Implementación del método simplificado Apnealink™Air® por médicos de atención primaria para el diagnóstico del síndrome de apnea-hipopnea durante el sueño / Implementation of simplified diagnostic method Apnealink™Air® to diagnose sleep apnea by general practioners of primary care

Objetivo: Valorar la interpretación de ApnealinkTM® (AL) por médicos de atención primaria (MAP), y la alcanzada mediante poligrafía respiratoria (PGR) en la Unidad de Sueño Hospitalaria (USH) en pacientes con alta probabilidad de síndrome de apnea e hipopnea del sueño (SAHS). Métodos: Se recogen aleatoriamente, durante tres meses, pacientes seleccionados en USH para estudio mediante PGR, con elevada probabilidad de SAHS que aceptaron repetir estudio mediante AL. La USH corregía la PGR según normativa SEPAR; el MAP corregía el AL y planteaba manejo. Se analizaron los pacientes con estudios válidos(tiempo registro ≥ 240 min) para ambos dispositivos, comparándose resultados. Se consideró el estudio AL automático y corregido, considerando un índice de desaturación de oxihemoglobina (ODI) al 4% (ODI 4%), (AL 4%) y al 3% (ODI 3%), (AL 3%). Cuando ODI 4% era ≥ 12/h, se estableció diagnóstico SAHS moderado/grave, suponiendo un IAH ≥ 15/h. Para interpretar AL con ODI 3% y tratamiento, se siguieron criterios SEPAR. Se compararon los resultados para las mismas variables del AL frente a PGR. Resultados: Se incluyeron 43 pacientes válidos para AL, 45 para PGR y 41 válidos para ambos estudios. El estudio AL 4% mostró 27 (62,8%) positivos (OR 5,5, p < 0,05), que el AL 3% corroboró con IAH ≥ 15/h. La PGR detectó 19 (42,2%) con IAH ≥ 15/h; el AL 3% detectó 31 (72%). El análisis del AL 4% y AL 3% comparado con PGR no mostró diferencias de diagnóstico o manejo. Se compararon los resultados para las mismas variables del AL frente a PGR.Conclusiones: Existe equivalencia entre las decisiones del MAP y la USH. El AL sería un buen método diagnóstico de SAHS en atención primaria, en pacientes seleccionados con alta probabilidad de SAHS (AU)

Objectives: To assess diagnosis and therapeutic decisions-making by General Practitioners (GP) using ApnealinkTM® (AL) in patients with high suspicion of obstructive sleep apnea (OSA), in comparison with conclusions of Hospital Sleep Unit (HSU) specialists based on home respiratory polygraphy (PGR) results. Methods: This study involved patients previously selected by HSU for sleep testing by PGR. After it, patients were offered to complete AL test. PGR was checked at HSU; AL was checked by hemoglobin desaturation index of 4% (4% ODI), (4% AL) and 3% (3% ODI) patients with positive test to proceed with CPAP; and those with negative test for further testing. Automatically adjusted 4% AL, was considered valid as it was demonstrated to be equivalent to manual AL. Results were compared by automatically adjusted 3%AL against PGR results. Results: 48 patients were collected. 43 had AL valid test, 45 had PGR valid study, and 41 had both valid test. 27 patients (62,8%) had positive 4% AL (OR 5,51, p < 0,05), that showed AHI ≥ 15/h at 3% AL test; and 19 patients (42,2%) had a positive PGR test. 31 (72%) patients had a positive 3% AL. AL had shown to be a good screening method of SAHS. Conclusions: There is equivalence between the decisions of GP and HSU. AL is a good diagnostic tool and screening method for OSA in primary care when it is used in patients with high suspicion of moderate-severe OSA (AU)

[Implementation of simplified diagnostic method Apnealink™Air® to diagnose sleep apnea by general practioners of primary care]. / Implementación del método simplificado Apnealink™Air® por médicos de atención primaria para el diagnóstico del síndrome de apnea-hipopnea durante el sueño.

