Alternative end-of-life options for disposable bioplastic products: Degradation and ecotoxicity assessment in compost and soil.

Four different end-of-life options for disposable bioplastic cups were investigated and compared based on their environmental implications. Two products with distinct polymeric composition were tested simulating the following scenarios at laboratory scale: i) industrial composting (180 days at 58 °C); ii) anaerobic digestion followed by industrial composting (45 days at 55 °C and 180 days at 58 °C); iii) anaerobic digestion followed by direct digestate use on soil for agricultural purposes (45 days at 55 °C and 180 days at 25 °C); iv) uncontrolled release into a soil environment (180 days at 25 °C). Ecotoxicity tests were run at the end of each experiment to investigate the effects of the materials on three main groups of terrestrial model organisms: plants, earthworms and nitrifying bacteria. Complete biodegradation of the cups was observed in 180 days in the scenarios involving composting environment. A low degree of biodegradation (22.9 ± 4.5%) of the digestates in soil was observed, warning for a potential micro-bioplastics discharge into the environment. No degradation was observed for the cups in soil during the same testing period. Ecotoxicity tests revealed a negative effect on plants biomass growth across all samples, which was 17-30% lower compared to the blank sample. The experimental campaign highlighted the need for a systematic assessment of controlled treatment of bioplastics, as well as the need for a harmonized legislative framework.

An Anthropological Investigation of the Sociocultural and Economic Forces Shaping Dental Crowding Prevalence.

OBJECTIVE: The aim of the current study is to explore country of origin and social race category differences in dental crowding prevalence through an anthropological approach. DESIGN: Data were collected from individuals within five countries (Australia, China, Japan, South Africa, United States; n = 1008) and seven social race groups in two countries (American Black, American White, Latinx, and Indigenous in the United States, South African Black, South African White, and South African Coloured; n = 654). Statistical significance between groups was assessed with a Kruskal-Wallis test, while a Dunn's post-hoc test identified which groups significantly differed. RESULTS: Results indicate South Africa is characterized by the lowest frequencies of dental crowding, with Coloured South Africans yielding the highest and Black South Africans displaying the lowest frequencies. Individuals in the United States exhibited relatively high levels of minor dental crowding. American Blacks had lower crowding levels, while the Indigenous group had high levels of severe crowding. Individuals within China and Japan exhibited higher relative prevalence of severe crowding. CONCLUSIONS: Overall, significant differences exist in dental crowding prevalence across countries and social race categories using an anthropological grading system to assess crowding. These differences are likely impacted by sociocultural (aesthetic preferences) and economic (access to dental care) factors.

A hospital incident reporting system (2016-2019): Learning from notifier's perception on incidents' risk, severity and frequency of adverse events.

Incident reporting systems (IRSs) are considered safety culture promoters. Nevertheless, they have not been contemplated to monitor professionals' perception about patient safety related risks. This study aims to describe the characteristics and evolution of incident notifications reported between 2016 and 2019 in a high complexity reference hospital in Barcelona and explores the association between notifications' characteristics and notifier's perception about incidents severity, probability of occurrence and risk. The main analysis unit was notifications reported. A descriptive analysis was performed and taxes by hospital activity were calculated. Odds ratios were obtained to study the association between the type of incident, the moment of incident, notifiers' professional category, reported incident's severity, probability and incidents' calculated risk. Through the study period, a total of 6379 notifications were reported, observing an annual increase of notifications until 2018. Falls (21.22%), Medical and procedures management (18.91%) and Medication incidents (15.49%) were the most frequently notified. Departments reporting the highest number of notifications were Emergency room and Obstetrics & Gynaecology. Incident type and notifiers' characteristics were consistently included in the models constructed to assess risk perception. Pharmaceutics were the most frequent notifiers when considering the proportion of staff members. Notification patterns can inform professionals' patient risk perception and increase awareness of professionals' misconceptions regarding patient safety.

Length of stay and trauma center finances: A disparity of payer source at a Level I trauma center.

