Uplink wavefront corrector system: from paper to reality.

The Uplink Wavefront Corrector System (UWCS) is a pathfinder instrument to demonstrate the uplink correction by Adaptive Optics techniques; this novel application can be directly usable in two fields: Free-Space Optical Communications and the generation of Laser Guide Stars. A Rayleigh LGS is propagated to the sky while the atmospheric wavefront aberrations are measured by a Shack-Hartmann WFS with 12 x 12 sub-apertures using a Natural Guide Star as a reference. The laser upwards propagation path is then pre-compensated by a 97-actuator deformable mirror. A scoring camera is attached to the finder telescope, next to the main aperture, in order to show the overall result, which is assessed in terms of beam power concentration. Present paper described the design process of the UWCS and its integration and testing in the Optical Ground Station telescope, at Teide Observatory (Spain).

Combined Elbow Release and Humeral Rotational Osteotomy in Arthrogryposis.

PURPOSE: The purpose of this study was to determine if a simultaneous posterior elbow release and humeral osteotomy to correct both the elbow extension contracture and the humeral internal rotation contracture in children with arthrogryposis can produce similar results as a posterior elbow release alone. METHODS: This study was a retrospective chart review of consecutive patients with arthrogryposis treated surgically for elbow extension contracture between 2007 and 2014. A total of 43 procedures in 36 patients had adequate available follow-up data and were included in the study. The postoperative range of motion reported was measured at the early follow-up (3-6 months), midterm follow-up (between 1 and 2 years), and the most recent long-term follow-up (after 2 years) from the date of surgery. Patients were grouped into 2 groups (simultaneous and release) based on the necessity of performing an ipsilateral humeral rotation osteotomy at the time of the release. RESULTS: At early follow-up, patients in both groups increased their total arc of motion. There was a significant difference in extension and arc of motion at midterm follow-up (between 1 and 2 years) between the simultaneous and the release groups with the simultaneous group significantly losing both terminal extension and total arc of motion. At more than 2 years follow-up, there remained a statistically significant difference in arc of motion, with the release group having a significantly larger arc of motion. Patients who underwent dual plating had a much larger arc of motion at early follow-up than the K-wire or single-plate fixation group, despite having similar preoperative extension, flexion, and arc of motion. This difference was also significant at late follow-up. CONCLUSIONS: Patients with posterior release alone had significantly greater improvement in total arc of motion and significantly better elbow extension than patients who underwent a simultaneous humeral osteotomy. However, rigid fixation with early mobilization may yield results comparable with the release alone group. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

BACKGROUND: Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. METHODS: In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. RESULTS: Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (P<0.0001). Compared with the preconference years, Hamot residents answered 3.99 more questions correctly (P<0.0001) and Pitt residents answered 2.93 more questions correctly (P<0.0001). Before the conference, site was not a predictor of OITE score (P=0.06) or percentile (P=0.08); there was no significant difference found between the mean scores per program. However, in the postconference years, site did predict OITE scores. Controlling for year in training, Hamot residents scored higher on the OITE (2.3 points higher, P=0.003) and had higher percentiles (0.07 higher, P=0.004) than Pitt residents during the postconference years. CONCLUSIONS: This study suggests that adding a didactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores. LEVEL OF EVIDENCE: Level III-retrospective case-control study.

Review: Spreading the word: precise animal models and validated methods are vital when evaluating prion-like behaviour of alpha-synuclein.

Synucleinopathies are characterized by abnormal proteinaceous aggregates, mainly composed of fibrillar α-synuclein (α-syn). It is now believed that α-syn can form small aggregates in a restricted number of cells, that propagate to neighbouring cells and seed aggregation of endogenous α-syn, in a 'prion-like manner'. This process could underlie the stereotypical progression of Lewy bodies described by Braak and colleagues across different stages of Parkinson's disease (PD). This prion-like behaviour of α-syn has been recently investigated in animal models of PD or multiple system atrophy (MSA). These models investigate the cell-to-cell transfer of α-syn seeds, or the induction and spreading of α-syn pathology in transgenic or wild-type rodent brain. In this review, we first outline the involvement of α-syn in Lewy body diseases and MSA, and discuss how 'prion-like' mechanisms can contribute to disease. Thereon, we debate the relevance of animal models used to study prion-like propagation. Finally, we review current main histological methods used to assess α-syn pathology both in animal models and in human samples and their relevance to the disease. Specifically, we discuss using α-syn phosphorylated at serine 129 as a marker of pathology, and the novel methods available that allow for more sensitive detection of early pathology, which has relevance for modelling synucleinopathies.

