Immune thrombotic thrombocytopenic purpura in older patients: Results from the Spanish TTP Registry (REPTT).

Immune thrombotic thrombocytopenic purpura (iTTP) is an ultra-rare disease that seldom occurs in the elderly. Few reports have studied the clinical course of iTTP in older patients. In this study, we have analysed the clinical characteristics at presentation and response to therapy in a series of 44 patients with iTTP ≥60 years at diagnosis from the Spanish TTP Registry and compared them with 209 patients with <60 years at diagnosis from the same Registry. Similar symptoms and laboratory results were described in both groups, except for a higher incidence of renal dysfunction among older patients (23% vs. 43.1%; p = 0.008). Front-line treatment in patients ≥60 years was like that administered in younger patients. Also, no evidence of a difference in clinical response and overall survival was seen in both groups. Of note, 14 and 25 patients ≥60 years received treatment with caplacizumab and rituximab, respectively, showing a favourable safety and efficacy profile, like that observed in patients <60 years.

CYB5R3 homozygous pathogenic variant as a rare cause of cyanosis in the newborn.

Detailed below is a very illustrative case of a rare pathology of recessive congenital methemoglobinemia. The patient, a newborn female, was homozygous for c.535G > A, p.(Ala179Thr) a pathogenic variant in the CYB5R3 gene. The reported population frequency of the allele is 0.853%, demonstrating why it is remarkable to find both parents are heterozygous carriers without consanguinity. A brief review of previously published cases is also presented.

[Habits and lifestyles modifiable in children with overweight and obesity]. / Hábitos y estilos de vida modificables en niños con sobrepeso y obesidad.

INTRODUCTION: In the prevention for being overweight and for obesity, much attention is given to the influence of dietary factors, making the joint evaluation with other modifiable factors necessary. OBJECTIVES: The aim of this project is to study the association between modifiable factors (physical activity, sedentary lifestyle, and dietary habits) with the prevalence of being overweight or obese in the youth population. METHODS: Cross-Sectional study of 1283 school children between the ages of 3 and 16 years old, with measurements of the MBI, dietary habits, physical activity, sedentary lifestyle and family history of being overweight. Physical activity measured in MET was classified according to Pate criteria. RESULTS: 22.4% of the boys and 32.9% of the girls were overweight. The presence of a BMI>25 in parents multiplied by 2.4 the risk of being overweight in children (OR CI 95% 1.5-3.7). 63.6% of overweight boys meet physical activity recommendations compared with 52.2% of girls, although in their case, it was greater than the average (45%). Sedentary time was 141 minutes for men and 128 minutes for women, with more sedentary behaviors associated with being overweight, especially in girls over 12 years of age (66.7%). Consuming cereal (OR 0.8) and having five meals per day (OR 0.5) act as protective factors. CONCLUSIONS: In subjects with overweight, the levels of physical activity are close to those recommended levels, so which the values of a sedentary lifestyle together with dietary habits (if the parents have overweight) acquire a new relevance in intervention strategies of this problem.

Life-style factors associated with overweight and obesity among Spanish adults.

OBJECTIVES: To assess the relationship between life styles and eating habits with the overweight and obesity prevalence in a Spanish adult population. METHODS: A population-based, cross-sectional study conducted on 2640 subjects older than 15 years, in Cádiz (Spain). Surveys were conducted in subjects' homes to obtain life styles, eating habits, and anthropometric data. Logistic regression has been used to study the association between the life style variables and overweight and obesity. RESULTS: Prevalence of overweight and obesity in Cadiz is 37% and 17%, respectively; higher in males and increases with age. BMI has an inverse relationship with educational level (PR = 2.3, 1.57-2.38). The highest levels of obesity are associated with daily alcohol consumption (PR = 1.39, 1.29-1.50), greater consumption of television,and sedentary pursuit (PR 1.5, 1.07-1.24). A lower prevalence of obesity is observed among those with active physical activity (10.9% vs 21.6%), with differences between sex. Following a slimming diet is more frequent in the obese and in women but dedicate more hours than men to passive activities. In men is greater the consumption of alcohol, high energy foods and snacks. Overweight and obesity is associated with the male sex (OR = 3.35 2.75-4.07), high consumption of alcohol (OR = 1.38 1.03-1.86) and watching television (OR = 1.52 1.11-2.07), and foods likes bread and cereals (OR = 1.47 1.13-1.91). Exercise activities is a protective factor (OR = 0.76 0.63-0.98). CONCLUSIONS: Life styles factors associated with overweight and obesity present different patterns in men and women and is necessary to understand them to identify areas for behavioural intervention in overweight and obesity patients.

