Alcohol Consumption in Nursing Students after the COVID-19 Lockdown.

Excessive alcohol consumption is a major public health issue that can negatively affect behavior among university students. The objective of this study was to estimate the frequency of alcohol consumption in nursing students as well as to describe the pattern of alcohol consumption after COVID-19 lockdown. A descriptive, cross-sectional observational study was carried out, in which 1162 degree-level nursing students were evaluated. Sociodemographic characteristics, lifestyles and levels of physical activity were determined using the International Physical Activity Questionnaire: Short Form (IPAQ-SF), and alcohol consumption was determined using the ISCA (Systematized Alcohol Consumption Questionnaire) and AUDIT (Alcohol Use Disorders Inventory Test) questionnaires. According to the AUDIT questionnaire, 36.7% of the students met the criteria for excessive alcohol consumption (26.8% men vs. 39.9% women; p < 0.001). The prevalence of hazardous drinkers was found to be 10.2% (95% CI 5.6-11.7), with the difference between men and women being statistically significant. The IPAQ-SF questionnaire indicated that 26.1% of students were sedentary. No relationship was observed between alcohol consumption and the level of physical activity. The frequency of hazardous drinkers was significantly higher in women (OR: 2.2) and in smokers (OR: 4.2). In conclusion, approximately 10% of nursing students can be considered hazardous drinkers, with significant differences between the sexes. The percentage is higher in women and in smokers. Strategies should be created that encourage healthy lifestyles, emphasizing preventive activities against excessive alcohol consumption. Furthermore, given the differences in excessive alcohol consumption between men and women, it would be advisable to include the gender perspective in these activities.

Attitudes towards Tattoos among Spanish Health Science Students.

(1) Background: The aim is to ascertain health science students' attitudes towards tattoos and their association with healthy lifestyles and socio-demographic variables. (2) Methods: Descriptive study conducted on pharmacy, medical and nursing students (n = 423). To ascertain attitudes towards tattoos, we used the Attitudes Towards Tattoos Scale. Other variables were physical activity, healthy diet, harmful habits and socio-demographic variables. (3) Results: A total of 12.6% (95% CI 9.1−16.2) of students reported having a tattoo; 58.9% did not regard tattoos as a health risk. In terms of attitudes, the mean score in the range of 7−35 (7­most unfavourable to 35­most favourable) was 22.6 (SD 5.2; 95% CI: 22.0−23.2). Scores were higher (p < 0.05) among women (23.1; SD: 5.3), persons aged <20 years (23.6; SD: 5.0) and smokers (23.9; SD: 4.6). Attitudes were found to be more favourable (p < 0.05) in nursing students than in pharmacy or medical students. No relationship was observed with physical activity, healthy diet or drug use. (4) Conclusions: The attitude to tattoos is most favourable among women, persons aged under 20 years and nursing students. In terms of health habits, attitudes are more favourable among smokers, regardless of their level of physical activity, compliance with healthy eating guidelines or consumption of alcohol or other drugs.

Development and Validation of a Novel Ultra-Compact and Cost-Effective Device for Basic Hands-On CPR Training: A Randomized, Sham-Controlled, Blinded Trial.

To examine the performance of a novel low-cost, ultra-compact, and attractive auditory feedback device for training laypeople in external chest compressions (ECCs), we conducted a quasi-experimental cross-sectional study from September to November 2021 at the Faculty of Nursing of Albacete, University of Castille-La Mancha, Spain. The ECC sequence was performed in the laboratory with the new device for basic hands-on CPR training. Results: One hundred college students were included in this study. The compression rate/min with the new device was 97.6, and the adequate %ECC was 52.4. According to the status of body mass index (BMI) and muscle strength of the upper limbs in the bivariate analysis, it was observed that the new device discriminated between those who performed correct ECCs according to their BMI and muscle strength and those who did not, which led to significantly influenced results in terms of the percentage of ECCs with correct depth. Conclusions: The new ultra-compact auditory feedback device "Salvando a Llanetes®" demonstrated utility for teaching and learning ECCs in basic CPR. We can affirm that the analyzed device is an adequate, safe and economical method for teaching "CPR Hands-Only™" to the general population.