Synthesis of oxocarbon-encapsulated gold nanoparticles with blue-shifted localized surface plasmon resonance by pulsed laser ablation in water with CO2 absorbers.

Colloidal suspensions of oxocarbon-encapsulated gold nanoparticles have been synthesized in a one-step procedure by pulsed-laser ablation (PLA) at 532 nm of a solid gold target placed in aqueous solution containing CO2 absorbers, but without any stabilizing agent. Multi-wavelength surface enhanced Raman spectroscopy allows the identification of adsorbed amorphous carbon and graphite, Au-carbonyl, Au coordinated CO2-derived bicarbonates/carbonates and hydroxyl groups around the AuNPs core. Scanning electron microscopy, energy dispersive x-ray analysis and high resolution transmission electron microscopy highlight the organic shell structure around the crystalline metal core. The stability of the colloidal solution of nanocomposites (NCs) seems to be driven by solvation forces and is achieved only in neutral or basic pH using monovalent hydroxide counter-ions (NaOH, KOH). The NCs are characterized by a blue shift of the localized surface plasmon resonance (LSPR) band typical of metal-ligand stabilization by terminal π-back bonding, attributed to a core charging effect caused by Au-carbonyls. Total organic carbon measurements detect the final content of organic carbon in the colloidal solution of NCs that is about six times higher than the value of the water solution used to perform PLA. The colloidal dispersions of NCs are stable for months and are applied as analytical probes in amino glycoside antibiotic LSPR based sensing.

Digital Chondrolysis and Epiphysiolysis Associated With Snakebite: A Report of 2 Cases.

BACKGROUND: Here, we present 2 cases of the unusual sequelae of a venomous bite to the finger in children resulting in chondrolysis and physeal loss. There have been few isolated case reports documenting this phenomenon. Currently, there is no preventative treatment, and patients should be warned of this possible complication of envenomation. METHODS: Two patients with chondrolysis and physeal loss have been seen in our practice. RESULTS: Chondrolysis and epiphysiolysis occurred in 2 patients. One patient was treated with proximal interphalangeal joint fusion and one is being managed conservatively. CONCLUSION: The toxic action of snake venom may cause loss of the growth plate and chondrolysis in the pediatric hand. LEVEL OF EVIDENCE: Level IV.

A line drawn along the radial shaft misses the capitellum in 16% of radiographs of normal elbows.

BACKGROUND: The radiocapitellar line (RCL) is a routinely referenced radiographic measurement for evaluating injury of the pediatric elbow, such as a Monteggia fracture. It is most commonly described as a line drawn along the radius that should intercept the center of the capitellum in a normal elbow. However, the RCL has not been rigorously defined or validated in young children. METHODS: The RCL was drawn out on the anteroposterior and lateral radiographs of 116 normal pediatric elbows by 3 examiners. On each radiograph, lines were drawn along the longitudinal center of the radial neck as well as the radial shaft. The distance from each of these lines to the center of the capitellum was defined as the line-capitellar distance (LCD). The LCD was standardized to the patient size and correlated with patient variables. RESULTS: Of the 2052 RCLs drawn, 50% (1029/2052) fell outside the middle third of the capitellum and 8.6% (176/2052) missed the capitellum completely. Lines drawn along the radial neck in the anteroposterior and lateral views missed the capitellum less frequently (1.2% vs. 12.7%, P<0.0001) and passed through its central third less (77.8% vs. 44.7%, P<0.0001) when compared with lines drawn using the radial shaft. Lines along the radial neck intersected the capitellum significantly more often on the lateral view than on the anteroposterior view (98.8% vs. 96.8%, P=0.06) and were more likely to pass through the center third of the capitellum (77.8% vs. 55.5%, P<0.0001). With both techniques of drawing the RCL, the percent of measurements falling within the middle third of the capitellum was higher in patients above 5 years of age (P<0.001). The RCL is more reliable in older patients and shows considerable variation in infants. CONCLUSIONS: The RCL does not invariably bisect or fall within the middle third of the capitellum in normal pediatric elbows. Therefore, an abnormal RCL is suggestive but not pathognomonic for injury such as Monteggia fracture. An RCL drawn along the radial shaft will miss the capitellum in 15.6% of elbows. The most consistent RCL is drawn along the radial neck on the lateral view. Patient variables such as age and sex should be considered in the ability of the RCL to identify elbow injury. LEVEL OF EVIDENCE: Diagnostic Level 3.

