Use of a depot steroid formulation with CHOP-based protocol in the treatment of mediastinal lymphoma in cats.

The aims of this retrospective study were to evaluate the efficacy of different steroid formulations (depot vs oral) and if the continuous administration of steroids throughout and beyond a CHOP protocol might improve the survival time and rate of cats with mediastinal lymphoma. The medical records of client-owned cats diagnosed with mediastinal lymphoma were reviewed at two veterinary referral hospitals in Spain. Cases were recruited from 2008 to 2016. Those cats with mediastinal lymphoma treated with chemotherapy were used in the collection of data including surgical procedures, chemotherapy protocol, side effects, complete remission (CR), partial remission and survival time were calculated from time of diagnosis. The median survival time (MST) of group with depot steroid was 370.7 days and all cats are still alive. The MST of group with oral steroid was 267.9 days. The survival distributions were found to be significantly different. The use of depot injectable steroids with a CHOP-based protocol seems to result in a longer survival time in patients with mediastinal lymphoma when comparing the survival distribution for those receiving oral steroids with a CHOP-based protocol. Prospective studies with a higher number of cats are warranted to investigate the utility of injectable steroids depot with a CHOP-based protocol in the treatment of mediastinal lymphoma.

Síndrome de Kartagener de diagnóstico tardío / Late diagnosis of Kartagener syndrome

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Dielectric, calorimetric and elastic anomalies associated with the first order [Formula: see text] phase transition in (Ca, Sr)TiO(3) perovskites.

Conduction calorimetry has been used to determine with high precision the latent heat and variation in heat capacity which accompany the first order [Formula: see text] phase transition in perovskites with compositions (Ca(1-x)Sr(x))TiO(3), x = 0.65, 0.68, 0.74 (CST65, CST68, CST74). In CST65 (CST68), the latent heat is dissipated/absorbed over a temperature interval of ∼11 K (∼6 K), which is centred on ∼292 K (∼258 K) during cooling and ∼302 K (∼270 K) during heating. The magnitude of the latent heat diminishes with increasing SrTiO(3) content and was not detected in CST74. Integration of the latent heat and excess heat capacity yields small excess entropies, which are consistent with the structural changes being displacive rather than order-disorder in origin. Resonant ultrasound spectroscopy measurements on the same CST65 sample as used for dielectric and calorimetric measurements through the same temperature intervals have allowed quantitative correlations to be made with the bulk modulus, shear modulus and acoustic dissipation parameter, Q(-1). The dielectric anomaly and changes in Q(-1) can be understood as being linear combinations of the properties of the separate I4/mcm and Pbcm phases in proportion to their volume fractions across the two-phase field. A change of only ∼0.5-1 GPa has been detected in the bulk modulus but the shear modulus softens by ∼5-8 GPa as the transition interval is approached from above and below. This shear mode softening presumably reflects clustering and/or phonon softening in both the I4/mcm and Pbcm structures. This pattern of structure-property relations could be typical of first order transitions in perovskites where there is no group/subgroup relationship between the high and low symmetry phases.

[Usefulness of MBDS in detection of adverse drug events]. / Utilidad del CMBD para la detección de acontecimientos adversos por medicamentos.

OBJECTIVE: To analyze the incidence of adverse drug events (ADE) as noted in hospital discharge reports, as well as their potential avoidability, drugs involved, clinical symptoms and the type of medication errors that led to the preventable ADE. MATERIAL AND METHODS: A retrospective study for the January- December 2005 period of time, at a district hospital. ADE were detected in which patients with discharge reports including event codes as defined by the IDC-9-CM system, using the minimum basic data set (MBDS). RESULTS: ADEs were detected in 4.01% of all discharge reports in the study period (n = 160). 45% of ADEs were were detected at the Emergency Department (n = 72) and 55% (n = 88) were detected during hospitalization.62.3% of ADEs were considered potentially avoidable (n = 109). 38.1% of ADEs were serious, 40.0% moderate and 21.9% mild. Drugs most commonly involved in the ADEs sample studied included: antimicrobials (24.0%), systemic corticoids (15.4%), NSAIDs (11.4%), diuretics (10.3%), digoxin (9.1%), insulin and oral hypoglycaemic agents (5.7%), anticoagulants and heparin (5.7%). Inadequate therapy monitoring (47.7%), excessive dosage (28.5%), drug-drug interactions (10.1%) were the most common identified type of errors leading to preventable ADE. CONCLUSIONS: 3.2% of admissions was caused by ADEs. 2.2% of hospitalized patients experienced ADEs. 62% of ADEs were potentially preventable. A high proportion of preventable ADEs were around a small number of drugs. Effective safety practices directed to reduce the incidence of medication errors are needed.

