Hábitos alimenticios, estilos de vida y riesgos para la salud. Estudio en una población militar / Eating habits, lifestyles and health risks. Study in a military population

Food is one of the main challenges that health has in the twenty-first century. An inadequate diet together with the absence of physical activity and sedentary lifestyle are among the leading causes of preventable disease and premature death in Europe. In our country, the Mediterranean Diet model is being relegated in favor of a Western diet model. The consequence is the existence, more and more frequent, of health problems linked to diet, among which obesity stands out, an entity that is increasing year after year that is associated with numerous chronic diseases, especially those of a cardiovascular and metabolic nature.Objective:Analyze the feeding habits lifestyles of a military population and antropometric measures.Material and methods:Observational, cross-sectional and descriptive study. The data will be collected through questionnaires on feeding habits, lifestyles and associated diseases and of anthropometric measures.Results:The sample was performed by 107 persons. More than 70% of the sample needs changes in their diet, the data for adherence to the Mediterranean Diet are uneven, they were only correct in fruits, cereals, legumes, olive oil, milk and eggs. 69.79% of the sample performs physical activity in their free time. The overweight and obesity figures are 30.17% and 8.75% respectively.Conclusions:The results obtained provide us with knowledge on this area, to try to modify unhealthy patterns and styles, through educational programs and to use them as instruments of health promotion and disease prevention. (AU)

La alimentación es uno de los principales desafíos que la salud tiene en el siglo XXI. Una inadecuada alimentación junto con la ausencia de actividad física y el sedentarismo se encuentran entre las primeras causas de enfermedad evitable y muerte prematura en Europa. En nuestro país, el modelo de Dieta Mediterránea se está relegando a favor de un modelo de dieta occidental. La consecuencia es la existencia, cada vez más frecuente, de problemas de salud ligados a la alimentación, entre los que destacan la obesidad, entidad en aumento año tras año que se asocia a numerosas enfermedades crónicas, especialmente de carácter cardiovascular y metabólico.Objetivo:analizar los hábitos alimenticios, estilos de vida y datos antropométricos de una población militar.Material y Métodos:Estudio observacional, transversal y descriptivo. Los datos fueron recogidos a través de cuestionarios sobre hábitos alimentarios, estilos de vida y enfermedades asociadas y de medidas antropométricas.Resultados:Se consiguió una muestra de 107 individuos. Más del 70% necesita cambios en su alimentación, los datos de adhesión a la Dieta Mediterránea son desiguales, siendo adecuados sólo en frutas, cereales, legumbres, aceite de oliva, leche y huevos. Un 69,79% realiza actividad física en su tiempo libre. Las cifras de sobrepeso y obesidad son del 30,17% y 8,75% respectivamente. (AU)

Payload for Contact Inspection Tasks with UAV Systems.

This paper presents a payload designed to perform semi-autonomous contact inspection tasks without any type of positioning system external to the UAV, such as a global navigation satellite system (GNSS) or motion capture system, making possible inspection in challenging GNSS- denied sites. This payload includes two LiDAR sensors which measure the distance between the UAV and the target structure and their inner orientation angle. The system uses this information to control the approaching of the UAV to the structure and the contact between both, actuating over the pitch and yaw signals. This control is performed using a hybrid automaton with different states that represent all the possible UAV status during the inspection tasks. It uses different control strategies in each state. An ultrasonic gauge has been used as the inspection sensor of the payload to measure the thickness of a metallic sheet. The sensor requires a stable contact in order to collect reliable measurements. Several tests have been performed on the system, reaching accurate results which show it is able to maintain a stable contact with the target structure.

[Functional results in isolated patellofemoral arthrosis treated by arthroscopy plus Fulkerson osteotomy vs patellofemoral arthroplasty]. / Resultados funcionales en artrosis patelofemoral aislada tratados mediante artroscopía más osteotomía de Fulkerson vs artroplastía patelofemoral.