Influencia de los estilos de vida de la madre en el inicio de la lactancia materna: estudio de casos y controles / Influence of the mother's lifestyles on the initiation of breastfeeding: A case-control study

Introducción: La lactancia materna es la alimentación óptima durante los primeros meses de vida. El objetivo principal de este estudio fue analizar los factores relacionados con no iniciar la lactancia materna, tanto referidos a los estilos de vida maternos como a las características epidemiológicas y la información sobre lactancia. Material y método: Estudio analítico observacional de casos y controles en 6 centros de salud. Se seleccionaron mujeres con algún hijo menor de 5 años, estimando un tamaño muestral de 166 casos (mujeres que no iniciaron lactancia materna) y 166 controles (que iniciaron lactancia). Se midieron variables sociodemográficas y estilos de vida maternos antes y durante la gestación, como la actividad física mediante el cuestionario BPAAT, la dieta con el cuestionario MEDAS-14 y el consumo de tabaco y alcohol. Se valoró la información y opiniones sobre lactancia, así como la experiencia previa. Resultados: Se incluyeron 348 mujeres (174 casos y 174 controles) con una edad media de 33,4 años (DE 5,4). Fueron variables asociadas de manera independiente con no iniciar lactancia: ausencia de experiencia previa con lactancia (OR: 12,75), tomar la decisión durante la gestación o el parto (OR: 10,55), no estar casada o con pareja (OR: 3,42) y permanecer sedentaria≥2h/día durante la gestación (OR: 1,77). Conclusiones: En nuestro estudio, los factores determinantes que se asocian a no iniciar lactancia materna son la ausencia de experiencia previa con lactancia, el momento de la decisión sobre la lactancia y el estado civil. Entre los estilos de vida, solo el sedentarismo se asocia a no iniciar lactancia materna, mientras que no tienen influencia los hábitos alimentarios u otros. (AU)

Introduction: Breast milk is the optimal food during the first months of life. The main objective was to analyse the factors associated with not initiating breastfeeding in terms of maternal lifestyles, epidemiological characteristics and information on breastfeeding. Material and method: Observational analytical study of cases and controls in 6 primary care centres. The sample included women with a child under 5 years, with an estimated necessary sample size of 166 cases (women who did not initiate breastfeeding) and 166 controls (women who began breastfeeding). Sociodemographic and maternal lifestyle variables were measured before and during pregnancy, such as physical activity using the BPAAT questionnaire, diet with the MEDAS-14 questionnaire, and tobacco and alcohol consumption. We assessed the information and opinions about breastfeeding as well as previous experience with it. Results: The study included 348 women (174 cases and 174 controls) with a mean age of 33.4 years (SD 5.4). The variables independently associated with not initiating breastfeeding were: absence of previous experience with breastfeeding (OR 12.75), making the decision during pregnancy or delivery (OR 10.55), not being married or in a partnership (OR 3.42) and being sedentary for periods of 2h or greater/day during pregnancy (OR 1.77). Conclusions: In our study, the determining factors associated with not initiating breastfeeding were the lack of previous experience with breastfeeding, the timing of the decision about breastfeeding, and marital status. When it came to lifestyle, only a sedentary lifestyle was associated with not initiating breastfeeding, while dietary or other habits had no influence. (AU)

Dermatitis asteatósica o de craquelé. A propósito de un caso / Asteatotic or Craquelé Dermatitis. A Case Study

La dermatitis de craquelé o dermatitis asteatósica es una enfermedad cutánea caracterizada por piel eritematosa, pruriginosa, seca y agrietada, que afecta preferentemente a personas de edad avanzada, siendo el tipo de eccema más común en pacientes ancianos. Entre los factores que contribuyen a su aparición, destacan la edad, el clima estacional y los hábitos del baño, que pueden favorecer la alteración del estrato córneo y la aparición de fisuras.(AU)

