Oral health-related quality of life after dental treatment in patients with intellectual disability.

BACKGROUND: The influence of dental treatment on oral health-related quality of life (OHRQOL) has rarely been evaluated in patients with intellectual disability (ID) through validated questionnaires. The aim of this study was to estimate the changes on OHRQOL in patients with ID after the implementation of an institutional dental treatment program under general anesthesia using the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHCOHRQOL-Q). MATERIAL AND METHODS: A prospective longitudinal study was conducted on 85 patients (mean age=24.85 years) classified according to DSM-V whose parents/caregivers completed the FHC-OHRQOL-Q. We analyzed the changes in the questionnaire's overall score and its dimensions from pre-treatment to 12-months of follow-up, considering effect sizes and minimal important differences estimated by the standard measurement error. The impact of clinical and therapeutic factors was evaluated using univariate and multiple linear regression analysis (p<0.05). RESULTS: Significant improvement of OHRQOL was found after dental treatment in oral symptoms (p0.001), daily life problems (p=0.018), parent's perceptions (p=0.013) and FHCOHRQOL-Q´s overall score (p=0.001). OHRQOL changes exhibited an intermediate magnitude (0.38-0.21) as estimated by effect sizes. Changes in oral symptoms showed positive correlation with DMFT index (r=0.375, p=0.002), decayed teeth (r=0.244, p=0.036), dental extractions (r=0.424, p<0.001) and number of treatments (r=0.255, p=0.019). The improvement was greater in patients with 4 decayed teeth (p=0.049) and undergoing 2 dental extractions (p=0.002). Multiple regression analysis demonstrated that dental extractions (p<0.001) and DMFT index (p=0.028) were significantly related to oral symptom improvement. CONCLUSIONS: Dental treatment under general anesthesia showed a positive effect on the overall FHC-OHRQOL-Q score and most of its dimensions. At 12-months of follow-up, the improvement of oral symptoms was significantly associated with DMFT index, decayed teeth, dental extractions and number of treatments. In our clinical setting, the implementation of a dental treatment program enhanced the OHRQOL of patients with ID.

Influence of electron acceptors on hexanoic acid production by Clostridium kluyveri.

Clostridium kluyveri was used for chain elongation of C2C4 fatty acids in stirred tank bioreactors. The influence of different electron acceptors (acetic acid, butyric acid and the mixture of both) on C6 fatty acid production was evaluated in presence of ethanol using similar molar alcohol/acid ratios around 3.5. Bottle batch assays without pH regulation and with only acetic acid as electron acceptor yielded a final C6 fatty acid concentration of 6.8 ±â€¯0.6 g L-1. Then, pH-regulated bioreactors were operated at constant pH of 6.8. Under such conditions, the maximum growth rate was 0.039 h-1 obtained using acetic acid and butyric acid as electron acceptors, whereas the lowest growth rate was 0.010 h-1 with only butyric acid as electron acceptor. The maximum growth rate with acetic acid only, was similar, though slightly lower, as with the mixture of C2C4 fatty acids. Besides, the maximum productions of hexanoic acid were 11.8 g L-1, 13.1 g L-1 and 21.2 g L-1 using, respectively, acetic acid, butyric acid and the mixture of both acids as electron acceptors. Thus, the use of a mixture of acetic acid and butyric acid in presence of ethanol for chain elongation, at constant pH, proved to be efficient for hexanoic acid production.

[Assessment of postural control and balance in persons with temporomandibular disorders: A systematic review]. / Valoración del control postural y del equibrio en personas con trastornos temporomandibulares: revisión sistemática.

The stomatognathic system is the anatomo-functional unit of the cranio-cervico-facial region. Some dysfunctions affect its motor control. The aim of this study was to analyse the clinical usefulness of the various scales and instruments used in the assessment of postural control in people with temporomandibular disorders. A systematic review was carried out by 2independent reviewers in the PubMed, Medline, Ebsco, Science Direct and PEDro databases, selecting observational studies published between January 2006 and March 2017. The risk of bias and methodological quality was analysed following Cochrane indications and the Downs and Black quality scale. Ten studies were included, of which 9used computerised platforms, one added photogrammetry and one used electromyography. Seven studies were classified as moderate quality and 3as low quality. Posturography was the most widely used assessment instrument. Methodological differences did not allow determination of their clinical implications or the relationship between balance and the presence of temporomandibular disorders.