BACKGROUND: In an effort to reduce costs, hospitals focus efforts on reducing length of stay (LOS) and often benchmark LOS against the geometric LOS (GMLOS) as predicted by the assigned diagnosis-related group (DRG) used by the Centers for Medicare and Medicaid Services. The objective of this cross-sectional study was to evaluate the impact of exceeding GMLOS on hospital profit/loss with respect to payer source. METHODS: Contribution margin for each insured patient admitted to a Level I trauma center between July 1, 2016, and June 30, 2019, was determined. Age, ethnicity, race, DRG weight, DRG version, injury severity, intensive care unit admission status, mechanical ventilation, payer, exceeding GMLOS, and the interaction between payer and exceeding the GMLOS were regressed on contribution margin to determine significant predictors of positive contribution margin. RESULTS: Among 2,449 insured trauma patients, the distribution of payers was Medicaid (54.6%), Medicare (24.0%), and commercial (21.4%). Thirty-five percent (n = 867) of patient LOS exceeded GMLOS. Exceeding GMLOS by 10 or more days was significantly more likely for Medicaid and Medicare patients in stepwise fashion (commercial, 2.7%; Medicaid, 4.5%; Medicare, 6.0%; p = 0.030). Median contribution margin was positive for commercially insured patients ($16,913) and negative for Medicaid (-$8,979) and Medicare (-$2,145) patients. Adjusted multivariate modeling demonstrated that when exceeding GMLOS, Medicare and Medicaid cases were less likely than commercial payers to have a positive contribution margin (p < 0.001 and p < 0.001). CONCLUSION: Government-insured patients, despite having a payer source, are a financial burden to a trauma center. Excess LOS among government insured patients, but not the commercially insured, exacerbates financial loss. A shift toward a greater proportion of government insured patients may result in a significant fiscal liability for a trauma center. LEVEL OF EVIDENCE: Economic and Value-Based Evaluation, Level III.

Early Psychiatric Consultation Is Associated With Decreased Cost and Length of Stay in the Patient Population at a Level I Trauma Center.

Introduction Psychiatric illness impacts nearly one-quarter of the US population. Few studies have evaluated the impact of psychiatric illness on in-hospital trauma patient care. In this study, we conducted a retrospective cohort study to evaluate hospital resource utilization for trauma patients with comorbid psychiatric illnesses. Methodology Trauma patients admitted to a level I center over a one-year period were included in the study. Patients were categorized into one of three groups: (1) no psychiatric history or in-hospital psychiatric service consultation; (2) psychiatric history but no psychiatric service consultation; and (3) psychiatric service consultation. Time to psychiatric service consultation was calculated and considered early if occurring on the day of or the day following admission. Patient demographics, outcomes, and resource utilization were compared between the three groups. Results A total of 1,807 patients were included in the study (n = 1,204, 66.6% no psychiatric condition; n = 508, 28.1% psychiatric condition without in-hospital psychiatric service consultation; and n = 95, 5.3% in-hospital psychiatric service consultation). Patients requiring psychiatric service consultation were the youngest (P < .001), with the highest injury severity (P = .024), the longest hospital length of stay (P < .001), and the highest median hospital cost (P < .001). Early psychiatric service consultation was associated with an average saving in-hospital length of stay of 2.9 days (P = .021) and an average hospital cost saving of $7,525 (P = .046). Conclusion One-third of our trauma population had an existing psychiatric diagnosis or required psychiatric service consultation. Resource utilization was higher for patients requiring consultation. Early consultation was associated with a savings of hospital length of stay and cost.

Responding to the American Academy of Forensic Sciences vision, mission, and values statements: Comments, revisions, and proposed actions.

•We call for revisions to the current AAFS vision, mission, and values statements.•Truly aspirational statements will provide guiding principles for forensic scientists.•Revisions should meaningfully engage with issues of diversity and equity.•Our goal of pursuing justice should also extend to our practitioner community.•We envision AAFS committees of diverse membership making positive changes to the statements.

Biomarkers of pediatric obstructive sleep apnea syndrome and the assessment of quality of life before and after adenotonsillectomy.