Craquelé dermatitis or asteatotic dermatitis is a skin disease characterized by erythematous, itchy, dry and cracked skin, which preferentially affects the elderly and is the most common type of eczema in elderly patients. Among the factors that contribute to its appearance are age, seasonal climate and bathing habits, which can favour the alteration of the stratum corneum and the onset of fissures.(AU)

Influence of the mother's lifestyles on the initiation of breastfeeding: A case-control study.

INTRODUCTION: Breast milk is the optimal food during the first months of life. The main objective was to analyse the factors associated with not initiating breastfeeding in terms of maternal lifestyles, epidemiological characteristics and information on breastfeeding. MATERIAL AND METHOD: Observational analytical study of cases and controls in 6 primary care centres. The sample included women with a child under 5 years, with an estimated necessary sample size of 166 cases (women who did not initiate breastfeeding) and 166 controls (women who began breastfeeding). Sociodemographic and maternal lifestyle variables were measured before and during pregnancy, such as physical activity using the BPAAT questionnaire, diet with the MEDAS-14 questionnaire, and tobacco and alcohol consumption. We assessed the information and opinions about breastfeeding as well as previous experience with it. RESULTS: The study included 348 women (174 cases and 174 controls) with a mean age of 33.4 years (SD, 5.4). The variables independently associated with not initiating breastfeeding were: absence of previous experience with breastfeeding (odds ratio [OR], 12.75), making the decision during pregnancy or delivery (OR, 10.55), not being married or in a partnership (OR, 3.42) and being sedentary for periods of 2 hours or greater/day during pregnancy (OR, 1.77). CONCLUSIONS: In our study, the determining factors associated with not initiating breastfeeding were the lack of previous experience with breastfeeding, the timing of the decision about breastfeeding, and marital status. When it came to lifestyle, only a sedentary lifestyle was associated with not initiating breastfeeding, while dietary or other habits had no influence.

A descriptive study on the adjacent segment degeneration related signs following a lumbar fusion procedure.

BACKGROUND: Adjacent segment degeneration (ASD) is a frequent complication following vertebral fusion procedures and is defined as the condition where patients recover after the initial procedure but develop compatible symptoms with radiological injuries in the segments adjacent to the fused ones at a later stage. The objective of the study was to describe the frequency and analysis of ASD related signs following a lumbar fusion procedure. METHODS: Observational descriptive retrospective study on patients with degenerative or instability conditions, operated on by posterolateral or circumferential lumbar fusion procedure. Pedicle screws, interbody peek cages (polyether-ether-ketone) and autologous bone graft were used. Clinical (pain and disability) and radiological (instability, rotation, disc height loss, radiological degeneration evaluated by X-ray and MR) variables were analysed. RESULTS: Postoperative disc height loss was observed in 159 free discs among 112 patients (42.6%) (95% CI: 36.4-48.8%). Anterior or posterior slippage (anterolisthesis or retrolisthesis) at the end of the follow-up period was observed in 33 patients (12.5%). Upper segment rotation increased in the postoperative period in 36 patients (13.6%). Radiological disc degeneration was observed in 107 discs among 72 patients, being more frequent in the immediate upper disc with grade 2 and 3 changes at the end of follow-up in 48 discs from 35 patients (13.6%) (95% CI: 13.4-23.1%). Radiological ASD signs were observed in 151 patients (57.4%; 95% CI: 51.2-63.6%) and 53 of them (20.2%; 95% CI: 15.1-25.2%) who also showed clinical ASD symptoms (clinical and radiological ASD). Degeneration changes with degrees IV and V shown by a preoperative and magnetic resonance (MR) study at end of the follow-up period performed in 73 patients (27.7%), were observed in 46 discs among 32 patients (43.8%) (95% CI: 31.8-55.9%). CONCLUSIONS: Radiological ASD signs evaluated in every free disc following a lumbar fusion procedure are observed with a variable frequency. All free discs after fusion were assessed as they could indicate mechanisms of compensation of lordosis loss and should be taken into consideration in a prospective revision surgery.

