[Epidemiological study of type 1 diabetes in children under 15 years-old in Castilla-La Mancha (Spain)]. / Estudio epidemiológico de la diabetes tipo 1, en menores de 15 años en Castilla-La Mancha.

INTRODUCTION: We studied the incidence and prevalence of type 1 diabetes in children under 15 years-old in Castilla-La Mancha. PATIENTS AND METHODS: Incidence: All new cases in a 12 months period (2007-2008) were included. To calculate the completeness of ascertainment we used the capture-recapture method. The result is expressed in cases/100,000 inhabitants under 15 years old/year. Prevalence: all children under 15 years diagnosed with diabetes on 31(st) of May of 2008 were registered. Results are expressed as cases/1000 inhabitants under 15 years old. RESULTS: The incidence in the Castilla-La Mancha was 27.6/100,000/year, but there was a wide variability among the different provinces: Ciudad Real (34.15), Albacete (28.19), Toledo (26.57), Guadalajara (20.3) and Cuenca (17.6). The prevalence was 1.44/1000 children under 15 years old and 0.21/1000 for the whole population. By provinces: Ciudad Real (1.67), Albacete (1.64), Toledo (1.42), Cuenca (1.02) and Guadalajara (1.01). By sex and age, we found a higher incidence (13/7) and prevalence (22/7) in males under 5 years old. The age group with highest incidence was the 4-9 year-olds, and the highest prevalence was in the 10-14 years group. CONCLUSIONS: Both, incidence and prevalence of type 1 diabetes in children under 15 years old in Castilla-La Mancha are high, with a wide range among the different provinces. There is a preponderance in males under 5 years old. The highest prevalence is that of the 10-14 years age group. The highest incidence was in the 5-10 year age group.

Outpatient management.

The successful management of outpatients with COPD requires a multifaceted approach that includes prophylactic, palliative, and life-extending therapies. All patients should undergo smoking cessation, avoid potentially harmful environments, and receive influenza and pneumococcal vaccines at recommended intervals. Although medical therapy may yield only marginal benefits in patients with minimal airway responsiveness, even small improvements may translate into significant functional benefits and will be greatly appreciated. Therefore, every effort should be expended to optimize the patient's medical regimen and to ascertain that methods of delivery (such as use of spacers) are as recommended. Physical therapy measures may be useful in patients with copious sputum production, and pursed-lip and diaphragmatic breathing exercises may reduce dyspnea and lend a sense of control to patients with severe flow limitation. Oxygen therapy is the only modality demonstrated to improve survival in patients with severe COPD and may give symptomatic relief to some patients. Its use, however, is restricted to patients meeting guidelines for hypoxemia, and although dyspneic patients not meeting these guidelines may desire oxygen, insurers will decline coverage for them. Newer modalities, such as noninvasive ventilation, may improve gas exchange and quality of life in some patients with hypercapnia and nocturnal oxygen desaturations, but subgroups of COPD patients who benefit have not been well-defined, and pending further investigation, guidelines for use should be considered tentative. Patients should be encouraged to enter a comprehensive rehabilitation program, but if one is unavailable or the patient declines, a rehabilitation approach should be applied. Practitioners should attempt to educate patients at each visit, offering advice not only on medications, but also on regular exercise, good nutrition, and ways of coping psychologically with chronic illness. By taking such a comprehensive and caring approach, and being available to assist with problems and crises, the practitioner can help to enhance the quality and length of the COPD patient's life.

Reacción periapical a la aplicación del formocresol diluido en pulpotomias en perros / Periapical reaction to the diluted formocresol application as pulpotomy agents in dogs

Este estudio fue realizado para valorar la reacción periapical producida con el uso de formocresol diluido 1:5 por cuatro minutos en pulpotomías de premolares temporales en perros, después de 45 días. Se tomaron 32 dientes, a 16 de los cuales se les colocó formocresol diluido 1:5 por cuatro minutos y la otra mitad fue utilizado como grupo de control. Se realizaron Cortes histológicos a nivel periapical, los cuales fueron evaluados a doble ciego, encontrando una marcada reacción inflamatoria a nivel periapical en el grupo experimental.