The study aims to explore the inflammatory cytokines and oxidative stress in children with obstructive sleep apnea syndrome (OSAS) triggered by adenoids and/or tonsillar hypertrophy and their changes after adenotonsillectomy (AT) and to investigate the associated behavioral disorders in OSAS, before and after AT. Thirty patients with OSAS and 20 healthy children, aged 3 - 13 years were included in the study. According to apnea-hypopnea index (AHI), OSAS children were classified into 3 groups: mild (n = 19), moderate (n = 5), and severe OSAS (n = 6). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α, malondialdehyde (MDA) and antioxidant enzymes activities were assessed in serum, preoperative and 6 weeks after AT. TNF-α, IL-6 and malondialdehyde levels were also estimated in adenoid and tonsils tissues. A Pediatric Sleep Questionnaire was completed by the parents before and after AT. As a result of the study, we obtained the following results: TNF-α, IL-6 and malondialdehyde evaluated preoperative increased in serum and tissues in OSAS, especially in severe disease compared to mild and moderate forms. Six weeks after AT, AHI diminished significantly in OSAS, as well as the inflammatory markers and malondialdehyde, in parallel with significant improvement of antioxidant enzymes activities. Daytime sleepiness, hyperactivity and attention deficit in OSAS, even in mild disease were present, with significant improvements of obstructive symptoms after AT. We conclude that OSAS caused by adenoids and/or tonsillar hypertrophy led to changes in the blood parameters, with significant improvement after AT. Postoperatively, a significant improvement in sleep quality and behavior in OSAS patients was also observed.

Assessment of concurrent infection with bovine viral diarrhoea virus (BVDV) and Mycobacterium bovis: A herd-level risk factor analysis from Northern Ireland.

Bovine viral diarrhoea virus (BVDV) is a significant pathogen of cattle, leading to severe economic and animal-welfare impacts. Furthermore, the pathogen has been associated with impacting the progression or spread of other pathogens (e.g. Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB)). During this study we investigated (i) risk factors for BVDV at a herd-level and (ii) whether there was any association between BVDV and herd-level bTB risk. The data for this study were gathered from a voluntary BVDV control programme in Northern Ireland (2013-2015) based on the identification of virus positive animals through tissue tag testing of calves. We assigned a herd-level BVDV status to 2827 participating herds, where a herd was assumed "infected" if one or more animals tested positive for BVDV. Two model suites were developed. Firstly, we assessed risk factors for BVDV herd status using multivariable logit random-effects modelling, aggregating to the calendar year level (2013-2015; n=4828; model 1). Secondly, we aggregated data across the three years of the study to give an overall status for the whole study period (n=2827; logistic model 2). Risk factors included year, herd-type, herd size, number of births, inward trade moves, calf mortality, and region. Furthermore, the herd-level bovine tuberculosis status (based on the single intradermal comparative cervical tuberculin (SICCT) test outcomes, or confirmation at post-mortem), or the size of bTB breakdowns (number of SICCT test positive animals), of herds was also investigated to assess whether there was an association (co-infection) with herd BVDV status. The final models suggested that BVDV herd status was positively associated with increased levels of calf mortality, herd size, number of births, the number of BVDV tests undertaken and the number of animals introduced to the herd. There was a significant univariable positive association between BVDV status, and SICCT breakdown risk, breakdown size and confirmed bTB status in model 2. However, there was no evidence of significant associations between bTB status (using SICTT status, confirmed status or herd breakdown size) and BVDV status in final multivariable models when controlling for other significant confounders. These results provide information for action for the future control and eradication of BVDV in Northern Ireland, though these data provide little support for the hypothesised association between BVDV and bTB status at herd-level. Further animal-level analyses are necessary to investigate whether there is support for a BVD-bTB co-infection association, including the impact of co-infection on the severity of infection.

The use of tooth crown measurements in the assessment of ancestry.

