Search

Background and Objectives: In the developed world, pellagra is a rare condition that is restricted to a small number of at-risk groups. It mainly affects alcoholic patients and those with dietary deficiencies, with intestinal malabsorption, or in treatment with certain drugs. The aim of this study was to analyze the clinical, histopathological, and epidemiological characteristics of patients diagnosed with pellagra in our hospital and to compare the results with the findings traditionally described for this disease., Patients and Methods: We undertook a retrospective study of patients with clinical or pathological evidence of pellagra who were seen in our hospital between 1998 and 2009., Results: Seven patients met the inclusion criteria. All were men and the most common predisposing factors were alcoholism and dietary deficiency. All exhibited photosensitivity mainly affecting the forearms and the upper surface of the feet, where the lesions were more severe. The most consistent histopathological findings were the presence of dilated blood vessels with extravasation and little or no inflammatory infiltrate. Various changes were observed in the epidermis, including those suggestive of mild pellagra, such as epidermal pallor and some degree of ballooning of the keratinocytes. Other abnormalities such as epidermal necrosis and hyperkeratosis were also observed. In most patients, pellagra was not initially suspected. Additional noncutaneous findings were observed in almost all cases., Conclusions: Pellagra should be ruled out in patients with lesions on sun-exposed areas. Predisposing factors for pellagra should be assessed along with the social situation of patients and the presence of digestive or neurological abnormalities., (Copyright © 2010 Elsevier España, S.L. and AEDV. All rights reserved.)

The A Coruña University Hospital Complex is developing an expert system to improve the decision support for transplanted patients. The system will access the data collected during the monitoring of patients and generate a database of statistics that will aid health professionals in several stages of the transplant process. All historical data will be revised to give an estimation of the patient's parameters evolution depending on his medical record and his actual treatment. We will use two different machine learning techniques to do both clustering and classification.

Background: High rates of missing, non-applicable items and insufficient reliability have been frequently reported as limitations of the generic Quality of Life questionnaires for older patients. The Nottingham Health Profile (NHP) might be more suitable as it contains easy to respond (yes/no) items covering moderate-to-severe health deterioration., Objectives: To assess feasibility, reliability and validity of the NHP in disabled, older patients., Design: Cross-sectional study., Setting: Acute care hospital., Subjects: 134 inpatients aged >or=65 with severe disability, abnormal cognitive function, or other persistent health problems precluding their discharge., Methods: The (interviewer-administered) NHP, Mini-Mental State Examination (MMSE), Barthel Index, and diagnostic information were recorded., Results: Completion rates varied from 98% of the 49 patients with normal cognition (MMSE >or=21) and 86.3% of the 51 with moderate cognitive impairment (MMSE 10-20), to 5.9% of the 34 with severe cognitive impairment (MMSE<10). Cronbach's alpha of the total NHP score was near 0.9 (0.82 and 0.87 for patients with MMSE >or= 21 and 10-20, respectively; p = 0.291). The correlation between 'Physical Mobility' of the NHP and Barthel Index was also similar in both cognitive groups (0.39 and 0.40)., Conclusion: Interviewer-administered NHP is suitable, reliable and valid, even in patients with moderate cognitive function.