Pápulas perladas / Pearly papules

Las pápulas perladas del pene (PPP) son lesiones benignas de aspecto blanquecino perlado que se encuentran alrededor de la corona del glande. A pesar de ser asintomáticas y benignas por naturaleza, la aparición de PPP puede causar un gran malestar psicológico tanto al paciente como a su pareja sexual, por lo que se trata de un motivo de consulta frecuente en Atención Primaria por parte de hombres jóvenes. Presentamos el caso de un joven de 22 años que consultó por hallazgo casual de lesiones indoloras en el glande. Debido a que es importante tranquilizar al paciente respecto a la naturaleza de la lesión, resulta fundamental para la médica o médico de familia conocer su localización y su aspecto típico.(AU)

Pearly penile papules (PPP) are benign, pearly-white lesions located around the crown of the glans penis. Despite being asymptomatic and benign by nature, the appearance of PPP can cause major psychological discomfort to the patient and their sexual partner. It is a common reason for primary healthcare consultation by young men. We report the case of a 22-year-old man who consulted due to the accidental finding of painless lesions on the glans penis. As it is important to reassure the patient about the nature of the injury, knowledge of the location and its typical appearance by the family doctor is essential.(AU)

Calidad de vida relacionada con la salud en pacientes consumidores de benzodiacepinas / Health-related quality of life in patients consuming benzodiazepine

Objetivo: Describir la calidad de vida relacionada con la salud (CVRS) en consumidores de benzodiacepinas y comprobar si existe asociación con las características del tratamiento, su efectividad y las variables sociodemográficas. Diseño: Estudio descriptivo de carácter transversal. Emplazamiento: Consultas de medicina de familia. Participantes: Cuatrocientos cincuenta y dos pacientes mayores de 18 años consumidores de benzodiacepinas o fármacos análogos. Mediciones principales: La CVRS se evaluó mediante el cuestionario EuroQol-5D. Otras variables: síntomas de ansiedad o insomnio, variables sociodemográficas y características del tratamiento. Resultados: La puntuación media ± desviación estándar en el estado de salud fue de 62,80 (IC del 95%: 60,69-64,86), inferior en personas sin estudios (59,27 ±21,97; p = 0,004) y menor categoría social (60,02 ± 21,27; p < 0,001). En cuanto a la tarifa social (índice EQ) se obtuvo una puntuación media de 0,6025 (IC del 95%: 0,5659-0,6391), superior en personas con mayor escolarización (0,6577 ± 0,3574; p = 0,001), más categoría social (0,7286 ± 0,3381; p < 0,001) y edad inferior a 65 años (0,6603 ± 0,3426; p < 0,001). Las variables que mediante regresión múltiple se asociaron con el valor del índice EQ fueron ausencia de ansiedad/insomnio, pertenencia a clases sociales superiores, edad menor de 65 años y menor consumo de ansiolíticos/hipnóticos. Conclusiones: Los pacientes consumidores de benzodiacepinas manifiestan, a pesar del tratamiento, una moderada CVRS, inferior a la obtenida en población general o en pacientes de atención primaria. La situación es más favorable en los de menor edad, en quienes no presentan ansiedad/insomnio, en pertenecientes a clases sociales superiores y cuando el consumo de fármacos es menor.(AU)

