RESUMEN
BACKGROUND: The pathogenesis of vitiligo is complex and multifactorial, accumulating evidence of increased oxidative stress and reduction in catalase levels in vitiligo patients has been shown, hence, pseudocatalase/superoxide dismutase (PSD) gel has been used as treatment option for vitiligo. AIM: To assesses the synergic effect of PSD when combines with Tacrolimus 0.1% ointment versus Tacrolimus 0.1% alone. METHOD: A randomized controlled trial that included 49 children with vitiligo with limited area (10% or less). Patients were randomized into two groups: Group 1 (24 patients) were treated only with Tacrolimus 0.1% ointment whereas Group 2 (25 patients) were treated with Tacrolimus 0.1% ointment plus PSD. Degree of repigmentation compared to baseline was assessed at 3, 6, and 9 months. RESULTS: The median age was 10.05 years (range 2-18). The percentages of pigmentation on 3, 6, and 9 months for Group 1 were 23.9%, 40.4%, and 60%, respectively and for Group 2 were 23.2%, 40.7%, and 62.4%, respectively. There was no significant difference according to repigmentation percentages between the two groups (p > .86, p > .97, and p > .78, respectively). CONCLUSIONS: The results showed that the addition of PSD to Tacrolimus ointment in children with limited vitiligo was not associated with any therapeutic benefit.
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Tacrolimus , Vitíligo , Adolescente , Catalasa , Niño , Preescolar , Humanos , Inmunosupresores/uso terapéutico , Pomadas , Superóxido Dismutasa , Tacrolimus/uso terapéutico , Resultado del Tratamiento , Vitíligo/tratamiento farmacológicoRESUMEN
Introducción. La población inmigrante es cada vez más numerosa en la consulta neurológica. No está bien establecido si existen diferencias geográficas en la prevalencia de las cefaleas primarias y la posible influencia de la emigración. Pacientes y métodos. Estudio retrospectivo (12 meses) y prospectivo (18 meses) de las primeras visitas en la Unidad de Cefaleas del Hospital de la Santa Creu i Sant Pau. Identificamos el país de origen, parámetros temporales de la cefalea y de la inmigración, diagnósticos según criterios de la Sociedad Internacional de Cefaleas y tratamientos realizados. Se considera cefalea relacionada la que se inicia en el período de un año tras la inmigración. Resultados. La población inmigrante representa el 13,6% (n = 142) del total de las primeras visitas por cefalea (n = 1.044). Proceden principalmente de Latinoamérica (83,9%). La cefalea comenzó posteriormente a la inmigración en el 40,1% de los casos, sin existir relación temporal con la inmigración. La distribución de los diagnósticos de la cefalea son semejantes a los de la población autóctona; los más frecuentes son migraña (57,7%) y cefalea tensional (15,5%). Al comparar los tratamientos anteriores y posteriores a la inmigración, encontramos diferencias en el uso de triptanes (2,1% frente a 46,2%), ergotamina (9,8% frente a 2,1%) y utilización de tratamientos preventivos (2% frente a 45%). Conclusiones. La población inmigrante representa el 13% de las primeras visitas de cefalea y sus diagnósticos son similares a los de la población autóctona. El hecho de la emigración no es desencadenante ni agravante de la cefalea en nuestra serie. El tratamiento sintomático y preventivo difiere significativamente entre el período anterior a la inmigración y el posterior(AU)
Introduction. The immigrant population (IP) is visiting neurology departments on an increasingly more frequent basis. Research has still not made it clear whether there are geographical differences in the prevalence of primary headaches and the possible influence of emigration. Patients and methods. We conducted a retrospective (12 months) and prospective study (18 months) of the first visits to the Headache Unit at the Hospital de la Santa Creu i Sant Pau. Data collected included the country of birth, time parameters of the headache and of the immigration, diagnoses according to the criteria of the IHS and treatments that had been used. Related headaches were considered to be those that began within one year of having immigrated. Results. The IP represents 13.6% (n = 142) of the total number of first visits because of headaches (n = 1044). Immigrants came mostly from Latin America (83.9%). Headaches began after immigration in 40.1% of cases without the existence of any temporal relation with immigration. The distribution of the diagnoses of headache is