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Background: Data from the sentinel surveillance system of severe acute respiratory infections in Spain were used to estimate the impact of administration of nirsevimab to children born from 1 April 2023 onwards., Methods: Estimated RSV hospitalisations in < 1-year-olds during weeks 40, 2023, to 8, 2024, were compared to the number that would be expected after accounting for the background change in RSV circulation in the 2023/24 season, compared to 2022/23., Results: We estimated 9364-9875 RSV hospitalisations less than expected, corresponding to a 74%-75% reduction., (© 2024 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Objective: Test whether high dose corticosteroid pulse therapy (HDCPT) with either methylprednisolone or dexamethasone is associated with increased survival in COVID-19 patients at risk of hyper-inflammatory response. Provide some initial diagnostic criteria using laboratory markers to stratify these patients., Methods: This is a prospective observational study, 318 met the inclusion criteria. 64 patients (20.1%) were treated with HDCPT by using at least 1.5mg/kg/24h of methylprednisolone or dexamethasone equivalent. A multivariate Cox regression (controlling for co-morbidities and other therapies) was carried out to determine whether HDCPT (among other interventions) was associated with decreased mortality. We also carried out a 30-day time course analysis of laboratory markers between survivors and non-survivors, to identify potential markers for patient stratification., Results: HDCPT showed a statistically significant decrease in mortality (HR = 0.087 [95% CI 0.021-0.36]; P < 0.001). 30-day time course analysis of laboratory marker tests showed marked differences in pro-inflammatory markers between survivors and non-survivors. As diagnostic criteria to define the patients at risk of developing a COVID-19 hyper-inflammatory response, we propose the following parameters (IL-6 > = 40 pg/ml, and/or two of the following: C-reactive protein > = 100 mg/L, D-dimer > = 1000 ng/ml, ferritin > = 500 ng/ml and lactate dehydrogenase > = 300 U/L)., Conclusions: HDCPT can be an effective intervention to increase COVID-19 survival rates in patients at risk of developing a COVID-19 hyper-inflammatory response, laboratory marker tests can be used to stratify these patients who should be given HDCPT. This study is not a randomized clinical trial (RCT). Future RCTs should be carried out to confirm the efficacy of HDCPT to increase the survival rates of COVID-19., Competing Interests: The authors have declared that no competing interests exist.