Low to moderate dose 137Cs (γ) radiation promotes M2 type macrophage skewing and reduces atherosclerotic plaque CD68+ cell content in ApoE(-/-) mice.

The effects of low doses of ionizing radiation on atherosclerosis remain uncertain, particularly as regards the generation of pro- or anti-inflammatory responses, and the time scale at which such effects can occur following irradiation. To explore these phenomena, we exposed atheroprone ApoE(-/-) mice to a single dose of 0, 0.05, 0.5 or 1 Gy of 137Cs (γ) administered at a 10.35 mGy min-1 dose rate and evaluated short-term (1-10 days) and long-term consequences (100 days). Bone marrow-derived macrophages were derived from mice 1 day after exposure. Irradiation was associated with a significant skewing of M0 and M2 polarized macrophages towards the M2 phenotype, as demonstrated by an increased mRNA expression of Retnla, Arg1, and Chil3 in cells from mice exposed to 0.5 or 1 Gy compared with non-irradiated animals. Minimal effects were noted in M1 cells or M1 marker mRNA. Concurrently, we observed a reduced secretion of IL-1ß but enhanced IL-10 release from M0 and M2 macrophages. Effects of irradiation on circulating monocytes were most marked at day 10 post-exposure, when the 1 Gy dose was associated with enhanced numbers of both Ly6CHigh and Ly6Low cells. By day 100, levels of circulating monocytes in irradiated and non-irradiated mice were equivalent, but anti-inflammatory Ly6CLow monocytes were significantly increased in the spleen of mice exposed to 0.05 or 1 Gy. Long term exposures did not affect atherosclerotic plaque size or lipid content, as determined by Oil red O staining, whatever the dose applied. Similarly, irradiation did not affect atherosclerotic plaque collagen or smooth muscle cell content. However, we found that lesion CD68+ cell content tended to decrease with rising doses of radioactivity exposure, culminating in a significant reduction of plaque macrophage content at 1 Gy. Taken together, our results show that short- and long-term exposures to low to moderate doses of ionizing radiation drive an anti-inflammatory response, skewing bone marrow-derived macrophages towards an IL-10-secreting M2 phenotype and decreasing plaque macrophage content. These results suggest a low-grade athero-protective effect of low and moderate doses of ionizing radiation.

Exposure to Low to Moderate Doses of Ionizing Radiation Induces A Reduction of Pro-Inflammatory Ly6chigh Monocytes and a U-Curved Response of T Cells in APOE -/- Mice.

Low dose ionizing radiation (LDIR) is known to have a protective effect on atherosclerosis in rodent studies, but how it impacts different cells types involved in lesion formation remains incompletely understood. We investigated the immunomodulatory response of different doses and dose-rates of irradiation in ApoE-/- mice. Mice were exposed to external γ rays at very low (1.4 mGy.h-1) or low (50 mGy.h-1) dose-rates, with cumulative doses spanning 50 to 1000 mGy. Flow cytometry of circulating cells revealed a significant decrease in pro-inflammatory Ly6CHi monocytes at all cumulative doses at low dose-rate, but more disparate effects at very low dose-rate with reductions in Ly6CHi cells at doses of 50, 100 and 750 mGy only. In contrast, Ly6CLo monocytes were not affected by LDIR. Similarly, proportions of CD4+ T cell subsets in the spleen did not differ between irradiated mice and non-irradiated controls, whether assessing CD25+FoxP3+ regulatory or CD69+ activated lymphocytes. In the aorta, gene expression of cytokines such as IL-1 and TGF-ß and adhesion molecules such as E-Selectin, ICAM-1, and VCAM-1 were reduced at the intermediate dose of 200 mGy. These results suggest that LDIR may reduce atherosclerotic plaque formation by selectively reducing blood pro-inflammatory monocytes and by impairing adhesion molecule expression and inflammatory processes in the vessel wall. In contrast, splenic T lymphocytes were not affected by LDIR. Furthermore, some responses to irradiation were nonlinear; reductions in aortic gene expression were significant at intermediate doses, but not at either highest or lowest doses. This work furthers our understanding of the impact of LDIR with different dose-rates on immune system response in the context of atherosclerosis.

