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Resumen El incremento de la supervivencia del enfermo con cancer, junto con el desarrollo de nuevas terapias antitumorales, han puesto de relieve el impacto negativo que las complicaciones vasculares asociadas con el tratamiento oncohematologico tienen en la salud cardiovascular del paciente con cancer. El objetivo de este documento de consenso, promovido por el Grupo de Trabajo de Cardio-oncologia de la Sociedad Espanola de Cardiologia (SEC) y elaborado conjuntamente con diferentes areas de conocimiento de la SEC junto con la Sociedad Espanola de Hematologia y Hemoterapia (SEHH), la Sociedad Espanola de Oncologia Medica (SEOM), la Sociedad Espanola de Oncologia Radioterapica (SEOR), la Sociedad Espanola de Medicos Generales y de Familia (SEMG), la Asociacion Espanola de Especialistas en Medicina del Trabajo (AEEMT), la Asociacion Espanola de Enfermeria Cardiovascular (AEEC), la Fundacion Espanola del Corazon (FEC) y la Asociacion Espanola contra el Cancer (AECC), es proporcionar un enfoque coordinado, multidisciplinar y practico para la estratificacion, la monitorizacion y el tratamiento del riesgo cardiovascular de los pacientes con cancer.

Resumen Introduccion y objetivos Las anomalias electrocardiograficas son muy comunes. El proposito de este estudio es analizar la prevalencia de hallazgos electrocardiograficos anormales y su significado clinico en la poblacion general espanola de 40 o mas anos. Metodos Subanalisis del estudio OFRECE; se selecciono una muestra representativa de la poblacion espanola de 40 o mas anos. Se dispuso de datos clinicos y electrocardiograma de todos los participantes. La lectura de los electrocardiogramas fue centralizada, los evaluaron de manera independiente 2 cardiologos expertos y se consulto con un tercero en caso de desacuerdo, para llegar al diagnostico final por consenso. Antes de iniciarse la lectura de los electrocardiogramas, se establecieron estrictamente los criterios diagnosticos de cada una de las anomalias analizadas. Se estudiaron la prevalencia y los factores clinicos asociados con: crecimiento de cavidades, trastornos de conduccion, anomalias de la repolarizacion, ondas Q patologicas, extrasistolia auricular y ventricular y preexcitacion. Resultados Se evaluo a 8.343 individuos (media de edad, 59,2 anos; el 52,4% mujeres). Solo 4.074 (51,2%) presentaron un electrocardiograma rigurosamente normal. Las anomalias mas frecuentes fueron las alteraciones inespecificas de la repolarizacion (16%) asociadas con enfermedad coronaria y fibrilacion auricular; el bloqueo de rama derecha (8,1%) asociado con enfermedad pulmonar obstructiva cronica; el hemibloqueo anterosuperior izquierdo (6,5%) relacionado con la hipertension y la insuficiencia cardiaca y el intervalo PR largo (3,7%) se asociaron con enfermedad coronaria. Conclusiones Las anomalias electrocardiograficas son muy comunes en la poblacion general de 40 o mas anos. Tan solo la mitad de la poblacion tenia un electrocardiograma rigurosamente normal.