OBJECTIVE: To Compare the clinical outcomes of patellofemoral arthroplasty and Fulkerson osteotomy. MATERIAL AND METHODS: 32 patients with the diagnosis of isolated patellofemoral arthrosis were treated, 16 patients with patellofemoral Arthroplasty and 16 patients with Fulkerson type osteotomy. Being a non-probabilistic sample of convenience and quota with random allocation. The indications for surgery were osteoarthritis patellofemoral grade III-IV of the classification Kellgren-Lawrence, treated with pharmacological therapy and physical rehabilitation without improvement of the symptomatology. Clinical evaluations were performed prior to surgical procedure at six months, one year and two years. With the questionnaires of Japanese Knee Injury and Osteoarthritis Outcome Score, Lysholm Knee Score and analogue visual scale. RESULTS: Significant improvement was found in both groups The pain component improved significantly in both groups at six months, one year and at two years (p 0.001 for both), daily activities (p = 0.001), sports (p = 0.001). The quality of life improved (p = 0.001). correlation between one-year follow-up score in the group of patients treated with patellofemoral arthroplasty on the Lysholm scale and the KOOS pain subscale (R2 = 0.8508). A moderate correlation in pain and sport dimensions on the KOOS scale (R2 = 0.783). DISCUSSION: In our study group, patellofemoral arthroplasty exhibits better function as well as a decrease in pain compared to arthroscopy and Fulkersons osteotomy at all stages of follow-up.

OBJETIVO: Comparar los resultados clínicos de la artroplastía patelofemoral y la osteotomía de Fulkerson. MATERIAL Y MÉTODOS: Se trataron 32 pacientes con el diagnóstico de artrosis patelofemoral aislada, 16 con artroplastía patelofemoral y 16 con osteotomía tipo Fulkerson, siendo una muestra no probabilística de conveniencia y de cuota con asignación aleatoria. Las indicaciones para cirugía fueron artrosis patelofemoral grado III-IV de la clasificación Kellgren-Lawrence, lo cual se trató con terapia farmacológica y rehabilitación física sin mejoría de la sintomatología. Las evaluaciones clínicas se realizaron previo a procedimiento quirúrgico, a los seis meses, un año y dos años, con los cuestionarios de Japanese Knee Injury and Osteoarthritis Outcome Score, Lysholm Knee Score y escala visual análoga. RESULTADOS: Se encontró una mejoría significativa en ambos grupos. El componente de dolor mejoró significativamente en ambos grupos a los seis meses, un año y a los dos años (p 0.001 para ambos), dolor (p = 0.001), actividades diarias (p = 0.001), deportes (p = 0.001). La calidad de vida mejoró (p = 0.001), la correlación entre la puntuación al seguimiento a un año de dolor en el grupo de pacientes tratados con artroplastía patelofemoral en la escala de Lysholm y la subescala de dolor de KOOS (R2 = 0.8508). Una correlación moderada en las dimensiones de dolor y deporte de la escala KOOS (R2 = 0.783). DISCUSIÓN: En nuestro grupo de estudio, la artroplastía patelofemoral presenta una mejor función, así como una disminución del dolor en comparación con la artroscopía y osteotomía tipo Fulkerson en todas las etapas de seguimiento.

New discretization method applied to NBV problem: Semioctree.

This paper presents a discretization methodology applied to the NBV (Next Best View) problem, which consists of determining the heuristical best position of the next scan. This new methodology is a hybrid process between a homogenous voxelization and an octree structure that preserves the advantages of both methods. An octree structure is not directly applicable to the NBV problem: as the point cloud grows with every successive scanning, the limits and position of the discretization, octree structure must coincide, in order to transfer the information from one scan to the next. This problem is solved by applying a first coarse voxelization, followed by the division of each voxel in an octree structure. In addition, a previous methodology for solving the NBV problem has been adapted to make use of this novel approach. Results show that the new method is three times faster than the homogenous voxelization for a maximum resolution of 0.2m. For this target resolution of 0.2m, the number of voxels/octants in the discretization is reduced approximately by a 400%, from 35.360 to 8.937 for the study case presented.