Background: The immune response involved in the pathogenesis of Inflammatory Bowel Disease (IBD) may be present years before the diagnosis, but the characteristics of the disease during the preclinical period have been scarcely investigated., Aim: To describe the microscopic findings of preclinical IBD and its relationship with the natural history of the disease., Methods: Medical records from all patients with an incidental diagnosis of IBD during a screening colonoscopy were included in this multicentric and retrospective study. We assessed 15 histologic items in the biopsy samples at diagnosis, and the Geboes score was calculated in patients with Ulcerative Colitis (UC). The main outcome was the development of gastrointestinal symptoms during follow-up., Results: We included 110 patients (79 UC, 24 Crohn's Disease (CD) and 7 with unclassified disease). In UC the most common histologic findings were acute or chronic inflammatory infiltrate and crypt epithelial polymorphs, while in CD we observed acute or chronic neutrophilic infiltrate and epithelial irregularity. Granuloma were only observed in 4% of CD patients. Crypt distortion and the infiltration of neutrophils in the epithelium were associated with a higher risk of developing symptomatic disease., Conclusions: Preclinical IBD shows specific microscopic findings and they are associated with the progression to symptomatic disease., Competing Interests: Declaration of Competing Interest IR-L has received financial support for travelling and educational activities from or has served as an advisory board member for MSD, Pfizer, Abbvie, Takeda, Janssen, Roche, Tillotts Pharma, Shire Pharmaceuticals, Ferring, Dr. Falk Pharma, Adacyte and Otsuka Pharmaceutical. MB-A has received financial support for travelling and educational activities from or has served as an advisory board member for Pfizer, MSD, Takeda, Abbvie, Kern, Janssen, Fresenius Kabi, Biogen, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Chiesi, Gebro Pharma, Otsuka Pharmaceuticals, and Tillotts Pharma. The remaining authors declare no conflicts of interest related to this manuscript., (Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Background: Although esophagogastroduodenoscopy (EGD) is the standard procedure for the diagnosis of gastric cancer (GC), some GCs are missed. There are no published data on the missed rate of GC in Spain., Aims: To determine the frequency and characteristics of missed GCs and assess the quality of the EGD in a specific population with GC., Methods: Records of all patients diagnosed with gastric adenocarcinoma between 2012 and 2016 in a defined geographic area were reviewed. Missed GC was defined as a case with a prior negative EGD for cancer. Quality indicators from the prior EGDs were measured., Results: From 212 cases of GC, 25 cases were excluded. Seventeen out of 187 patients had a prior EGD (9.1%). Twelve of those 17 missed GC had a prior EGD with some abnormal findings. In 6 of them, biopsies were taken. Survival was no different between patients with missed and non-missed GC. Quality indicators that failed to meet standards were recording time, image documentation, and a protocol of biopsies., Conclusions: Missed GC in an EGD in a defined population in Spain is not uncommon (9.1%). The endoscopist is an important factor in missed GC due to lack of adequate detection and sampling error. Compliance with performance of quality indicators could reduce missed GC., (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Background: One of the most frequently used instruments to assess posttraumatic stress in children and adolescents is the Child PTSD Symptom Scale. However, there has been limited evaluation of its construct validity in the Spanish language despite Spanish being one of the most widely spoken languages in the world., Objective: To provide data on the psychometric properties of the CPSS in a sample of Spanish adolescents, to establish the internal consistency of the measure, and to examine its criterion validity., Method: The participants were 339 adolescents (172 boys and 167 girls, mean age 13.95) exposed to peer violence during the previous year., Results: Confirmatory factor analysis demonstrated a good fit to the four-factor dysphoria model. The alpha reliabilities for the overall measure and its subscales were suitable., Discussion: The Spanish version of the scale has sound psychometric properties with good reliability and validity. Moreover, it integrates the four-factor structure corresponding to the dimensions of PTSD described in the DSM-V.

A hexanucleotide repeat expansion in chromosome 9 open reading frame 72 (C9orf72) can cause amyotrophic lateral sclerosis (ALS) and/or frontotemporal dementia (FTD). We assessed its frequency in 781 sporadic ALS (sALS) and 155 familial ALS (fALS) cases, and in 248 Spanish controls. We tested the presence of the reported founder haplotype among mutation carriers and in 171 Ceph Europeans from Utah (CEU), 170 Yoruba Africans, 81 Han Chinese, and 85 Japanese subjects. The C9orf72 expansion was present in 27.1% of fALS and 3.2% of sALS. Mutation carriers showed lower age at onset (P = 0.04), shorter survival (P = 0.02), greater co-occurrence of FTD (P = 8.2 × 10(-5)), and more family history of ALS (P = 1.4 × 10(-20)), than noncarriers. No association between alleles within the normal range and the risk of ALS was found (P = 0.12). All 61 of the mutation carriers were tested and a patient carrying 28 hexanucleotide repeats presented with the founder haplotype. This haplotype was found in 5.6% Yoruba Africans, 8.9% CEU, 3.9% Japanese, and 1.6% Han Chinese chromosomes., (© 2012 Wiley Periodicals, Inc.)

This study analyses the relationships between patients' dispositional optimism and pessimism and the coping strategies they use. In addition, the coping strategies repercussions on adjustment to chronic pain were studied. Ninety-eight patients with heterogeneous chronic pain participated. The assessment tools were as follows: Life Orientation Test (LOT), the Vanderbilt Pain Management Inventory (VPMI), the McGill Pain Questionnaire (MPQ), Hospital Anxiety and Depression Scale (HADS), and the Impairment and Functioning Inventory for Chronic Pain Patients (IFI). The hypothetical model establishes positive relationships between optimism and the use of active coping strategies, whereas pessimism is related to the use of passive coping. Active coping is associated with low levels of pain, anxiety, depression and impairment and high levels of functioning. However, passive coping is related to high levels of pain, anxiety, depression and impairment and low levels of functioning. The hypothetical model was empirically tested using the LISREL 8.20 software package and the unweighted least squares method. The results support the hypotheses formulated regarding the relations among optimism, pessimism, coping and adjust of chronic pain patients. By analysing optimism among chronic pain patients, clinicians could make better predictions regarding coping and adjustment.