Tumor óseo de células gigantes en techo orbitario de paciente con retinoblastoma bilateral / Giant cell tumour of frontal bone in a patient with bilateral retinoblastoma

Paciente de 5 años de edad con diagnóstico de retinoblastoma hereditario bilateral tratada con radioterapia en el ojo izquierdo (OS) y enucleación del ojo derecho (OD). Después de 3 años sin evidencia de progresión presenta una nueva masa tumoral en la órbita derecha, con compromiso del techo, cuyo diagnóstico anatomopatológico tras su exéresis mediante abordaje neuroquirúrgico resultó ser de tumor óseo de células gigantes. Los tumores óseos primarios de la órbita como el tumor de células gigantes son una entidad poco frecuente. Los estudios radiológicos y anatomopatológicos resultan esenciales para establecer el diagnóstico diferencial de las lesiones que asientan en la órbita

A case is presented of a 5 year-old patient with bilateral hereditary retinoblastoma treated with radiotherapy in the right eye and enucleation of the left eye. After three years without evidence of progression, the patient presented with a right orbital mass that compromised the frontal bone. After surgical excision, the histology analysis was consistent with a diagnosis of giant cell tumour. Primary orbital bone neoplasms, such as giant cell tumours, are extremely rare. Both radiological and histopathology studies are essential to establish the differential diagnosis of orbital mass lesions

Valoración del control postural y del equibrio en personas con trastornos temporomandibulares: revisión sistemática / Assessment of postural control and balance in persons with temporomandibular disorders: A systematic review

El sistema estomatognático es la unidad anatomofuncional de la región craneocervicofacial. Existen disfunciones condicionantes en su control motor. El objetivo fue estudiar la utilidad clínica de las diferentes escalas e instrumentos empleados en la valoración del control postural en personas con trastornos termporomandibulares. Se realizó una revisión sistemática, por 2revisores independientes, en las bases de datos PubMed, Medline, Ebsco, Science Direct y PEDro, seleccionando estudios observacionales publicados entre enero de 2006 y marzo de 2017. Se analizó el riesgo de sesgo y la calidad metodológica siguiendo las indicaciones Cochrane y la escala de Downs and Black. Se incluyeron 10estudios, de los que 9emplearon plataformas computarizadas, uno sumó la fotogrametría y uno usó electromiografía. Siete estudios fueron clasificados como de calidad moderada y 3de calidad baja. La posturografía es el instrumento de valoración más utilizado. Diversidades metodológicas no permiten determinar sus implicaciones clínicas ni la relación entre el equilibrio y la presencia de trastornos temporomandibulares

The stomatognathic system is the anatomo-functional unit of the cranio-cervico-facial region. Some dysfunctions affect its motor control. The aim of this study was to analyse the clinical usefulness of the various scales and instruments used in the assessment of postural control in people with temporomandibular disorders. A systematic review was carried out by 2independent reviewers in the PubMed, Medline, Ebsco, Science Direct and PEDro databases, selecting observational studies published between January 2006 and March 2017. The risk of bias and methodological quality was analysed following Cochrane indications and the Downs and Black quality scale. Ten studies were included, of which 9used computerised platforms, one added photogrammetry and one used electromyography. Seven studies were classified as moderate quality and 3as low quality. Posturography was the most widely used assessment instrument. Methodological differences did not allow determination of their clinical implications or the relationship between balance and the presence of temporomandibular disorders

Giant cell tumour of frontal bone in a patient with bilateral retinoblastoma. / Tumor óseo de células gigantes en techo orbitario de paciente con retinoblastoma bilateral.

A case is presented of a 5 year-old patient with bilateral hereditary retinoblastoma treated with radiotherapy in the right eye and enucleation of the left eye. After three years without evidence of progression, the patient presented with a right orbital mass that compromised the frontal bone. After surgical excision, the histology analysis was consistent with a diagnosis of giant cell tumour. Primary orbital bone neoplasms, such as giant cell tumours, are extremely rare. Both radiological and histopathology studies are essential to establish the differential diagnosis of orbital mass lesions.

Anaerobic degradation of glycol ether-ethanol mixtures using EGSB and hybrid reactors: Performance comparison and ether cleavage pathway.

