Knowledge about Cervical Cancer Prevention and Screening in Women with Cervical Cancer Attending Gynecological Services in Southern Mozambique

BACKGROUND

Mozambique has high rates of cervical cancer and cancer-related deaths among women. A high rate of refusal and low acceptance of treatment is observed among cervical cancer patients. The extent of their knowledge of the disease is unknown.

OBJECTIVES

To assess knowledge about this disease (prevention, risk factors, and the possibilities of early diagnosis) in women with cervical cancer attended in gynecological services in Gaza province, Mozambique.

MATERIALS AND METHODS

This cross-sectional study took place in the city of Xai-Xai at the Provincial Hospital of Xai-Xai (HPXX) in the southern province of Gaza (Mozambique). Non-probability convenience sampling was used. Eligible patients (women) aged 35-50 years, diagnosed with cervical cancer and followed at the HPXX in the second quarter of 2021 (n = 60), took part in the survey during their scheduled consultations. Descriptive statistics were calculated using SPSS statistical software (version 16).

RESULTS

The study included 60 women, 39 (65%) HIV positive. More than half (55.0%) believed that having a single sexual partner was an effective form of prevention; 50.0% reported that excessive alcohol consumption and having many sexual partners could cause the disease, and 46.7% affirmed that having many children increased the risk. Thirty-eight (63.3%) women reported that early diagnosis of cervical cancer was important for receiving prompt treatment, and 54 (90.0%) said regular visits to the gynecologist were important for an early diagnosis. Thirty-five (58.3%) mentioned acetic acid screening as a diagnostic test.

CONCLUSIONS

There are significant gaps in awareness of cervical cancer among high-risk groups.

[Estimating the number of COVID-19 cases using a web-based tool: Results from the first week of the 'Covid-19 Trends' project in the Basque Country]

OBJECTIVE

In the Basque Country, two cases of COVID-19 were diagnosed on February 28 2020. On March 14, the Spanish Government established a state of alarm. Only cases confirmed by molecular biology (reverse-transcriptase polymerase chain reaction [RT-PCR]) were known. We launched a web-based surveillance tool to estimate the number of symptomatic cases of COVID-19 to contribute to Public Health decision-making.

MATERIAL AND METHODS

We implemented an anonymous web questionnaire and disseminated it through online social media social. We collected epidemiological information about «time» (date of onset of symptoms), «place» (zip code), and «person» (gender, age). We compared cases detected by RT-PCR with the estimated cases, according to the case definition of the Ministry of Health. We calculated the questionnaire response rate and the cumulative incidence at 14days.

RESULTS

Between March 19 and 26, 128,009 people answered the questionnaire (5.5% of the Basque population). Of these, 26,375 met the case definition (symptom prevalence of 21.4%). The estimated cases were almost six times more than COVID-19 positive RT-PCR. The estimated 14-day cumulative incidence was 578.3 per 100,000 population compared to RT-PCR positive cases, which was 139.6 per 100,000 population.

CONCLUSIONS

This tool was useful in estimating the minimum number of symptomatic cases in the Basque Country, which could support Public Health actions.

Bed 13 is not worse than any other. A retrospective cohort study

INTRODUCTION

Risk management and patient safety are closely related, following this premise some industries have adopted measures to omit number 13. Healthcare is not left behind, in some hospital the day of surgery's or bed numbering avoid number 13. The objective was to assess whether it is necessary to redesign the safety policies implemented in hospitals based on avoiding 13 in the numbering of rooms/beds.

METHODS

A retrospective cohort study was conducted. Mortality and the number of adverse events suffered by patients admitted to rooms/beds numbering 13 (bad chance) or 7 (fair chance) over a two-year period to Intensive Care Unit, Medicine, Gastroenterology, Surgery, and Paediatric service were registered and compared.

RESULTS

A total of 8553 admissions were included. They had similar length-of-stay and Charlson Index scores (p-value=0.435). Mortality of bed 13 was 268 (6.2%, 95% CI 5.5-6.9) and 282 in bed 7 (6.7%, 95% CI 5.9-7.5) (p-value=0.3). A total of 422 adverse events from 4342 admissions (9.7%, 95% CI 8.9-10.6) occurred in bed 13, while in bed 7 the count of adverse events was 398 in 4211 admissions (9.4%, 95% CI 8.6-10.4) (p-value=0.6). Odds Ratio for mortality was equal to 0.9 (95% CI 0.8-1.1) and suffering adverse events when admitted to bed 13 versus bed 7 was 1.03 (95% CI 0.9-1.2).

CONCLUSIONS

Bed 13 is not a risk factor for patient safety. Hospitals should pay attention to causes and interventions to avoid adverse events based on evidence rather than beliefs or myths.

