Linfoma primario bilateral de localización suprarrenal / Primary bilateral adrenal lymphoma

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Hemorragia cerebral lobular por endocarditis infecciosa con absceso de la raíz aórtica por Streptococcus viridans / Lobar cerebral hemorrhage due to infectious endocarditis with aortic root abscess due to screptococcus viridians

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Esclerosis sistémica y enfermedad inflamatoria intestinal / Progressive systemic sclerosis and inflammatory bowel disease

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[Effect of home hospitalization in the reduction of traditional hospitalization and frequency of emergencies in heart failure]. / Efecto de la hospitalización a domicilio en la reducción de la hospitalización convencional y frecuentación de urgencias en la insuficiencia cardíaca.

OBJECTIVE: Medical care to patients with heart failure (HF) entails high needs in health care and social resources. Hospital at home (HH) is a potentially useful care alternative for these patients. MATERIALS AND METHODS: Observational study with 110 elderly patients with non complicated HF admitted to an HH unit. Patients were treated with educational support (clinical, dietetic and pharmacologic) and intensive home follow-up. Conventional hospital admissions and visits to the Emergency Department were analyzed during the 90 days before and after HH. RESULTS: After HH, conventional hospital admissions decreased by 86% and visits to the Emergency Department by 91%. The mean Barthel Index changed from 74 to 77 (p < 0.05, in all cases). Ninety-six percent of patients were satisfied or very satisfied with HH. CONCLUSIONS: In elderly patients with non complicated HF, the intervention of an HH unit reduces conventional hospital admissions and the number of visits to the Emergency Department, the personal satisfaction degree is high and the functional capacity does not worsen.

Efecto de la hospitalización a domicilio en la reducción de la hospitalización convencional y frecuentación de urgencias en la insuficiencia cardíaca / Effect of hospital at home in the reduction of conventional hospitalization and emergency visits in heart failure

Objetivo. La atención de pacientes afectados de insuficiencia cardíaca comporta unas necesidades elevadas de recursos sanitarios y sociales. La hospitalización a domicilio (HaD) es una alternativa asistencial potencialmente útil en estos pacientes. Material y métodos. En este estudio observacional 110 pacientes ancianos con IC no complicada, ingresados en una unidad de HaD se trataron con soporte educacional (clínico, dietético y farmacológico) y seguimiento domiciliario intensivo. Se analizaron los ingresos en hospitalización convencional y la frecuentación del servicio de Urgencias durante los 90 días previos y posteriores a la HaD. Resultados. Tras la HaD, los ingresos en hospitalización convencional se redujeron el 86 por ciento y la frecuentación del servicio de urgencias el 91 por ciento. El índice medio de Barthel pasó de 74 a 77 (p < 0,05 en todos los casos). El 96 por ciento estaban satisfechos o muy satisfechos con la HaD. Conclusiones. En pacientes ancianos con insuficiencia cardíaca no complicada la intervención de una unidad de HaD reduce los ingresos en hospitalización convencional y la frecuentación de urgencias, el grado de satisfacción personal es elevado y no empeora la capacidad funcional (AU)

Reduction of the susceptibility to infective endocarditis with time in animals with endocavitary catheters.

In a previous study we showed that the lesions of non-bacterial thrombotic endocarditis induced by means of implantation of a catheter in the left ventricle (LV) of the rabbit, undergo inner connectivization and surface endothelialization, which are completed within 2-3 months. In the present study we have investigated whether these histological changes lead to a variation in susceptibility to infective endocarditis (IE). After studying two control groups, we compared the incidence of IE in four groups of 15 rabbits each, inoculated with Streptococcus mitis I, 10, 35 and 70 days after implantation of a catheter in the LV. The frequency of infection was shown to be progressively reduced from 100% to 26.7%. This demonstrates that endothelialization of the catheter and the sterile vegetations protect the animals from IE.

Oral is superior to systemic antibiotic prophylaxis in operations upon the colon and rectum.

The prophylactic effect of a short preoperative loading dose of oral neomycin and erythromycin upon infectious complications following elective operations upon the colon and rectum was compared with the prophylactic effect of systemic administration of metronidazole and gentamicin preoperatively and postoperatively. In this randomized prospective clinical study, 45 patients received neomycin-erythromycin while 48 received metronidazole-gentamicin; all patients were prepared mechanically using whole gut irrigation with a mannitol solution. Both groups were comparable in sex, age, clinical diagnosis and type of operation performed. In the neomycin-erythromycin group, 41 of 45 patients had an uncomplicated postoperative course versus 35 of 48 patients in the other group (p less than 0.001) and fewer wound infections (p less than 0.05). We conclude that the better results observed with the neomycin-erythromycin combination is probably an addition of two effects--the decrease in colon flora and the adequate serum levels of antibiotics during the operation.