Major complications after 400 continuous popliteal sciatic nerve blocks for post-operative analgesia.

BACKGROUND: A continuous popliteal sciatic nerve block (CPSNB) has been performed with increasing frequency for post-operative analgesia after foot surgery. Major complications associated with the placement of a perineural catheter remain rarely studied. The aim of this study was to prospectively determine the incidence of major complications (neurological and infectious) in post-operative adult patients with a continuous popliteal catheter inserted by the anatomical posterior approach for analgesia after foot surgery. METHODS: All popliteal catheters were placed pre-operatively under sterile conditions with the aid of a nerve stimulator technique. The primary outcome measure was the incidence of major complications including infection and neuropathy. As a secondary outcome, adverse effects as well as other complications were also evaluated. Data were expressed as median [25th-75th percentiles]. RESULTS: A total of 400 patients were included in the study during a 2-year period. The median time the catheter remained indwelling was 47 h [23, 54]. Major complications included three events (0.75%) with one infection (0.25%) and two neuropathies (0.50%). Three blocks were unsuccessful and the catheter insertion was difficult in 12 patients (3%). During the CPSNB procedure, one patient reported slight paraesthesia during stimulation. Patient satisfaction was scored at 4 for 89%, 3 for 6% and 2 for 5% on the analogue scale. CONCLUSIONS: Major complications after the use of CPSN are not in fact rare. The incidence of severe neuropathy or infection complications is, respectively, 0.50% and 0.25%. However, the insertion of CPSN could be considered effective and is associated with only a few minor complications.

Central retinal artery occlusion after peribulbar anesthesia: report of 3 cases.

We report 3 cases of central retinal artery occlusion following peribulbar anesthesia. Those patients were scheduled for retinal detachment repair, removal of a pterygium, and cataract surgery, respectively. In patient 1, a peribulbar anesthesia was performed with 17 ml of ropivacaine and a compression with a Honan's balloon was maintained at 30 mmHg for 30 min to reduce intra ocular pressure and facilitate intra ocular surgery. In the second patient, 13 ml of ropivacaine was administered without compression of the ocular globe. Patient 3 received 14 ml of mepivacaine and compression was maintained at 30 mmHg for 10 min. In these 3 cases, the surgeon noticed a whitening of the retina during the postoperative period, corresponding with a typical occlusion of the central artery of the retina. Several mechanisms may be cited in an attempt to explain this retinal ischemia: the high volume injected, the speed of injection, a compression of the ocular globe at high pressures for a prolonged period of time, and/or an intrinsic vasoconstricting effect of local anesthetic agents.

Racial Diversity in Orthopedic Surgery.

Data from the US Census Bureau, the Accreditation Council for Graduate Medical Education, and the American Academy of Orthopaedic Surgeons reveal that orthopedic surgery is the least diverse of any surgical specialty and that diversity within orthopedics is not improving. Considerable data from both medicine and business suggest that improving diversity within the orthopedic surgery specialty would be of significant benefit to the orthopedic surgery profession and to patients. Multiple avenues for increasing diversity exist, including large-scale pipeline programs as well as personal and institutional efforts examining biases and decision-making processes.

Sleep and disruptive mood dysregulation disorder: A pilot actigraphy study.

OBJECTIVE: To explore the clinical characteristics and motor activity profile during sleep periods of children and adolescents presenting with disruptive mood dysregulation disorder (DMDD). METHOD: Twenty-one youths (mean age±standard deviation, 11.7±3 years) wore a wrist actigraph for 9 consecutive days (including both school days and non-school days), to measure sleep parameters: sleep latency, sleep efficiency and the number and duration of periods of wakefulness after sleep onset (WASO). We divided the night-time actigraphy recording sessions into three sections and compared the first and last thirds of the night. RESULTS: All the study participants had a psychiatric comorbidity (primarily attention deficit hyperactivity disorder, depressive disorder or anxiety disorder). On non-school days, bedrest onset and activity onset were shifted later by about 1h. There was no significant difference between school days and non-school days with regard to the total sleep time. Sleep efficiency was significantly greater on non-school days. Sleep was fragmented on both school days and non-school days. The mean number of episodes of WASO was 24.9 for school days and 30.9 for non-school days. Relative to the first third of the night, we observed a significantly greater number of episodes of WASO during the last third of the night, a period associated with a larger proportion of rapid eye movement (REM) sleep. DISCUSSION: Sleep appeared to be fragmented in the study population of youths with DMDD. The greater frequency of WASO in the last third of the night points to a possible impairment of the motor inhibition normally associated with REM sleep.