Interventions to decrease short-term peripheral venous catheter-related bloodstream infections: impact on incidence and mortality.

BACKGROUND: Short-term peripheral venous catheters are a significant source of healthcare-acquired bloodstream infections and a preventable cause of death. AIM: To assess the effectiveness of interventions applied to reduce the incidence and mortality associated with short-term peripheral venous catheter-related bloodstream infections (PVCR-BSIs). METHODS: The intervention included continuous PVCR-BSI surveillance, implementation of preventive measures related to catheter insertion and maintenance in accordance with evidence-based recommendations and the hospital's own data, front-line staff educational campaigns, and assessment of adherence to hospital guidelines by ward rounds. A Poisson regression model was used to estimate the trend of rate per year. FINDINGS: From January 2003 to December 2016, 227 episodes of PVCR-BSI were identified among hospitalized patients at a university hospital. The mean age of patients was 67 years (standard deviation 14 years), 69% were male and the median Charlson score was 3 (interquartile range 2-5). Staphylococcus aureus caused 115 (50.7%) episodes. Thirty-day mortality was 13.2%. After implementation of the intervention, the incidence of PVCR-BSIs decreased significantly from 30 episodes in 2003 (1.17 episodes/10,000 patient-days) to eight episodes in 2016 (0.36/10,000 patient-days). The number of episodes caused by S. aureus decreased from 18 episodes in 2003 (0.70/10,000 patient-days) to three episodes in 2016 (0.14/10,000 patient-day), and mortality decreased from seven cases in 2003 (0.27/10,000 patient-days) to zero cases in 2016 (0.00/10,000 patient-days). CONCLUSIONS: Surveillance, implementation of a multi-modal strategy and periodical assessment of healthcare workers' adherence to hospital guidelines led to a sustained reduction in PVCR-BSIs. This reduction had a major impact on S. aureus BSI rates and associated mortality.

Mortality risk factors among non-ICU patients with nosocomial vascular catheter-related bloodstream infections: a prospective cohort study.

BACKGROUND: Vascular catheter-related bloodstream infections (CRBSIs) are highly preventable hospital-acquired infections and a major threat to patient safety. While there is significant information regarding CRBSI outcome among intensive care unit (ICU) patients, data regarding non-ICU patients are scarce. AIM: To determine the risk factors associated with 30-day mortality among non-ICU patients with nosocomial CRBSIs. METHODS: Prospective cohort study of non-ICU patients with nosocomial CRBSIs in a tertiary care centre between January 2004 and December 2014. The primary outcome was 30-day mortality, defined as death from any cause within 30 days of CRBSI. Follow-up was performed 30 days after CRBSI onset. Time until death was the dependent variable in Cox regression analysis. FINDINGS: In total, 546 cases of CRBSI were identified. The mean age of patients was 64.5 years [interquartile range (IQR) 55-75 years], 66% were male, and the mean Charlson score was 3.59 (IQR 2-5). Of the 546 cases, 58.4% resulted from central venous catheters and 41.6% from peripheral venous catheters. The causative agents were Gram-positive cocci (70.1% of cases), Gram-negative bacilli (31.1%) and Candida spp. (1%). Mortality within 30 days was 13.9%, with no significant changes over the study period. Independent risk factors for 30-day mortality were Charlson score ≥4 [hazard ratio (HR) 1.80, 95% confidence interval (CI) 1.19-2.73], Staphylococcus aureus infection (HR 2.67, 95% CI 1.61-4.43) and Candida spp. infection (HR 6.1, 95% CI 2.08-18.04). Age; area of admission; type, use and site of vascular catheter; and administration of appropriate empirical antibiotic treatment were not independent risk factors for 30-day mortality. CONCLUSION: Nosocomial CRBSIs outside ICUs are associated with high risk of mortality, particularly among patients with a higher Charlson score and bloodstream infections caused by Staphylococcus aureus and Candida spp.