The aim of this paper was to develop an instrument to assess levels of stress experienced by Latin-American immigrants in their acculturative process in Spain. A sample of 692 immigrants from Latin America, aged 20 to 63 years, took part on this study (54.9% males and 45.1% females). A 24-item questionnaire with high reliability (.92) was elaborated. Six factors related to acculturative stress were found: 1) discrimination and rejection; 2) differences with the out-group (native Spaniards); 3) citizenship problems and legality; 4) problems concerning social relationships with other immigrants; 5) nostalgia and longing; and 6) family break-up. Our findings show that participants have a high level of stress related to nostalgia and longing, family break-up, and the perception of discrimination and rejection by natives. The usefulness of the instrument and its applications and restrictions are discussed.

Objective: To describe an outbreak of hepatitis A in the city of Albacete (Spain) and to assess the effectiveness of the control measures implemented., Methods: When the outbreak was noted, definitions of a case were established. Clinical and epidemiological data were collected through a survey. The temporal-spatial distribution was identified through mapping and the epidemic curve. Health education and immunoglobulin (IG) administration were conducted as immediate prevention and control measures in the population at risk., Results: From January 2005 to January 2006, 62 cases were reported. The most affected age groups were school children and young adults. Transmission was person to person. The epidemic curve was divided into two periods. Initial control measures consisted of hygiene measures and IG administration to contacts. In the second period, these measures were complemented with vaccination against hepatitis A in students of the school centers of the two neighborhoods initially involved. Due to public alarm and spread of the outbreak to adjacent neighborhoods, vaccination was extended to schools close to those where cases had been detected. No cases were notified after the last vaccination in January 2006., Conclusions: The use of vaccination after exposure to the hepatitis A virus in young adults and the school population seems to be an effective outbreak control measure., (Copyright © 2009 SESPAS. Published by Elsevier Espana. All rights reserved.)

Objective: to compare health-related quality of life (HRQL) assessed using the Short Form-12 (SF-12) and the Short Form-36 (SF-36) questionnaires in coronary patients with different diagnoses, testing the hypothesis that the SF-12 is capable of discriminating between patients with acute myocardial infarction (AMI) and patients with unstable angina in the same way as the SF-36., Study Design: Cross-sectional study., Methods: HRQL was studied in 186 patients admitted to hospital for ischaemic cardiopathy, using the SF-36 and SF-12. Intraclass correlation coefficients were calculated for each summary component. The proportion of variability of the physical and mental summary components of the SF-36 (PCS-36 and MCS-36) explained by each component of the SF-12 was examined using a linear regression model, adjusted for age and gender., Results: The mean scores observed were similar in the two questionnaires. The degree of agreement was high, and the corresponding regression model explained 87% of the variability in the PCS-36 and 93% of the variability in the MCS-36. The SF-12 identified the differences between AMI and angina in the same way as the SF-36., Conclusions: The SF-12 replicates the information of the summary component scores of the SF-36, and discriminates between patients with AMI and those with unstable angina. Its use allows the same information to be obtained as from the SF-36, with less effort for the patient and the doctor.