[Incomplete POEMS syndrome with multicentric Castleman's disease]

Castleman's disease (CD) is an atypical lymphoproliferative disorder of unknown cause, characterized by non-clonal nodal hyperplastic growth. Two forms of clinical presentation are currently recognized, one localized and the other multicentric, and four histopathologic variants. It is characterized by generalized lymphadenopathy, hepatosplenomegaly, fever and night sweats. CD may present severe pancytopenia, multi-organ failure, lymphoma evolution and it can sometimes be associated with paraneoplastic syndromes such as POEMS syndrome. Associations of these two entities have been widely described in the current literature, although its less common association with amyloidosis is described as isolated clinical cases. We report a case with this triple association: EC, POEMS and amyloidosis.

Mycological profile of tinea capitis in schoolchildren in rural southern Ethiopia

Tinea capitis is a known common infection among schoolchildren in developing countries that is still underreported in Ethiopia. The aim of this study was to examine the epidemiologic and etiologic profile of tinea capitis among school-aged children in a rural area in southern Ethiopia. We collected demographic and clinicodermatological data from school children aged 3-12 years with tinea infections. Pathologic specimens were taken for potassium hydroxide (KOH) mount and mycological culture. Dermatophyte species were identified by macroscopic examination of the colony and microscopic examination of fungal cultures. A total of 634 schoolchildren were screened in the study; 128 cases were suspected for tinea capitis based on clinical examination of which 99 patients (mean age 6.7 years within a range of 4-12 years), who were subsequently positive, either based on KOH examination or showed growth of dermatophytes on culture, were included in our study. The ratio of males to females was 3:1. A total of 88 patients (89.9%) had a culture positive for dermatophytes. The zoophilic species Trichophyton verrucosum was the most prevalent isolate (n = 29 cases), followed by the anthropophilic species T. tonsurans (n = 27). The other Trichophyton species implicated were T. mentagrophytes (n = 14), as well as T. schoenleinii, T. soudanense, and T. violaceum. Only 11 of the isolates belonged to the genus Microsporum: M. audouinii (n = 8), M. ferrugineum (n = 2), and M. gallinae (n = 1). T. verrucosum, followed by T. tonsurans were the most frequent causative agents in this study.

Improved detection of mixed P. falciparum-P. vivax infection at a rural health centre in Ethiopia using PCR

This study aims to this study is to compare the co-infection Plasmodium falciparum + Plasmodium vivax and compare the detection of cases of mixed-species malaria using light microscopy versus semi-nested multiplex PCR (sPCR). Investigators collected 3060 samples at a rural health centre in Ethiopia from December 2010 to October 2011. Two capillary blood specimens were taken from each patient, one for diagnosis of Plasmodium infection by light microscopy and the other for sPCR-based diagnosis. LM detected 627 positive cases; these samples, together with 582 negatives by LM, were also subjected to sPCR testing. Of the 627 positive samples by LM, 68.4% were positive for P. vivax, 30.5% for P. falciparum, and 1.1% for P. falciparum + P. vivax co-infection. Using the sPCR technique, we identified 788 samples positive for Plasmodium: 33.0% for P. vivax, 26.5% for P. falciparum, 3.7% for P. falciparum + P. vivax co-infection, 2.0% for P. ovale and 0.8% for P. vivax + P. ovale co-infection. In the case of P. falciparum + P. vivax co-infection, light microscopy diagnosis showed a sensitivity of 11.1%, a specificity of 99.8%, a positive predictive value of 71.4% and a negative predictive value of 96.6%. The concordance rate for identifying P. falciparum + P. vivax co-infection (kappa statistic) with microscopy and sPCR was 0.184. The LM approach has low sensitivity for the detection of mixed-species infections, while sPCR is more useful.

Seasonal influenza in octogenarians and nonagenarians admitted to a general hospital: epidemiology, clinical presentation and prognostic factors

OBJECTIVE

Seasonal influenza is responsible for high annual morbidity and mortality worldwide, especially in elderly patients. The aim of the study was to analyse the epidemiological, clinical and prognostic features of influenza in octogenarians and nonagenarians admitted to a general hospital, as well as risk factors associated with mortality.

METHODS

Retrospective, cross-sectional, descriptive study in patients admitted and diagnosed with influenza by molecular biology in the General University Hospital of Alicante from 1 January to 31 April 2015.

RESULTS

A total of 219 patients were diagnosed with influenza in the study period: 55 (25.1%) were ≤64 years-old; 77 (35.2%) were aged 65-79; 67 (30.6%) were aged 80-89 years; and 20 (9.1%) were aged ≥90 years. Most flu episodes were caused by influenza A (n=181, 82.6%). Patients aged 80 years or older had lower glomerular filtration rate (mean: 49.7 mL/min vs. 62.2 mL/min; p=0.006), a greater need for non-invasive mechanical ventilation (22% vs 9.3%; p=0.02), greater co-morbidity due to cardiac insufficiency (40.5% vs. 16.4%; p<0.001) and chronic renal disease (32.9 vs. 20%, p=0.03), and greater mortality (19% vs. 2.9%; p<0.001). In a multivariate analysis, mortality was higher in those aged 80 or over (adjusted odds ratio [ORa] 9.2, 95% confidence interval [CI] 1.65-51.1), those who had acquired the flu in a long-term care facility (ORa 11.9, 95% CI 1.06-134), and those with hyperlactataemia (ORa 1.89, 95% CI 1.20-3.00).