OBJECTIVES: To assess diagnosis and therapeutic decisions-making by General Practitioners (GP) using ApnealinkTM® (AL) in patients with high suspicion of obstructive sleep apnea (OSA), in comparison with conclusions of Hospital Sleep Unit (HSU) specialists based on home respiratory polygraphy (PGR) results. METHODS: This study involved patients previously selected by HSU for sleep testing by PGR. After it, patients were offered to complete AL test. PGR was checked at HSU; AL was checked by hemoglobin desaturation index of 4% (4% ODI), (4% AL) and 3% (3% ODI) patients with positive test to proceed with CPAP; and those with negative test for further testing. Automatically adjusted 4% AL, was considered valid as it was demonstrated to be equivalent to manual AL. Results were compared by automatically adjusted 3%AL against PGR results. RESULTS: 48 patients were collected. 43 had AL valid test, 45 had PGR valid study, and 41 had both valid test. 27 patients (62,8%) had positive 4% AL (OR 5,51, p < 0,05), that showed AHI ≥ 15/h at 3% AL test; and 19 patients (42,2%) had a positive PGR test. 31 (72%) patients had a positive 3% AL. AL had shown to be a good screening method of SAHS. CONCLUSIONS: There is equivalence between the decisions of GP and HSU. AL is a good diagnostic tool and screening method for OSA in primary care when it is used in patients with high suspicion of moderate-severe OSA.

OMENTAL INFARCTION: SURGICAL or CONSERVATIVE TREATMENT? A CASE REPORTS and CASE SERIES SYSTEMATIC REVIEW.

BACKGROUND: Omental infarction (OI) is an infrequent cause of acute abdominal pain and there is no consensus on whether conservative or surgical treatment is the best strategy when performing positive CT diagnosis. OBJECTIVES: To assess which of the two treatments is the most commonly adopted and compare outcomes in terms of success rate in resolution of symptoms and hospital length of stay. ELIGIBILITY CRITERIA: Case report and case series of patients with abdominal pain and positive diagnosis by CT of omental infarction. DATA SOURCES: PubMed, Science Direct and Google Scholar in combination with cross-referencing searches and manual searches of eligible articles from January 2000 to June 2018. PARTICIPANTS: Patients older than 18 years of age. METHODS: Patient characteristics and results were summarized descriptively. Categorical variables were assessed by chisquare test or Fischer's exact test, and continuous variables by the Wilcoxon-Mann-Whitney or Kruskal-Wallis test. Risk factors for failure of the conservative management were identified using multivariate logistic regression. RESULTS: 90 articles were included in the final analysis (146 patients). 107 patients (73.3%) received conservative treatment with a failure rate of 15.9% (patients needing surgery) and 39 patients (26.7%) received surgery as first treatment. The mean hospital length of stay was 5.1 days for the conservative treatment group and 2.5 days for the surgery group with statistically significant differences (p = 0.00). Younger age and white blood cells count ≥12000/µl were predictive factors of conservative treatment failure. CONCLUSIONS: Although conservative treatment is effective in most patients, surgery has advantages in terms of hospital length of stay.

Prevalencia del tabaquismo en los estudiantes de bachillerato de la Comarca de Osona (Barcelona) / Smoking Prevalence in High School Students in the Barcelona Region (De Osona District)

El entorno sociocultural influye en el tabaquismo juvenil, y actualmente parece que hay descenso de su prevalencia. Objetivos: Valorar la prevalencia del tabaquismo en estudiantes de bachillerato, la influencia del entorno en su inicio en la Comarca de Osona (Barcelona) (COB) y analizar, si existiera, su disminución. Material y métodos: Estudio transversal en alumnos de bachillerato de COB. Mediante encuesta anónima se interrogó sobre tabaquismo, influencia del entorno y contexto sociocultural en el inicio. Resultados: Participaron 842, se recogieron 714 encuestas y 705 se consideraron válidas. Tenían residencia urbana 303 (93,5%). Fumaban 159 (22,6%) y el 62% eran mujeres; 70 (44%) eran cristianos, 3 (1,9%) musulmanes, 14 (8,8%) de otras religiones y 72 (45,3%) aconfesionales. Consumían alcohol 529 (76,3%) y otras sustancias 308 (46,5%). Padecían alguna enfermedad 40 (6,1%) alumnos y 334 (47,5%) familiares. Había 207 (29,4%) padres fumadores y 152 (22%) madres. Existía tabaquismo familiar en 214 (59%) alumnos y en 582 (82,6%) amigos. Los padres tenían estudios superiores en 212 (30,1%), medios en 331 (48,7%) y primarios en 137 (20,1%); en relación con las madres en 279 (39,6%), en 294(41,7%) y en 116 (16,5%) respectivamente. Ser fumador se relacionaba con consumir alcohol (p = 0,000) y otras sustancias (p = 0,000), ser aconfesional (p = 0,000), no padecer enfermedades (p = 0,043) y con tener madre (p = 0,001), padre (p = 0,005), hermano (p = 0,006), familiares (p = 0,016) o amigos fumadores (p = 0,000). Conclusiones: La prevalencia del tabaquismo en estudiantes de bachillerato en COB es elevada, aunque ha disminuido. Fumar se relacionó con tabaquismo de progenitores, familiares y amigos, ser aconfesional, consumir alcohol y otras sustancias. Se deben implantar programas preventivos dirigidos a estudiantes, progenitores y personal docente