As the hardest tissue in the body, teeth have the potential to offer a wealth of biological information to the forensic anthropologist, which can include the assessment of ancestry. Using a large data set of dental measurements, the efficacy of mesiodistal and buccolingual tooth dimensions to discriminate between broad, geographically based groups is explored. A general pattern is identified: African populations have the largest teeth, Asians possess teeth of intermediate size, and Europeans have the smallest teeth. In a discriminant function analysis using crown measurements of all teeth (mandibular and maxillary and excluding the third molar), individuals were correctly classified in 71.3% of cases. When the sex of the individual is known, classification is improved up to 88.1% in females and 71.9% of males (cross-validated). Based on these results, we argue that dental metrics can be regularly employed as part of the development of the biological profile.

[Study of nutrition and health claims on labelling of fermented milk products]. / Estudio de declaraciones nutricionales y saludables en el etiquetado de leches fermentadas.

BACKGROUND: The consumption of fermented milk products in Spain has been increased for the last 40 years. In addition to yogurt, new varieties of milk products fermented by bifidobacteria or other Lactobacillus species have been introduced. The nutritional importance of these products, together with the likely beneficial effects of the fermentative strains, has propitiated labelling with nutritinal and health claims. Present regulations do not specifically regulate these wordings and a proposal for a European Regulation for standardization of these claims is currently under elaboration. OBJECTIVES: To study the nutrition and health claims on labelling of fermented milk products taking into account current legislation, the proposal for a European Regulation and the related literature. To compare labelling on yogurt with that of other fermented milk products, in relation to these claims. RESULTS: Ninety-four percent of the studied labelling has nutritional information. Nutritional claims have ben found on 38%, of which 20% have mentioned fat content, 12% calcium content, although 26% have less than 15% of the RDA, 7% mention dietary fiber content. Health claims has been presented in 32% of the studied labelling. CONCLUSIONS: Health claims have been more frequently found in fermented milk products other than yogurt, most of them mentioning the prebiotic or probiotic properties. A lack of information to consumers has been observed concerning the necessary amounts to be consumed and the real benefit provided by the product. Nutrition claims in products with normal content of certaint nutrients have been found; this fact might create confusion as regards to really enriches foods.

[Effectiveness and efficiency of a specialized unit in the care of patients with chronic obstructive pulmonary disease and respiratory insufficiency]. / Efectividad y eficiencia de una consulta monográfica hospitalaria para pacientes con EPOC e insuficiencia respiratoria.

OBJECTIVE: In the absence of a clear health care model for the management of patients with chronic obstructive pulmonary disease and chronic respiratory insufficiency, we evaluated the effectiveness and efficiency of a specialized outpatient unit for these patients managed by the hospital s respiratory medicine department. PATIENTS AND METHODS: This was a 1-year prospective study of a group of patients for whom historical control data were available. The mean (SD) descriptive data for the 124 patients (105 men) were as follows: age, 69 (7) years; forced vital capacity, 64.6% (16.1%); forced expiratory volume in the first second (FEV1), 35.6% (12.8%); PaO2, 56.6 (8.3) mm Hg; PaCO2, 49.8 (6.7) mm Hg. Forced spirometry and arterial blood gas analysis were performed at 3-monthly visits. Participants completed a quality-of-life questionnaire (Guyatt's Chronic Respiratory Disease Questionnaire) at the beginning and end of the study. The following variables were analyzed: forced spirometry, arterial blood gases, quality of life, number of emergency visits and hospital admissions, mean length of stay in hospital, reduction in the number of inpatient bed-days, mean cost of emergency visits, mean cost of hospital stays for both the Catalan Health Service (CHS) and the hospital, mean total cost per patient for the CHS and the hospital, and aggregate cost for the CHS and the hospital. The results were compared with data for the preceding year taken from the hospital records. RESULTS: Significant improvement was found in forced vital capacity and PaO2 (which went from 56.6 [8.2] mm Hg to 59.1 [8.9] mm Hg during the prospective part of the study); FEV1 also tended to improve (875 [282] mL as against 912 [321] mL), but this change was not significant (P= .17). A significant reduction was observed in the following variables: PaCO2; hospital admissions, 1.16 (1.15) in the historical control period compared to 0.67 (1.17) during the prospective study; emergency visits, 2.06 (1.9) as against 1.5 (2.1); mean length of stay in hospital, 14.2 (19) compared to 8.1 (16) days; total number of inpatient bed-days (756 inpatient bed-days were saved in the study period); mean cost of emergency visits and hospital stays for both the hospital (2246 euros [3007 euros] in the historical period as against 1297 euros [2639 euros] with the new management system) and for the CHS; and the aggregate cost both for the hospital (40,011 euros in the historical control period as against 6048 euros with the new model) and the CHS (238,513 euros as against 152,312 euros). The quality-of-life score improved, but the change was not significant. CONCLUSIONS: The change in the health care model used to manage these patients led to an improvement in care (effectiveness) as well as a marked reduction in costs (greater efficiency) for both the funding entity (CHS) and for the care provider (the hospital). No change was observed in the quality of life as reported by the patients.