CONCLUSIONS

Seasonal influenza is a serious problem leading to elevated mortality in octogenarian and nonagenarian patients admitted to a general hospital.

A systematic review of randomized clinical trials published in Malaria Journal between 2008 and 2013

OBJECTIVE

Randomized controlled trials (RCT) are a key component in clinical research and they provide the highest quality clinical results. The objective of this study was to describe the main characteristics of RCTs published in Malaria Journal, including research topics, study population and design, funding sources and collaboration between institutions. This may help researchers and funders define future research priorities in this field.

METHODS

A retrospective analysis was performed on the RCTs published in Malaria Journal between January 1, 2008 and December 31, 2013. A key-word search by "Randomized controlled trial" or "Random*" was carried out in PubMed. RCT indexed to MEDLINE were selected for the analysis.

RESULTS

A total of 108 published articles containing RCTs were analysed. Treatment of uncomplicated Plasmodium falciparum malaria (n=45, 41.6%), especially the efficacy and safety of antimalarial drugs, and malaria prevention (n=34, 31.5%) were the two main research topics. The majority of trials were conducted in Africa (62.2%) and Asia (27%) and received external funding (private, 42.3% and/or public, 38.6%). Paediatric population was the primary study group (n=63, 58.3%), followed by adults (n=29, 26.9%). Pregnant women (n=7) and geriatric population (n=1) remain underrepresented. Nearly 75% of trials were conducted in individual subjects and 25% in groups of subjects (cluster RCTs). A considerable collaboration between researchers and institutions is noteworthy.

CONCLUSIONS

RCTs published in Malaria Journal address a wide range of research topics. Paediatric trials conducted in Africa and Asia are frequently performed, and a significant worldwide collaboration to fight against malaria has been identified.

Estimating influenza vaccine effectiveness in Spain using sentinel surveillance data

We aimed to estimate influenza vaccine effectiveness (VE) against laboratory-confirmed influenza during three influenza seasons (2010/11 to 2012/2013) in Spain using surveillance data and to compare the results with data obtained by the cycEVA study, the Spanish component of the Influenza Monitoring Vaccine Effectiveness (I-MOVE) network. We used the test-negative case–control design, with data from the Spanish Influenza Sentinel Surveillance System (SISS) or from the cycEVA study. Cases were laboratory-confirmed influenza patients with the predominant influenza virus of each season, and controls were those testing negative for any influenza virus. We calculated the overall and age-specific adjusted VE. Although the number of patients recorded in the SISS was three times higher than that in the cycEVA study, the quality of information for important variables, i.e. vaccination status and laboratory results, was high in both studies. Overall, the SISS and cycEVA influenza VE estimates were largely similar during the study period. For elderly patients (> 59 years), the SISS estimates were slightly lower than those of cycEVA, and estimates for children (0–14 years) were higher using SISS in two of the three seasons studied. Enhancing the SISS by collecting the date of influenza vaccination and reducing the percentage of patients with incomplete information would optimise the system to provide reliable annual influenza VE estimates to guide influenza vaccination policies.

Thyroid surgery in a district hospital in Southern Ethiopia: experience from a rural center

BACKGROUND

Diseases of the thyroid are not uncommon, particularly in the highlands of Ethiopia. The aim of the present study was to describe the experience of thyroid surgery in a rural hospital in Southern Ethiopia.

METHODS

The present study was based on review of surgical cases of thyroid diseases operated in a rural hospital in Southern Ethiopia during the period 2009-2010.

RESULTS

During the study period, 211 patients underwent surgery for goiter. The mean age was 31.9 years (range: 14-80 years). The sex ratio, M:F, was 1:9. A total of 103 patients had unilateral nodules, and in 108 patients the nodules were located bilaterally. The mean duration of symptoms was 5.7 years (range: 0.7-25 years). In total, 161 (76.7 %) subtotal thyroidectomy operations, and 50 (23.3 %) hemi-thyroidectomy operations were performed. Histological examination revealed multinodular goiters in 203 (96.2 %) cases. Papillary and follicular cancers were found in 7 (3.3 %) and 1 (0.5 %) cases, respectively.

CONCLUSIONS

Thyroid surgery is feasible in a small rural Ethiopian District Hospital. The provision of surgical services in rural areas of low income and middle income countries is extremely important and delivers more health opportunities to the local people.

