Prevalence of atrial fibrillation and its associated factors in Spain: An analysis of 6 population-based studies. DARIOS Study. / Prevalencia de fibrilación auricular y factores asociados en España, análisis de seis estudios de base poblacional. Estudio DARIOS.

BACKGROUND AND OBJECTIVES: Atrial fibrillation (AF) is the most common type of arrhythmia. The purpose of this study was to determine the prevalence of atrial fibrillation and its relationship with cardiovascular risk factors in Spain. METHODOLOGY: Cross-sectional study based on a grouped analysis of 17,291 randomized individuals recruited in 6 population studies. RESULTS: The prevalence of atrial fibrillation was 1.5% (95% CI:1.3-1.7%). Men had a greater prevalence of the disease than women (1.9 vs. 1.1%, respectively). The prevalence of atrial fibrillation progressively increased with age: 0.05% for patients younger than 45 years, 0.5% for those between 45-59 years of age, 2.3% for those between 60-74 years of age and 6.3% for those older than 75 years. The percentage of individuals who were underwent anticoagulant treatment was 74.3%. The risk factors significantly associated with arrhythmia were an age older than 60 years (odds ratio [OR]: 7.6; 95% CI: 5.1-11.2), the male sex (OR:1.8; 95% CI: 1.4-2.4), arterial hypertension (OR:1.6; 95% CI: 1.2-2.1), obesity (OR:1.5; 95% CI:1.2-2.1) and a history of coronary artery disease (OR:1.9; 95% CI: 1.3-3.0). CONCLUSION: Atrial fibrillation is a common disease in elderly individuals, while its prevalence is low in individuals younger than 60 years. Most individuals with atrial fibrillation were on anticoagulant treatment. The risk factors for this type of arrhythmia are age, the male sex, hypertension, obesity and a history of coronary artery disease.

[Schizophrenia in primary health care centers: the SASPE study (alert signs and prodromic symptoms of schizophrenia in primary health care)]. / La esquizofrenia en atención primaria: el estudio SASPE (señales de alerta y síntomas prodrómicos de la esquizofrenia en atención primaria).

OBJECTIVES: To contribute to the knowledge of the alert signs and precursors of the schizophrenia, just as they can appear in the childhood, and of the prodromic signs other ages. DESIGN: Five descriptive studies: three retrospective, one transversal and one longitudinal study, based in the revision of clinical histories of an Community Mental Health Unit closely linked with the APS, additional revisions of the clinical histories of Family Doctors and Peadiatrics of Primary Care, and structured interviews with patients, patient's offspring, and PHC professionals. Two prospective studies: one, with schizophrenic's children; other, of children with alert signs detected in the first childhood. LOCATION OF THE PROJECT: USM-MHU of Sant Martí-La Mina, 5 Sanitary Basic Areas of Barcelona and Sant Adriá (Barcelona), besides the Functional Unit of Attention to the First Childhood of Sant Martí (Barcelona). PARTICIPANTS: Schizophrenic patients and relatives detected by the USM-MHU. Schizophrenic patients and relatives not detected by the USM. MHU-USM assistance staff and assistance staff of 5 ABS and of the Functional Unit of Attention to the First Childhood (UFAPI). Children with alert signs detected in the UFAPI and children with alert signs or risk factors detected in the EAP and in the Pediatric Teams of PC. METHODOLOGY AND INSTRUMENTS: Diagnoses DSM-IV. Structured interviews SCAN and IRAOS. Scales of positive and negative symptoms. Scales or screenings for the first childhood: ARBB, CBCL, and LISMEP. Structured interviews to determine precursory and prodromic signs: FETZ (Colony), ERIE-IRAOS (Hamburg-Barcelona), ERIE-red (reduced version of the IRAOS, adapted by the investigating team).

Anti-neutrophil cytoplasmic antibody-associated mucocutaneous allergic vasculitis with oral manifestations caused by propylthiouracil.

A 49-year-old woman treated with increasing dosage of propylthiouracil (PTU) in order to control hyperthyroidism, developed progressive necrotic ulcers in the oral cavity, oropharynx and rhinopharynx and vasculitic ulcers on both auricular pinnae after a few days. The PTU treatment was immediately discontinued and the mucosal and skin manifestations resolved promptly. Laboratory findings, including anti-neutrophil cytoplasmic antibodies (ANCA), suggested allergic vasculitis. This is to our knowledge the first reported case of oral manifestations of PTU-induced allergic vasculitis.

[Results of bat ear surgery over a period of ten years]. / Resultater af stritøreoperationer i en tiårig periode.

A material of 286 patients or 545 ears submitted to operation for protruding ears operated by Stenströms and Nordzells surgical procedure over a period of ten years were reviewed retrospectively. One hundred and sixty-three patients were clinically investigated and interviewed. The mean observation time was eight years. Satisfactory results were obtained in 94% of the patients subjectively. Objectively there was a good result in 74% of the cases. Relatively few complications and reoperations occurred. However 20% of the patients interviewed had postoperative pain more than one year after the operation. The results of the operations are reviewed and discussed. There was no significant difference between the results of the surgical procedure a.m. Stenström and a.m. Nordzell.

[Oral ranula. A follow-up study]. / Mundbundsranula. En efterundersøgelse.

Ranula is a cystic swelling of the floor of the mouth, which is usually unilateral and relatively uncommon. The cyst arises from the sublingual salivary gland. We reviewed 14 patients operated in the period 1976-April 1998. There was no recurrence after marsupialization and after extirpation of the sublingual gland. Fourteen percent of the patients had recurrence after extirpation of the cyst. At the follow-up time (average 8.1 years) 18.2% had complications. We suggest that marsupialization/extirpation of the cyst should be primary treatment. In case of recurrence the sublingual gland should be extirpated.

[Fatal hyperthrombotic condition complicating nephrotic syndrome]. / Letal hypertrombotisk tilstand ved nefrotisk syndrom.

A twenty-year old woman was admitted to hospital with impaired consciousness and a left hemiparesis. A cerebral CAT-scanning was reported normal. Convulsions and respiratory insufficiency made intubation and mechanical ventilation necessary. Laboratory examination showed an extremely low concentration of albumin in plasma (109 microM) and gross albuminuria was present. No other signs of renal failure occurred. The patient deteriorated during three days and died with signs of cerebral incarceration, despite efforts to reduce intracranial pressure. Autopsy showed a large thrombus of the sagittal sinus as the presumed cause of death. No thrombus was found in the renal vein. The association between nephrotic syndrome and thrombosis is discussed.