Objective: To describe the health-related quality of life (HRQoL) in benzodiazepine users and to verify whether there is an association with the characteristics of the treatment, its effectiveness, and the sociodemographic variables. Design: Descriptive cross-sectional study. Location: Family medicine consultations. Participants: Four hundred and fifty 2patients over 18 years of age consuming benzodiazepines or similar drugs. Main measurements: HRQoL was assessed using the EuroQol5-D questionnaire. Other variables: symptoms of anxiety or insomnia, sociodemographic variables and characteristics of the treatment. Results: The mean score in health status was 62.80 (95% CI: 60.69–64.86), lower in people without studies (59.27±21.97 SD; P=.004) and lower social category (60.02±21.27 SD; P<.001). Regarding the social rate (EQ index), a mean score of 0.6025 (95% CI: 0.5659–0.6391) was obtained, higher in people with higher education (0.6577±0.3574 SD; P=.001), plus social category (0.7286±0.3381 SD; P<.001) and age less than 65 years (0.6603±0.3426 SD; P<.001). The variables that were associated with the value of the EQ index by means of multiple regression were absence of anxiety/insomnia, belonging to higher social classes, age less than 65 years and less consumption of anxiolytics/hypnotics. Conclusions: Patients who use benzodiazepines show, despite treatment, a moderate HRQL, lower than that obtained in the general population or in primary care patients. The situation is more favorable in the youngest, in those who do not present anxiety/insomnia, in those belonging to higher social classes and when the consumption of drugs is lower.(AU)

[Health-related quality of life in patients consuming benzodiazepine]. / Calidad de vida relacionada con la salud en pacientes consumidores de benzodiacepinas.

OBJECTIVE: To describe the health-related quality of life (HRQoL) in benzodiazepine users and to verify whether there is an association with the characteristics of the treatment, its effectiveness, and the sociodemographic variables. DESIGN: Descriptive cross-sectional study. LOCATION: Family medicine consultations. PARTICIPANTS: Four hundred and fifty 2patients over 18 years of age consuming benzodiazepines or similar drugs. MAIN MEASUREMENTS: HRQoL was assessed using the EuroQol5-D questionnaire. Other variables: symptoms of anxiety or insomnia, sociodemographic variables and characteristics of the treatment. RESULTS: The mean score in health status was 62.80 (95% CI: 60.69-64.86), lower in people without studies (59.27±21.97 SD; P=.004) and lower social category (60.02±21.27 SD; P<.001). Regarding the social rate (EQ index), a mean score of 0.6025 (95% CI: 0.5659-0.6391) was obtained, higher in people with higher education (0.6577±0.3574 SD; P=.001), plus social category (0.7286±0.3381 SD; P<.001) and age less than 65 years (0.6603±0.3426 SD; P<.001). The variables that were associated with the value of the EQ index by means of multiple regression were absence of anxiety/insomnia, belonging to higher social classes, age less than 65 years and less consumption of anxiolytics/hypnotics. CONCLUSIONS: Patients who use benzodiazepines show, despite treatment, a moderate HRQL, lower than that obtained in the general population or in primary care patients. The situation is more favorable in the youngest, in those who do not present anxiety/insomnia, in those belonging to higher social classes and when the consumption of drugs is lower.

Analysis of compliance of the criteria recommended by the European resucitation council in first aid books published in Spanish.

AIMS: Analyse the compliance of criteria recommended by the European Resuscitation Council (ERC) in the layperson First Aid (FA) and Cardiopulmonary resuscitation (CPR) books published in Spanish. METHODS: A review of FA literature published in Spain, carried out through a systematic literature search procedure. We drew up a checklist with clarifications, based on different responses to twenty categories published in November 2015 by the ERC. The validity of the questions was analysed using the Fleiss' Kappa measure of inter-rater reliability, with a value >0.7 being deemed valid and questions displaying the lowest level of agreement being excluded. RESULTS: Eight texts obtained from the limited search of materials published between 2016-2020 in the ISBN 13 database were analysed. Evaluation of eight texts ranging from 47 to 328 pages in length showed that only three included the upgraded 2015 CPR recommendations. Twenty categories/items were analysed, after exclusion of categories/items that displayed a low consistency. None of the handbooks was in total compliance with the new CPR recommendations, and only one included 70% of the recommendations. Seven categories were included in more than 50% of the texts, and nine categories were not included in any of them. CONCLUSIONS: There is a gap between the 2015 CPR recommendations and those published in Spanish FA handbooks. The ERC Guidelines should serve to standardise FA and CPR training materials. Systematic analysis of compliance with scientific societies' recommendations for FA handbooks enables detection of guidelines and patterns that need to be updated and adapted.