Surface enhanced Raman scattering, electronic spectrum, natural bond orbital, and Mulliken charge distribution in the normal modes of diethyldithiocarbamate copper (II) complex, [Cu(DDTC)2]

Surface-enhanced Raman scattering (SERS) was used to study the interactions of the normal modes of the diethyldithiocarbamate copper (II) complex, [Cu(DDTC)2] on nano-structured mixture silver-gold surfaces and on silver surfaces. The electronic spectrum of this complex was measured and the charge transfer bands were assigned through the TD-PBE1PBE procedure. Natural bond orbital (NBO) were also carried out to study the Cu(II) hybridation leading to the square planar geometry of the framework of the [Cu(DDTC)2] complex, and to study which are the donor NBO and the acceptor NBO in meaningful charge transfer through the Second Order Perturbation Theory Analysis of the Fox Matrix in NBO basis. To see the electronic dispersion, the Mulliken electronic charges (MAC) were calculated for each normal mode and correlated with the SERS effect. Full assignment of the SERS spectra was also supported by carefully analysis of the distorted geometries generated by the normal modes.

Surface enhancement Raman scattering of tautomeric thiobarbituric acid. Natural bond orbitals and B3LYP/6-311+G (d, p) assignments of the Fourier Infrared and Fourier Raman Spectra

Surface enhancement Raman scattering (SERS) of two tautomer of thiobarbituric acid was obtained using silver and gold nanoparticles. Large band enhancement in the region of the ν(C=S), ν(C=C), δ(CH2), and δ(CNH) vibrational modes was found. Natural bond analysis of the tautomer species revealed expressive values of charge transfer, principally from lone pair electron orbitals of the S, N, and O atoms. Complete vibrational assignment was done for the two tautomers using the B3LYP/6-311+G (d, p) procedure, band deconvolution analysis, and from a rigorous interpretation of the normal modes matrix. The calculated spectra agree well with the experimental ones.

Surface enhanced Raman scattering, electronic spectrum and Mulliken charge distribution in the normal modes of bis(diethyldithiocarbamate)zinc(II) complex

Surface-enhanced Raman scattering (SERS) was used to study the interactions of the normal modes of the bis(diethyldithiocarbamate)zinc(II) complex, [Zn(DDTC)2], on nano-structured silver surfaces. The electronic spectrum of this complex was measured and the charge transfer bands were assigned through the TD-PBE1PBE procedure. To see the electronic dispersion, the Mulliken electronic charges were calculated for each normal mode and correlated with the SERS effect. Full assignment of the SERS spectra was also supported by carefully analysis of the distorted geometries generated by the normal modes.

DFT: B3LYP/6-311G (d, p) vibrational analysis of bis-(diethyldithiocarbamate)zinc(II) and natural bond orbitals

Theoretical and experimental bands have been assigned for the Fourier Transform Infrared (FT-IR) and Fourier Transform Raman (FT-Raman) spectra of the bis-(diethydithiocarbamate)Zn(II) complex, [Zn(DDTC)(2)]. The calculations and spectra interpretation have been based on the DFT/B3LYP method, infrared and Raman second derivative spectra as well as band deconvolution analysis. To assign the metal-ligand normal modes the deviation percentage of the geometrical parameters was used. Results confirms a pseudo tetrahedral structure around the Zn(II) cation. The calculated infrared and Raman spectra has an excellent agreement with the experimental spectra. The Natural Bond Orbital analysis (NBO) was carried out as a way to study the Zn(II) hybridization leading to the pseudo tetrahedral geometry of the framework of the [Zn(DDTC)(2)] complex, and to study also which are the donor NBO and the acceptor NBO in meaningful charge transfer through the Second Order Perturbation Theory Analysis of Fox Matrix in NBO basis.

Fourier Transform Infrared and Raman spectra, DFT: B3LYP/6-311G(d, p) calculations and structural properties of bis(diethyldithiocarbamate)copper(II)

Theoretical and experimental bands have been assigned for the Fourier Transform Infrared (FT-IR) and FT-Raman spectra of the bis(diethydithiocarbamate)Cu(II) complex, [Cu(DDTC)(2)]. The calculations and spectra interpretation have been based on the DFT/B3LYP method, infrared and Raman second derivative spectra, and band deconvolution analysis. To better assign the metal-ligand normal modes in the spectral region of low energy, the deviation percentage of the geometrical parameters was used, with values from the interpretation of the normal modes of L matrix. Results indicate a planar structure around the Cu(II) cation. The calculated infrared and Raman spectra, based on the proposed geometrical structure of the bis(diethyldithiocarbamate)copper(II) complex, agreed with the experimental spectra.