The composition and depth of green roof substrates affect the growth of Silene vulgaris and Lagurus ovatus species and the C and N sequestration under two irrigation conditions.

Extensive green roofs are used to increase the surface area covered by vegetation in big cities, thereby reducing the urban heat-island effect, promoting CO2 sequestration, and increasing biodiversity and urban-wildlife habitats. In Mediterranean semi-arid regions, the deficiency of water necessitates the use in these roofs of overall native plants which are more adapted to drought than other species. However, such endemic plants have been used scarcely in green roofs. For this purpose, we tested two different substrates with two depths (5 and 10 cm), in order to study their suitability with regard to adequate plant development under Mediterranean conditions. A compost-soil-bricks (CSB) (1:1:3; v:v:v) mixture and another made up of compost and bricks (CB) (1:4; v:v) were arranged in two depths (5 and 10 cm), in cultivation tables. Silene vulgaris (Moench) Garcke and Lagurus ovatus L. seeds were sown in each substrate. These experimental units were subjected, on the one hand, to irrigation at 40% of the registered evapotranspiration values (ET0) and, on the other, to drought conditions, during a nine-month trial. Physichochemical and microbiological substrate characteristics were studied, along with the physiological and nutritional status of the plants. We obtained significantly greater plant coverage in CSB at 10 cm, especially for L. ovatus (80-90%), as well as a better physiological status, especially in S. vulgaris (SPAD values of 50-60), under irrigation, whereas neither species could grow in the absence of water. The carbon and nitrogen fixation by the substrate and the aboveground biomass were also higher in CSB at 10 cm, especially under L. ovatus - in which 1.32 kg C m(-2) and 209 g N m(-2) were fixed throughout the experiment. Besides, the enzymatic and biochemical parameters assayed showed that microbial activity and nutrient cycling, which fulfill a key role for plant development, were higher in CSB. Therefore, irrigation of 40% can maintain an adequate plant cover of both endemic species, particularly in a deeper and soil-containing substrate.

[Use of multiple regression models in observational studies (1970-2013) and requirements of the STROBE guidelines in Spanish scientific journals]. / Utilización de los modelos de regresión múltiple en estudios observacionales (1970-2013) y requerimiento de la guía STROBE en revistas científicas españolas.

BACKGROUND: In medicine and biomedical research, statistical techniques like logistic, linear, Cox and Poisson regression are widely known. The main objective is to describe the evolution of multivariate techniques used in observational studies indexed in PubMed (1970-2013), and to check the requirements of the STROBE guidelines in the author guidelines in Spanish journals indexed in PubMed. METHODS: A targeted PubMed search was performed to identify papers that used logistic linear Cox and Poisson models. Furthermore, a review was also made of the author guidelines of journals published in Spain and indexed in PubMed and Web of Science. RESULTS: Only 6.1% of the indexed manuscripts included a term related to multivariate analysis, increasing from 0.14% in 1980 to 12.3% in 2013. In 2013, 6.7, 2.5, 3.5, and 0.31% of the manuscripts contained terms related to logistic, linear, Cox and Poisson regression, respectively. On the other hand, 12.8% of journals author guidelines explicitly recommend to follow the STROBE guidelines, and 35.9% recommend the CONSORT guideline. CONCLUSIONS: A low percentage of Spanish scientific journals indexed in PubMed include the STROBE statement requirement in the author guidelines. Multivariate regression models in published observational studies such as logistic regression, linear, Cox and Poisson are increasingly used both at international level, as well as in journals published in Spanish.