similar to those of the local population, the most frequent being migraine (57.7%) and tension-type headache (15.5%). On comparing treatments prior to and following immigration, we find differences in the use of triptans (2.1% versus 46.2%), ergotamine (9.8% versus 2.1%) and in the use of preventive treatments (2% versus 45%). Conclusions. The IP accounts for 13% of all first visits due to headaches and their diagnoses are similar to those of the local population. Emigration is neither a precipitating nor an aggravating factor for headaches in our series. There is a significant difference in symptomatic and preventive treatment between the period prior to immigration and afterwards (AU)
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Humanos , Cefalea/epidemiología , Analgesia , Cefalea/tratamiento farmacológico , Migración Humana/estadística & datos numéricos , Estudios Retrospectivos , Trastornos Migrañosos/epidemiología , Ergotaminas/uso terapéutico , Triptaminas/uso terapéuticoRESUMEN
INTRODUCTION: The immigrant population (IP) is visiting neurology departments on an increasingly more frequent basis. Research has still not made it clear whether there are geographical differences in the prevalence of primary headaches and the possible influence of emigration. PATIENTS AND METHODS: We conducted a retrospective (12 months) and prospective study (18 months) of the first visits to the Headache Unit at the Hospital de la Santa Creu i Sant Pau. Data collected included the country of birth, time parameters of the headache and of the immigration, diagnoses according to the criteria of the IHS and treatments that had been used. Related headaches were considered to be those that began within one year of having immigrated. RESULTS: The IP represents 13.6% (n = 142) of the total number of first visits because of headaches (n = 1044). Immigrants came mostly from Latin America (83.9%). Headaches began after immigration in 40.1% of cases without the existence of any temporal relation with immigration. The distribution of the diagnoses of headache is similar to those of the local population, the most frequent being migraine (57.7%) and tension-type headache (15.5%). On comparing treatments prior to and following immigration, we find differences in the use of triptans (2.1% versus 46.2%), ergotamine (9.8% versus 2.1%) and in the use of preventive treatments (2% versus 45%). CONCLUSIONS: The IP accounts for 13% of all first visits due to headaches and their diagnoses are similar to those of the local population. Emigration is neither a precipitating nor an aggravating factor for headaches in our series. There is a significant difference in symptomatic and preventive treatment between the period prior to immigration and afterwards.
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Emigración e Inmigración , Cefalea/fisiopatología , Departamentos de Hospitales , Adulto , Ergotamina/uso terapéutico , Cefalea/tratamiento farmacológico , Cefalea/epidemiología , Humanos , Pacientes Ambulatorios , Estudios Prospectivos , Estudios Retrospectivos , Vasoconstrictores/uso terapéuticoRESUMEN
INTRODUCTION: The presence of psychopathological symptoms as anxiety and depression in chronic daily headache and in fibromyalgia is common. AIM: To study whether there are any difference in the psychopathological profile and treatment response between patients with chronic headache and fibromyalgia (CHFM) and patients with chronic headache without fibromyalgia (CH). PATIENTS AND METHODS: A comprehensive psychological test battery was administered to 30 patients with CH and 30 patients with CHFM, diagnosed by a rheumatologist. We included chronic migraine and chronic tensional headache in CH group. Patients were matched for age and gender. Depression, anxiety and obsession scores, and the profile of psychopathological symptoms (MMPI-2, SCL-90-R) were compared (t-test). Correlations between symptoms and treatment response were examined. RESULTS: Patients with CHFM showed significant highest scores on hypochondriasis, depression, hysteria, paranoia, psychasthenia and schizophrenia (MMPI-2) and more somatization, obsession and anxiety according to SCL-90-R. A poorer response to treatment was observed in CHFM (17.85%) versus CH (42,85%) group. CONCLUSIONS: Patients with CHFM showed a psychopathological profile with highest scores and symptoms than patients without fibromyalgia. These differences correlated with the therapeutic response.