Continuous infusion versus bolus injection of loop diuretics in congestive heart failure.

BACKGROUND: Loop diuretics, when given as intermittent bolus injections in acutely decompensated heart failure, may cause fluctuations in intravascular volume, increased toxicity and development of tolerance. Continuous infusion has been proposed to avoid these complications and result in greater diuresis, hopefully leading to faster symptom resolution, decrease in morbidity and possibly, mortality. OBJECTIVES: To compare the effects and adverse effects of continuous intravenous infusion of loop diuretics with those of bolus intravenous administration among patients with congestive heart failure Class III-IV. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003) and the HERDIN database. We also contacted pharmaceutical companies . SELECTION CRITERIA: Randomized controlled trials comparing the efficacy of continuous intravenous infusion versus bolus intravenous administration of loop diuretics in congestive heart failure were included DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed study eligibility, methodological quality and did data extraction. Included studies were assessed for validity. Authors were contacted when feasible. Adverse effects information was collected from the trials. MAIN RESULTS: Eight trials involving 254 patients were included. In seven studies which reported on urine output, the output (as measured in cc/24 hours) was noted to be greater in patients given continuous infusion with a weighted mean difference (WMD) of 271 cc/24 hour (95%CI 93.1 to 449; p<0.01). Electrolyte disturbances (hypokalemia, hypomagnesemia) were not significantly different in the two treatment groups with a relative risk (RR) of 1.47 (95%CI 0.52 to 4.15; p=0.5). Less adverse effects (tinnitus and hearing loss) were noted when continuous infusion was given, RR 0.06 (95%CI 0.01 to 0.44; p=0.005). Based on a single study, the duration of hospital stay was significantly shortened by 3.1days with continuous infusion WMD -3.1 (95%CI -4.06 to -2.20; p<0.0001) while cardiac mortality was significantly different in the two treatment groups, RR 0.47 (95% CI 0.33 to 0.69; p<0.0001). Based on two studies, all cause mortality was significantly different in the two treatment groups, RR 0.52 (95%CI 0.38 to 0.71; p<0.0001). AUTHORS' CONCLUSIONS: Currently available data are insufficient to confidently assess the merits of the two methods of giving intravenous diuretics. Based on small and relatively heterogenous studies, this review showed greater diuresis and a better safety profile when loop diuretics were given as continuous infusion. The existing data still does not allow definitive recommendations for clinical practice and larger studies should be done to more adequately settle this issue.

A brief review of extensor tendon injuries specific to the pediatric patient.

Extensor tendon injuries in the pediatric population require careful evaluation and treatment. This article focuses on the differences in injury type and treatment of pediatric versus adult extensor tendon injuries. A detailed history and physical examination is crucial in the management of extensor tendon injuries of the young patient. Treatment of pediatric extensor tendon injuries depends largely on the site of injury. A majority of these injuries may be treated with splinting or primary repair. Treatment methods that require high compliance must be adjusted for the young child.

Disruption of zinc and copper interactions with Aß(1-40) by a non-toxic, isoniazid-derived, hydrazone: a novel biometal homeostasis restoring agent in Alzheimer's disease therapy?

Disruptions of biometal-Aß(1-40) interactions by an isoniazid-derived hydrazone, INHHQ, were demonstrated via in vitro NMR titrations. The compound has adequate theoretical BBB absorption properties, assessed by in silico studies. In vivo acute toxicity assays indicate that INHHQ is innocuous up to 300 mg kg(-1), showing potential as an anti-Alzheimer's drug.

Continuous infusion versus bolus injection of loop diuretics in congestive heart failure.