Background: Foot infections are a common reason for hospitalization and a cause of complications in patients with diabetes. The aim of this study was to determine the prevalence of microorganisms found on culture in complicated diabetic foot infections in hospitalized patients, and the sensitivity of the causative microorganisms to antimicrobial agents., Methods: Between December 2001 and December 2005 in our department, 84 samples in 62 diabetic patients with moderate/severe infection were collected for microbiological study., Results: At least one microorganism was isolated in 88% of samples. The most frequently isolated germ group was gram-positive bacteria (55% of the samples), with Staphylococcus aureus (33%) in the first position, followed by Pseudomonas aeruginosa (12%), Enterococcus spp. (9%), and Escherichia coli (8%). Culture for anaerobic microorganisms was only performed in half the samples; 25% were positive, and Peptostreptococcus spp. predominated. Among the multiresistant microorganisms, methicillin-resistant staphylococci aureus (MRSA) were the most common, accounting for 38% of the isolated strains of S. aureus, ie, 12% of all samples. As to the gram-negative microorganisms, nearly 30% of E. coli strains were resistant to amoxicillin/clavulanic acid and ciprofloxacin., Conclusion: Most of the cultures in our study were monomicrobial, with S. aureus being the most prevalent microorganism, followed by enterobacteria and P. aeruginosa. The main resistant microorganism in diabetic foot infections requiring hospitalization was methicillin-resistant golden staphylococcus, which was found in 12% of the series.

Cats are important in the epidemiology of Toxoplasma gondii because felids are the only definitive hosts that can excrete environmentally resistant oocysts. Fresh samples of brain from 103 Spanish cats with antibodies to T. gondii were analyzed for T. gondii DNA using nested-PCR; 47 (45.5%) were found to be positive. Further characterization of DNA from 46 cats using RFLP-PCR at the 3' and 5' ends of the SAG2 locus revealed that 12 (26%) isolates were Type I and 34 (74%) were Type II; no Type III were found, and the 47th sample could not be classified to its genetic type. In addition, T. gondii was also isolated by bioassay in mice from 42 of 103 seropositive cats. This is the first report of T. gondii characterization from cats in Spain.

Background: Non cephalic presentation in childbirth involves various risks to both the mother and the foetus. The incidence in Spain is 3.8% of all full-term pregnancies. The most common technique used to end the gestation in cases of non cephalic presentation is that of caesarian section, and although it provokes a lower rate of morbi-mortality than does vaginal delivery in such situations, there remains the possibility of traumatic injury to the foetal head and neck, while maternal morbidity is also increased. The application of heat (moxibustion) to an acupuncture point, in order to correct non cephalic presentation, has been practised in China since ancient times, but as yet there is insufficient evidence of its real effectiveness., Methods/design: The experimental design consists of a multi-centre randomised controlled trial with three parallel arms, used to compare real moxibustion, sham moxibustion and the natural course of events, among pregnant women with a non cephalic presentation and a gestational duration of 33-35 weeks (estimated by echography). The participants in the trial will be blinded to both interventions. The results obtained will be analyzed by professionals, blinded with respect to the allocation to the different types of intervention. In addition, we intend to carry out a economic analysis., Discussion: This trial will contribute to the development of evidence concerning moxibustion in the correction of non cephalic presentations. The primary outcome variable is the proportion of cephalic presentations at term. As secondary outcomes, we will evaluate the proportion of cephalic presentations at week 38 of gestation, determined by echography, together with the safety of the technique, the specificity of moxibustion and the control of the blinding process. This study has been funded by the Health Ministry of the Andalusian Regional Government., Trial Registration: Current Controlled Trials ISRCTN10634508.

Unlabelled: The purpose of the present study was to test a hypothetical model of the relationships between perceived social support, coping responses to pain, pain intensity, depressed mood, and functional disability (functional status and functional impairment) in a population of patients with chronic pain in a Spanish Clinical Pain Unit. It was postulated that social support and pain coping responses both independently influence reported pain intensity, depressed mood, and functional disability. Analyses were performed by Structural Equation Modelling. The results indicated that satisfaction with social support is significantly associated with a depressed mood and pain intensity, but not with functional disability. Although this effect is independent of the use of active coping responses by patients, there is a modest but significant relationship between social support and passive coping strategies, indicating that higher levels of perceived social support are related to less passive pain coping strategies. The findings underscore the potential importance of psychosocial factors in adjustment to chronic pain and provide support for a biopsychosocial model of pain., Perspective: This article tested a hypothetical model of the relationships between social support, pain coping, and chronic pain adjustment by using Structural Equation Modelling. The results indicate that perceived social support and pain coping are independent predictors of chronic pain adjustment, providing support for a biopsychosocial model of pain.