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Fibromialgia/complicaciones , Cefalea/complicaciones , Cefalea/psicología , Enfermedad Crónica , Femenino , Cefalea/diagnóstico , Cefalea/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Introducción. La presencia de sintomatología psicopatológica, como la ansiedad y la depresión, en las cefaleascrónicas y en la fibromialgia es común. Objetivos. Estudiar si existen diferencias en el perfil psicopatológico entre pacientescon cefalea crónica y fibromialgia (CCFM) y pacientes con cefalea crónica sin fibromialgia (CC), y si existen diferencias enla respuesta al tratamiento entre ambos grupos. Pacientes y métodos. Se administra una batería de test de evaluación de síntomaspsicopatológicos a 30 pacientes con CC y a 30 pacientes con CCFM diagnosticados por un reumatólogo. Incluimos enla CC a pacientes con migraña crónica y cefalea tensional crónica. El diseño es con datos apareados de edad y sexo. Se comparanlas puntuaciones de depresión, ansiedad, obsesión y perfil de sintomatología psicopatológica inventario multifásicode personalidad de Minnessota (MMPI-2) y cuestionario de 90 síntomas revisado (SCL-90-R) (prueba t). Se correlacionanlos datos con la respuesta al tratamiento. Resultados. Los pacientes con CCFM muestran puntuaciones significativamente superioresen las escalas de hipocondriasis, depresión, histeria, paranoia, psicastenia y esquizofrenia (MMPI-2), y más somatizaciones,obsesión y ansiedad según el SCL-90-R. La respuesta favorable al tratamiento es inferior en el grupo CCFM(17,85%) que en el CC (42,85%). La hipocondriasis se correlaciona con una peor respuesta (regresión logística). Conclusiones.Los pacientes con CCFM muestran un perfil psicopatológico con mayores puntuaciones y síntomas que los pacientes sinfibromialgia. Esta diferencia se correlaciona con la respuesta terapéutica(AU)
Introduction. The presence of psychopathological symptoms as anxiety and depression in chronic daily headacheand in fibromyalgia is common. Aim. To study whether there are any difference in the psychopathological profile andtreatment response between patients with chronic headache and fibromyalgia (CHFM) and patients with chronic headachewithout fibromyalgia (CH). Patients and methods. A comprehensive psychological test battery was administered to 30 patientswith CH and 30 patients with CHFM, diagnosed by a rheumatologist. We included chronic migraine and chronic tensionalheadache in CH group. Patients were matched for age and gender. Depression, anxiety and obsession scores, and the profileof psychopathological symptoms (MMPI-2, SCL-90-R) were compared (t-test). Correlations between symptoms and treatmentresponse were examined. Results. Patients with CHFM showed significant highest scores on hypochondriasis, depression,hysteria, paranoia, psychasthenia and schizophrenia (MMPI-2) and more somatization, obsession and anxiety accordingto SCL-90-R. A poorer response to treatment was observed in CHFM (17.85%) versus CH (42,85%) group. Conclusions.Patients with CHFM showed a psychopathological profile with highest scores and symptoms than patients without fibromyalgia.These differences correlated with the therapeutic response(AU)
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Humanos , Masculino , Femenino , Psicopatología/métodos , Trastornos de Cefalalgia/complicaciones , Fibromialgia/fisiopatología , Fibromialgia/psicología , Hipocondriasis/complicaciones , Hipocondriasis/diagnóstico , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/terapia , Cefalea de Tipo Tensional/diagnóstico , Cefalea de Tipo Tensional/terapia , Batería Neuropsicológica de Luria-Nebraska/normas , Depresión/complicaciones , Depresión/epidemiología , Ansiedad/complicaciones , Ansiedad/diagnóstico , Modelos LogísticosRESUMEN
Cat-scratch disease is caused by a Gram-negative bacillus known as Bartonella henselae. This disease is usually benign and causes regional adenitis that does not require treatment. However, some patients develop more serious atypical forms of the disease including prolonged systemic illness with hepatic and splenic abscesses.A 14-year-old girl was admitted to hospital with a 12-day history of persistent high fever and abdominal pain. Ultrasonography and computerized tomography of the abdomen revealed splenic abscesses. These findings, together with an antecedent of cat exposure, led to the suspicion of cat-scratch disease, which was confirmed by serology. The girl was treated with intramuscular ceftriaxone and clinical evolution was favorable. Splenic cat-scratch disease is infrequent. Cat-scratch disease sometimes presents as fever of unknown origin and consequently this disease should be considered in the differential diagnosis of prolonged fever. Although evolution is usually favorable, antibiotic therapy is recommended in systemic manifestations of cat-scratch disease.