Aspectos psicológicos de la supervivencia en operaciones militares / Psychological aspects of survival in military operations

El adiestramiento y entrenamiento militar en supervivencia enfatiza la preparación física y la adquisición de determinados conocimientos técnicos, concediendo escasa relevancia a la preparación psicológica. Partiendo de este hecho, en el presente artículo se exponen y analizan brevemente una serie de factores psicológicos que condicionan y limitan la adaptación del militar que se ve inmerso en una situación de supervivencia. Seguidamente se presentan una serie de pautas y medidas psicológicas que, incidiendo en los aspectos anteriormente señalados, tienen como objetivo mejorar y favorecer la adaptación del militar a dichas situaciones, incrementando de esa manera sus posibilidades de superarlas con éxito (AU)

Military survival training emphasizes physical fitness and the acquisition of technical skills, giving little importance to psychological preparation. Given this, this article presents and briefly analyzes a number of psychological factors that influence and limit the adaptation of the military member who is engaged in a survival situation. It then presents a set of guidelines and psychological measures, affecting the aspects described above, which are intended to improve and promote the adaptation of the military member to such situations, thereby increasingtheir chances of successfully overcoming them (AU)

Second-hand smoke exposure in a sample of European hospitals.

Smoking in hospitals is banned in many European countries; nevertheless, the level of compliance is diverse, and, in some cases, smoking areas remain. The present study describes the levels of second-hand smoke, as derived from respirable suspended particle measurements, in a sample of European hospitals during the year 2007. The present study was a multicentric descriptive cross-sectional study carried out in 30 hospitals in seven European countries (Austria, Belgium, France, Germany, Greece, Romania and Spain). Particulate matter with a 50% cut-off aerodynamic diameter of 2.5 microm (PM(2.5)) concentration was measured by means of a hand-held laser-operated monitor of particle size and mass concentration in six selected indoor locations. Medians and interquartile ranges of PM(2.5) concentration were computed in order to describe the data by country and location of measurement. The median PM(2.5) concentration in all countries and locations was 3.0 microg x m(-3), with half of the measurements ranging 2.0-7.0 microg. x m(-3). PM(2.5) levels were similar across countries. Eleven (5.5%) measurements were >25.0 microg x m(-3), which is the 24-h mean limit recommended by the World Health Organization outdoor air quality guideline. The present results show that exposure to second-hand smoke in this sample of European hospitals is very low, and can be easily monitored in order to ensure smoke-free legislation compliance.

Dosificación de vancomicina en pacientes en hemodiálisis / No disponible

Dado el amplio uso de vancomicina en hemodiálisis (HD) es necesario adecuar la dosificación a las actuales membranas de diálisis, asegurando niveles óptimos. Objetivo: Valorar si, en HD, tras 1 gramo intravenoso (IV) los niveles plasmáticos de vancomicina se encuentran en rango terapéutico. Material y métodos: Estudio de cohorte transversal que incluye 28 pacientes en HD 3 veces/semana tratados con vancomicina entre el 15/2/2006 y el 14/2/2007. Sead ministró 1 gramo IV durante la última hora de HD, determinando niveles antes y después de la sesión siguiente(preHD1, postHD1) y antes de la 2ª sesión siguiente(preHD2). Resultados: De los 28 pacientes, 5 presentaban 3determinaciones y 5 presentaban 2 y el resto 1. De las 43muestras, 19 eran hombres (44,2%) y 24 mujeres (55,8%),con edad media 70 ± 8,4 años. La dosis de 1 gramo correspondía a > 15 mg/kg en 31 pacientes (72,1%) y < 15 mg/kgen 12 (27,9%). El 44,2% utilizaban polietersulfona de alta permeabilidad (PES-AP), 7% eval, 32,5% polietersulfona de media-baja permeabilidad (PES-BP) y 16,3% poliacrilonitrilo. El nivel medio preHD1 fue 7,06 mcg/ml, 7,5 mcg/mlpara la dosis > 15 mg/kg y 6 mcg/ml para < 15 mg/kg (p <0,05). El 16,3% presentó niveles por debajo del rango terapéutico, siendo 6,45% para una dosis > 15 mg/kg frente a 41,67% para la dosis < 15 mg/kg. Respecto a los dializadores, los niveles más bajos se observaron con PES-AP (5,95 mcg/ml) y los más elevados con PES-BP (7,27 mcg/ml) (p no significativa). Ningún paciente con PES-BP se encontró en rango infraterapéutico, frente a 31,58% con PES-AP (p = 0,07). Los valores postHD1 y preHD2 se encontraban en niveles subóptimos, tanto la media como los que recibían > 15 mg/kg y < 15 mg/kg, y en todos los dializadores. Conclusiones: La administración de 1 gramo IV de vancomicina cada 5-7 días no es adecuado para pacientes en HD, sobre todo cuando se utilizan membranas de alto flujo. Mientras no se actualizan las pautas de dosificación es necesario monitorizar los niveles prediálisis del fármaco para evitar concentraciones infraterapéuticas (AU)