We describe priority issues and some of the results obtained from the implementation of the Prevention and Reduction of Traffic Accident Injuries program in a health area. Since 1999 the public health center has made a priority of identifying and recruiting partners from other sectors (the local police association and the local education authority), increasing its capacity for working together, and setting up an intersectorial working group. Teaching activities and meetings were held. A network of people was created from 17 of a total of 39 town halls that participate in activities supported by the intersectorial group. Ten are involved in educational activities and a further seven focus on ensuring compliance with the law. The intersectorial group promoted their visibility through the local media. These activities are not aimed at reducing injuries from road traffic accidents, but rather at creating an action framework through which all the sectors involved can be mobilized. The aim is to strengthen commitment among political, technical and civil sectors by focussing on social values of respect for a healthier life.

Background: We estimated the effect of remote BCG vaccination on tuberculin reactivity and the booster effect among hospital employees., Methods: Cross-sectional survey at a university hospital. All personnel employed during a 24-month period were included in the study. Employees were administered 2-step tuberculin testing, and BCG vaccination scars were verified., Results: Of 665 hospital employees studied, 239 (36%) had been vaccinated with BCG in childhood. Significant tuberculin reactions (> or =5 mm) were more frequent among BCG-vaccinated (60%) than among nonvaccinated (29%) employees (odds ratio [OR], 3.6; 95% confidence interval [CI], 2.6-5.2). The predictive value of tuberculosis infection increased with increasing reaction size and greater age (from 37% in subjects 30 years or younger with indurations > or =5 mm to 100% in subjects 50 years or older with indurations > or =15 mm). Among 374 employees with a negative tuberculin test reaction who underwent a second test, 39 (43%) of 91 vaccinated subjects had a positive booster reaction in contrast to 51 (22%) of 232 nonvaccinated subjects (OR, 3.4; 95% CI, 2-5.7). Neither different size criteria nor different definitions of the booster effect had an impact on the predictive value of tuberculosis infection., Conclusions: Remote BCG vaccination largely influences the tuberculin reaction and the boosting phenomenon among hospital employees. The interpretation of the results of 2-step tuberculin testing in a BCG-vaccinated subject must take into account age, size of the reaction, and local prevalence of tuberculosis infection. No single criterion, however, can accurately separate reactions caused by true infection from those caused by BCG vaccination.

Genetic analysis of the SAG2 locus was performed to determine the prevalence of the different genotypes of Toxoplasma gondii (strain types I, II, and III) associated with human toxoplasmosis in Spain. This determination was made directly from primary clinical samples, obviating the previous process of isolation in mice or cell culture. A total of 34 isolates of T. gondii, collected from immunocompromised patients and congenital infection cases, were analyzed. Restriction fragment length polymorphism in PCR-amplified SAG2 products was used to group strains into one of the three genotypes of T. gondii. Complete characterization of the SAG2 gene was successful in 76.5% of the cases, demonstrating the feasibility of direct genotype analysis from clinical samples of different origins. Strains of T. gondii type II were the most prevalent in immunocompromised patients, with 52% of cases, while strains of type I were present in 75% of the congenital infection cases. These data differ from previous reports that show type II strains to be mostly associated with all kinds of human toxoplasmosis. These differences might be an effect of selection in the process of culture and isolation of the samples performed by other researchers prior to strain characterization.