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Absceso/microbiología , Bartonella henselae , Enfermedad por Rasguño de Gato/complicaciones , Enfermedades del Bazo/microbiología , Adolescente , Femenino , HumanosRESUMEN
La enfermedad por arañazo de gato es una infección causada por un bacilo gramnegativo conocido como Bartonella henselae. Esta enfermedad se comporta habitualmente de forma benigna causando un cuadro de adenitis regional que no precisa tratamiento; sin embargo, algunos pacientes desarrollan formas atípicas y más graves entre las que se encuentra un cuadro caracterizado por una afectación visceral en forma de granulomas hepáticos y esplénicos. Se presenta el caso de una niña de 14 años con síntomas de fiebre elevada de 12 días de evolución y abdominalgia. La ecografía y la tomografía computarizada (TC) abdominal mostraron abscesos esplénicos que junto al antecedente de exposición a gatos hizo sospechar el diagnóstico de enfermedad por arañazo de gato que se confirmó por serología. Fue tratada con ceftriaxona intramuscular con muy buena evolución clínica. La afectación hepatoesplénica suele ser una forma poco común de la enfermedad. En ocasiones se presenta como un síndrome febril de origen desconocido por lo que debemos tener en cuenta esta enfermedad en el diagnóstico diferencial de fiebre prolongada. Aunque la evolución suele ser favorable se recomienda tratamiento antibiótico en las formas atípicas de la enfermedad por arañazo de gato (AU)
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Adolescente , Femenino , Humanos , Bartonella henselae , Enfermedades del Bazo , Absceso , Enfermedad por Rasguño de GatoRESUMEN
Three separate classes of ribonucleotide reductases exist in nature. They differ widely in protein structure. Class I enzymes are found in aerobic bacteria and eukaryotes; class II enzymes are found in aerobic and anaerobic bacteria; class III enzymes are found in strict and facultative anaerobic bacteria. Usually, but not always, one organism contains only one or two (in facultative anaerobes) classes. Surprisingly, the genomic sequence of Pseudomonas aeruginosa contains sequences for each of the three classes. Here, we show by DNA hybridization that other species of Pseudomonas also contain the genes for three classes. Extracts from P. aeruginosa and P. stutzeri grown aerobically or microaerobically contain active class I and II enzymes, whereas we could not demonstrate class III activity. Unexpectedly, class I activity increased greatly during microaerobic conditions. The enzymes were separated, and the large proteins of the class I enzymes were obtained in close to homogeneous form. The catalytic properties of all enzymes are similar to those of other bacterial reductases. However, the Pseudomonas class I reductases required the continuous presence of oxygen during catalysis, unlike the corresponding Escherichia coli enzyme but similar to the mouse enzyme. In similarity searches, the amino acid sequence of the class I enzyme of P. aeruginosa was more related to that of eukaryotes than to that of E. coli or other proteobacteria, with the large protein showing 42% identity to that of the mouse, suggesting the possibility of a horizontal transfer of the gene. The results raise many questions concerning the physiological function and evolution of the three classes in Pseudomonas species.
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Pseudomonas/enzimología , Ribonucleótido Reductasas/aislamiento & purificación , Aerobiosis , Genes Bacterianos , Pseudomonas/genética , Pseudomonas aeruginosa/enzimología , Pseudomonas aeruginosa/genética , Ribonucleótido Reductasas/clasificación , Ribonucleótido Reductasas/genética , Ribonucleótido Reductasas/metabolismoRESUMEN
We assessed the prevalence of antibodies to spotted fever group rickettsiae in human beings and dogs by indirect immunofluorescence in the region of 'Vallés Occidental', Barcelona (Spain). In the group of 150 serum samples from patients without former history of Mediterranean spotted fever, 12 had antibodies to Rickettsia conori. The overall seroprevalence was 8% (95% confidence interval, 4.6% to 13.5%). There were no statistically significant differences between the mean ages of patients with positive and negative antibodies to R. conorii. However, seropositivity was significantly more common among patients living in semi-rural areas. In the group of 138 dog serum samples, 36 (26.1%) sera had antibodies to R. conorii. When the present results were compared with those obtained in a previous seroepidemiological survey carried out in the same geographical region in 1987, no significant differences were found. Therefore, although the epidemiological markers have dropped, this does not absolutely confirm the decrease of the presence of R. conorii in this area.