Fascitis plantar diagnosticada mediante ecografía / Plantar fascitis diagnosed with ultrasound

La fascitis plantar constituye una causa frecuente de dolor en la planta del pie. Se produce por un exceso de carga a nivel de la inserción de la fascia en el calcáneo. Típicamente, el paciente describe dolor al inicio del día con la deambulación y aumento del mismo a la palpación. La ecografía complementa e incluso confirma el diagnóstico, y además sirve como guía para determinados tratamientos cuando las medidas conservadoras no dan resultado.(AU)

Plantar fascitis is a common cause of pain in the sole of the foot; it occurs because of excess load at the insertion of the fascia into the calcaneus. The patient typically reports pain at the start of the day upon gait and this increases on palpation. Ultrasound complements and even confirms the diagnosis and also serves as a guide for certain treatments when conservative measures have not proved to be effective.(AU)

Prevalence of Overweight and Obesity among Health Sciences Students in the Amazonia Region of Peru.

A cross-sectional study was conducted to evaluate 199 health sciences students in the city of Iquitos. Their socio-demographic characteristics, lifestyle, level of physical activity, type of food, substance abuse, and prevalence of overweight and obesity were ascertained using purpose-validated questionnaires, i.e., the Systematic Alcohol Consumption Interview (Interrogatorio Sistematizado de Consumos Alcohólicos/ISCA), a questionnaire on the frequency of dietary intake (CFCA), the International Physical Activity Questionnaire (IPAQ), and anthropometric measurements. The prevalence of overweight (body mass index (BMI) of 25.0-29.9 kg/m2) was 26.5% (95% CI = 19.9-33.0%) and that of obesity (BMI ≥ 30.0 kg/m2) was 7.9% (95% CI = 3.8-12.1%). A total of 34.4% of students (95% CI = 27.4-41.4%) presented with a BMI > 25 kg/m2. The frequency of overweight was significantly higher in persons aged over 20 years (OR = 2.5) and smokers (OR = 3.2), and the frequency of obesity was significantly higher in older students (OR = 4.1) and males (OR = 5.5). In conclusion, a considerable proportion of health sciences students in the Amazonia region presented with a high BMI. The proportion of students with overweight was higher among students aged over 20 years and smokers, while that of obesity was also higher among males. In the university setting, the development of more overweight- and obesity-preventive activities and educational interventions would therefore be desirable.

Mapa bibliométrico de la investigación realizada en atención primaria en España durante el periodo 2013-2017 / Bibliometric map of research carried out in Primary Care in Spain during the period 2013-2017