BACKGROUND: Loop diuretics, when given as intermittent bolus injections in acutely decompensated heart failure, may cause fluctuations in intravascular volume, increased toxicity and development of tolerance. Continuous infusion has been proposed to avoid these complications and result in greater diuresis, hopefully leading to faster symptom resolution, decrease in morbidity and possibly, mortality. OBJECTIVES: To compare the effects and adverse effects of continuous intravenous infusion of loop diuretics with those of bolus intravenous administration among patients with congestive heart failure Class III-IV. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003) and the HERDIN database. We also contacted pharmaceutical companies. SELECTION CRITERIA: Randomized controlled trials comparing the efficacy of continuous intravenous infusion versus bolus intravenous administration of loop diuretics in congestive heart failure were included DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed study eligibility, methodological quality and did data extraction. Included studies were assessed for validity. Authors were contacted when feasible. Adverse effects information was collected from the trials. MAIN RESULTS: Eight trials involving 254 patients were included. In seven studies which reported on urine output, the output (as measured in cc/24 hours) was noted to be greater in patients given continuous infusion with a weighted mean difference (WMD) of 271 cc/24 hour (95%CI 93.1 to 449; p<0.01). Electrolyte disturbances (hypokalemia, hypomagnesemia) were not significantly different in the two treatment groups with a relative risk (RR) of 1.47 (95%CI 0.52 to 4.15; p=0.5). Less adverse effects (tinnitus and hearing loss) were noted when continuous infusion was given, RR 0.06 (95%CI 0.01 to 0.44; p=0.005). Based on a single study, the duration of hospital stay was significantly shortened by 3.1days with continuous infusion WMD -3.1 (95%CI -4.06 to -2.20; p<0.0001) while cardiac mortality was not significantly different in the two treatment groups, RR 0.47 (95% CI 0.33 to 0.69; p<0.0001). Based on two studies, all cause mortality was not significantly different in the two treatment groups, RR 0.52 (95%CI 0.38 to 0.71; p<0.0001). REVIEWER'S CONCLUSIONS: Currently available data are insufficient to confidently assess the merits of the two methods of giving intravenous diuretics. Based on small and relatively heterogenous studies, this review showed greater diuresis and a better safety profile when loop diuretics were given as continuous infusion. The existing data still does not allow definitive recommendations for clinical practice and larger studies should be done to more adequately settle this issue.

[Descriptive study of suicide in Galicia, 1987]. / Estudio descriptivo do suicidio en Galicia, 1987.

Deaths caused by suicide in Galicia during 1987 are studied, in order to identify high incidence areas where further studies could be designed to define specific factors for suicide. Three hundred and three death certificates and their corresponding judicial reports in the subgroup E950-959 of the International Classification of Diseases (ICD-9) were processed. Suicide rate in Galicia was found to be 10.65 per 100,000 inhabitants, with 5,313 Years of Potential Life Lost. The suicide rate in the province of Coruña was the highest (12.79 per 100,000 inhabitants) and, within it, the Narón area reached the highest rate (35.40 deaths per 100,000 inhabitants). Male to female ratio was 3.7. Mean age at suicide was 52.8 (sigma = 18.8), the range being 14-90 years. The age distribution was concentrated at older ages, especially among women, who contributed to a higher number of deaths by suicide on sundays and first days of the week. Hanging was the method chosen in 66% of deaths. We conclude that Galicia has a high mortality due to suicide, especially in the industrial area where the economic crisis is more pronounced.

[The quality of mortality statistics. Galicia 1987]. / Aproximación a calidade das estadísticas de mortalidade. Galicia 1987.

We intend to study the reliability of the mortality statistics in Galicia (1987), comparing the basic cause of death, with that we obtain by the Autopsy Report (AR). After independently studying 90 AR, three physicians selected the basic cause of death, subsequently coded by the same team. All this persons were blind in relation with the previous certification. 41.1% of the causes of death agreed in 4 digit, 45.6% agreed in 3 digit and the 63.3% remained in the same ICD-9 group. Taking into account all the mistakes found, the 13.3% took place due to an incomplete definition, but the classification remained correct. The 10.0% due to an error in the logic sequence, the 15.6% by an error in the selection of the cause of death and, in the 20.0% there was no relationship between causes. For cardiovascular diseases, the Predictive Positive Value (PPV) was 76.9%, the Sensibility (S) was 83.0% and the Specificity (Sp) 90.9%. For the tumors, the value of the PPV and the S was 73.7% and the Sp was 92.9%. In spite of selection bias because of the method used, we think that the information produced is useful for evaluating the quality of mortality statistics in Galicia. When comparing our results with similar studies, we find an acceptable level.