Both cancer treatment and survival have significantly improved, but these advances have highlighted the deleterious effects of vascular complications associated with anticancer therapy. This consensus document aims to provide a coordinated, multidisciplinary and practical approach to the stratification, monitoring and treatment of cardiovascular risk in cancer patients. The document is promoted by the Working Group on Cardio Oncology of the Spanish Society of Cardiology (SEC) and was drafted in collaboration with experts from distinct areas of expertise of the SEC and the Spanish Society of Hematology and Hemotherapy (SEHH), the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Radiation Oncology (SEOR), the Spanish Society of General and Family Physicians (SEMG), the Spanish Association of Specialists in Occupational Medicine (AEEMT), the Spanish Association of Cardiovascular Nursing (AEEC), the Spanish Heart Foundation (FEC), and the Spanish Cancer Association (AECC). (C) 2020 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Background: Anthracycline cardiotoxicity (AC) may manifest years after treatment (long-term cardiotoxicity). There is little data on the incidence and natural history of AC in the current context, with protocols including lower anthracycline doses. The present study prospectively evaluated the incidence, time of occurrence and clinical correlates of long-term cardiotoxicity and the evolution of systolic function in patients with breast cancer treated with anthracyclines. Methods: This study prospectively included 85 consecutive patients undergoing chemotherapy (CHT) with anthracyclines without trastuzumab. All patients underwent evaluation at baseline, at the end of CHT, 3 months after the end of CHT and 1 and 4 years subsequent to the beginning of CHT. Clinical data and echocardiographic parameters were evaluated in all examinations. Results: The mean dose of doxorubicin used was 243.53 mg/m 2 . Median follow-up of the current cohort was 4.5 years. At 1 year the incidence of AC was 1% and at the end of the follow-up 16.5% (14 of 85 patients). Therefore, the incidence of long-term cardiotoxicity was 15%. Of these 14 patients with AC, 12 had asymptomatic systolic dysfunction, 1 had heart failure and 1 suffered sudden death. Fifteen percent developed systolic dysfunction during follow–up. An early decline in strain was observed in patients who developed long-term AC. Conclusions: The incidence of long-term cardiotoxicity in patients treated with low-cumulative dose of anthracyclines is high, 16.5% at 4.5 years. This was observed in almost all cases after the first year of follow-up. Therefore, long-term monitoring may be advisable.

Anthracycline cardiotoxicity (AC) may manifest years after treatment (long-term AC). There are few data on the incidence and natural history of AC in the current context. We evaluated incidence, onset time and clinical correlates of long-term AC and the evolution of systolic function in patients (

Introduction and objectives Abnormal electrocardiographic findings are highly common. The aim of this study was to analyze the prevalence of abnormal electrocardiographic patterns in the general Spanish population aged 40 years or older. Methods This subanalysis of the OFRECE study selected a representative sample of the Spanish population aged 40 years or older. Clinical data and electrocardiograms were available in all participants. The electrocardiograms were read centrally. Each electrocardiogram was independently assessed by 2 trained cardiologists and, if there was disagreement, a third was consulted to reach a consensus-based diagnosis. Prior to reading the electrocardiograms, diagnostic criteria were strictly defined for each of the abnormalities analyzed. We analyzed the prevalence and clinical factors associated with cavity enlargement, conduction disorders, repolarization abnormalities, pathological Q waves, atrial and ventricular premature beats, and pre-excitation. Results A total of 8343 individuals were evaluated, (mean age, 59.2 years; 52.4% women). Only 4074 (51.2%) participants had a completely normal electrocardiogram. The most frequent abnormalities were nonspecific repolarization abnormalities (16%) associated with coronary heart disease and atrial fibrillation; right bundle-branch block (8.1%) associated with chronic pulmonary obstructive disease; left anterior hemiblock (6.5%) related to hypertension and congestive heart failure; and long PR interval (3.7%), which was associated with coronary heart disease. Conclusions Electrocardiographic abnormalities are very common in the general population aged 40 years or older. Only about half of the population had a completely normal electrocardiogram.