OBJETIVO: Describir la producción científica española de atención primaria durante 2013-2017, analizando su distribución geográfica, factor de impacto, áreas de investigación y participación de diferentes sectores institucionales. DISEÑO: Estudio observacional bibliométrico. PARTICIPANTES: Publicaciones indexadas en Medline. MEDICIONES PRINCIPALES: Revista y año de publicación, primer/último autor, centro de trabajo y comunidad autónoma. Se clasificaron los artículos según su contenido. El factor de impacto fue obtenido de la base de análisis bibliométrico Journal Citation Reports. RESULTADOS: Incluidos 980 documentos. El índice de transitoriedad fue 78,8%. La mayoría de los artículos (43,2%) procedía de centros de salud, originados en unidades o institutos de investigación, desde 14,9% en 2013 hasta 19,1% en 2017. El 63,3% se clasificaron como «aspectos clínicos». El 19,3% fueron publicados en la revista Atención Primaria, el 40,6% en revistas extranjeras y el 72,4% en revistas con factor de impacto, siendo esta proporción significativamente inferior (p < 0,001) en los procedentes de centros de salud (59,6%) o de unidades docentes/gerencias/servicios de salud (70,0%) respecto a los originados en unidades/institutos de investigación (93,1%) o en universidades (89,0%). En relación al número de habitantes (documentos/100.000 habitantes), las comunidades más productivas fueron Cataluña (4,2), Aragón (3,9) e Islas Baleares (3,3). CONCLUSIONES: En las publicaciones de atención primaria existe gran diversidad tanto en áreas de investigación como en las revistas donde se publican. La mayoría proceden de centros de salud, tratan aspectos clínicos y se publican en revistas españolas. Se observan diferencias en el volumen de producción científica entre comunidades autónomas

OBJECTIVE: To describe the Spanish scientific production of primary care during 2013-2017 and analyze their geographical distribution, impact factor, areas of research and involvement of different institutional sectors. DESIGN: Observational study bibliometric. PARTICIPANTS: The study focused on publications indexed in Medline. MAIN MEASUREMENTS: Journal and year of publication, first/last author, workplace and autonomous community. Later, articles were classified according to their content. The impact factor was obtained from the basis of bibliometric analysis Journal Citation Reports. RESULTS: Using search criteria, were selected 980 documents. The transiency rate was 78,8%. The highest proportion of articles (43.2%) came from health centers, but we observed an increase of the articles from units or research institutes (14.9% in 2013, 19.1% in 2017). Of the total, 63.3% were classified as “clinical aspects”, 19.3% were published in the journal Atención Primaria, 40.6% in foreign journals and 72.4% in journals with impact factor, being this proportion significantly lower (p <0.001) in those coming from health centers (59.6%) or teaching units/management/health services (70.0%) with respect to those originated in research units/institutes (93.1%) or in universities (89.0%). In relation to population (articles/100.000 inhab.), the most productive communities were Cataluña (4.2), Aragón (3.9), e Islas Baleares (3.3). CONCLUSIONS: In primary care publications there is great diversity in both research areas such as in journals where published. Most are from health centers, treat clinical aspects and published in Spanish journals. Differences in the volume of scientific production between regions are observed

Thoracic pedicle subtraction osteotomy for correction of proximal junctional kyphosis after surgery for adolescent idiopathic scoliosis: A case report.

INTRODUCTION: Complications in the upper thoracic spine are not uncommon after corrective surgery for deformities in adults and adolescents. Proximal junctional failure has been linked to structural osseous or ligamentous failure and proximal junctional kyphosis has been described as an increase in preoperative proximal kyphosis. CASE DESCRIPTION: A 20-year-old male patient intervened after atypical development of idiopathic scoliosis, with rapid progression nearing skeletal maturity. While an increase in the magnitude of the main thoracic curve in the coronal plane was observed, the progression of structural sagittal plane deformity of the proximal thoracic curve was not identified due to poor visualization. This resulted in improper identification of curve type and choice of fusion levels, with progressive residual kyphosis across follow-up. At the age of 27, the patient was re-intervened by means of pedicle subtraction osteotomy in the apical area of the proximal thoracic deformity. Although an adequate correction was achieved, the remaining deformity of 50° and the proximal failure required extending the instrumentation and fusion to the cervical spine. This has shown itself to be an effective technique for correction of proximal residual or progressive symptomatic fixed kyphosis, thereby avoiding the morbidity of the anterior or combined approaches. CONCLUSIONS: In adolescent deformity, an adequate preoperative planning including clinical and radiological study must be carried out, paying special attention to the sagittal plane to identify major and minor structural curves. The pedicle subtraction osteotomy, despite being a demanding technique and not entirely risk-free, has shown itself to be an effective corrective technique.

