Double bifurcation optimization stent system technique for left main stenosis.

We present a first-in-man case with implantation in culottes' fashion of two dedicated coronary bifurcation stents (BiOSS Lim) in distal left main stenosis. The immediate procedural and very short-term result was excellent.

Type of desmin expression in cardiomyocytes - a good marker of heart failure development in idiopathic dilated cardiomyopathy.

AIM: The aim of this study was to determine whether remodelling of the desmin (DES) cytoskeleton affects myocardial function and whether it could be a useful marker of disease progression in patients with idiopathic dilated cardiomyopathy (IDCM). MATERIAL AND METHODS: Endomyocardial biopsy was performed in 195 IDCM patients, and five to six specimens were collected from the left ventricle. DES expression was evaluated using tissue immunostaining and Western blotting. The study population was assigned to four groups according to DES expression type: I, normal DES staining at Z-lines giving a regular pattern of cross-striation (n = 57); IIA, increased DES staining with a regular pattern of cross-striation (n = 40); IIB, increased DES staining with an irregular pattern of cross-striation and/or the presence of aggregates (n = 56); and III, decreased/lack of DES staining (n = 42). Fibrosis, cardiomyocyte hypertrophy and ultrastructure were assessed for the four types of DES expression. RESULTS: The pathological types of DES expression (IIB or III) were associated with pathological changes in mitochondria and the contractile apparatus. Cardiomyocyte diameter and level of fibrosis were both significantly affected. DES expression type correlated with NYHA class, left ventricular end-diastolic diameter, left ventricular ejection fraction and the level of N-terminal pro-brain natriuretic protein. CONCLUSION: The type of immunohistochemical DES expression correlated with the level of myocardial injury at the cellular and organ levels. This correlation was similar to that observed between DES expression and the well-established biochemical, echocardiographic and clinical parameters of heart failure (HF). DES expression type could be used as an important diagnostic feature of HF development.

[Adolescents and sources of sex information: preferences and perceived usefulness]. / Adolescentes y fuentes de información de sexualidad: preferencias y utilidad percibida.

OBJECTIVES: To find adolescents' assessment of the information received at their school on questions relating to sexuality. To discover their main sources of information on sexuality, the perceived utility of these and their preferences. DESIGN: Observational study. SETTING: Province of Cordoba. MEASUREMENTS AND MAIN RESULTS: 955 adolescents at secondary schools were chosen through multistage randomised sampling. Anonymous health questionnaire. Average age was 16.62% were girls. 545 valued as a lot or sufficient the AIDS information received (57%; 54.3-59.6), more than when asked about STD (29%; 25.4-31.9), contraceptives (33%; 29.7-35.2), sexual relations (22%; 19.5-24.1) or pregnancy (22%; 19.3-24.2). They were able to talk openly about sexuality, firstly with friends (90.8%) and girl/boy-friend (80.5%), and least with teachers (18.7%), parents (17.4%) or priests (8.9%). Sexual information came basically from friends (26%) and magazines (24%), and least from doctors (7%) and parents (6%). The most useful source for adolescents was magazines (21%) and teachers (21%), with parents and cinema/T.V. in the last positions. When adolescents were asked from whom they would prefer to receive information, they chose firstly parents (34%) and doctors (33%). CONCLUSIONS: Adolescents perceived a centering of the information received at their school on AIDS. Their preferred sources of information did not coincide with what was most accessible. Despite considering doctors as a preferred source, they have received little information from us. The usefulness given to magazines is worthy of note.

[Primary care research: attitude of family physicians trained at the Córdoba Teaching Unit]. / Investigación en atención primaria: visión de los médicos de familia formados en la Unidad Docente de Córdoba.

OBJECTIVE: To study the opinions and attitudes of a group of Family Doctors concerning various aspects of Primary Health Care (PHC) research. DESIGN: A descriptive observational study. SETTING: Health Centres and Primary Care consulting rooms. PARTICIPANTS: Family doctors trained in the Family and Community Medicine Teaching Unit in Córdoba between 1982 and 1992 (N = 70). There was a 59.7% reply rate. MEASUREMENTS AND RESULTS: Among the obstacles noted for the development of research in PHC, lack of time at work was the main one (82.5%); and as a handicap, lack of understanding how to work out designs was in first place (85.0%); and as a handicap, lack of understanding how to work out designs was in first place (85.0%). 60.0% considered that PHC research is not sufficiently valued in our country and 77.5% thought that it is not taken into account enough on applying for jobs. 78.0% (C.I.95%: 62.0 - 88.9%) took part in a congress giving papers or reports during the last year. 63.4% (C.I.95%: 46.9 - 77.4%) were working on a research project. CONCLUSIONS: In spite of the perceived methodological difficulties and the lack of incentives, the number of family doctors who devote part of their time to research projects is notable and their participation in scientific events is considerable.