[Resumen] Introducción y objetivos: Hay patrones electrocardiográficos asociados a mayor riesgo de muerte súbita por arritmias ventriculares. En España no existe información acerca de su prevalencia en la población. El objetivo es estudiar la prevalencia de estos patrones, así como los factores clinicoepidemiológicos asociados a su presencia. Métodos: Subanálisis del estudio OFRECE en el que se estudió la prevalencia de patrones electrocardiográficos de síndrome de Brugada o anomalías del intervalo QT en una muestra representativa de la población española ≥ 40 años. Se dispuso de datos clínicos y electrocardiogramas de todos los participantes. Los electrocardiogramas fueron evaluados de forma independiente por 2 cardiólogos y, en caso de desacuerdo, se consultó con un tercero. Se analizaron las prevalencias ponderadas y los factores clínicos asociados a patrones tipo Brugada o a anomalías del segmento QT. Resultados: Se evaluó a 8.343 individuos (59,2 años, 52,4% mujeres) y se detectaron 12 casos de patrón Brugada (tipo 1, 2 casos; tipo 2, 10 casos; prevalencia ponderada, 0,13%). Para el análisis del QT corregido (QTc) se excluyó a los participantes con bloqueo de rama izquierda o ritmos no sinusales. Las prevalencias ponderadas fueron: QTc corto (< 340 ms) 0,18%, QTc borderline (441-469 ms) 8,33%, QTc largo (criterio ≥ 470 ms) 1,01% y QTc largo (criterio ≥ 480 ms) 0,42%. Conclusiones: El 0,6-1,1% de la población española de edad ≥ 40 años presenta un patrón electrocardiográfico de riesgo de muerte súbita (síndrome de Brugada, QT largo o QT corto). [Abstract] Introduction and objectives: Some electrocardiographic patterns are associated with an increased risk of sudden cardiac death due to ventricular arrhythmias. There is no information on the prevalence of these patterns in the general population in Spain. The objective of this study was to analyze the prevalence of these patterns and associated clinical and epidemiological factors. Methods: This subanalysis of the OFRECE study selected a representative sample of the Spanish population aged ≥ 40 years. We studied the presence or absence of electrocardiographic patterns of Brugada syndrome and QT interval abnormalities. Clinical data and electrocardiograms were available in all participants. Electrocardiograms were evaluated by 2 cardiologists and a third cardiologist was consulted if there was disagreement in the diagnosis. We calculated the weighted prevalence and clinical factors associated with the presence of Brugada-type patterns or QT segment abnormalities Results: Overall, 8343 individuals were evaluated (59.2 years, 52.4% female). There were 12 Brugada cases (type 1, 2 cases; type 2, 10 cases; weighted prevalence, 0.13%). For corrected QT (QTc) analysis, we excluded participants with left bundle branch block or without sinus rhythm. Weighted prevalences were as follows: short QTc ( < 340 ms) 0.18%, borderline QTc (441-469 ms) 8.33%, long QTc ( ≥ 470 ms criterion) 1.01% and long QTc ( ≥ 480 criterion) 0.42%. Conclusions: A total of 0.6% to 1.1% of the Spanish population aged ≥ 40 years has an electrocardiographic pattern associated with a higher risk of sudden death (Brugada syndrome, long QT, or short QT).

Annular pancreas is a rare congenital disorder that results in a ring of pancreatic parenchyma that surrounds the second portion of the duodenum, and it usually presents in newborns and infants. When the constriction is severe enough to cause obstruction it usually presents itself in newborns and infants with symptoms of gastric outlet obstruction, and is associated with other congenital abnormalities. When the constriction is not severe enough, it usually passes unnoticed to adulthood. Most cases remain asymptomatic for life, and when symptomatic it is rarely diagnosed. We present a case of an annular pancreas in an adult that developed severe symptoms that required surgical management.