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Fiebre Botonosa/inmunología , Fiebre Botonosa/veterinaria , Enfermedades de los Perros/epidemiología , Enfermedades Endémicas/estadística & datos numéricos , Infecciones por Rickettsiaceae/inmunología , Infecciones por Rickettsiaceae/veterinaria , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Animales , Anticuerpos Antibacterianos/análisis , Fiebre Botonosa/epidemiología , Niño , Preescolar , Enfermedades de los Perros/inmunología , Perros , Enfermedades Endémicas/veterinaria , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Rickettsia/inmunología , Infecciones por Rickettsiaceae/epidemiología , Población Rural , Estaciones del Año , Distribución por Sexo , España/epidemiología , Infestaciones por Garrapatas/epidemiología , Infestaciones por Garrapatas/inmunología , Infestaciones por Garrapatas/veterinariaAsunto(s)
Educación Continua en Enfermería , Edema Pulmonar/enfermería , Enfermedad Aguda , Anciano , Humanos , Masculino , EspañaAsunto(s)
Lesión Renal Aguda/enfermería , Educación Continua en Enfermería , Anciano , Humanos , Masculino , EspañaRESUMEN
"Do poor economies grow faster than rich ones? This...economic question...is analyzed in this paper using two regional data sets: 47 prefectures in Japan and 48 states of the United States. We find clear evidence of convergence in both countries: poor prefectures and states grow faster. We also find that there is intraregional as well as interregional convergence. We analyze the cross-sectional standard deviation across prefectures and states.... Finally we study the determinants of the rates of regional in-migration.... We find little evidence in favor of the argument that population movements are the reason why we find convergence across economies."
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Economía , Emigración e Inmigración , Geografía , Crecimiento Demográfico , Américas , Asia , Demografía , Países Desarrollados , Asia Oriental , Japón , América del Norte , Población , Dinámica Poblacional , Investigación , Estados UnidosRESUMEN
We studied 91 strains of Streptococcus pneumoniae isolated in the Children's and Maternity Hospital San Juan de Dios of Barcelona, Spain, from July 1984 to June 1986. All strains were recovered from miscellaneous sites in different patients. We tested their susceptibility to 14 antimicrobial agents: penicillin, gentamicin, chloramphenicol, tetracycline, co-trimoxazole, erythromycin, vancomycin, rifampicin, cephalothin, cefaclor and cefotaxime. In addition, for 56 of the strains, cefonicid, cefoxitin and imipenem were included. We found many strains with decreased penicillin susceptibility (52.8%). Among the beta-lactam antibiotics tested, cefotaxime and imipenem showed the lowest MIC (less than or equal to 1 mg/l). Only 5.5% of the strains showed resistance to erythromycin, and all were susceptible to vancomycin and rifampicin. Tetracycline and co-trimoxazole were the antimicrobials with the highest prevalence of resistance (72.5% and 67%, respectively). Our isolates were distributed in 21 serotypes, serotype 23 being the most frequent among strains with decreased penicillin susceptibility (50%).
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Antibacterianos/farmacología , Streptococcus pneumoniae/efectos de los fármacos , Niño , Humanos , Pruebas de Sensibilidad MicrobianaRESUMEN
Authors study 464 strains of N. meningitidis isolated from cerebrospinal fluid and/or blood of children with meningococcal disease in a childrens' hospital in Barcelona from January 1979 to September 1986. These strains are distributed in four serogroups and eight serotypes, being serogroup B and serotype 2 the most frequent ones. Authors have isolated 4 strains with decreased penicillin susceptibility, three with a MIC of 0.2 microgram/ml and one with a MIC of 0.4 microgram/ml. All four belong to serogroup B, three to serotype 1 and one was non-typable. This alert on possible therapeutic failures that could emerge in next future and implies the necessity of in vitro testing susceptibility of all strains of N. meningitidis isolated from pathologic products in order to detect possible resistances.