Idiopathic ileocolitis with perforation associated with HIV infection: thalidomide treatment

Idiopathic cutaneous ulcers, oesophageal ulcers and severe ulcerative ileocolitis occurred in a human immunodeficiency virus (HIV)-infected patient early after the initiation of combination antiretroviral therapy. This massive inflammatory process led to acute colonic perforation on two occasions. The disease was refractory to standard therapy, but responded successfully to thalidomide. Here, we discuss the potential benefits of thalidomide in refractory inflammatory processes in HIV-infected patients.

Molecular structure, natural bond analysis, vibrational, and electronic spectra of aspartateguanidoacetatenickel(II), [Ni(Asp)(GAA)]·H₂O: DFT quantum mechanical calculations

The aspartateguanidoacetatenickel (II) complex, [Ni(Asp)(GAA)], was synthesized and structural analysis was performed by means of the experimental methods: determination of the C, H, N and O contents, thermogravimetry, infrared and Raman spectroscopy. DFT:B3LYP/6-311G(d, p) calculations have been performed giving optimized structure and harmonic vibrational wavenumbers. Second derivative of the FT-infrared, FT-Raman and Surface Raman Enhanced Scattering (SERS) spectra, and band deconvolution analysis were also performed. Features of the FT-infrared, FT-Raman and SERS confirmed theoretical structure prediction. Full assignment of the vibrational spectrum was also supported by a carefully analysis of the distorted geometries generated by the normal modes. The Natural Bond Orbital analysis (NBO) was also carried out as a way to study the Ni (II) hybridization leading to the pseudo planar geometry of the framework, and the extension of the atomic N and O hybrid orbital of the different amino acids in the bond formation. Bands of charge transfer and d-d transitions were assigned in the UV-Vis spectrum.

Early estimates of the effectiveness of the 2011/12 influenza vaccine in the population targeted for vaccination in Spain, 25 December 2011 to 19 February 2012

We present early estimates of influenza vaccine effectiveness (VE) in the population targeted for vaccination, during 25 December 2011 to 19 February 2012. The adjusted VE was 55% (95% CI: 3 to 79) against any type of influenza virus and 54% (95% CI: 1 to 79) against influenza A(H3N2) virus. This suggests a moderate protective effect of the vaccine in the targeted population in a late influenza epidemic with limited match between vaccine and circulating strains.

A bibliometric study of scientific literature on obesity research in PubMed (1988-2007)

This article describes a bibliometric review of the publications on obesity research in PubMed over the last 20 years. We used Medline via the PubMed online service of the US National Library of Medicine from 1988 to 2007. The search strategy was: ([obesity] in MesH). A total of 58,325 references were retrieved, 25.5% in 1988-1997, and 74.5% in 1998-2007. The growth in the number of publications showed an exponential increase. The references were published in 3613 different journals, with 20 journals contributing 25% of obesity literature. The two journals contributing most were the International Journal of Obesity (5.1%), Obesity-Obesity Research (2.9%). North America and Europe were the most productive world areas with 44.1% and 37.9% of the literature, respectively. The US was the predominant country in number of publications, followed by the United Kingdom, Japan and Italy. The ranking of production changed when the number of publications was normalized by population, gross domestic product and obesity prevalence by countries. The great increase of publications on obesity during the period 1988-2007 was particularly evident in the second decade of the period which is concordant with the worldwide obesity epidemic. USA and Europe were leaders in the production of scientific articles on obesity.

A bibliometric overview of infectious diseases research in European countries (2002-2007)

This study analyses the distribution of papers published by authors from the European Union (EU) in 47 international infectious diseases journals from 2002 to 2007. The Web of Science of the Institute for Scientific Information was used to collect medical articles. From 46,149 papers recovered, 24,064 (52.1%) were from the EU. The EU15 countries published 23,239 papers (96.7%). The ten countries that joined the EU in 2004 published only 767 (3.2%) and the two countries that last joined the EU in 2007 contributed only 0.1% of the papers. The United States contributed 41.2% of the documents. The leading EU27 countries in number of publications were the United Kingdom, France, and Germany. After taking the population into account, Denmark, Sweden, and The Netherlands headed the list, and after correcting for gross domestic product the greatest producers were Malta, Estonia, and Sweden. In conclusion, the production of scientific papers on infectious diseases during the last six years was greater in the EU than in the United States. The contribution to the infectious diseases research of the 12 countries that joined the EU in the last few years has yet been limited.

A bibliometric analysis of tuberculosis research indexed in PubMed, 1997-2006

OBJECTIVE

To describe a bibliometric review of the literature on tuberculosis (TB) research indexed in PubMed over a 10-year period.

METHODS

Medline was used via the PubMed online service of the US National Library of Medicine from 1997 to 2006. The search strategy was: [(tuberculosis) OR (tuberculous) in all fields].