La revascularizacion coronaria es una intervencion terapeutica plenamente consolidada y, por tanto, incluida en todas las estrategias de tratamiento de los pacientes con enfermedad coronaria. A pesar de sus mas de 40 anos de desarrollo, los continuos avances tecnicos, tanto de la revascularizacion quirurgica como de la percutanea, hacen que cada vez haya mas grupos de pacientes en los que se ha demostrado su utilidad. Por tanto, es necesario actualizar periodicamente sus indicaciones y limitaciones. El objetivo de la revascularizacion es mejorar el pronostico o la sintomatologia y calidad de vida de los pacientes con cardiopatia isquemica. La revascularizacion comprende 2 aspectos: 1) la indicacion y seleccion del tipo de revascularizacion y 2) la intervencion revascularizadora. En el primero, la participacion del cardiologo clinico es fundamental. Su mision consiste en detectar y seleccionar, sobre la base de datos clinicos, funcionales y anatomicos, a los pacientes que se pueden beneficiar de la revascularizacion, asi como ayudar en la seleccion de la tecnica. En este articulo de «Puesta al Dia» sobre revascularizacion se revisaran, referidos a la cardiopatia isquemica estable y al sindrome coronario agudo sin elevacion del ST: 1) los aspectos clinicos mas relevantes que es necesario considerar en la valoracion de la necesidad o el tipo de revascularizacion (edad, genero, diabetes, funcion renal, alteraciones electrocardiograficas, funcion ventricular, cuantificacion de la importancia funcional de la enfermedad coronaria o el grado de viabilidad de areas acineticas); 2) las indicaciones, tanto de la cirugia como de la angioplastia coronaria, y la estrategia terapeutica de acuerdo con las ultimas evidencias y recomendaciones de las sociedades cientificas, y 3) los datos disponibles en el momento actual sobre la controversia de la seleccion del tipo de revascularizacion en los pacientes con enfermedad multivaso

Los estudios publicados desde 1999 que compararon una estrategia invasiva moderna (con disponibilidad de stent y nuevos antitromboticos) y conservadora (invasive selectiva) en los pacientes con sindrome coronario agudo sin elevacion del ST han demostrado que la estrategia invasive disminuye, a largo plazo, la incidencia de muerte o infarto y mejora la evolucion clinica en los pacientes de alto riesgo, aunque durante la hospitalizacion aumenta levemente las complicaciones isquemicas. El momento de realizar la coronariografia es controvertido, aunque la mayoria de las guias recomiendan que se haga en las primeras 48 h. Los pacientes que mas se benefician son los que presentan cambios en el ST, elevacion de troponinas o diabetes. Los de bajo riesgo con ambas estrategias tienen resultados similares. El beneficio de la estrategia invasiva se atribuye a la revascularizacion mecanica, pero tambien al uso de los nuevos antitromboticos (clopidogrel e inhibidores de la glucoproteina IIb/IIIa). La utilizacion de clopidogrel esta recomendada por la mayoria de las guias, aunque el momento de su aplicacion es objeto de controversia y los datos mas recientes indican que parece preferible la heparina no fraccionada si se planifica una estrategia invasiva. La administracion precoz de inhibidores de la glucoproteina IIb /IIIa (tirofiban o eptifibatida) esta indicada. En los casos en que la coronariografia se realiza tempranamente (menos de 2,5-6 h), el uso de abciximab o eptifibatida en el laboratorio de hemodinamica, una vez conocida la anatomia coronaria, parece una estrategia razonable.

Background: abnormal electrocardiograms (EKG) are very common in clinical practice. We want to analyze the prevalence of abnormal EKG patterns in a Caucasian population ≥ 40 years and clinical factors related to them. Methods: A cross-sectional study endorsed by the Spanish Society of Cardiology

Introduccion y objetivos. Tras la angioplastia con balon convencional, la incidencia de reestenosis es elevada en las lesiones del segmento proximal de la arteria descendente anterior, por lo que se ha recomendado alternativamente el empleo electivo del stent . El objetivo de este estudio fue analizar los principales factores clinicos y anatomoangiograficos relacionadas con el resultado a corto plazo de la dilatacion sobre lesiones en el segmento proximal de la arteria descendente anterior con y sin implante de stent . Material y metodos. Estudiamos a 87 pacientes dilatados con exito por estenosis severa ( 3 70%) del segmento proximal de la arteria descendente anterior. En 54 pacientes (62%) se utilizo solo balon (grupo A) y en 33 (38%) se implanto un stent (grupo B). Resultados. La edad media fue de 61,9 ± 12 anos, el 74% eran varones y se efectuo revascularizacion por angina inestable en el 72%. Al final del periodo de seguimiento (media 6,3 ± 1,5 meses), un 21% de pacientes en el grupo B tenian angina frente a un 54% de pacientes en el grupo A (p = 0,03). La incidencia de reestenosis (el 30 frente al 50%; p = 0, 07) y la necesidad de una nueva angioplastia coronaria transluminal percutanea (el 21 frente al 33%; p = NS) fueron tambien menores en el grupo B. Estos resultados se mantuvieron independientemente del calibre del vaso ( 3 3 mm) o de la obtencion de un resultado optimo (£ 25%) tras la angioplastia con balon. Conclusiones. En la poblacion estudiada, la implantacion de un stent en lesiones localizadas en el segmento proximal de la arteria descendente anterior parece comportar un mejor pronostico clinico y angiografico a corto plazo, con una menor incidencia de reestenosis, frente a la angioplastia con balon, a pesar de un resultado optimo e independientemente del tamano del vaso. Seran necesarios futuros estudios para confirmar estos resultados.

