist in non-traumatic epistaxis?]. / Existe agrupación en las epistaxis no traumáticas?

OBJECTIVE: Non traumatic epistaxis seems to be clustering in different periods. This paper tries to find out if there is any relationship between incidence of epistaxis and the year season, month, week, day, hour and/or lunar phase. METHODS: We have retrospectively studied 754 episodes seen between May 2001 and April 2002 in our Hospital. The following parameters were registered in each patient: age, sex, number of episodes, season, month, week, day, hour and lunar phase. RESULTS: Epistaxis represented 12.1% of the total otolaryngological emergencies. That means an incidence of 0.1% of non traumatic epistaxis which needed hospital specialized attention. We found statistical differences (p = 0.003) in the number of epistaxis per day and the different months (greater in june and november). No differences were found in the remaining periods studied. CONCLUSIONS: This paper shows monthly clustering of epistaxis episodes.

¿Existe agrupación en las epistaxis no traumáticas? / Does clustering exist in non traumatic epistaxis?

Objetivo: Las epistaxis no traumáticas parecen concentrarse en determinados períodos del año. El objetivo de este trabajo es demostrar si existe correlación entre la incidencia de epistaxis y las distintas estaciones, meses, semanas, días, horas y/o fases lunares. Material y métodos: Estudiamos retrospectivamente 754 episodios de epistaxis atendidos entre mayo de 2001 y abril de 2002 en nuestra institución. Registramos en cada sujeto la edad, sexo, número del episodio, estación, mes, día de la semana, hora del día y fase lunar. Resultados: Las epistaxis supusieron el 12,1 por ciento de las urgencias atendidas por el servicio ORL. Estimamos una incidencia del 0,1 por ciento de epistaxis no traumáticas que requieren atención hospitalaria especializada. Encontramos diferencias significativas (p=0,003) en el número de episodios por día según los meses del año (mayor en junio y noviembre). No hallamos diferencias entre el resto de parámetros estudiados. Conclusión: Se observa una agrupación mensual de las epistaxis (AU)

OBJECTIVE: Non traumatic epistaxis seems to be clustering in different periods. This paper tries to find out if there is any relationship between incidence of epistaxis and the year season, month, week, day, hour and/or lunar phase. METHODS: We have retrospectively studied 754 episodes seen between May 2001 and April 2002 in our Hospital. The following parameters were registered in each patient: age, sex, number of episodes, season, month, week, day, hour and lunar phase. RESULTS: Epistaxis represented 12.1% of the total otolaryngological emergencies. That means an incidence of 0.1% of non traumatic epistaxis which needed hospital specialized attention. We found statistical differences (p = 0.003) in the number of epistaxis per day and the different months (greater in June and November). No differences were found in the remaining periods studied. CONCLUSIONS: This paper shows monthly clustering of epistaxis episodes (AU)

Imagen radiológica de las anomalías congénitas de las costillas. Parte I. Anomalías de número y fusión.Costillas finas / Radiologic imaging of congenital anomalies of the ribs: number and fusion anomalies thin ribs

Las anomalías congénitas del tórax son una causa significativa de morbilidad en neonatos, lactantes, niños e incluso en la edad adulta. La evaluación de los pacientes afectados requiere frecuentemente múltiples modalidades de imagen para diagnosticarlas y, en su caso, planear la corrección quirúrgica. Este artículo analiza e ilustra aspectos prácticos de ciertas anomalías congénitas comunes e infrecuentes que afectan a las costillas, con énfasis particular en las manifestaciones radiológicas. Se evalúa, asimismo, la utilidad de las diferentes modalidades de imagen en el diagnóstico y manejo de estas alteraciones. Las alteraciones descritas incluyen anomalías de número y fusión (ausencia e hipoplasia de costillas y costillas supernumerarias) y costillas finas (neurofibromatosis, síndrome de la trisomía 13, síndrome de la trisomía 18 y osteogénesis imperfecta congénita). Las bases embriológicas y patológicas de los distintos hallazgos radiológicos se discuten en los casos apropiados. Se incluye también el diagnóstico diferencial de algunos de estos procesos (AU)

Analysis of the causes of immediate unanticipated bleeding after pediatric adenotonsillectomy.

OBJECTIVES: To assess the incidence of unexpected postoperative bleeding in children undergoing adenoidectomy and/or tonsillectomy (T&A), and to investigate its possible undetected haematological causes. METHODS: We prospectively collected all patients under 14 years of age with a normal preoperative haematologic work-up (activated partial thromboplastic time, prothrombin time, fibrinogen, and platelet count), who underwent surgery of adenoids and/or tonsils at our institution between January 1997 and November 2000. RESULTS: There were 1516 cases that accomplished the inclusion criteria in the period of survey. Thirteen patients bled after surgery. This represents an incidence of 0.8% of immediate postoperative haemorrhage among the 1516 procedures analyzed. No statistical differences were found between bleeding and non-bleeding patients according to age, sex, and type of procedure (P>0.05). In 6 of the 13 bleeding patients (46.1%) an alteration of the coagulation system was subsequently found: 5 von Willebrand's disease, and 1 releasing thrombopathy. CONCLUSIONS: The incidence of bleeding after adeno and/or tonsillectomy at our institution is comparable with series previously reported in the current medical literature. In nearly one half of the cases, undetected coagulation diseases (mainly von Willebrand's disease) are diagnosed after surgery in the haematological study.

[Cost-benefit analysis of the anatomo-pathological study of tonsillectomy specimens in the pediatric population]. / Análisis costo-beneficio del estudio anatomopatológico de las piezas de amigdalectomía en la población pediátrica.

To study the cost-benefit of the histological examination of tonsilar samples, we evaluated 567 cases (547 routine and 20 nonroutine cases) of patients under 14 years of age, operated between 1st January 1996 and 30th November 2000. There were 2 routine cases (0.3%), and 6 nonroutine cases (30%) with a diagnosis different to follicular hyperplasia. In this way, our clinical preoperative sensitivity was 75% and specificity 97%. The average cost per case at our Centro to study the tonsilar samples was 30$. We conclude that the histological examination of tonsilar specimens is economically worth only in nonroutine cases, although additional factors (e.g. training of residents of Pathology and the quality control of the institution must be taken into consideration.

[The value of waiting in spontaneous remission of recurrent tonsillitis without associated adenoid pathology]. / Utilidad de la espera en la remisión espontánea de la amigdalitis de repetición sin patología adenoidea asociada.

In order to assess the rate of spontaneous remission in children with recurrent acute tonsillitis (RAT), we revised the pediatric patients who were seen between 1994 and 1999. For this purpose, 123 cases that were on the waiting list for tonsillectomy under the indication of RAT without associated adenoid disease were selected. Only 23 (18.7%) of the children who were included in the study were removed from the waiting list after a mean time of 9 months because of spontaneous remission of the disease. Thus, there is no justification for claiming that long waiting lists for tonsillectomy are frequently associated with spontaneous remission of RAT.