Background: Schools being the ideal setting for carrying out Health Education activities, the aim of this study was that of pinpointing and quantifying the changes in attitudes and knowledge on the part of teenagers enrolled in school in Algemesí (Valencia) following an educational intervention regarding HIV infection., Method: Eleven schools at which a total of 2,599 teenagers (ages 12-19) were enrolled in eleven different years of study (Secondary Education, Secondary Ed. and School Leaving Certificate, College Preparation Course and Vocational Training) were invited to take part. The Aulasida intervention carried out during the 1996-1997 school year consisted of an informative lecture-panel discussion and student involvement activities in small groups using educational materials. The gauging instrument was a questionnaire. This questionnaire was designed in a before-and-after cross-sectional study. An analysis was made divided into age and educational level strata. The averages were compared with the Student "t" test and the percentages of change with ji square., Results: A total of nine schools accepted taking part. 1575 students answered the "before" test (47.4% males and 52.1% females), the average age being 15.2 (1.96) years old. The average number of correct answers to the "before" test was 13.5 (2.8). The "after" test showed an overall increase of up to 14.7 (3.0) correct answers (p < 0.01). By educational levels, this increase was highly appreciable in the younger age group. The most common sources of information on HIV were: television (80.8%); Aulasida (76.8%), teachers (60.9%), pamphlets (58.4%) and films (53.7%9., Conclusions: Educational interventions are useful tools for increasing knowledge and improving attitudes regarding HIV infection. Secondary schools are the best environment for this purpose, it being necessary to carry out interventions among younger groups, as a greater impact is thus achieved.

The present study describes a clinical trial in which Spanish patients suffering from peripheral vascular disease (Fontaine stage II) were given specific lipid supplements. Designed as a longitudinal intervention study, patients were provided with olive oil for 3 months, followed by a 3 month wash-out period, then supplemented with a combination of fish oil and olive oil for the final 3 months. Changes in plasma and lipoprotein fatty acid composition and susceptibility of LDL to in vitro oxidation were examined. Furthermore, lipid-supplement-induced changes in LDL properties were measured as relative electrophoretic mobility and macrophage uptake. In addition, thirteen patients not provided with olive oil and fish oil were included as a control group and twenty healthy age-matched individuals were used as a reference group. A complete clinical study and a nutritional survey concerning food habits and lifestyle were performed every 3 months. Yao indices and claudicometry did not change significantly with dietary intervention although changes in plasma lipid composition suggested an improvement in the condition of the patients. The intake of the fish-oil supplement resulted in significantly increased plasma levels of eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3) in comparison with baseline concentrations, olive-oil and control groups. Fish-oil consumption significantly decreased plasma triacylglycerol levels compared with the olive-oil period, control and reference groups. The susceptibility of LDL to Cu-mediated oxidation was lower in the patients consuming olive oil and the fish-oil supplement than in the control group, and the uptake of LDL by macrophages was significantly lower in the group supplemented with fish oil. In conclusion, consumption of olive oil together with a dietary supplement of fish oil may be useful in the nutritional management of patients suffering from peripheral vascular disease in terms of increasing plasma n-3 long-chain polyunsaturated fatty acids and decreasing susceptibility of LDL to oxidation.

We present a retrospective study of 551 patients treated with conservative surgery for glottic carcinoma at the Gregorio Marañón Hospital between 1962 and 1996. In all, 12% of cases were locally advanced carcinomas. In early-stage carcinomas there were no statistical differences in 5-year survival between those treated by endoscopic laser resection, vertical hemilaryngectomy and radiotherapy. However, tumor recurrence after primary radiotherapy was higher (27%) than with conservative surgery (12%), while the voice preservation rate was significantly higher with surgery (83%) than with radiotherapy (72%). With locally advanced cancer, irradiated patients (to 60 Gy) had a 50% probability of recurrence with a very low chance for salvage by total laryngectomy (5-year survival rate, 38.5%). In contrast, partial laryngectomy could be performed on carefully selected patients, and the results for these patients were comparable to those for smaller lesions (with a 5-year survival rate of 81%).

Polymorphisms in the two variable ADH loci (ADH2 and ADH3) were analyzed in two groups (alcoholics and nonalcoholics) from a Spanish population. The frequencies were similar to those reported for other Causcasian groups. ADH2-1 and ADH3-1 genotypes were more frequent in alcoholics than in nonalcoholics, but the differences were not significant.