Assessment of potential (inhalation and dermal) and actual exposure to acetamiprid by greenhouse applicators using liquid chromatography-tandem mass spectrometry.

New analytical methods based on liquid chromatography with electrospray tandem mass spectrometry (LC-MS/MS) have been developed and validated for assessing the exposure of greenhouse workers to acetamiprid. Both ambient (potential inhalation and dermal exposure) and internal dose (biological monitoring of urine samples) measurements were carried out. Potential inhalation exposure was assessed using Chromosorb 102 cartridges connected to air personal samplers. Potential dermal exposure was estimated by using whole body dosimetry. The measurement of actual exposure was done by analyzing the parent compound in urine samples of the applicators, after a solid-phase extraction (SPE) step. The methods showed a good accuracy (72-92%), precision (2-13%) and lower limits (few microg l(-1)). The validated approaches have been applied to assess potential and actual exposure of agricultural workers spraying acetamiprid in greenhouses. The results shown the need to wear personal protective equipment (suits) in order to reduce the absorbed dose of acetamiprid.

[Evaluation of medical reports received from the second level of care]. / Valoración de los informes médicos recibidos del segundo nivel.

OBJECTIVES: To quantify the monthly inter-clinic rate (MIR), the medical reports received, their quality and the period of delay until the first second-level consultation. DESIGN: Cross-sectional, descriptive study. SETTING: Rural health centre. SAMPLE: 498 first consultations requested of the second level by three family medicine lists between June and November 1999. 132 were excluded for presenting a criterion of exclusion (consultations within the second level, check-ups, appointments missed by the patient and consultations that could not be recorded), which left a sample size of 366. MEASUREMENTS AND RESULTS: Mean MIR was 34 . Ophthalmology (21.9%), gynaecology (15.3%) and traumatology (13.9%) were the most commonly requested services. 69 reports (18.8%) were received, leaving 297 (81.2%) not received. Pneumology (100%) and internal medicine (81.8%) services sent through most reports, whereas haematology and rehabilitation (0%) sent through least. The mean score on the reports was 8 +/- 2 out of a maximum of 10. Mean delay was 73 +/- 46 days. CONCLUSION: The monthly inter-clinic rate found was within the figures cited in the literature. The percentage of reports received was way below what was found in the literature, but their quality was good.

[An assessment of the quality of life of patients with COPD and chronic hypoxemia by using the Spanish version of the Chronic Respiratory Disease Questionnaire]. / Valoración de la calidad de vida de los pacientes con EPOC e hipoxemia crónica mediante la versión española del Chronic Respiratory Disease Questionaire.