RESULTS

A total of 35 735 references were located. The average annual growth rate was +4.7%. The articles were published in 2874 scientific journals. Sixteen journals contained 25% of the TB journal literature. The main journal was the International Journal of Tuberculosis and Lung Disease. Western Europe was the most productive region, with 31.1% of the articles. The USA ranked second (21%) and Asia third (19.9%). The USA is the predominant country, followed by India, Japan and the United Kingdom. When normalised by population, the order of prominence is Switzerland, New Zealand and Denmark. Normalised by GDP, Gambia, Malawi and Guinea-Bissau were the most productive countries. Normalised by estimated number of TB cases, Iceland, Switzerland and Norway were in leading positions.

CONCLUSIONS

There was increasing research activity in the field of TB during the period 1997-2006. The countries with more estimated cases of TB produced less research in TB than industrialised countries.

Non-imported brucellosis outbreak from unpasteurized raw milk in Moroccan immigrants in Spain

Nine cases of brucellosis were identified in the city of Elche (Comunidad Valenciana, Spain) in two families of Moroccan immigrants. All of the patients had drunk unpasteurized raw milk from goats. Brucella melitensis biovar 3 was identified in clinical specimens. Preventive measures for brucellosis should be implemented among immigrant populations in Spain.

[Scientific output of Spanish dermatology departments in international journals, 1997-2006]

BACKGROUND

The aim of this study was to determine the scientific output in international journals by Spanish dermatologists between 1997 and 2006 using PubMed.

MATERIAL AND METHODS

Publications were identified with the following search query: (dermat*) and (spain or espagne or espanha or espana or spanien), with the limit "affiliation". Articles described in PubMed as "journal articles" or "reviews" were included and those published in Spanish journals excluded.

RESULTS

We identified 1018 articles: 492 published between 1997 and 2001, and 526 published between 2002 and 2006. The majority were case reports (705, 69.3 %), but there were also 120 reviews (11.8 %). Most of the articles were published in dermatology journals with Science Citation Index impact factors (877, 86.1 %), with the following representing the main ones: Contact Dermatitis (129, 12.7 %), Journal of the European Academy of Dermatology and Venereology (115, 11.3 %), and the British Journal of Dermatology (86, 8.4 %). Nine institutions accounted for more than 50 % of the articles published. Notable among them were the following: Hospital Universitario La Princesa in Madrid (78, 7.7 %), Hospital Santa Creu i Sant Pau in Barcelona (71, 7.1 %), and Hospital Clínic in Barcelona (63, 6.2 %). Seven provinces produced 80 % of the publications, with Madrid (257, 25.2 %), Barcelona (244, 24.0 %), and A Coruña (98, 9.6 %) accounting for the highest proportion. Five autonomous communities accounted for 82 % of the publications: Madrid (257, 25.2 %), Catalonia (251, 24.7 %), Galicia (116, 11.4 %), the Autonomous Community of Valencia (112, 11.0 %), and Andalusia (96,9.4 %).

CONCLUSIONS

The scientific output in international journals has remained stable over the last decade. Authors and institutions from Barcelona and Madrid continued to be the most productive.

Vibrational normal modes of diazo-dimedone: a comparative study by Fourier infrared/Raman spectroscopies and conformational analysis by MM/QM

The 2-diazo-5,5-dimethyl-cyclohexane-1,3-dione (3) was synthesized and the FT-IR/Raman spectra were measured with the purpose of obtain a full assignment of the vibrational modes. Singular aspects concerning the -CNN oscillator are discussed in view of two strong bands observed in the region of 2300-2100 cm(-1) in both, Infrared and Raman spectra. The density functional theory (DFT) was used to obtain the geometrical structure and for assisting in the vibrational assignment joint to the traditional normal coordinate analysis (NCA). The observed wavenumbers at 2145 (IR), 2144(R) are assigned as the coupled nu(NN)+nu(CN) vibrational mode with higher participation of the NN stretching. A 2188 cm(-1) (IR) and at 2186 cm(-1) (R) can be assigned as a overtone of one of nu(CC) normal mode or to a combination band of the fundamentals delta(CCH) found at 1169 cm(-1) and the delta (CCN) found at 1017 cm(-1) enhanced by Fermi resonance.

Incidence of Beijing genotype of Mycobacterium tuberculosis in Elche, Spain: A 13-year surveillance study

Binary file ES_Abstracts_Final_ECDC.txt matches

Diels-Alder cycloaddition approach to puupehenone-related metabolites: synthesis of the potent angiogenesis inhibitor 8-epipuupehedione

A new synthetic strategy toward puupehenone-related bioactive metabolites from sclareol oxide, based on a Diels-Alder cycloaddition approach, is described. Utilizing this, marine ent-chromazonarol and the potent angiogenesis inhibitor 8-epipuupehedione have been synthesized.