Characteristics of eating disorders in a university hospital-based Spanish population.

OBJECTIVE: To describe the personal and family antecedents and clinical characteristics of patients with eating disorders (EDs) in a population of the south of Spain; to analyse the influence of lifestyles, family functioning, socioeconomic status (SES), and psychological characteristics in these processes. DESIGN: A university-based case-control study. SETTING: University Hospital (Andalusia, Spain). SUBJECTS: A total of 120 patients with EDs and 240 controls. INTERVENTIONS: SCOFF, EDI, APGAR family, and SES questionnaires. RESULTS: In all, 67.5% of patients presented anorexia (AN), 15% bulimia (BN), and 17.5% mixed forms. EDs emerged at around 18-20 y (95% CI 17.9-19.8). Factors associated with EDs are psychiatric conditions (depression OR: 4.16, anxiety OR: 4.59), more frequent use of medication (OR: 2.26), dietary fibre (OR: 2.59), and laxatives (OR: 3.47). Toxics consumption, sport activity, SES, and family antecedents of pathology are not associated with EDs. An inverse relationship was found between family functioning and the scores in various subscales of the EDI. CONCLUSIONS: Eating disorders in Andalusia (Spain) are influenced significantly more by psychological, family, and cultural factors than by social factors.

Epidemiological study of the influence of family and socioeconomic status in disorders of eating behaviour.

OBJECTIVE: To analyse the differences in family functioning and socioeconomic status between subjects with disorders of eating behaviour and the healthy population, considering the possible relationship of these factors with the psychic characteristics of patients, with consumption of various substances, and with sexual practices. DESIGN: Case-control study. SETTING: 'Puerta del Mar' University Hospital (Andalusia, Spain). SUBJECTS: Conducted on a sample of 120 patients with AN and BN, and 240 controls with an identical distribution by age and sex. INTERVENTIONS: SCOFF, eating disorder inventory (EDI), Apgar family and socioeconomic questionnaires are utilised. RESULTS: Patients with disorders of eating behaviour present greater family dysfunctioning than controls; among cases, this difference is greater in the acute forms, but there are no differences between recent situations or crises due to previous episodes. Family dysfunction is associated with higher scores of multiple subscales of the EDI, which is corroborated on analysing each of the Apgar parameters independently. Family functioning is not associated with other variables such as breast-feeding or consumption of toxic substances. Socioeconomic status does not differentiate cases from controls, or acute situations from evolving ones, or new episodes from other crisis episodes, although differences may be found in the psychic manifestations according to social class. CONCLUSIONS: It is confirmed that family functioning has an influence in these types of disorder, in their evolution and in the psychic characteristics of the patients, without any evidence being found of a relationship between these disorders and socioeconomic status.

Photocatalytic degradation of formaldehyde containing wastewater from veterinarian laboratories.

The photocatalytic destruction of methanol, formaline (mixture of formaldehyde, methanol and water) and formaline wastes from the preservation of vertinarian physiologic samples has been attempted by two different processes, at high concentrations of reagents and by dossification of reagents, varying pH in both. Experiment evolution has been monitored by measuring the organic matter such as TOC and formaldehyde concentrations [H2CO]. Also, methanol and methanol-formaldehyde interactions with the TiO2 surface have been analysed by FTIR spectroscopy. Results indicate that at high concentrations the catalyst surfacial alterations given by methoxy, formates or carbonates, according to the pH of the sample can profoundly affect catalyst behaviour. It has been established that reagent dossification is advantageous for enhancing photonic efficiency as it minimizes the adsorbate presence that hampers the photocatalytic process.

[Physical exercise and food habits: a study of adolescents in Cádiz]. / Ejercicio físico y hábitos alimentarios: un estudio en adolescentes de Cádiz.