Vancomycin is widely used in haemodialysis (HD) patients for treating infections of vascular access due to St. Aureus. To avoid subtherapeutic levels it is important to know the adequate dosing in patients undergoing haemodialysis with high flux membranes. Objective: The aim of this study was to evaluate whether HD patients treated with 1 g intravenous (IV) vancomycin reached optimum plasma levels. Material and methods: In a crossover design we studied 28 chronic HD patients, 3 times a week, treated with vancomycin between 15/2/2006 and 14/2/2007. Antibiotic wasgiven at dose of 1 g during the last hour of dialysis session. Plasma levels of vancomycin were measured immediately before next HD (preHD1) and after (postHD1), and prior to the beginning of the second next session (preHD2). We evaluated age, sex, dry height, week Kt/V and the type of membrane used. Results: Of 28 patients, 5 were analysed 3 times, 2 were analysed twice and 9 were analysed once. There were 43 samples, 19 men (44.2%) and 24 women (55.8%), with a mean age of 70 ± 8,4 years. 1 g dose is equivalent to > 15 mg/kg in 31 patients (72.1%) and < 15 mg/kg in 12 (27.9%). The type of membrane used was high flux polyetersulfone (PES-AP) (44.2%), eval (7%), medium-low polyetersulfone (PES-BP) (32.5%) and polyacrylonitrile (16.3%). PreHD1 mean concentration results for the total population was 7.06 mg/ml, being 16.3% bellow optimum levels. There were not difference between patients treated with dose > 15 mg/kg (7.5 mg/ml) and < 15 mg/kg (6 m/ml). When the dose administered was > 15 mg/kg, 6.45% results were subtherapeutic, whereas if the dose was < 15 mg/kg, 41.67% values were bellow optimum levels (p < 0.05). With regard to the dialyzers used, the lowest concentrations were observed with PES-AP (5.95 mg/ml) and the highest values were observed with PES-BP (7.27 mg/ml) (p no significance). No patient using PESBP versus 31.58% patients using PES-AP showed suboptimum values (p = 0,07). All postHD1 and preHD2 results were in subtherapeutic range (mean values, dose > and < 15 mg/kg and all types of membrane). Conclusions: Based on the above results, the vancomycin dosing schedule of 1 g IV every 5-7 days is not recommended for patients undergoing haemodialysis with high flux membranes. Since there are not guidelines for handling this antibiotic in these patients our findings suggest that it may be necessary to monitorize predialysis plasma levels to avoid subtherapeutic values (AU)

[Vancomycin dosing in hemodialysis patients]. / Dosificación de vancomicina en pacientes en hemodiálisis.

