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Two hundred and four patients with pleural effusion were studied to investigate the utility of Light’s criteria and pleural fluid cholesterol level (pCHOL) in the identification of exudative pleural effusion (EPE) and transudative pleural effusion (TPE). There were 48 TPE, 56 tumor, 47 tuberculous, 30 metapneumonic and 23 miscellaneous patients. A value ≧ 54 mg/dl for pCHOL and > 0.32 for the pleura/serum cholesterol ratio (p/sCHOL) showed sensitivity (S) and specificity (Sp) of 95.5% and 91.6% for pCHOL, and 97.4% and 91.6% for p/sCHOL, respectively. Combined pCHOL and/or p/sCHOL showed a S of 98.7% and Sp of 89.5%. Light’s criteria achieved a S of 100% and Sp of 64.5%. Combined pCHOL and p/sCHOL revealed a similar accuracy to Light’s criteria in EPE diagnosis but was found to be more exact in TPE diagnosis.

The purpose of this study was to determine whether the clinical and microbiological characteristics of parapneumonic effusions in patients with community-acquired pneumonia (CAP) infected with the human immunodeficiency virus (HIV) were different from those observed in patients without HIV infection. One hundred and thirty seven patients with parapneumonic effusions were included and divided into two groups depending on whether they had HIV infection or not. The parapneumonic effusion rate was significantly higher in HIV-positive than in noninfected patients (21 vs 13%). Their clinical course was more severe, presenting a higher rate of bacteraemias (58 vs 18%). Pleural fluid in patients infected with HIV had significantly lower glucose levels than that of patients without HIV infection. Chest tube drainage was more frequent in parapneumonic effusions of patients infected with HIV than in those without HIV infection (71 vs 44%). Staphylococcus aureus was the most common microorganism found in the bacteriological samples of patients with CAP infected with HIV (53 vs 12%). We conclude that patients with community-acquired pneumonia and HIV infection have a higher rate of parapneumonic effusions and a more severe clinical course than non-HIV patients, and that Staphylococcus aureus predominates in their bacteriological samples.

Todas las organizaciones de los diferentes sectores productivos del país están realizando un esfuerzo importante para confeccionar e implantar su estrategia, marcando los objetivos que les permitan alcanzar una posición de ventaja en el mercado y conseguir, así, la visión que han definido. Para poner en marcha el despliegue de sus objetivos se ayudan de la identificación de una serie de indicadores que les informarán del grado de consecución de los mismos. Es lo que se conoce como el Cuadro de Mandos de una empresa u organización. Cuando este proceso incorpora objetivos e indicadores estratégicos y no sólo operativos, hablamos, en términos generales, de Cuadro de Mando Integral o Balance Scorecard (CMI o BSC). Los indicadores se convierten así en elementos transcendentales que toman «el pulso» diario a la evolución de la empresa. El sistema de información es el que facilita la obtención de los indicadores, su transmisión, análisis, comparación, etc., utilizando diferentes herramientas informáticas (software) para realizar estas tareas. Además garantiza la calidad, transparencia, vigencia, coherencia y disponibilidadde sus indicadores. El Sistema Nacional de Salud (SNS) es la organización encargada de promover, mantener y recuperar el estado de salud de los ciudadanos de nuestro país y de aquellos que aún no siendo ciudadanos españoles, tienen derecho a las prestaciones sanitarias. Como organización, el SNS se

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