BACKGROUND: A increased number of eating disorders among teen-agers are currently being reported. Physical exercise, especially when done individually, is one of the methods chosen for losing weight. We are basing this study on the hypothesis of a larger number of eating habit disorders (EHD's) in subjects who do physical exercise alone. This study describes and compares eating habits among teen-agers that do individual exercise as opposed to athletes who work out in groups or on teams. METHOD: Cross-section study of 532 teen-agers ages 14-18 who are enrolled in school and who do physical exercise, having been selected at random by means of a two-stage, stratified sampling process. The subjects were divided into two groups according whether they did individual physical exercise alone (Number: 216) or in groups (Number: 316). The eating habits of both groups were analyzed based on a questionnaire filled out by the subjects themselves. RESULTS: In the group preferring individual sports, females were predominant (degree of males 0.44). Of these females, their being on diets in order to lose weight was 3.12 times more frequent, compulsive eating episodes being 3.73 times more frequent. As regards behaviors which might be considered to be compensatory, there is a clear concentration thereof among those who do sports individually, hence 43% stated to voluntarily undergo periods of fasting (4.96 times more than those who exercise in groups), 46% stating to have brought on vomiting at one time or another for "dieting" purposes (3.76 more) and up to 26% have used laxatives with the intention of losing weight (2.56 times more than among athletes who play on teams). CONCLUSION: The existence of EHD's seems to be associated with teen-agers who play individual sports as opposed to those who play on teams.

[Hospital infections. Risky practices of nursing students]. / Infección hospitalaria. Prácticas de riesgo en estudiantes de Enfermería.

In this study the health habits performed by nursing students during their practices in hospitals are describe in the province of Cádiz, Spain and the relationship between these activities involving risk, and the level of knowledge of Public Health of these students. A total of 397 nursing students were studied, 43% male, with an average age of 21.6 years (SD 2.9); the average practice period per student was 73 days. Washing of hands before and after each intervention is performed by 97% of students, and gloves are used on all the sanitary occasions recommended by only 21%; the groups using masks least are those not vaccinated for influenza and not subjected to a Mantoux test (p < 0.05). The relationship between taking unnecessary risk in hospital practice and the low level of knowledge is positive (collective protection p < 0.05, use of gloves p < 0.05, among others).

[Level of knowledge about nourishment/nutrition among school adolescents in Cadiz]. / Nivel de conocimientos sobre alimentación/nutrición en adolescentes escolarizados de Cádiz.

OBJECTIVE: To determine the level of knowledge about nourishment/nutrition and how this knowledge is distributed among school adolescent population in the town of Cádiz. DESIGN: Descriptive and transversal study. SETTING: Schools. PARTICIPANTS: Sample of 630 subjects from the school adolescent population in the town of Cádiz. MEASUREMENTS AND MAIN RESULTS: The average level of knowledge about nourishment/nutrition is 6.63 (in a 0-13 scale). No significant differences were found according to the perception of proportion or disproportion in height and weight, level of concern about body fats and getting fat, diets, avoiding some food or taking some medication, dietary fibers and infusions or any other weight-reducing products and physical exercise and fitting. The relationship between the level of knowledge and the BMI is very close to statistical significance. CONCLUSIONS: We found a middle level of knowledge about nourishment/nutrition. We think this level of knowledge should be raised and other factors determining healthy habits should be considered. It is necessary to go on with research and contextualize nourishment habits.

[Contraception in adolescents included in a family planning program]. / Anticoncepción en adolescentes incluidas en un programa de planificación familiar.

OBJECTIVE: To describe the motives of consultation, kinds of contraceptive methods and side-effects of oral contraceptives (OCs) in adolescent users of a family planning program. DESIGN: Family planning program at the District Primary Care Unit, Cádiz, Spain. PATIENTS: 283 adolescent females who requested attendance in a family planning program from January 1993 until January 1994. MEASUREMENTS AND MAIN RESULTS: A medical history of every adolescent was carried out and every patient was examined. Those who were recommended the use of OCs passed through 3 controls: at the beginning, after the 6th month and after 1 year. These controls consisted in recording sexual risk behaviours as well as several analytic tests. RESULTS: Most adolescents requested the prescription of contraceptive methods (81.7% of the most prescribed and demanded methods were OCs). We found no serious side-effects after 1 year, so we can conclude that OCs are an usefull contraceptive choice for sexually active adolescents because of its security, acceptance and easy use.