The anaerobic biodegradation of ethanol-glycol ether mixtures as 1-ethoxy-2-propanol (E2P) and 1-methoxy-2-propanol (M2P), widely used in printing facilities, was investigated by means of two laboratory-scale anaerobic bioreactors at 25oC: an expanded granular sludge bed (EGSB) reactor and an anaerobic hybrid reactor (AHR), which incorporated a packed bed to improve biomass retention. Despite AHR showed almost half of solid leakages compared to EGSB, both reactors obtained practically the same performance for the operating conditions studied with global removal efficiencies (REs) higher than 92% for organic loading rates (OLRs) as high as 54 kg of chemical oxygen demand (COD) m-3 d-1 (REs of 70% and 100% for OLRs of 10.6 and 8.3 kg COD m-3 d-1 for E2P and M2P, respectively). Identified byproducts allowed clarifying the anaerobic degradation pathways of these glycol ethers. Thus, this study shows that anaerobic scrubber can be a feasible treatment for printing emissions.

Aspen Plus process-simulation model: Producing biogas from VOC emissions in an anaerobic bioscrubber.

A process-simulation model for a novel process consisted of an anaerobic bioscrubber was developed in Aspen Plus®. A novel approach was performed to implement the anaerobic reactor in the simulation, enabling it to be connected to the scrubber. The model was calibrated and validated using data from an industrial prototype that converted air emissions polluted with volatile organic compounds with an average daily concentration of 1129 mgC Nm-3 into bioenergy for more than one year. The scrubber, which showed a removal efficiency within 83-93%, was successfully predicted with an average absolute relative error of 5.2 ±â€¯0.08% using an average height-to-theoretical-plate value of 1.05 ±â€¯0.08 m and 1.37 ±â€¯0.11 m for each of the two commercial packing materials used, respectively. The anaerobic reactor, which treated up to 24 kg of chemical oxygen demand m-3 d-1 with efficiencies of about 93%, was accurately simulated, both in effluent-stream characteristics and in the biogas stream. For example, the average absolute error between the experimental biogas production and the model values was 19.6 ±â€¯18.9%. The model proved its capability as a predictive tool and an aid in design, resulting in savings of time and money for practitioners. In addition, the approach proposed can be expanded to other bioprocesses that include unit operations.

Granulation and microbial community dynamics in the chitosan-supplemented anaerobic treatment of wastewater polluted with organic solvents.

The effect of chitosan on the development of granular sludge in upflow anaerobic sludge blanket reactors (UASB) when treating wastewater polluted with the organic solvents ethanol, ethyl acetate, and 1-ethoxy-2-propanol was evaluated. Three UASB reactors were operated for 219 days at ambient temperature with an organic loading rate (OLR) of between 0.3 kg COD m-3 d-1 and 20 kg COD m-3 d-1. One reactor was operated without the addition of chitosan, while the other two were operated with the addition of chitosan doses of 2.4 mg gVSS-1 two times. The three reactors were all able to treat the OLR tested with COD removal efficiencies greater than 90%. However, the time required to reach stable operation was considerably reduced in the chitosan-assisted reactors. The development of granules in the reactors with chitosan was accelerated and granules larger than 2000 µm were only observed in these reactors. In addition, these granules exhibited better physicochemical characteristics: the mean particle diameter (540 and 613 µm) was approximately two times greater than in the control reactor (300 µm), and the settling velocities exceeded 35 m h-1. The extracellular polymeric substances (EPS) in the reactors with the chitosan was found to be higher than in the control reactor. The protein-EPS content has been correlated with the granule size. The analyses of the microbial communities, performed through denaturing gradient gel electrophoresis and high-throughput sequencing, revealed that the syntrophic microorganisms belonging to genus Geobacter and the hydrogenotrophic methanogen Methanocorpusculum labreanum were predominant in the granules. Other methanogens like Methanosaeta species were found earlier in the chitosan-assisted reactors than in the control reactor.

[Obstetric brachial plexus palsy: incidence, monitoring of progress and prognostic factors]. / Paralisis braquial obstetrica: incidencia, seguimiento evolutivo y factores pronosticos.