UNLABELLED: Vancomycin is widely used in haemodialysis (HD) patients for treating infections of vascular access due to St. Aureus. To avoid subtherapeutic levels it is important to know the adequate dosing in patients undergoing haemodialysis with high flux membranes. OBJECTIVE: The aim of this study was to evaluate whether HD patients treated with 1 g intravenous (IV) vancomycin reached optimum plasma levels. MATERIAL AND METHODS: In a crossover design we studied 28 chronic HD patients, 3 times a week, treated with vancomycin between 15/2/2006 and 14/2/2007. Antibiotic was given at dose of 1 g during the last hour of dialysis session. Plasma levels of vancomycin were measured immediately before next HD (preHD1) and after (postHD1), and prior to the beginning of the second next session (preHD2). We evaluated age, sex, dry height, week Kt/V and the type of membrane used. RESULTS: Of 28 patients, 5 were analysed 3 times, 2 were analysed twice and 9 were analysed once . There were 43 samples, 19 men (44,2%) and 24 women (55,8%), with a mean age of 70 +/- 8,4 years. 1 g dose is equivalent to > 15 mg/kg in 31 patients (72,1%) and < 15 mg/kg in 12 (27,9%). The type of membrane used was high flux polyetersulfone (PES-AP) (44,2%), eval (7%), medium-low polyetersulfone (PES-BP) (32,5%) and polyacrylonitrile (16,3%). PreHD1 mean concentration results for the total population was 7,06 mg/ml, being 16,3% bellow optimum levels. There were not difference between patients treated with dose > 15 mg/kg (7,5 mg/ml) and < 15 mg/kg (6 m/ml). When the dose administered was > 15 mg/kg, 6,45% results were subtherapeutic, whereas if the dose was < 15 mg/kg, 41,67% values were bellow optimum levels (p<0,05). With regard to the dialyzers used, the lowest concentrations were observed with PES-AP (5,95 mg/ml) and the highest values were observed with PES-BP (7,27 mg/ml) (p no significance). No patient using PES-BP versus 31,58% patients using PES-AP showed suboptimum values (p> or =0,07). All postHD1 and preHD2 results were in subtherapeutic range (mean values, dose > and < 15 mg/kg and all types of membrane). CONCLUSIONS: Based on the above results, the vancomycin dosing schedule of 1 g IV every 5-7 days is not recommended for patients undergoing haemodialysis with high flux membranes. Since there are not guidelines for handling this antibiotic in these patients our findings suggest that it may be necessary to monitorize predialysis plasma levels to avoid subtherapeutic values.

[Infantile dyspnea due to pyogenic laryngeal granuloma]. / Disnea infantil por "granuloma piogénico" laríngeo.

Two appearances are outstanding in this case report. First is the clinical picture of chronic laryngeal stridor of a child due to an acquired haemangioma. And that the anatomopathologic subtype of angioma is a pyogenic granuloma noteworthy, as we shall see, the use of the term "pyogenic granuloma" based only on anatomopathological findings in order to circumscribe this lesion.

[Transient atrial fibrillation induced by adenosine in a patient with atrial tachycardia]. / Fibrilación auricular transitoria inducida por adenosina en una paciente con taquicardia auricular.

The administration of adenosine during atrial tachycardia usually terminates the arrhythmia or induces AV block and makes the diagnosis clear. We present a patient with atrial tachycardia in which the administration of adenosine induced a transient atrial fibrillation (AF). A continuous transition between both arrhythmias was observed and the original tachycardia persisted after the termination of the AF. This proarrhythmic effect may be due to the adenosine-mediated shortening of the atrial refractory periods, which produces a decreased wavelength of the reentry circuits and the potential coexistence of several wave-fronts in the atria, favoring the development of AF. The recognition of this uncommon effect is important, since the repeated administration of increasing doses of adenosine may induce sustained AF.

Fibrilación auricular transitoria inducida por adenosina en una paciente con taquicardia auricular / Adenosine-induced transient atrial fibrillation in a patient with atrial tachycardia

La administración de adenosina durante taquicardia auricular suele producir la terminación de la misma o aumentar el grado de bloqueo AV facilitando su diagnóstico. Presentamos un caso de inducción de fibrilación auricular (FA) transitoria por adenosina en una paciente con taquicardia auricular. La transición entre ambos ritmos fue contínua, persistiendo la taquicardia original al finalizar la FA. Este efecto proarrítmico se cree debido al acortamiento de los peridodos refractarios auriculares inducido por la adenosina, disminuyendo la longitud de onda de los circuitos de reentrada y facilitando de este modo la coexistencia simultánea de varios frentes de activación en las aurículas como ocurre en la FA.Aunque es un fenómeno poco común, su reconocimiento es importante para evitar la administración repetida de dosis crecientes de adenosina, que podría llevar a la inducción de FA sostenida (AU)

[CCND1 oncogene amplification and cellular DNA content in squamous cell carcinomas of the head and neck]. / Amplificación del oncogén CCND1 y contenido celular de ADN en los carcinomas epidermoides de cabeza y cuello.