INTRODUCTION: The Chronic Respiratory Disease Questionnaire (CRDQ) is a specific evaluation instrument that has been recently translated to Spanish and validated in patients with COPD without chronic respiratory insufficiency. OBJECTIVE: To study the relation of CRDQ scores to several lung function parameters in COPD patients with chronic hypoxemia (PaO2 < 65). MATERIAL AND METHODS: Forty-four middle aged [68 (7)] men with COPD (FEV1 post-PBD < 50%; PaO2 < 65 mmHg) were enrolled with established medical histories, including blood gas and spirometric data. We collected the patients' responses to the CRDQ and measured blood gas levels, spirometric and plethysmographic variables and DLCO. Performance on a six-minute walking test was recorded, with dyspnea assessed on a visual analogue scale (VAS) initially and at the end of the walk. Nighttime pulse oximetry was also monitored. Pearson's and Spearman's correlation coefficients were used to study the relation between CRDQ scores and the aforementioned parameters. Gas and spirometric data were compared to CRDQ scores between groups of patients treated with continuous domiciliary oxygen therapy (CDOT) and the untreated group, using Student t-test and a Mann-Whitney U-test. RESULTS: Results are expressed as means and standard deviations within parentheses. FVC was 2,609 (618) ml, 72 (15)%; FEV1 867 (297) ml, 34 (11)%; FEV1/FVC 33 (8)%; PaO2 55(8) mmHg; and PaCO2 49(6) mmHg. The overall CRDQ score was related to FEV1 (0.38; p < 0.01); FEV1/FVC (0.43, p < 0.005); walking test distance (0.49, p < 0.01); final VAS (-0.64, p < 0.0001) and DLCO (0.59, p < 0.01). No relation was observed between CRDQ score and blood gases, nighttime pulse oximetry or plethysmograph data. "Dyspnea", "fatigue", "emotional function" and "disease control" dimensions of the CRDQ were related to the same variables as was the overall score, with the exception of FEV1/FVC for the "fatigue" dimension and FEV1 and DLCO for the "disease control" dimension. The CRDQ scores were similar in the CDOT and non-CDOT groups in spite of differences in their spirometric and gasometric variables. CONCLUSIONS: 1) Score on the CRDQ is related to FEV1, the FEV1/FVC ratio, walking test distance, dyspnea and DLCO but not to blood gases, FVC, lung volume or nighttime pulse oximetry. 2) The VAS dyspnea score recorded at the end of the walking test is the variable that is most strongly related to CRDQ score. 3) We found that use of CDOT did not undermine the COPD patient's quality of life.

[Real clinical medicine and evidence-based medicine: evaluative clinical research]. / Medicina clínica real y medicina basada en la evidencia: una investigación clínica evaluativa.

BACKGROUND: The clinical view is essential in the application of a new paradigm on "evidence based medicine". Also, we hardly haven't studies that had been made with patients in real time and place. We analyzed the rate of evidence that found our clinical praxis. METHODS: A randomized observational epidemiological study was made over 689 clinical decisions in relation with 167 pathological processes, considered in 36 patients. Age (65.9, SD 2.1), sex (23 F, 13 M), comorbidity (4.6, SD 2.1), poly-pharmacy (8.8, SD 3.3). Case-mix of GRDs (infections--even HIV-, chronic respiratory affections, neurologic, cardiovascular diseases, diabetes and its complications ..., in decreased order. We used the D.L. Sackett's criterium (evidence level one "experimental", level two "no experimental but convincing-rational", level three "without any scientific base". A progressive internal control was used in order to adjust the "arbitrariness in the assignation". RESULTS: 60% of the decisions provided elevated care evidence level; 24.5% in level number two, and 15.5% without any foundation. The proceedings reasonably founded were 84.5%. The pharmacological treatment had more evidence. The diagnosticum was more empiric. The primary illness and its treatment concentrated more evidence that the enclosed conditions (65% level one and 50% respectively). The prediction is still unknown (null evidence). CONCLUSIONS: More than a half of the patients were benefited of a clinical praxis, tested in effectiveness and safety. 15.5% of the decisions had an uncertain effect (favourable, newer or damaging). Nowadays, the complex clinical praxis, despite of exceeding the paradigm of "evidence based medicine", should tend toward scientific foundation as much as possible.

[Elderly, poor, solitary and marginal patients: geriatric vulnerability in emergency services]. / Viejos, pobres, solitarios y marginados: vulnerabilidad geriátrica en un servicio de urgencias.