INTRODUCTION: Obstetric brachial plexus palsy is related with shoulder dystocia, and its main risk factor is macrosomia. Its incidence is estimated to be between 0.1 and 6.3 cases per 1,000 live newborn infants. Most cases are resolved but can give rise to permanent functional deficiency, which means that there is an interest to identify possible prognostic factors. PATIENTS AND METHODS: We conducted a descriptive study of newborn infants with obstetric brachial plexus palsy born in our hospital between the years 2011 and 2015. Maternal, perinatal and obstetric variables, as well as the type of lesion, were collected and were related with the possibility of recovery at six months. RESULTS: Altogether 32 cases were diagnosed, which represents an incidence of 1.44‰ of live newborn infants. 59% were males and 37.5% of them were macrosomic. The most frequent disorder was injury to the plexus at the proximal level (94%). 44% suffered from shoulder dystocia, and 47% still had sequelae at the sixth month. The antecedent of shoulder dystocia was related with a poor prognosis for recovery. CONCLUSIONS: The incidence of obstetric brachial plexus palsy has remained stable in recent years. The percentage of children who present sequelae at six months is significant. Prospective studies are needed to be able to establish the long-term prognostic factors of this pathology.

TITLE: Paralisis braquial obstetrica: incidencia, seguimiento evolutivo y factores pronosticos.Introduccion. La paralisis braquial obstetrica se relaciona con la distocia de hombros, y su principal factor de riesgo es la macrosomia. Su incidencia se estima entre 0,1 y 6,3 casos por 1.000 recien nacidos vivos. La mayoria de los casos se resuelve, pero puede provocar deficit funcional permanente, por lo que es de interes identificar posibles factores pronosticos. Pacientes y metodos. Estudio descriptivo de los recien nacidos con paralisis del plexo braquial obstetrica nacidos en el hospital entre los años 2011 y 2015. Se han recogido variables maternas, perinatales, obstetricas y del tipo de lesion, y se han relacionado con la posibilidad de la recuperacion a los seis meses. Resultados. Se diagnosticaron 32 casos, lo que supone una incidencia del 1,44‰ de recien nacidos vivos. El 59% fueron varones, y el 37,5%, macrosomicos. La afectacion mas frecuente fue la lesion del plexo a nivel proximal (94%). El 44% sufrio distocia de hombros, y el 47% permanecio con secuelas al sexto mes. El antecedente de distocia de hombros se relaciono con mal pronostico de recuperacion. Conclusiones. La incidencia de paralisis braquial obstetrica se mantiene estable en los ultimos años. El porcentaje de niños que presentan secuelas a los seis meses es relevante. Son necesarios estudios prospectivos para poder establecer los factores pronosticos a largo plazo de esta patologia.

Bioaccumulation of pathogenic bacteria and amoeba by zebra mussels and their presence in watercourses.

Dreissena polymorpha (the zebra mussel) has been invading freshwater bodies in Europe since the beginning of the nineteenth century. Filter-feeding organisms can accumulate and concentrate both chemical and biological contaminants in their tissues. Therefore, zebra mussels are recognized as indicators of freshwater quality. In this work, the capacity of the zebra mussel to accumulate human pathogenic bacteria and protozoa has been evaluated and the sanitary risk associated with their presence in surface water has also been assessed. The results show a good correlation between the pathogenic bacteria concentration in zebra mussels and in watercourses. Zebra mussels could therefore be used as an indicator of biological contamination. The bacteria (Escherichia coli, Enterococcus spp., Pseudomonas spp., and Salmonella spp.) and parasites (Cryptosporidium oocysts and free-living amoebae) detected in these mussels reflect a potential sanitary risk in water.

¿Son útiles los cuestionarios utilizados actualmente en el tratamiento del tabaquismo? / Are the questionnaires currently used in the treatment of the smoking habit useful?

Objetivo: Valorar la utilidad de los cuestionarios en la evaluación del perfil del paciente fumador. Pacientes y métodos: Estudio analítico en fumadores que solicitan tratamiento en una unidad de tabaquismo a lo largo del período 2004/2006. Variables de estudio: sexo, edad, consumo de cigarrillos diarios, consumo de psicofármacos, antecedentes de ansiedad/depresión, intentos previos de cesación, cumplimentación, dependencia física (test de Fagerström), dependencia psicológica (test de Glover-Nilsson), grado de motivación (test de Richmond) y ansiedad rasgo (cuestionario STAI-R). Se consideró éxito a la abstinencia, según el criterio de intención de tratar, continuada y validada con cooximetría (monóxido de carbono espirado ≤ 10 ppm). Los resultados se expresan como proporciones y frecuencias absolutas para las variables cualitativas, y como medias ± desviación estándar para las variables cuantitativas. Resultados: Se han analizado 683 fumadores que solicitaron tratamiento en la Unidad de Tabaquismo, 601 iniciaron terapia grupal y 82 únicamente realizaron la historia clínica; los fumadores que no iniciaron tratamiento estaban menos motivados con respecto a los que sí lo hicieron. Las puntuaciones de los test fueron: test de Fagerström: 6,13± 2,27; test de Richmond: 7,71 ± 1,58, y test de Glover-Nilsson 21,62 ±6,50. Los pacientes con intentos previos estaban más motivados y tenían menos dependencia física. Del mismo modo una puntuación menor en el test de Fagerström se relacionó con buena cumplimentación y con estar abstinente al mes y 3 meses (p ≤ 0,05). Conclusiones: Se confirma la utilidad del test de Fagerström, tanto en el diagnóstico como en su valor pronóstico (AU)