In this paper, in order to assess the prevalence and features of insomnia as a subjective complaint in a sample of asthmatic outpatients. (n = 43; mean age = 36.39 +/- 12.85), items 44, 64 and 66 (that deal with insomnia complaints) of Derogatis' SCL-90-R (Symptom Check List 90 REvised), that was applied to the patients of the sample, are studied. A high prevalence of insomnia complaints is observed in our patients; over 70% of the sample manifests complaints of some type of insomnia. Insomnia complaints were higher (p < 0.0001) than in general population. No significant differences were evidenced according to sex and no correlation with age was observed in any of the items taken into account for insomnia complaints. A high positive intercorrelation was evidenced among the three items that we considered. Various factors associated with insomnia in asthma are discussed.

Four new species of Penicillium Link ex Fries are described and illustrated. All of them but one have been isolated from the atmosphere in Madrid. Spain. They clearly differ from all species of the genus described so far and are, therefore, described and proposed as new taxa: Penicillium aurantio-flammiferum sp. nov., Penicillium gallaicum sp. nov., Penicillium granatense sp. nov., and Penicillium ilerdanum sp. nov.

During a two-year survey on the air-borne fungi in the atmosphere of Barcelona (Spain), the following genera were isolated in decreasing order: Aureobasidium, Rhizopus, Mucor, Arthrinium, Phoma, Fusarium, Trichoderma, and Botrytis.

Six new species of Penicillium Link ex Fries are described and illustrated. Four of them have been recovered from the atmosphere in Madrid, Spain, the other two species were isolated from must and from soil respectively. They clearly differ from all species of the genus described so far and are, therefore described and proposed as new taxa: Penicillium gerundense sp. nov., Penicillium valentinum sp. nov., Penicillium alicantinum sp. nov., Penicillium malacaense sp. nov., Penicillium tarraconense sp. nov., and Penicillium vasconiae sp. nov.

A prospective study on 175 hepatitis HBsAg positive patients was carried out between March 1986 and June 1987 in order to study the epidemiological and clinical aspects of the HVD infection. The global prevalence of this infection was 19.42%, with a statistically relevant predominance amongst intravenous drug addicts (IVDA). Moreover, in most cases it was associated with liver disease (91.17%). Chronic liver disease had a greater incidence amongst HVD positive infected patients and presented more severe clinical and biochemical aspects than other chronic liver diseases without HVD infection. The HVD infection was confirmed in 39.4% of the HBs Ag positive acute hepatitis, being in the majority of the cases delta coinfections with a clinical and biochemical evolution similar to the hepatitis caused by the B virus only. The overinfections evolved to cronicity in all cases. No delta infection occurred amongst immunodepressed patients, and there was an incidence amongst hemophiliacs of 40%. In view of our results, we may conclude that in our community the parenteral route is the main mechanism for the transmission of HVD.

Quantitative and qualitative studies were made of the fungi of the air in Barcelona City. The genera Cladosporium and Alternaria formed two of the most important components of the fungus population studied during a two-year period running from January 1976 through January 1978. Penicillium species formed the 16.3% of the total colonies while Aspergillus species represented only the 2.8%. The occurrence of the genera was greatly affected by climatic conditions. An attempt was made to summariza the data of various kinds of fungi on a volumetric basis. Most of the fungi reported here have been identified as far as genera.

Two cases of sporothricosis originating from the same geographical area (Province of Barcelona) are described, including the circumstances of infection and the isolation of a wild strain of Sporothrix schenckii at the same locality. This finding could classify this particular area as a zone of interest in the epidemiological and ecological study of the mediterranean sporothricosis.

The genus Alternaria Nees formed one of the more important components of the fungus population of the air at Barcelone (Spain), during a two-year study, from February 1976 through January 1978. Results were based only on studied of colonies obtained by gravity-exposed plates. The occurrence of this genus was greatly affected by climatic conditions. In general. however, Alternaria appeared to prefer warmer weather. A total of six species of Alternaria was identified, of which, Alternaria alternata (Fries) Keissler was by far the commonest, representing 71.3% of all colonies.