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The quantification of forests available for wood supply (FAWS) is essential for decision-making with regard to the maintenance and enhancement of forest resources and their contribution to the global carbon cycle. The provision of harmonized forest statistics is necessary for the development of forest associated policies and to support decision-making. Based on the National Forest Inventory (NFI) data from 13 European countries, we quantify and compare the areas and aboveground dry biomass (AGB) of FAWS and forest not available for wood supply (FNAWS) according to national and reference definitions by determining the restrictions and associated thresholds considered at country level to classify forests as FAWS or FNAWS. FAWS represent between 75 and 95 % of forest area and AGB for most of the countries in this study. Economic restrictions are the main factor limiting the availability of forests for wood supply, accounting for 67 % of the total FNAWS area and 56 % of the total FNAWS AGB, followed by environmental restrictions. Profitability, slope and accessibility as economic restrictions, and protected areas as environmental restrictions are the factors most frequently considered to distinguish between FAWS and FNAWS. With respect to the area of FNAWS associated with each type of restriction, an overlap among the restrictions of 13.7 % was identified. For most countries, the differences in the FNAWS areas and AGB estimates between national and reference definitions ranged from 0 to 5 %. These results highlight the applicability and reliability of a FAWS reference definition for most of the European countries studied, thereby facilitating a consistent approach to assess forests available for supply for the purpose of international reporting.
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BACKGROUND AND OBJECTIVE: The gold standard of carpal tunnel syndrome (CTS) treatment is the section of the transverse carpal ligament, the most common technique being the palmar cutaneous incision. Percutaneous techniques have been developed, although their risk/benefit ratio remains controversial. OBJECTIVE: To analyze the functional outcome of patients undergoing CTS percutaneously ultrasound-guided and compare it with those of open surgery. MATERIAL AND METHOD: Prospective observational cohort study of 50 patients undergoing CTS (25 percutaneous with WALANT technique and 25 by open surgery with local anesthesia and tourniquet). Open surgery was performed using a short palmar incision. The percutaneous technique was performed anterograde using the Kemis® H3 scalpel (Newclip). A preoperative and postoperative assessment was performed at 2 weeks, 6 weeks and 3 months. Demographic data, presence of complications, grip strength and Levine test score (BCTQ) were collected. RESULTS: The sample consists of 14 men and 36 women with a mean age of 51.4 years (95% CI: 48.4-54.5). Percutaneous technique was performed anterograde using the Kemis® H3 scalpel (Newclip). All patients improved from their CTS clinic without obtaining statistically significant differences in BCTQ score, nor in the presence of complications (p> 0.05). Patients operated on percutaneously recovered faster grip strength at 6 weeks, but it was similar in the final review. CONCLUSIONS: In view of the results obtained, percutaneous ultrasound-guided surgery is a good alternative for the surgical treatment of CTS. Logically, this technique requires its learning curve and familiarization with the ultrasound visualization of the anatomical structures to be treated.
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BACKGROUND AND OBJECTIVE: The gold standard of carpal tunnel syndrome (CTS) treatment is the section of the transverse carpal ligament, the most common technique being the palmar cutaneous incision. Percutaneous techniques have been developed, although their risk/benefit ratio remains controversial. OBJECTIVE: To analyse the functional outcome of patients undergoing CTS percutaneously ultrasound-guided and compare it with those of open surgery. MATERIAL AND METHOD: Prospective observational cohort study of 50 patients undergoing CTS (25 percutaneous with WALANT technique and 25 by open surgery with local anaesthesia and tourniquet). Open surgery was performed using a short palmar incision. The percutaneous technique was performed anterograde using the Kemis H3® scalpel (Newclip). A preoperative and postoperative assessment was performed at 2 weeks, 6 weeks and 3 months. Demographic data, presence of complications, grip strength and Levine test score (BCTQ) were collected. RESULTS: The sample consists of 14 men and 36 women with a mean age of 51.4 years (95% CI: 48.4-54.5). Percutaneous technique was performed anterograde using the Kemis H3® scalpel (Newclip). All patients improved from their CTS clinic without obtaining statistically significant differences in BCTQ score, nor in the presence of complications (p>0.05). Patients operated on percutaneously recovered faster grip strength at 6 weeks, but it was similar in the final review. CONCLUSIONS: In view of the results obtained, percutaneous ultrasound-guided surgery is a good alternative for the surgical treatment of CTS. Logically, this technique requires its learning curve and familiarisation with the ultrasound visualisation of the anatomical structures to be treated.
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INTRODUCTION: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. METHOD: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. RESULTS: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. CONCLUSION: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.
