In recent years, the number of cases of tuberculosis (TB) among immigrants in Spain has increased markedly, and led to this analysis of the recent transmission patterns of TB in the immigrant population in Madrid. The countries from which the highest number of immigrant cases have been reported were Ecuador (21%), Romania (16%), Morocco (12%), Peru (11%) and Bolivia (9%). Fifty-one per cent of the cases were from South America. In a multicentre study (2004-2006), IS6110 restriction fragment length polymorphism and spoligotyping were used to genotype the Mycobacterium tuberculosis isolates from 632 immigrant cases from 47 countries. A total of 183 cases (29%) were grouped into 59 clusters, which are markers of potential transmission events. Most of the clusters (81%) included patients living in different healthcare districts, and 54% of the clusters were multinational. When a sample of 478 autochthonous cases was included, 53% of the clusters involving immigrants also included autochthonous cases. This study revealed marked transmission permeability among nationalities and between the immigrant and the autochthonous populations.

Summary Alveolar proteinosis is a relatively rare disease of unclear pathogenesis associated with opportunistic-infections. Although nocardiosis is the most frequent one, only 22 cases have been reported previously and are reviewed here. We present a patient with alveolar proteinosis with nocardiosis treated as an emergency with bilateral bronchopulmonary lavage and antibiotics. No previous cases of this association have been successfully managed in this way.

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RESUMEN INFECCIÓN POR PAPILLOMAVIRUS EN EL HOMBRE. ESTADO ACTUALEl Virus del Papiloma Humano (VPH), clásicamente se ha relacionado con infecciones de transmisión sexual y procesos oncológicos malignos del aparato genital femenino y con menos frecuencia del masculino. Las nuevas técnicas diagnósticas, basadas en biología molecular (mediante reacción en cadena de la polimerasa), ayudan a una mejor aproximación epidemiológica, una mejora en el diagnostico viral, y un correcto enfoque terapéutico. El objeto de este trabajo es revisar el estado actual del VPH desde los puntos de vista etiopatogénico, epidemiológico, clínico, diagnóstico, terapéutico y profiláctico.Palabras clave: Papiloma Humano. Reacción en Cadena de la Polimerasa. Cáncer genital. ABSTRACT INFECTION FOR PAPILLOMAVIRUS IN THE MAN. CURRENT STATE.The Virus of the Human Papiloma (HPV), classically he/she has been related with infections of sexual transmission and processes wicked oncologists of the feminine genital apparatus and with less frequency of the masculine one. The new technical diagnostics, based on molecular biology (by means of polymerase chain reaction), they help to a better epidemic approach, an improvement in the I diagnose viral, and a correct therapeutic focus. The object of this work is to revise the current state of the VPH from the points of view etiopatogenics, epidemic, clinical, diagnosis, therapeutic and preservative.

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