Ti/Ta-based composite polysaccharide scaffolds for guided bone regeneration in total hip arthroplasty.

Guided bone regeneration can play an important role in orthopedic applications. This work presents the synthesis and characterization of composite scaffolds based on polysaccharides loaded with microparticles of titanium or tantalum as novel materials proposed for composite systems with promising characteristics for guided bone regeneration. Ti/Ta composite scaffolds were synthesized using chitosan and gellan gum as organic substrates and crosslinked with oxidized dextran resulting in stable inorganic-organic composites. Physico-chemical characterization revealed a uniform distribution of metal nanoparticles within the scaffolds that showed a release of metals lower than 5 %. In vitro biological assays demonstrated that Ta composites exhibit a 2 times higher ALP activity than Ti and a higher capacity to support the full differentiation of human mesenchymal stem cells into osteoblasts. These results highlight their potential for bone regeneration applications.

Trend in cervical cancer screening in Spain (2003-2009) and predictors of adherence.

Cervical cancer remains a public health problem in developed countries. Early detection of both premalignant lesions and cervical cancer through an appropriate screening programme may decrease its incidence and mortality. High rates of participation are essential to ensure the desired impact on the population. The aims of this study were to assess the use of Pap smears in Spain in 2009 to identify factors associated with screening adherence (predictors) and assess the trend from 2003 to 2009. We included women surveyed in the European Health Interview Survey for Spain. Cervical cancer screening included self-reported Pap smears over the last 3 years. The target age range was 25-64 years. The following independent variables were analysed: sociodemographic variables, chronic conditions, and lifestyle. Predictors of Pap smear adherence were explored using multivariate logistic regression. The screening coverage in the target population was 66.1% (95% confidence interval: 64.8-67.4). Undergoing Pap smears was associated positively with the following: being married, higher levels of education and income, having visited a general practitioner in previous weeks, and suffering from musculoskeletal disease. Belonging to an older age group (55-64 years) and obesity were associated with nonadherence to Pap smears. We did not find significant differences when we compared cervical cancer screening adherence over time since 2003. Adherence to cervical cancer screening in Spain does not seem to be improving. An effort must be made, and the implementation of population-based programmes instead of opportunistic screening could be considered, to recruit women who are less likely to undergo screening.

The association between excess weight and self-rated health and psychological distress in women in Spain.

OBJECTIVE: To investigate the associations between obesity and self-rated health and psychological well-being in Spanish women. DESIGN: Cross-sectional study. Three dependent variables were defined: self-rated health; self-declared diagnosis of psychiatric disorders or use of psychiatric drugs; and General Health Questionnaire-12 (GHQ-12) score. A set of variables (sociodemographic, morbidity and lifestyle) were used to adjust for possible confounding effects. SETTING: The National Health Survey was conducted in Spain in 2006. SUBJECTS: A total of 15 099 women aged ≥18 years. Participants were classified into groups according to their BMI. RESULTS: In all, 55·4 % of the women had normal weight, 29·4 % were overweight and 15·2 % were obese. Self-perception of poor health in obese women was 57·8 %, a significantly higher value than in women of normal weight (28·8 %). Prevalence of psychiatric disease was 35·5 % in obese women and 18·9 % in women of normal weight. In multivariate analysis, obese women had 34 % higher odds of declaring poor self-perception of health (OR = 1·34; 95 % CI 1·12, 1·61), 18 % higher odds of self-reporting psychiatric disease (OR = 1·18; 95 % CI 1·02, 1·38) and 26 % higher odds (OR = 1·26; 95 % CI 1·02, 1·55) of having an abnormal outcome (≥3) on the GHQ-12 than women of normal weight. CONCLUSIONS: The present study highlights that obese Spanish women have worse self-rated health and psychological health than those with normal weight. These aspects are relevant because of the growing importance placed on the functionality of patients and their mental health within the obesity epidemic.

Increased use of oral contraceptives in Spain: related factors and time trend, 2003-2006.

AIMS: We aimed to determine the prevalence of consumption of oral contraceptives (OCs) among women living in Spain and to identify the factors associated with this consumption. METHODS: Descriptive cross-sectional epidemiologic study on consumption of OCs by women aged 16-50 years resident in Spain. As the dependent variable, we took the answer to the question, "In the last two weeks, have you taken the contraceptives pill?" Independent variables were sociodemographic, comorbidity, and healthcare resources. Using logistic multivariate regression models, we have analyzed the temporal evolution of OCs consumption between 2003 and 2006. MAIN OUTCOME MEASURES: We used secondary individualized data drawn from the 2003 (n=5,807) and 2006 (n=9,103) Spanish National Health Surveys. RESULTS: In 2003, the 4.99% of women reported having taken the contraceptive pill; this proportion increased to 9.44% in 2006 (P<0.05). Multivariate analysis highlighted the association between OCs use gynecologist visits (odds ratio [OR]=5.67, 95% confidence interval [CI]=2.52-12.79 in 2003, and OR=5.09, 95% CI=2.87-9.02 in 2006); cervical smear test (OR=2.98 95% CI=1.83-4.85 in 2003 and OR=1.79 95% CI=1.28-2.50 in 2006); and risk variables such alcohol consumption or hypertension in the year 2006 (OR=1.53, 95% CI=1.05-2.22). CONCLUSIONS: We can conclude that there was a significant increase in OC use among women living in Spain from 2003 to 2006. The OC consumers in our study were young women who visited the gynecologist and took preventive measures such as smear testing, although they did have risk variables associated with OC, such as alcohol use and arterial hypertension.