This multicenter prospective study was performed to determine risk factors for knee prosthesis infection and the effect of timing doses of prophylactic low-molecular-weight heparins (LMWH) related to time of surgery on the risk of knee prosthesis infection. A total of 5496 consecutive patients who underwent total knee arthroplasty from 2005 to 2006 in 13 orthopedic centers were prospectively followed up for 6 months, and the incidence of knee prosthesis infection was recorded. A case control study was nested in the cohort. Case patients were matched to uninfected (control) patients, and the timing of perioperative LMWH was recorded as the main risk factor. Fifty patients developed postoperative knee prosthesis infection during the follow-up period, yielding an incidence of prosthesis infection of 0.91% (95% CI, 0.68%–1.20%). Forty-four patients were matched to 106 controls. Case patients received the first LMWH dose ±12 hours from the start of surgery more frequently than their control counterparts (odds ratio, 1.5; 95% CI, 0.73–3.0). After adjusting by main risk factors, no statistical association was found between close perioperative timing of LMWH and risk of prosthesis infection. Diabetes mellitus (adjusted odds ratio, 3.2; 95% CI, 1.2–8.8) and wound hematoma (adjusted odds ratio, 4.2; 95% CI, 1.1–16.5) were found to be independent risk factors for prosthesis infection.

We present a case of tuberculous peritonitis in a woman with rheumatoid arthritis (RA), treated with adalimumab, and we review the association between anti-tumour necrosis factor (anti-TNF) therapy and tuberculosis. There have been only 2 case reports of peritoneal tuberculosis associated with anti-TNF , and only 1 with adalimumab.

The maximum entropy principle is used to obtain a new analytic extrapolation method just complementary to the Pade‐type method which leads to rigorous upper and lower bounds on the extrapolated function on the cut complex plane. Among the large class of functions that could equally well represent an analytical function in the experimental region a choice is made of the unique function that maximizes the entropy functional associated to this set of functions. The result is the least biased function compatible with the actual experimental data. This extrapolation method is applied to kaon–nucleon experimental data in order to obtain the most reasonable values for the KNY coupling constants compatible with the available experimental data and analytical constraints.

To know the number of patients that are admitted in the hospital with TED or those who have developed it during their stay, analyzing how to manage this disease and make a basis for a prospective study of this disease.It is a descriptive and retrospective study of TED diagnosed patients during their stay at the Hospital Clínico San Carlos of Madrid for a 6 month period. Data related with epidemiologic records, diagnosis, treatment and complications of patients with Deep-Vein Thrombosis (DVT), Pulmonary Thromboembolism (PTE) or both (DVT+PTE) are collected.From October 1st of 2003 to March 31st of 2004, 239 patients were diagnosed with TED (64 DVT, 125 PTE y 51 DVT + PTE) when they were discharged from our hospital, with an average age of 73.2 years (standard desviation 13.64). We classify as risky factors with significative statistical differences chemotherapy, acute myocardium infarction and obesity. It has not been found any relation between the treatment used and the development of hemorrhage. Patients with previous episodes of TED had more frequent hemorrhagies than those without such records. Hypokinesia in the right ventricle shown on the echocardiogram supposed a gloomy prognosis of the death for TED as well as the development of DVT + PTE.In more than a 50% of patients, TED was PTE and more than a 60% were women. It is important to obtain information about these patients because 2/3 of them are admitted to internal medicine. Chemotherapy, AIM and obesity were factors significatively associated to DVT, PTE and DVT + PTE. Hypokinesia in the right ventricle shown on the echocardiogram supposed a gloomy prognosis for TED as well as the development of DVT + PTE.