The socio-cultural setting influences youth smoking and its prevalence presumibly has decreased. Objectives: To assess smoking prevalence in high school students, as well as the environmental influence on its onset in the Osona Disrtict of Barcelona (ODB), and to determine whether it has decreased. Material and methods: A cross-sectional study was conducted on high school students in the ODB. In the anonymous questionnaire it was sked asked about smoking and the influence of the social and cultural setting on its onset. Results: A total of 842 students participated, with 714 questionnaires completed, of which 705 were included as valid. A total of 203 (93.5%) students lived in an urban setting. There were 159 smoker students and 62% were women. The smokers were 70 (44%) christians, 3 (1.9%) muslims, 14 (8.%) students with other religions, and 72 (45.3%) non-denominational students. It was detected that 529 (76.3%) of the students consumed alcohol consumers, and 308 (46.5%) consumed other substances. There were 40 (61%) students that suffered a disease, and also 334 students who had ill relatives. There were 207 (29.4%) fathers and 152 (22%) mothers who smoked and 214 (59%) students declared family smoking. Finally 582 (82.6%) had smoker friends. Among fathers, 212 (30.1%), had high level studies, 331 (48.7%) had mid- level studies, and 137 (20.1%) fathers had primary studies. Among mothers, it was 279 (39.6%), 294 (41.7%), and 116 (16.5%). respectively. Being a smoker was associated with alcohol (P = .000) and other substances consumption (P = .000), being non-denominational (P = .000), did not to suffer any disease (P = .043), with having mother (P = .001), father (P = .005), brother or sister (P = .006), and family members (P = .016) who smoked, and smoker friends (P = .000). Conclusions: smoking prevalence in high school students in the ODB is high, but has decreased. Smoking was associated with alcohol and consumption of other substances, being non-denominational, and with friends, parents, and relatives who smoked. It is necessary to establish prevention programs addressed to teenagers, parents and teachers

[Smoking Prevalence in High School Students in the Barcelona Region (De Osona District)]. / Prevalencia del tabaquismo en los estudiantes de bachillerato de la Comarca de Osona (Barcelona).

The socio-cultural setting influences youth smoking and its prevalence presumibly has decreased. OBJECTIVES: To assess smoking prevalence in high school students, as well as the environmental influence on its onset in the Osona Disrtict of Barcelona (ODB), and to determine whether it has decreased. MATERIAL AND METHODS: A cross-sectional study was conducted on high school students in the ODB. In the anonymous questionnaire it was sked asked about smoking and the influence of the social and cultural setting on its onset. RESULTS: A total of 842 students participated, with 714 questionnaires completed, of which 705 were included as valid. A total of 203 (93.5%) students lived in an urban setting. There were 159 smoker students and 62% were women. The smokers were 70 (44%) christians, 3 (1.9%) muslims, 14 (8.%) students with other religions, and 72 (45.3%) non-denominational students. It was detected that 529 (76.3%) of the students consumed alcohol consumers, and 308 (46.5%) consumed other substances. There were 40 (61%) students that suffered a disease, and also 334 students who had ill relatives. There were 207 (29.4%) fathers and 152 (22%) mothers who smoked and 214 (59%) students declared family smoking. Finally 582 (82.6%) had smoker friends. Among fathers, 212 (30.1%), had high level studies, 331 (48.7%) had mid- level studies, and 137 (20.1%) fathers had primary studies. Among mothers, it was 279 (39.6%), 294 (41.7%), and 116 (16.5%). respectively. Being a smoker was associated with alcohol (P=.000) and other substances consumption (P=.000), being non-denominational (P=.000), did not to suffer any disease (P=.043), with having mother (P=.001), father (P=.005), brother or sister (P=.006), and family members (P=.016) who smoked, and smoker friends (P=.000). CONCLUSIONS: smoking prevalence in high school students in the ODB is high, but has decreased. Smoking was associated with alcohol and consumption of other substances, being non-denominational, and with friends, parents, and relatives who smoked. It is necessary to establish prevention programs addressed to teenagers, parents and teachers.

Descripción de un caso de interacción farmacocinética entre ácido valproico e imipenem / No disponible

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Vigilancia de los valores de colesterol sérico en una población de Cataluña. Resultados del año 2001 / Watching the levels of serum cholesterol in a town in Catalonia. Results from the year 2001

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