Predictors of breast and cervical cancer screening in a Spanish metropolitan area.

BACKGROUND: Gynecological cancers are an important cause of morbidity and mortality. Screening with mammography and Pap smear reduces breast and cervical cancer mortality. Neverthless, high participation rates are needed to ensure their effectiveness. We sought to assess the use of mammography and Pap smear and analyzed predictors of attendance at these cancer screenings in a large metropolitan area in Spain. METHODS: We included women surveyed in the Madrid City Health Survey 2005. Cancer screening included mammography in the last 2 years and Pap smear in the last 3 years. Independent variables included sociodemographics, chronic diseases, and lifestyles. Predictors of mammography or Pap smear attendance were explored using logistic regression. RESULTS: The number of women eligible for mammography, aged >or=40 years, was 2580, and the number eligible for Pap smear, aged 18-69 years, was 3200. Overall, 60.5% and 76.6%, respectively, had received a mammography and Pap smear. Mammography uptake was positively associated with age, higher educational level, and osteomuscular disease. Obesity and unhealthy lifestyle were associated with nonattendance to mammography. Predictors of Pap smear attendance were the same as for mammography. CONCLUSIONS: Attendance at gynecological cancer screening in a large metropolitan area in Spain is acceptable in the age group for which it is recommended. An effort must be made, however, to recruit those women who are less likely to undergo screening, as they are at the highest risk of having these diseases.

Breast and cervical cancer screening in Spain and predictors of adherence.

Gynecological cancers are an important cause of morbidity and mortality. Secondary prevention programmes attempt to improve their prognosis. High participation rates are needed to ensure the desired population impact. We sought to assess the use of mammography and Pap smear and analyze predictors of screening adherence. We included women surveyed in the Spanish National Health Survey 2006. Cancer screening included mammography in the last 2 years and Pap smear in the last 3 years. The target age range of the screening programmes was 50-69 years in breast cancer screening and 25-64 years in cervical cancer screening. Independent variables included: sociodemographics, chronic diseases and lifestyles. Predictors of mammography or Pap smear adherence were explored using logistic regression. The screening coverage for the target age range was 84.1% (95% confidence interval=82.9-85.2) in breast cancer and 67.4% (95% confidence interval=66.5-68.4) in cervical cancer. Mammography uptake was positively associated with age, being married, higher educational level, having visited a physician or gynecologist, supplementary private health coverage and osteomuscular disease. Some unhealthy lifestyles were associated with nonadherence to mammography. Positive predictors of Pap smear adherence behaved in the same way as for mammography and also higher monthly incomes and eating a healthy diet were associated with higher screening compliance. In conclusion, adherence to breast cancer screening in Spain is acceptable in the target age group; nevertheless Pap smear screening must be improved. In both cases, an effort must be made to recruit those women who are less likely to undergo screening, as they are those who are at higher risk of suffering these diseases.

[Adequacy assessment of antibiotic prophylaxis in orthopedic and traumatologic surgery]. / Evaluación de la adecuación de la profilaxis antibiótica en cirugía ortopédica y traumatológica.

INTRODUCTION: Antibiotic prophylaxis is an essential strategy for preventing surgical wound infection. This study assesses the adequacy of surgical antibiotic prophylaxis in trauma and orthopedic patients. METHODS: Cross-sectional study including consecutive patients who underwent hip or knee replacement, or spinal surgery. Sample estimation was based on 95% confidence, 5% precision, an overall adequacy of 85%, and assuming a loss of 5%. Thus, 206 patients were required. The appropriateness of the indication, time of administration, administration route, and dose according to the hospital protocol was assessed. The cumulative incidence of surgical site infection at discharge was determined. RESULTS: A total of 221 patients were included, 33.5% men and 66.5% women; mean age was 61.1 (SD=14.1) for men and 67.1 (SD=12.4) for woman (P<0.05). Antibiotic prophylaxis was indicated in all patients. Overall adequacy of prophylaxis according to the hospital protocol was 89.1%. Cumulative incidence of surgical wound infection at discharge was 3.2%. There was no association between the adequacy of antibiotic prophylaxis and surgical site infection (P>0.05). CONCLUSIONS: The adequacy of postoperative antibiotic prophylaxis was high in this study, but it can be improved.

[Idiopathic atrophoderma of Pasini and Pierini. Study of 4 cases]. / Atrofodermia idiopática de Pasini y Pierini. Estudio de cuatro casos.

Idiopathic atrophoderma of Pasini and Pierini (IAPP) is an infrequent form of cutaneous atrophy, of unknown etiology. We describe the clinical and histological symptoms of four women with IAPP. Three of them had lesions on the back, while the fourth had them on the buttocks. The histological study of two patients revealed a variable degree of collagen alteration (sclerosis and hyalinization). In the other patients, the dermis was apparently normal. There is discussion about whether IAPP is a distinct entity or is related to morphea. Both sets of symptoms, although separate, could form part of the same spectrum within the fibrosing type of dermatoses. We found no positive serology for B. burgdorferi in our patients.