Objective: Evaluate the utility of the questionnaires in the evaluation of the profile of the patient who smokesPatients and methods: Analytic study in smokers who request treatment in a smoking cessation unit during the period of 2004/2006. Study variables: gender, age, daily cigarette consumption, psychodrug consumption, background of anxiety/depression, previous attempts to quite, compliance, physical dependence (Fagerström test), psychological dependence (Glover-Nilsson test), motivation grade (Richmond test) and anxiety trait (STAI-R questionnaire). Abstinence is considered to be successful when, according to the intention to treat criterion, it is continued and validated with cooximetry (expired carbon monoxide 10 ppm). The results are expressed as proportions and absolute frequencies or qualitative variables and as means ± standard deviation for quantitative variables. Results: A total of 683 smokers who requested treatment in the Smoking Cessation Unit were analyzed. Of these, 601 initiated group therapy and only a clinical history was obtained in 82. The smokers who did not initiate treatment were less motivated regarding those who did. The test scores were: Fagerström test: 6.13 ± 2.27; Richmond test: 7.71± 1.58, and Glover-Nilsson test 21.62 ± 6.50. The patients with previous attempts were more motivated and had less physical dependence. In the same way, a lower score on the Fagerström test was related with good compliance and with being abstinent at one month and 3 months (p 0.05). Conclusions: The utility of the Fagerström test, both in the diagnosis and in prognostic value, is confirmed (AU)

Liposarcoma mediastínico / No disponible

No disponible

Epidermal growth factor receptor activating mutations in Spanish gefitinib-treated non-small-cell lung cancer patients.

BACKGROUND: North American and Japanese non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) activation via tyrosine kinase (TK) mutations respond dramatically to gefitinib treatment. To date, however, the frequency and effect of EGFR TK mutations have not been examined in European patients. PATIENTS AND METHODS: Eighty-three Spanish advanced NSCLC patients who had progressed after chemotherapy, were treated with compassionate use of gefitinib. Patients were selected on the basis of available tumor tissue. Tumor genomic DNA was retrieved from paraffin-embedded tissue obtained by laser capture microdissection. EGFR mutations in exons 19 and 21 were examined by direct sequencing. RESULTS: EGFR mutations were found in 10 of 83 (12%) of patients. All mutations were found in adenocarcinomas, more frequently in females (P=0.007) and non-smokers (P=0.01). Response was observed in 60% of patients with mutations and 8.8% of patients with wild-type EGFR (P=0.001). Time to progression for patients with mutations was 12.3 months, compared with 3.6 months for patients with wild-type EGFR (P=0.002). Median survival was 13 months for patients with mutations and 4.9 months for those with wild-type EGFR (P=0.02). CONCLUSIONS: EGFR TK mutational analysis is a novel predictive test for selecting lung adenocarcinoma patients for targeted therapy with EGFR TK inhibitors.

Fibrohistiocitoma maligno retroperitoneal / Retroperitoneal malignant fibrous histiocytoma