Synthesis, molecular structure and vibrational spectra of a dimeric complex formed by cobalt and glycine

The structure of [Co(gly)(2)(OH)(2)].1.5(H(2)O) was solved by X-ray diffraction. It crystallizes in the space group P-1, with two independent dimmers in the unit cell. The results for the calculated vibrational spectra are in good agreement with the experimental one. The infrared spectrum and ab initio calculations are consistent with the crystallographic results.

Severe toxicity associated with the combination of tenofovir and didanosine: case report and review

The combination of tenofovir and didanosine results in an increase in the didanosine plasma exposure and might augment the risk for didanosine toxicity. Although pharmacokinetic studies support a didanosine dose reduction to 250 mg when used concurrently with tenofovir in patients weighing at least 60 kg, no data are available in lower-weight patients. We describe a case of lactic acidosis and acute liver failure in a low-weight patient receiving tenofovir and a reduced dose of didanosine (200 mg/day). To our knowledge, this is the first case of severe toxicity associated with a reduced dose schedule of didanosine. Previous cases of severe toxicity associated with the combination of tenofovir and didanosine are reviewed.

[Spanish scientific production in antimicrobial agents and susceptibility procedures during period 1990-2002]

The aim of this study was to analyze the scientific production of Spanish authors on antimicrobial agents and susceptibility tests during the period 1990-2002. Articles from Spanish scientific institutions of microbiology, bacteriology, mycology and parasitology published and recorded in the MEDLINE database (WEBSPIRS version 4.2) during the period 1990-2002 were selected. Only articles about antimicrobial agents and susceptibility procedures were reviewed. A total of 5,259 documents were analyzed, of which 1,041 (19.8%) were about antimicrobal agents. The annual number of documents increased by two-fold (from 48 in 1990 to 101 in 2002). The journal that published most documents was Antimicrobial Agents and Chemotherapy, with 183 (17.1%). The main field of interest of the documents was antimicrobial agents and susceptibility tests (765; 73.5%) and in vitro resistance analyses (265; 25.5%). The highest number of contributions came from hospitals (571; 54.9%), followed by universities (351; 33.7%). The institutions with most documents published were the Ramón y Cajal Hospital (8.6%), and Seville University Faculty of Medicine (6%). The most productive autonomous communities were Madrid (43.4%), Catalonia (16.4%) and Andalusia (4.7%). A total of 787 documents (75.6%) were published in journals with impact factors and the mean expected impact factor was 2.390 +/- 1.546. It was concluded that the scientific production of Spanish researchers in antimicrobial agents had increased during the period 1990-2002, and that hospitals were the most productive institutions in this area of microbiology, with the main areas of interest being antimicrobial agents and susceptibility tests.

[Risk of superinfection related to antibiotic use. Are all antibiotics the same?]

The aim of this study was to analyze the effect of using different antibiotics on the risk of acquiring a bacterial or fungal superinfection in hospital-acquired infections. A systematic review of the literature using the PubMed (Medline) database from January 1990 to December 2003 was performed. We selected only those studies with at least 25 patients in each arm in which the clinical efficacy of several antibiotics (third generation cephalosporins, fluorquinolones, piperacillin-tazobactam and carbapenems) were evaluated for the treatment of severe infections, and which specifically reported the rate of superinfection. The microorganisms most frequently implicated in the development of superinfection were: Candida spp. (42.3%), Enterococcus spp. (18.8%), enterobacteria (13.8%), Staphylococcus spp. (9.5%), Pseudomonas aeruginosa (6.6%), and Clostridium difficile (4.1%). The antibiotic most frequently related to superinfection was ciprofloxacin (38.1%), followed by cefotaxime (23.3%), imipenem (12%), meropenem (10.2%), and cefepime (6.1%). The lowest percentage of superinfection was observed with the use of piperacillin-tazobactam (5.4%).

Epidemiological and clinical characteristics of occult bacteremia in an adult emergency department in Spain: influence of blood culture results on changes in initial diagnosis and empiric antibiotic treatment

A prospective study was carried out to analyze the usefulness of blood culture results for adult patients who were discharged from the emergency department with bacteremia. Over a 29-month period, 110 patients with significant bacteremia who were seen in the emergency department and discharged home were studied. The mean age of the patients was 61.8 years. The most frequent initial major diagnosis was urinary tract infection (UTI) (n=63; 57.3%). Gram-negative organisms were isolated in 79 (71.8%) cases. A change in diagnosis (44.5% cases) was more common when the initial diagnosis was something other than UTI or when empiric antimicrobial therapy was ineffective or was not given (P<0.001). The significant predictors of modification of the initial empiric antibiotic therapy were ineffective empiric antimicrobial therapy and transfer of the patient from the emergency department to an infectious diseases outpatient clinic (P=0.01). Blood culture results may be useful for achieving the correct diagnosis in adult patients with bacteremia and for guiding treatment in the subsequent management of outpatients.