Endocarditis due to Listeria monocytogenes is a very uncommon and very serious disease that may lead to valve dysfunction and cardiac arrest. We report two cases of endocarditis caused by L. monocytogenes and review the papers previously published on the subject.

Objetivo: Conocer el numero de pacientes que ingresan o que desarrollan durante su ingreso en un hospital ETEV, analizar el manejo de esta enfermedad y sentar las bases para un estudio prospectivo de dicha enfermedad. Metodos: Se trata de un estudio descriptivo retrospectivo de pacientes diagnosticados de ETEV durante su ingreso en el Hospital Clinico San Carlos de Madrid en un periodo de 6 meses. Se recogen los datos relacionados con antecedentes epidemiologicos, diagnostico, tratamiento y complicaciones de los pacientes con trombosis venosa profunda (TVP), tromboembolismo pulmonar (TEP) o ambas (TVP + TEP). Resultados: Del 1 de octubre de 2003 al 31 de marzo de 2004, 239 pacientes fueron diagnosticados de ETEV (64 TVP, 125 TEP y 51 TVP + TEP) al alta en nuestro hospital con una edad media de 73,2 anos (desviacion estandar 13,64). Como factores de riesgo con diferencias estadisticamente significativas detectamos la quimioterapia, el infarto agudo de miocardio y la obesidad. No se ha observado relacion entre el tipo de tratamiento utilizado y la aparicion de hemorragia. Los pacientes con episodios previos de ETEV presentaron hemorragias mas frecuentemente que aquellos sin dichos antecedentes. La hipocinesia de ventriculo derecho en el ecocardiograma fue un factor de mal pronostico para la muerte por ETEV asi como la aparicion de TVP + TEP. Conclusion: En mas del 50% de los pacientes la ETEV era TEP y mas del 60% eran mujeres. Es importante disponer de informacion sobre estos pacientes, ya que 2/3 ingresan en medicina interna. La quimioterapia, el IAM y la obesidad fueron factores que se asociaron a TVP, TEP y TVP + TEP de forma significativa, respectivamente. La hipocinesia de ventriculo derecho en el ecocardiograma fue un factor de mal pronostico para la muerte por ETEV asi como la coincidencia de TVP + TEP.

Coronary artery revascularization is an established therapeutic intervention and is therefore included in all treatment guidelines for patients with coronary artery disease. Although the procedure has been available for more than 40 years, constant technical progress in surgical and percutaneous revascularization continues to bring the benefits of revascularization therapy to new groups of patients. Therefore the indications and limitations of this approach need to be reviewed and updated periodically. The aim of revascularization therapy is to improve the prognosis or symptoms and quality of life in patients with ischemic heart disease. The revascularization process comprises two aspects: 1 ) indication and selection of the revascularization procedure, and 2 ) performance of the procedure. Involvement of the clinical cardiologist in the first step is fundamental. Basing their decisions on clinical, functional and anatomical features, these professionals detect and select patients who would benefit, and also help to select the revascularization technique. In this Update article on revascularization we review, for stable ischemic heart disease and non-ST segment elevation acute coronary syndromes, the following: 1 ) the most relevant aspects to consider when evaluating the need for and the type of revascularization (age, sex, diabetes, renal function, electrocardiographic changes, ventricular function, and quantification of functional relevance of coronary artery disease and viability of the acinetic areas); 2 ) indications for surgical or percutaneous intervention, and the choice of therapeutic strategy according to the latest clinical evidence and guidelines of scientific societies; and 3 ) currently available data on the controversy regarding choice of the revascularization procedure in patients with multivessel disease.