Cyclin D1 protein (encoded by the CCND1 gene) contributes to the progression of the cell cycle in the G1/S checkpoint. Cyclin D1 overexpression (for instance as a consequence of CCND1 amplification) might result in loss of control over genetic damage at this point and in an accumulation of chromosomal aberrations. In this work we analyze whether CCND1 amplification is associated with a higher incidence of alterations in cellular DNA content. 31 squamous cell carcinomas of the head and neck were studied. CCND1 amplification was determined by polymerase chain reaction. Cellular DNA content was determined by flow cytometry. CCND1 amplification was found in 6 (19%) cases. Thirteen (42%) cases were diploid and 18 (58%) were aneuploid. Two (33%) of the 6 cases with CCND1 amplification were aneuploid compared with 16 (64%) of the cases without CCND1 amplification (P = 0.36). We conclude that CCND1 amplification is not associated to a higher incidence of chromosomal aberrations in squamous cell carcinomas of the head and neck.

Evolución y análisis de la demanda asistencial infanto-juvenil en una unidad de salud mental general de área / Evolution and analysis of the child and adolescent asistential demand in a general mental health service of area

En este artículo se presentan los resultados de un análisis de la evolución de la demanda asistencial infanto-juvenil en un servicio de salud mental para la población general (Unidad de Salud Mental de Xàtiva, Valencia) desde su creación, en 1986 hasta 1999. Se analizan variables sociodemográficas y psicopatológicas de una muestra de 1.296 pacientes de 0 a16 años extraídos del registro de casos de la unidad. La incidencia anual ha aumentado progresivamente a lo largo de los años y en la actualidad es comparable a la reportada por servicios de salud mental infantil. La demanda se relaciona con variables de accesibilidad y con el desarrollo de los equipos de Atención Primaria. Se discuten las implicaciones para el diseño de recursos sanitarios infanto-juveniles (AU)

[Ventricular arrhythmias induced by appropriate antibradycardia pacing in patients with implantable defibrillators]. / Inducción de arritmias ventriculares por estimulación antibradicardia apropiada en pacientes portadores de desfibrilador automático.

INTRODUCTION AND OBJECTIVES: The induction of ventricular arrhythmias by appropriate antibradycardia ventricular pacing in patients with implantable cardioverter defibrillators has been reported in only a few cases. The aim of this study was to assess the incidence, characteristics and management of these episodes. METHODS: The follow-up records of 180 patients with implantable cardioverter defibrillators with intracardiac electrogram storage were reviewed. Pacing induced episodes were defined as those occurring immediately after an appropriate paced stimulus in a patient with sporadic paced beats. We assessed the number and type of episodes, mode of onset, therapy administered and the efficacy of different prevention measures. RESULTS: Pacing induced episodes were found in 9 patients (5%). Seven received device administered therapy which was effective in all cases. One to 95 episodes were observed per patient, of which 138 were monomorphic ventricular tachycardias and 20 polymorphic ventricular tachycardia/ventricular fibrillation episodes. All were induced by a paced ventricular beat after a post-extrasystolic pause or after long RR intervals during atrial fibrillation. Pacing induced arrhythmias were prevented by changing the pacing rate or hysteresis in 3 out of 6 patients and by decreasing the stimulus energy in 3 out of 3. Antibradycardia pacing function was disabled in 4 patients. CONCLUSIONS: Ventricular arrhythmias induced by appropriate antibradycardia ventricular pacing are relatively common in patients with implantable cardioverter defibrillators. Effective prevention can be achieved in most cases by changing the pacing rate or the pacing stimulus energy, however in selected cases the antibradycardia function may be disabled.