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Ground vegetation (GV) is an important component from which many forest biodiversity indicators can be estimated. To formulate policies at European level, taking into account biodiversity, European National Forest Inventories (NFIs) are one of the most important sources of forest information. However, for monitoring GV, there are several definitions, data collection methods, and different possible indicators. Even though it must be considered that natural conditions in different countries form very different understory types, each one has its own cost-efficient monitoring design, and they can hardly be compared. Therefore, the development of general guidelines is a particularly complex issue. This paper is a review of data collection methods and consequently a selection of the best available methods for the set of indicators with an emphasis on GV sampling methodologies in NFIs. As a final result, recommendations on GV definitions and classifications, sampling methodologies, and indicators are formulated for NFIs. Different sampling areas are recommended for each life form (shrubs, herbs, etc.). Inventory cycles and sampling seasons (depending on the phonological stages) should be specially considered and evaluated in the results. The proposed indicators are based on composition at different levels of sampling intensity for each life form and on coverage measurements.
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Biodiversidad , Monitoreo del Ambiente/métodos , Plantas , ÁrbolesRESUMEN
We report our initial experience in 2 patients with degenerative calcific aortic stenosis who underwent ultrasonic debridement of the aortic valve. Compared with preoperative studies, doppler echocardiographic and hemodynamic evaluation before hospital discharge revealed a reduction in the mean aortic valve pressure gradient (80 and 65 mmHg to less than 10 mmHg). There was no change in aortic regurgitation grade. Follow-up doppler echocardiographic evaluation at four and six months showed no changes in gradient or regurgitation in the comparison to the postoperative data. Long-term results will show the convenience to attempt or not ultrasonic salvage of the native aortic valve in severe calcific stenosis.
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Estenosis de la Válvula Aórtica/terapia , Válvula Aórtica , Calcinosis/terapia , Terapia por Ultrasonido , Anciano , Estenosis de la Válvula Aórtica/etiología , Calcinosis/complicaciones , Enfermedades de las Válvulas Cardíacas/complicaciones , Enfermedades de las Válvulas Cardíacas/terapia , Humanos , MasculinoRESUMEN
PIP: A comparative overview is provided of trends in family structure and relationships in Europe as a whole, followed by an analysis of the political debate concerning family policy in Spain and elsewhere in Europe. The forms of cohabitation are undergoing diversification throughout Europe, and the size of households is declining. Fewer children are born and fewer reside with both parents until maturity. Separation and divorce, the possibility of remarriage, and independent living of older persons have influenced household size. The improved status of women and legal equality between men and women throughout Europe have influenced marital relationships and family organization. Statistics on age at marriage, divorce rates, number of children, and similar topics permit an approach to comparative analysis of families, but several obstacles must be overcome. Both explicit policies that are publicly debated and implicit policies must be considered. The diversity of focuses, instruments, and political actions in the different European countries hinder comparison. The family policies of the UK, Denmark, Germany, Sweden, and France are described to illustrate their differences and convergences and their backgrounds in culture and tradition. The Spanish case is then examined in detail. No explicit family policy has appeared in the post-Franco period, probably in reaction to the demagogic use of the family by the Franco regime. Progressive and leftist parties have avoided mention of the family even as they promulgated reforms greatly benefiting families.^ieng
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Composición Familiar , Política de Planificación Familiar , Relaciones Familiares , Formulación de Políticas , Política , Países Desarrollados , Europa (Continente) , Planificación en Salud , Organización y Administración , Política Pública , Investigación , EspañaRESUMEN
An investigation was made of the effect of emergency endoscopic sclerotherapy on the evaluation of digestive hemorrhage (HDA) secondary to gastroduodenal ulcer disease in two consecutive groups of patients. The control group included 92 patients and the sclerotherapy group contained 63. Both groups had the same management and basic treatment of hemodynamic stabilization, anti-H2 agents and alkaline . The sclerotherapy group also received a local injection of 1/10,000 (5-12 ml) adrenaline and 1% polydocanol (5-12 ml) if direct signs of hemorrhage (active bleeding, red clot, visible vessel) were seen at the time of early endoscopy. Surgery was indicated in the presence of persistent, recurrent or massive digestive hemorrhage. Thirty-two percent of the control group and 34% of the sclerosis group presented direct signs of hemorrhage at the time of endoscopy. Both groups were homogeneous with respect to sex distribution, NSAID intake, hemoglobin, presence of shock and etiology (33.3% and 36.3%, respectively, had duodenal ulcer). The average age was significantly higher in the control group than in the sclerotherapy group. Neither the presence of any endoscopic sign nor etiology contributed to the evolution of digestive bleeding. It is concluded that emergency endoscopic sclerotherapy with injection of adrenaline and polydocanol has a clearly favorable effect on the evolution of bleeding secondary to gastrointestinal ulcer disease evidencing direct signs on endoscopy.