To evaluate the comprehension level of the information provided to patients and relatives attending an emergency department and to know their satisfaction degree.A cross-sectional descriptive study was designed. The selection of study patients was made by means of a simple randomized sampling and the total of patients was 213. At discharge, these patients and their relatives answered a written, anonymous questionnaire. To evaluate the comprehension of the information provided, the questionnaire responses were checked against the clinical records.The self-identification of the health care providers, information on the estimated length of stay at the ED, the explanation of complementary tests and their results significantly determined the satisfaction score on the provided information, which for the patients was 6.3 on a 10-point scale. The percentages of patients who were knowledgeable of the performed tests, diagnosis, and administered treatment were 61.5%, 50.7%, and 35.2%, respectively. Understanding the diagnosis and the administered treatment differed according to age (p0.001) and the assimilation of the information on recommendations at patients's discharge differed according to the education level (p0.05).The self-identification of health care personnel would allow for a better bi-directional information flow. Given the socio-cultural characteristics of our population, the information provided should be clear and concise. The transmission of information to most emergency department users would be best achieved with previous information of the workflow at the emergency department in the form of booklets at the entrance, and also establishing protocols for the informed consent on different diagnostic and treatment techniques inherent to emergency care.

a) to determine the prevalence of anti-ribosomal P antibodies in patients with ESL in our setting; b) to determine if there are associations between clinical signs of ESL and these autoantibodies; c) to analyze if there is any correlation between the presence of anti-P in patients with ESL and the results of other routine lab tests; and d) to assess the usefulness of implementing as routine test the determination of anti-P antibodies.The study included 60 patients diagnosed of ESL and 61 healthy subjects as the control group. ELISA was used to determine anti-ribosomal antibodies. Chi-square, Fisher and Student t tests were used for the statistical analyses.Of the 60 patients with SLE, 29 (48%) had anti-P antibodies as determined by ELISA. No association was observed between the presence of anti-P antibodies and psychosis, depression, hepatic failure, renal failure or any other clinical signs of ESL. A correlation was found between the levels of anti-P antibodies as determined by ELISA and anti-histone, ANA and AMA antibodies.The prevalence of anti-P antibodies was high among our ESL patients (48%). Their presence was not significantly associated with any clinical sign; however, an association was found with other lab markers related to the presence of active disease.

Objetivos: a) determinar la prevalencia de anticuerpos anti-ribosomales P en pacientes con LES en nuestro medio; b) averiguar si existen asociaciones entre manifestaciones clínicas en el LES y estos autoanticuerpos; c) analizar si existe correlación entre la presencia de anti-P en pacientes con LES y otros parámetros de laboratorio determinados habitualmente, y d) valorar la utilidad de introducir, como determinación habitual los anticuerpos anti-P. Material y métodos: Se incluyeron en el estudio 60 pacientes diagnosticados de LES y 61 individuos sanos como grupo control. La determinación de anticuerpos anti-ribosomales se realizó mediante ELISA. En el análisis estadístico se utilizaron los test de Chi-cuadrado, Fisher y t de Student. Resultados: De los 60 pacientes con LES, 29 (48%) tenían anticuerpos anti-P mediante ELISA. No se observó asociación entre la presencia de anticuerpos anti-P y psicosis, depresión, afectación hepática, afectación renal o cualquier otra manifestación clínica del LES. Se encontró correlación entre los niveles de anticuerpos anti-P determinados por ELISA y los anticuerpos anti-histonas, ANA y AMA. Conclusiones: La prevalencia de los anticuerpos anti-P en nuestros enfermos de LES es elevada (48%). Su presencia no se asoció significativamente con ninguna manifestación clínica, pero sí con otros marcadores de laboratorio relacionados con la presencia de enfermedad activa.

We describe the first case reported in the literature of liver abscess due to Lactococcus lactis cremoris in an immunocompetent adult patient. The patient was treated with catheter drainage and antibiotics, which resulted in improvement and resolution.