Quiste óseo aneurismático / Aneurysmal bone cyst

El quiste óseo aneurismático es una lesión ósea reactiva que está formada por cavidades quísticas que contienen sangre. Generalmente ocasiona dolor de intensidad leve o moderada, pero el paciente puede presentar deformidad y fractura patológica, ya que en su evolución es común el crecimiento local agresivo y la destrucción cortical. Aparece con más frecuencia en las dos primeras décadas de la vida y representa aproximadamente el 1,4 % de todos los tumores óseos primarios. Presentamos el caso de un varón de 16 años diagnosticado de quiste óseo aneurismático que inicialmente consultó por dolor mecánico en el tobillo izquierdo. El paciente fue intervenido quirúrgicamente mediante resección y reconstrucción con injerto óseo. La evolución fue favorable, permaneciendo asintomático al cabo de unos meses de la intervención. El quiste óseo aneurismático se debe probablemente a un cambio fisiopatológico como consecuencia de un traumatismo o de un proceso vascular anómalo. El médico de familia debe sospecharlo cuando observe en la radiografía ósea una imagen lítica y multiloculada de carácter expansivo

Aneurysmal bone cyst is a reactive bone lesion formed by cystic cavities containing blood. It generally causes mild to moderate pain, but the patient can present deformity and pathological fracture, since aggressive local growth and cortical destruction are frequent during its development. It occurs most frequently in the first two decades of life, and accounts for approximately 1.4% of all primary bone tumors. We present the case of a 16-year-old man diagnosed with aneurysmal bone cyst who initially presented mechanical pain in left ankle. The patient underwent surgical resection and reconstruction with bone graft. The evolution was favorable and the patient remains asymptomatic several months after surgery. Aneurysmal bone cyst is probably due to a pathophysiological change caused by a trauma or by an anomalous vascular process. The family doctor should suspect this disease when the bone radiography shows a lytic, multilocular, expansive lesion

[Bibliometric map of research carried out in Primary Care in Spain during the period 2013-2017]. / Mapa bibliométrico de la investigación realizada en atención primaria en España durante el periodo 2013-2017.

OBJECTIVE: To describe the Spanish scientific production of primary care during 2013-2017 and analyze their geographical distribution, impact factor, areas of research and involvement of different institutional sectors. DESIGN: Observational study bibliometric. PARTICIPANTS: The study focused on publications indexed in Medline. MAIN MEASUREMENTS: Journal and year of publication, first/last author, workplace and autonomous community. Later, articles were classified according to their content. The impact factor was obtained from the basis of bibliometric analysis Journal Citation Reports. RESULTS: Using search criteria, were selected 980 documents. The transiency rate was 78,8%. The highest proportion of articles (43.2%) came from health centers, but we observed an increase of the articles from units or research institutes (14.9% in 2013, 19.1% in 2017). Of the total, 63.3% were classified as "clinical aspects", 19.3% were published in the journal Atención Primaria, 40.6% in foreign journals and 72.4% in journals with impact factor, being this proportion significantly lower (p <0.001) in those coming from health centers (59.6%) or teaching units/management/health services (70.0%) with respect to those originated in research units/institutes (93.1%) or in universities (89.0%). In relation to population (articles/100.000 inhab.), the most productive communities were Cataluña (4.2), Aragón (3.9), e Islas Baleares (3.3). CONCLUSIONS: In primary care publications there is great diversity in both research areas such as in journals where published. Most are from health centers, treat clinical aspects and published in Spanish journals. Differences in the volume of scientific production between regions are observed.

[PAPPS GdT Major 2020 Update]. / Actualización PAPPS GdT Mayor 2020.

In this update, we have introduced new topics that we believe are of vital importance in the major areas, such as the revision of walking aids, as well as recommendations on nutrition and social isolation. Recommendations on deprescribing, fragility, mild cognitive impairment, and dementia have already been presented in previous updates.