Utilidad del CMBD para la detección de acontecimientos adversos por medicamentos / Usefulness of MBDS in detection of adverse drug events

Objetivo: Analizar la incidencia de los acontecimientos adversos a medicamentos (AAM) notificados en el informe de alta hospitalaria, valorar su evitabilidad y describir los fármacos implicados, las manifestaciones clínicas y los tipos de errores asociados a los AAM prevenibles. Material y método: Estudio retrospectivo del Conjunto Mínimo Básico de Datos (CMBD) del periodo enero-diciembre de 2005 en todos los servicios asistenciales de un hospital de ámbito comarcal, centrado en los pacientes en cuyo informe de alta se incluían los códigos asociados a efectos adversos por medicamentos según la Clasificación Internacional de Enfermedades (CIE-9-MC) Resultados: Se detectan AAM en un 4,01% de las altas codificadas en el período de estudio (n = 160). 45% de los AAM (n = 72) causados por el uso extrahospitalario de fármacos y 55% (n = 88) durante la hospitalización. El 62,3% de los AAM eran prevenibles (n = 109). El 38,1% de los AAM fueron graves, 40,0% moderados y 21,9% leves. Los fármacos más frecuentemente implicados en AAM fueron: antiinfecciosos 24,0%, glucocorticoides sistémicos 15,4%, AINEs y otros analgésicos 11,4%, diuréticos 10,3%, digoxina 9,1%, insulina y antidiabéticos orales 5,7%, anticoagulante orales y heparina 5,7%. Las causas que motivaban su aparición fueron la falta de seguimiento (47,7%), dosis elevada (28,5%), e interacción medicamentosa (10,1%) Conclusiones: Un 3,2% de los ingresos urgentes estaba motivado por AAM. Un 2,2% de los pacientes hospitalizados presentó AAM. Un 62% de AAM era prevenible. Un alto grado de AAM prevenibles se centran en un número reducido de fármacos. Es necesario implantar prácticas efectivas de seguridad para reducir los errores de medicación

Objective: To analyze the incidence of adverse drug events (ADE) as noted in hospital discharge reports, as well as their potential avoidability, drugs involved, clinical symptoms and the type of medication errors that led to the preventable ADE. Material and methods: A retrospective study for the January- December 2005 period of time, at a district hospital. ADE were detected in which patients with discharge reports including event codes as defined by the IDC-9-CM system, using the minimum basic data set (MBDS). Results: ADEs were detected in 4.01% of all discharge reports in the study period (n = 160). 45% of ADEs were were detected at the Emergency Department (n = 72) and 55% (n = 88) were detected during hospitalization. 62.3% of ADEs were considered potentially avoidable (n = 109). 38.1% of ADEs were serious, 40.0% moderate and 21.9% mild. Drugs most commonly involved in the ADEs sample studied included: antimicrobials (24.0%), systemic corticoids (15.4%), NSAIDs (11.4%), diuretics (10.3%), digoxin (9.1%), insulin and oral hypoglycaemic agents (5.7%), anticoagulants and heparin (5.7%). Inadequate therapy monitoring (47.7%), excessive dosage (28.5%), drug-drug interactions (10.1%) were the most common identified type of errors leading to preventable ADE. Conclusions: 3.2% of admissions was caused by ADEs. 2.2% of hospitalized patients experienced ADEs. 62% of ADEs were potentially preventable. A high proportion of preventable ADEs were around a small number of drugs. Effective safety practices directed to reduce the incidence of medication errors are needed

Hipertensión arterial e hipopotasemia: ¿a quién y cómo investigar? / Arterial hypertension andhypopotassemia: who and what shouldbe investigated?

La prevalencia del hiperaldosteronismo primario ha aumentado significativamente, por lo que algunos autores lo consideran la causa principal de hipertensión arterial secundaria. Este hecho se basa en la gran frecuencia con que se detectan cocientes elevados de aldosterona/renina en pacientes hipertensos. Presentamos dos casos de hiperaldosteronismo primario por adenoma suprarrenal y revisamos el protocolo de estudio escalonado de los pacientes con dicha patología. El tratamiento farmacológico de los adenomas productores de aldosterona es una opción válida para el control de la presión arterial y la hipopotasemia, cuando no pueden intervenirse quirúrgicamente

The prevalence of primary aldosteronism has increased significantly so that some authors consider it as the main cause of secondary hypertension. This fact is based on the great frequency with which high aldosterone/renin ratios are detected in hypertensive patients. We present two cases of primary aldosteronism due to adrenal adenoma and review the protocol for stepwise investigation in patients with such a condition. Drug management of aldosterone-producing adenomas is an adequate option for controlling blood pressure and hypopotassemia when adrenalectomy is not viable

Mujer de 62 años con aftosis orogenital, lesiones oculares y condritis / 62 year old woman with orogenital apththosis, eye lesions and chondritis

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Levofloxacino y rotura bilateral del tendón de Aquiles con evolución fatal / Levofloxacin-induced tendon rupture with fatal outcome

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[Pneumonia by Rhodococcus equi in patients with HIV infection]. / Neumonía por Rhodococcus equi en pacientes con infección por VIH.

We present the case of a patient with AIDS who developed abscessified pneumonia by Rhodococcus equi. We publish this case given the rare frequency of presentation of this opportunistic infection in this type of patient and given its good clinical evolution, on the contrary of other cases described so far in the literature. The good evolution of the patient may be due to an early diagnosis, less than one month, and the combined medical therapy with rifampicine and tetracyclines.