Propósito: Se realiza un estudio clínico, radiológico y patológico de un caso de fibrohistiocitoma maligno retroperitoneal y revisión bibliográfica acerca de tipos histológicos y comportamiento biológico, factores que condicionan el pronóstico y tratamiento. Material y métodos: Mujer de 31 años que consulta por masa en fosa ilíaca derecha (FID), anorexia y pérdida de peso. Diagnosticada, mediante biopsia incisional, de fibrohistiocitoma maligno se administra quimioterapia neoadyuvante y se procede, en un segundo tiempo, a extirpación quirúrgica completa del tumor y quimioterapia coadyuvante. Resultados: Pieza de 22 x 18 x 16 cms de aspecto irregular que infiltra pala ilíaca y músculo glúteo. Areas de necrosis y hemorragia. Microscópicamente presenta patrón común con transiciones entre áreas de células fusiformes que se entrecruzan con áreas pleomórficas donde se observan gran número de células gigantes con núcleos irregulares e hipercromáticos. Conclusiones: Son tumores asintomáticos en estadios precoces que se manifiestan por masa abdominal (80 por ciento) y dolor (70 por ciento), basando el diagnóstico de presunción en la Tomografía Axial Computerizada (TAC) y Resonancia Nuclear Magnética (RNM) que se confirmará con la biopsia.El factor pronóstico más importante es la exéresis completa con un margen no inferior a 2 cms., lo que sólo se puede conseguir en el 40 por ciento de los casos. Se discute el tamaño como factor pronóstico. No hay consenso acerca de la eficacia de quimio y/o radioterapia adyuvante, mostrándose, la mayoría de los autores, contrarios a ellas (AU)

[Descriptive study of patients diagnosed with asthma in a regional respiratory medicine practice]. / Estudio descriptivo de los pacientes diagnosticados de asma en una consulta neumológica de ámbito comarcal.

OBJECTIVE: To describe the characteristics of patients diagnosed of bronchial asthma (BA) in a regional respiratory medicine practice. METHODS: Over a period of two years, 88 adult patients followed a prospective-diagnostic protocol for BA that included taking of patient history to determine the probability of initial diagnosis (PID) of asthma, assessment of atopy and a lung function test that included spirometry with a bronchodilator test, recording of forced expiratory volume, and a methacholine challenge test. BA was diagnosed when symptoms denoting high or moderate PID were present and there was a positive reversibility and/or bronchial hyperreactivity test. The severity of disease was evaluated using the consensus criteria of the Global Initiative for Asthma (GINA). A student-t test and a chi 2 test were performed to compare data. RESULTS: BA was diagnosed in 24 men (30%) and 56 women (70%) with a mean age of 43.0 +/- 17.6 years (range 16 to 68). Significant differences between men and women were detected only for function parameters and cigarette consumption (p < 0.05). Fifty-three patients (66%) were referred by general practitioners, 22 (27%) were referred by hospital, and 5 came from other sources. The first group had a shorter history of disease course (p = 0.05) upon first evaluation. Sixty-one patients (76%) had mild asthma; these patients were younger and had had symptoms for a shorter period of time than those with more serious degrees of disease (16 with moderate asthma and 3 with severe asthma) (p < 0.05). Symptoms indicated a high PID in 57 cases (71%), and this figure increased significantly to 89.5% for those with more severe asthma (p < 0.05). Asthma was intrinsic for 39 patients and extrinsic for 41, with significant differences in age and total IgE between the two groups (p < 0.01). CONCLUSIONS: 1. BA is more than twice as common among women as among men. 2. Two thirds of patients are referred by general practitioners. 3. Mild asthma clearly predominates. 4. Clinical symptoms point to asthma, the PID in most cases being high.

Infusion phlebitis in post-operative patients: when and why.

BACKGROUND: The most common complication of intravenous therapy is infusion phlebitis. This study was done to prospectively assess its frequency in a series of consecutive patients who will undergo surgery, and to identify which variables may predict an increased risk for phlebitis. PATIENTS AND METHODS: 400 consecutive patients who will undergo surgery in a general surgery department were included. Only the first catheter, inserted the day before surgery, was taken into account. Eighteen variables (from the infusion, the catheter and from the patient) were prospectively evaluated for their contribution to the occurrence of phlebitis. RESULTS: 60/400 patients (15%) developed phlebitis, and most of them needed insertion of a further catheter. The univariate analysis showed that patients who developed phlebitis were older, and their pre-operative levels of both blood haemoglobin and neutrophil cound were significantly higher than those in patients who did not develop phlebitis. However, the multivariate analysis only confirmed the association with blood haemoglobin levels: the risk of phlebitis sharply increased in the patients with the highest haemoglobin levels. As to the influence of time on phlebitis development, there was a significant decrease in the day-specific risk, from the 5th day on. COMMENTS: In our series, blood haemoglobin levels were found to be the only variable associated to a higher risk of phlebitis. Besides, in contrast with the recommendations by the Centers for Disease Control, no significant increase in the day-specific risk of phlebitis was found. Thus, a guideline to select the type of catheter to be inserted in an individual patient is suggested.