[A 41 year-old female with abdominal pain and fever of 24 hours]

A 41 year-old female with intrauterine contraceptive device (ICD) from 8 year ago that complained fever and abdominal pain during 24 hours and leucocytosis. The radiology examination tests showed cegal, appendiceal, and right ovary enlargement with swollen of fat adjacent. In the differential diagnosis should be include: appendicitis, diverticulitis, chronic inflammatory digestive disease or mesenterical adenitis. In the differential diagnosis included: ovarian neoplasm, endometriosis, ectopic pregnancy, ovarian torsion and pelvic inflammatory diseases. From pelvic infections, it is import consider pelvic inflammatory disease, genital tuberculosis and pelvic actinomycosis. With the antecedent of ICD, the clinic and the radiological finding as abdominal mass with invasion of adjacent structures and absence of adenopathy; the first diagnosis is a abdominopelvic actinomycosis and the second is a genital tuberculosis.

Characteristics of louse-borne relapsing fever in Ethiopian children and adults

Louse-borne relapsing fever (LBRF) is endemic in Ethiopia. The epidemiological and clinical aspects of LBRF and the differences between the infection in children and that in adults were investigated in a rural hospital in Ethiopia. During the 5-year study (1997-2002), 197 patients had a confirmed diagnosis of LBRF. Most (62.1%) of the cases were children under 15 years of age. The adult cases (i.e. those aged > or =15 years) were far more likely to present with headache (76.9% v. 40%; P <0.001), musculo-skeletal pains (61.5% v. 30.5%; P <0.001), dizziness (64% v. 39%; P =0.002) and bleeding (16.9% v. 3.8%; P =0.005) than the paediatric. The overall level of case fatality was 6.4%. Death appeared to be significantly associated with adulthood (P =0.01), delay in consultation (P =0.026) and the presence of vomiting (P =0.023). LBRF is clearly still a public-health problem in Ethiopia, where the clinical manifestations of the disease differ according to the age of the case.

Publication of European Union Research on Infectious Diseases (1991?2001): A Bibliometric Evaluation

The study presented here analyzed the contents of 36 international infectious diseases journals from 1991 to 2001 to determine the number of reports prepared by authors in the European Union and to compare the per country scientific productivity. Articles included in the study were identified using the PubMed website. The number of publications in infectious disease journals produced by authors in the European Union experienced an exponential growth from 461 (19.2% of world production) in 1991 to 2,401 (35.9%) in 2001. The mean impact factor increased from 2.259 in 1991 to 3.001 in 2001. The leading countries in the total number of publications were the UK, France, and Germany. After taking population figures into account, Sweden, Denmark, and Finland headed the list, and after correcting for gross domestic product, the greatest producers were Sweden, Finland, and the UK. Overall, the scientific production and repercussion index of European Union research on infectious diseases experienced a notable rise during the last decade of the 20th century.

[Chickenpox outbreak in Herrera del Duque, Badajoz, Spain]

INTRODUCTION

Chickenpox is a worldwide disease with high morbidity but few complications, although complications can be sevre in immunocompromised individuals and healthy adults. The annual chickenpox rate declared to the National Notification Disease Surveillance System is approximately 5 cases per 1,000 inhabitants in Extremadura (Spain). The aim of this study was to identify and describe the characteristics and cost of an epidemic outbreak of chickenpox in Extremadura.

METHODS

Between November 2000 and March 2001, a descriptive study was performed. Cases of chickenpox were actively sought in a cohort of schoolchildren in Herrera del Duque (Badajoz). The protocols of the Monitoring Network of the Autonomous Community of Extremadura was used for case definition. Microbiological confirmation was performed by isolation of the virus and the presence of IgM and IgG markers in serum. We analyzed the direct and indirect tangible costs as well as the intangible costs of the outbreak.

RESULTS

Seventy-five cases were identified, of which 94.7% occurred in children aged between 1-9 years, mainly boys. The attack rate was 18.5 cases per 1,000 inhabitants and 68.2% occurred in children aged less than 10 years charing a home. The clinical course was benign, without hospital admissions or complications. A total of 71.6% of children aged between 3 and 8 years were susceptible. A possible temporary aggregation of cases in the school was analyzed and a relative risk of 5.01 (p < 0.0001) was obtained. The virus was isolated in the 4 vesicle samples studied and serology was positive (IgM) in the 9 serum samples studied. The total cost of the outbreak was of 927,21 e, with a mean of 12,53 e per case and 205 school days lost.

CONCLUSION

A chickenpox outbreack was confirmed in Herrera del Duque, with person-to-person transmission, affecting children aged between 1 and 9 years. The high susceptibility of the pupils, the characteristics of teaching, and the meetings prior to the carnivals played a determining role in the transmission of the epidemic. The estimated cost of this outbreak was 76% less than the cost that would have been generated by single-dose vaccination of the 75 individuals who contracted the disease.