BACKGROUND: Status is a powerful determinant of health, and it may influence on the demand of Hospital emergency services. The aim of our investigation is to assess whether elderly patients usually wandering emergency services gather more negative socioeconomic conditions. PATIENTS AND METHODS: A cross-sectional study on 800 randomised patients cared in emergency services was carried out. A questionnaire about economic, educational and professional levels, domestic violence, loneliness and life style was applied. A crude analysis was used to assess the age-factor (>/= 65 y.o.) by BMDP (PC 90). The trial was approved by the local Bioethics board. RESULTS: Low incomes, low educational level and loneliness were clinic and statistically related with age (65 and more). Data is offered as n (%), X2 and p < 0.0001 (Fisher exact Test two sided p value). CONCLUSIONS: Elderly patients frequently demanding hospital emergency services gather more vulnerability conditions, not merely medical. Low incomes, low educational level and loneliness are probably working as key factors on the geriatric demand of emergency services.

[Epidemiology of tobacco use in health-science students]. / Epidemiología del tabaquismo en los estudiantes de ciencias de la salud.

The characteristics of tobacco use by students of the Division of Health Sciences of the University of Barcelona have been studied. During the 1988-1989 school year, 382 students were individually interviewed about their use of tobacco by means of a questionnaire routinely used by the Department of Health and Social Security of the Generalitat of Catolonia (Spain), with pertinent modifications for this specific group. These interviews were performed by appropriately trained personnel. Information was also gathered on the influence of university-level studies on smoking habits, the effect of advertising and the efficacy of antitobacco programs and campaigns carried out by the government. The study sample was drawn from lists supplied by the registrars' offices, by means of a random sampling by school (Medicine, Pharmacy, Psychology, Odontology and Nursing). The prevalence of tobacco use was 40.8% (29.8% daily smokers and 11% occasional smokers). These results are similar to those described in the literature, although these values are somewhat higher than those in more developed countries with a longer tradition of resistance to the use of tobacco. It is important to note that studying health sciences does not appear to be a major influence on the student's habits, but that the social and cultural environment is the factor which weighs the most in this respect. In conclusion, to reduce the prevalence of tobacco use in this important group, educational programs must be begun at the pre-university level (secondary school) and changes should be made in the curricula of the health professional so that areas related to tobacco use are more motivational for students.

[Value of local cerebral hypoperfusion in the diagnosis of frontal syndromes. Importance in medical expert assessment of head injuries]. / L'apport de l'étude des débits sanguins locaux dans le diagnostic des syndromes frontaux. Son intérêt dans les expertises médicales des traumatisés du crâne.

The importance of the symptoms linked to a frontal disorder in the intellectual and behavioral sequelas of severe cranial trauma, is now measured carefully because these troubles are one of the most important obstacle to the social and professional come-back. The handicap linked to a disorder of the frontal lobe is not well known in all its neurological, mental and sociological dimensions because the diagnosis is not easy. To help to this diagnosis, the study of cerebral blood flow with SPECT is usefull in medical practice. We present here 4 clinical cases of post-trauma frontal syndrome not easy to measure. With a measure of cerebral blood flow with SPECT, it was observed a decrease of frontal blood flow, that allowed to link the neuropsychological symptom to a frontal lobe disorder. It seems that in these conditions the post-trauma frontal syndrome is not so uncommon.

[Supplementary criteria of evaluation of health status in selecting the personnel for work in coal mines]. / Dopolnitel'nye kriterii otsenki sostoianiia zdorov'ia pri prieme na rabotu v ugol'nykh shakhtakh.

200 newly-engaged young miners were medically examined in an outpatient department. The routine examination techniques were supplemented with studies of the changes after 2 minute-long inhalations of 0.6% acetylcholine chloride and mine dust (78 mg/m3), hemodynamics and electrocardiography indices, as well as the indices of the immunologic and hormonal state. Established was diversified manifestations of the respiratory tract's response to the aerogenic irritations, combined with deviations in the immunologic state indices. The studies provide basis for further improvements in the preventive examination techniques for workers in coal-mining industries.