We analysed the prevalence of clinical manifestations and immunological parameters in 194 patients with SLE and classified them in subgroups according to age at onset, gender and type of antibodies: we detected significant differences in the various subgroups. In SLE that initiated before the age of 20 years, the most frequent manifestation at onset was malar rash (25% vs 14%). During the course of the disease, this group had a greater prevalence of malar rash (70% vs 45%), mouth ulcers (48% vs 29%), and convulsions or psychosis (35% vs. 17%). In SLE that initiated late in life (after 50 years) malar rash was less frequent at onset and during subsequent evolution of the disease (27% vs 45%). The existence of ANA, and elevated values of anti-dsDNA, anti-ENA and antiphospholipid antibodies also differentiated the SLE subgroups with clinical significance.

Fundamento : Estudiamos la presencia de anticuerpos anti-s2-glucoproteina I (anti-s2GPI) en pacientes con lupus eritematoso sistemico (LES) relacionandolos con anticuerpos anticordiolipina (AAC) y manifestaciones clinicas asociadas a anticuerpos antifosfolipido (AAF). Pacientes y metodo : Se incluyo a 63 pacientes con LES y 54 controles. Se determinaron anticuerpos anti-s2GPI mediante enzimoinmunoanalisis. Resultados : Un total de 25 (40%) pacientes con LES y un control (2%) tenian anticuerpos anti-s2GPI (p Conclusiones : Los anticuerpos anti-s2GPI son mas frecuentes en el LES y mas prevalentes en pacientes con AAC. Existe asociacion entre trombosis y AAC, pero la asociacion entre trombosis y anticuerpos anti-s2GPI no fue significativa.

Hematologic alterations are frequent in SLE. The hematologic changes of 111 patients diagnosed as suffering from SLE are described, associating them to 89 clinical, biological and hystological variables. The most frequent alteration was normocytic and normochromic anemia. Coombs positive hemolytic anemia appeared in 10% of the cases. Approximately 20% of patients had leukopenia. Lymphopenia was observed during the active period of the disease. Mild thrombocytopenia is common, as well as quality changes of the platelets. The sedimentation rate is high in nearly all patients with SLE and this is a non-specific index of the disease activity. These changes have seldom been described in our area.

The appearance of chorea due to systemic lupus erythematosus is extremely rare. A greater frequency of circulating anticoagulant, false positive luetic serology and antiphospholipid antibodies has been recently detected in these patients. For this reason, it has been postulated that these could be involved in the genesis of the chorea through a thrombotic mechanism or autoimmune encephalitis. We describe a case or chorea in a female patient with systemic lupus erythematosus.

Presentamos un caso de rotura coronaria encapsulada tras implantacion de un stent en la anastomosis distal de un injerto de safena a descendente anterior que evoluciono satisfactoriamente con tratamiento conservador. El paciente no requirio pericardiocentesis y fue manejado con inflados prolongados a baja presion en el punto de rotura. La cirugia coronaria previa con sus efectos sobre elpericardio limito la extravasacion de sangre a estacavidad y, por tanto, la repercusion hemodinamica.

Positivity and unimodality hypotheses on an unknown function χ1(x) confer Stieltjes character to another function H1(z), known in a discrete set of real points and affected by errors caused by experimental measurements, and impose constraints on the coefficients of its formal expansion which limit the universe of approximant functions, so acting as stabilizers of the analytic extrapolation. The type I Pade approximants, built with the coefficients of the formal expansion, provide rigorous bounds on the function in the cut complex plane. The application of a Stieltjes–Chebyshev technique allows approximations to the function, even on the cut, to be obtained. The physical problem of K±p forward elastic scattering is approached by the previous method, and bounds on the coupling constant and real part of the amplitude are found.

A patient with systemic lupus erythematosus (SLE) who developed disseminated intravascular coagulation during the beginning of SLE is presented. No other cause responsible for the producing of DIC was found. After treatment with corticoids, and cyclophosphamide the DIC was rapidly settled. This case supports the need for a complete blood test in patients with SLE who show coagulation alterations.