Lepra versus SIDA: comparación de la actitudes que generan ambos conceptos mediante un diferencial samántico (D. S)

Para medir el perfil connotativo de las palabras y analisar las actitudes que éstas evocan se utiliza el Diferencial Semántico (D.S), de gran interés en psicología de la salud puesto que nos permite analizar las connotaciones de diversas palabras alusivas a la enfermedad. Así hemos analizado y contrastado el perfil connotativo-actitudinal que nos evocan las palabras LEPRA y SIDA, mediante un D.S de elaboración propia, según las variables, SEXO, EDAD, SER O NO PERSONAL SANITARIO y SER O NO UNIVERSITARIO, en una muestra de 144 sujetos de ambos os sexos, de 21 a 60 años, de la provincia de Cádiz. Tras el análisis de los datos se ofrecen varias conclusiones, entre las que destacan el que el SIDA está ocupando el espectro semántico negativo-"ignominioso" que antes ocupaba la lepra, abundando los juicios "morales" negativos hacia ambos conceptos, y el que se desconozca o niegue la posibilidad preventiva en ambos casos.

[The USFAM Study: the prevalence of allergic diseases in the school-age population of the province of Cádiz. I. Ubrique, San Fernando, Algeciras and Medina Sidonia]. / Estudio USFAM: prevalencia de las enfermedades alérgicas en la población escolar de la provincia de Cádiz. Parte I.

The purpose of this study was to determine the prevalence of allergic diseases in the school population of the province of Cádiz in order to confirm the hypothesis that these diseases are more frequent there than in the rest of the Spanish provinces. Four cities of our province were chosen (Ubrique, San Fernando, Algeciras and Medina Sidonia, whose initials form the acrostic USFAM) with clear differential characteristics (climatological, orographical, environmental, etc). In each city, schools, both public and private, were chosen at random. Complete classes were used, and the age-limit was that established in each school. A questionnaire was given to all of the parents who, together with the teachers, were given instructions for its completion. Of the 4,000 questionnaires distributed, 2,572 were correctly completed. Of these, 1,988 answered that their child was non-allergic and 584 as allergic (22.7%). The ratio male/female was almost 2/1 (64.4%/35.6%) and the largest prevalence of these allergic diseases was in the group of children between 10 and 13 years of age. We have found that the prevalence of this pathology in the province of Cádiz is higher than the national mean.

La lepra y sus estereotipos: un estudio de sus connotaciones semánticas a la luz de un diferencial samántico (D. S.)

Introducción: El significado de nuestras palabras abarca dos aspectos: el denotativo (sistema de símbolos que tienen un significado compartido grupalmente y específico) y el connotativo que deriva de las asociaciones -más afectivas que cognoscitivas- que solemos hacer cuando oímos o empleamos una palabra. Para medir este perfil connotativo-actitudinal se suele utilizar el diferencial semántico (D.S.) formado por una lista, en un continuum bipolar de siete intervalos, de adjetivos antagónicos, reunidos en RADICALES (evaluación, potencia y actividad añadiendo nosotros AFECTIVIDAD)... Técnica que, en nuestro caso, hemos aplicado al concepto "LEPRA", para medir y contrastar las connotaciones que evoca puesto que -por desgracia- a veces es más difícil tratar los prejuicios y estereotipos que genera la propia enfermedad. Objetivos: Analiza las connotaciones semático-afectivas y actitudinales del concepto "LEPRA", mediante un D.S. de elaboración propia, contrastando las variables SEXO, EDAD, SER O NO PERSONAL SANITARIO y SER O NO UNIVERSITARIO. Metodología: a) Muestra: Hemos trabajado con 144 sujetos, de ambos os sexos, de 21 a 60 años, de Cádiz y su provincia, repartidos en subgrupos proporcionales y estratificados. b) Material: A esta muestra le hemos pasado un D.S. de elaboración propia y aplicación individual, efectuando la recogida de datos entre el 10/11/94 y el 20/11/94. c) Tratamiento estadístico: El análises estadístico de los datos se ha realizado en base al recuendo de las frecuencias, en suma algebraica, a los valores asignados en cada pareja de adjetivos, efectuándose la prueba de diferencia de medias mediante el test de Kurskal con un nivel de confianza del 95%. Análisis y discusión de los resultados: - En el radical EVALUACIÓN constatamos que la lepra recibe una evaluación negativa, aunque no extrema, percibiéndose como bastante mala e injusta, extraña y relativamente indigna,...