[Multi-tissue donor: a reachable option]. / El donante multitejido: una opción a nuestro alcance.

The clinical use of human tissues is a therapeutic reality in many diseases, observing a spectacular increase in their demand in recent years. This has also generated an increase in the demand for donors which, in regarding to obtaining tissues, is not limited to brain death donors. Consequently, tissues obtained from cardiorespiratory arrest donors must be promoted in our hospitals. With this purpose, we present our experience in the last five years and the mechanisms we used to reach these goals. During this period, an awareness and health care staff information campaign was carried out in the Emergency and Hemodynamic areas. The next step will be to extend this campaign to the rest of the hospital staff. We believe that the mechanisms needed to obtain hospital staff collaboration in the detection of multi-tissue donors is to offer updated information on the indications and therapeutic advantages of clinical use of human tissues, favoring hospital awareness on this subject and therefore the detection of potential donors.

[Smoking prevention intervention among secondary school students in the Spanish province of Malaga]. / Intervención sobre tabaquismo en estudiantes de enseñanza secundaria de la provincia de Málaga.

OBJECTIVE: To assess the prevalence of smoking among 13- to 18-year-old students, analyze smoking-related factors in this population, and design an intervention program to reduce smoking. POPULATION AND METHODS: A 6-month smoking prevention intervention was designed for students at a public secondary school in the Spanish province of Malaga. The objective of the intervention was to inform students of the gravity of smoking and its deleterious effects on health. The efficacy of the intervention was subsequently assessed. RESULTS: Of the 337 students who completed the questionnaire, 27% declared they were smokers. Smoking prevalence was significantly higher among girls (36.1%) than boys (18.1%) (P<.001) and progressively increased with age. Initiation occurred at 13 to 14 years of age. The most common reason for starting was to try something new (52.2% of students). The greatest risk factor in the family environment was having a smoking sibling. After the program, 78% of smokers admitted that the intervention had not affected their smoking but had made them more aware of its detrimental effects, and 66.8% planned to quit in the future. CONCLUSIONS: The study shows the high prevalence of smoking among adolescents, particularly among girls. It also shows that health education increases understanding of the problems related to smoking, causing changes of attitude with regard to whether they will smoke in the future.

[Lung scintigraphy with technetium 99m depreotide in the assessment of solitary pulmonary nodules]. / La gammagrafía con 99mTc-depreótida en la valoración del nódulo pulmonar solitario.

A solitary pulmonary nodule (SPN) is defined as a parenchymal lesion measuring less than 3 cm in diameter that is not associated with other lesions. Ninety percent of SPNs are discovered incidentally and most are benign. The management of radiographically indeterminate SPNs has not been established and invasive procedures must be undertaken in order to understand the nature of the nodule. We review our experience with the use of somatostatin receptor scintigraphy with technetium Tc99m depreotide in 10 patients with suspected malignant SPN. We discuss the limitations and applications of this technique in the evaluation of whether SPNs are benign or malignant for the purpose of identifying patients for biopsy. For this application, this technique can be considered an alternative to positron emission tomography using fluorine-18 fluordeoxyglucose.

[Cor pulmonale-PHT secondary to crest syndrome. Treatment with slow continuous ultrafiltration]. / Cor pulmonale hipertensión pulmonar secundaria a síndrome crest. Tratamiento con ultrafiltración lenta continua.

Pulmonary hypertension is a severe disease with complex treatment based on general measurements, anticoagulation and use of specific vasodilator drugs. Right heart failure initiated in final stages of the disease is treated with diuretics. We present the case of slow continuous ultrafilitration as treatment in right heart failure secondary to pulmonary hypertension associated to collagen disease refractory to diuretic treatment.

[Utility of plasmapheresis in intensive care]. / Utilidad de la plasmaféresis en cuidados intensivos.

We discuss the plasmapheresis (PE) carried out in an 18-bed polyvalent intensive care unit between the years 2003-2007. This article aims to report our experience in plasmapheresis performed with specific monitors for continuous renal replacement therapy (CRRT) that shows the versatility of the use of these procedures in intensive care. The utility of these procedures include many different critical disease settings in our units (neurology, hematology, and rheumatology patients). In short, our experience in PE has led us to the conclusion that plasmapheresis is a simple extracorporeal depuration treatment that can be performed by staff trained in intensive care at any moment within a wide spectrum of clinical indications, with CRRT monitors and with minimum adverse effects.

[Indications and long-term outcomes for solid organ transplant. Quality of life in solid organ transplant recipients]. / Indicaciones y resultados a largo plazo de los trasplantes de órganos sólidos. Calidad de vida en pacientes trasplantados.

Organ transplant constitutes one of the most encouraging advances in the history of the medicine. The organ transplants that were a distant challenge in the seventies currently are a routine procedure in the medical practice that has contributed to extending survival and quality of life in the general population. Spain has reached the highest rate for donation and transplants per one million inhabitants worldwide, this extraordinary health care work being a combined achievement of Spanish Health Care System. The objective of this article is to review the indications of solid organ transplants and their long-term outcomes, evaluating the impact on the health-related quality of life in solid organ transplant recipients.