Impacto sobre el consumo en bares, cafeterías y restaurantes de la modificación de la ley del tabaco española / Impact of new Spanish smoke-free legislation on the business activity of bars, cafes and restaurants

Objetivo. analizar el impacto sobre el consumo en bares, cafeterías y restaurantes de la Ley 42/2010 de modificación de medidas sanitarias frente al tabaquismo. Métodos. explotación de los microdatos de la Encuesta de Presupuestos Familiares en 2010 y 2011. Los ficheros de enlace nos permiten hacer un seguimiento a un amplio número de hogares que permanecen en la muestra 2 años consecutivos. Tomando como referencia el año 2010 se cuantifica cómo han cambiado las pautas de consumo en los establecimientos hosteleros, diferenciando entre hogares fumadores y no fumadores. Resultados. los efectos marginales en la primera etapa del modelo en dos partes muestran una probabilidad media de realizar algún gasto del 96% en las familias fumadoras,frente al 86% de las no fumadoras, sin variaciones significativas entre 2010 y 2011. En lo que respecta a la proporción sobre el gasto total del hogar, las familias fumadoras gastaron en establecimientos hosteleros un 7,961% en 2010 y un 7,796% en 2011, frente al 7,25% y el 7,272%, respectivamente, de las familias no fumadoras. El estimador de dobles diferencias, entre años y entre familias, no resulta estadísticamente significativo. Conclusiones. la Ley 42/2010 no ha tenido influencia en los cambios de los hábitos de consumo de las familias españolas en los establecimientos de hostelería. Las decisiones de consumo están más relacionadas con las características sociodemográficas (como el número de hijos del hogar) y con el impacto de la crisis económica (desempleo y reducción de los ingresos) (AU)

Objective. to analyze the impact of Spanish smoke-free legislation (Law 42/2010) on the business activity of bars, cafés, and restaurants. Methods. we used the micro-data from the Household Budget Survey for 2010 and 2011. The linking files allowed close follow-up of the households that remained in the sample for 2 consecutive years. Taking the year 2010 as the base reference for our analyses, we quantified how levels of consumption expenses on hospitality venues have changed over the years, differentiating between smoking households and non-smoking households. Results. the marginal effects of the first stage of the two-part model showed that the mean probability of expenditure on hospitality venues was 96% in smoking households and was 86% in non-smoking households. There were no statistically significant variations in the probability of expenditure between 2010 and 2011. The proportion of expenditure on hospitality venues in total household consumption expenditure in smoking households was 7.961% and 7.796% in 2010 and 2011, respectively. These proportions were 7.25% in 2010 and 7.272% in 2011 for non-smoking households. The difference in differences estimator, which takes into account both differences between years and households, showed no statistically significant differences in levels of household consumption. Conclusions. the introduction of the Law 42/2010 has had noimpact on the levels of household consumption expenses on hospitality venues. Changes in consumption expenses could be explained by sociodemographic characteristics (such as the number of children per household) and the impact of the economic crisis (unemployment and a decrease in household income) (AU)

[Impact of new Spanish smoke-free legislation on the business activity of bars, cafes and restaurants]. / Impacto sobre el consumo en bares, cafeterías y restaurantes de la modificación de la ley del tabaco española.

OBJECTIVE: to analyze the impact of Spanish smoke-free legislation (Law 42/2010) on the business activity of bars, cafés, and restaurants. METHODS: we used the micro-data from the Household Budget Survey for 2010 and 2011. The linking files allowed close follow-up of the households that remained in the sample for 2 consecutive years. Taking the year 2010 as the base reference for our analyses, we quantified how levels of consumption expenses on hospitality venues have changed over the years, differentiating between smoking households and non-smoking households. RESULTS: the marginal effects of the first stage of the two-part model showed that the mean probability of expenditure on hospitality venues was 96% in smoking households and was 86% in non-smoking households. There were no statistically significant variations in the probability of expenditure between 2010 and 2011. The proportion of expenditure on hospitality venues in total household consumption expenditure in smoking households was 7.961% and 7.796% in 2010 and 2011, respectively. These proportions were 7.25% in 2010 and 7.272% in 2011 for non-smoking households. The difference in differences estimator, which takes into account both differences between years and households, showed no statistically significant differences in levels of household consumption. CONCLUSIONS: the introduction of the Law 42/2010 has had no impact on the levels of household consumption expenses on hospitality venues. Changes in consumption expenses could be explained by sociodemographic characteristics (such as the number of children per household) and the impact of the economic crisis (unemployment and a decrease in household income).

Genetic variability in the severity and outcome of community-acquired pneumonia.

BACKGROUND: Several studies have investigated single nucleotide polymorphisms (SNP) in candidate genes associated with susceptibility, severity or outcome in patients with community-acquired pneumonia (CAP) with conflicting results. METHODS: Multi-centre, prospective observational study. We studied 1162 white Spanish patients with CAP and 1413 controls. Severe forms of sepsis were recorded in 325 patients. Subjects were genotyped for the following polymorphisms: TNF -238 and -308, LTA +252, IL6 -174, IL1RN 86bp variable number of tandem repeats and TNFRSF1B+676 (TNFR2 M196R). RESULTS: No significant differences in genotype or allele frequencies were seen among patients and controls. We did not find any association between TNF, LTA, IL6 and IL1RN polymorphisms with disease severity or outcome. Analysis of 28-day mortality showed a significant difference in the distribution of TNFRSF1B+676 G/T genotypes (p=0.0129). Sequential Kaplan-Meier survival analysis of TNFRSF1B+676 G/T polymorphism showed a protective role of the GT genotype. Cox regression analysis adjusted for age, gender, hospital of origin and comorbidities showed that patients with GT genotypes had lower mortality rates compared to patients with GG or TT genotypes (p=0.02; HR 0.53; 95% CI 0.31-0.90 for 90-day survival; p=0.01; HR 0.41; 95% CI 0.21-0.81 for 28-day survival and p=0.049; HR 0.48; 95% CI 0.23-0.997 for 15-day survival). CONCLUSIONS: Our study does not support a role for the controversial studied polymorphisms of the TNF, LTA, IL6 and IL1RN genes in the susceptibility or outcome of CAP. A protective role of heterozygosity for the functionally relevant TNFRSF1B+676 polymorphism in the outcome of CAP was observed.

Sensorimotor recovery after partial facial (mystacial pad) transplantation in rats.

Most research in facial transplantation has been conducted in rats. This skill demanding model has a steep learning curve and is accompanied by high mortality rates. Investigations were carried out to minimize these disadvantages and a whiskers flap properly named mystacial pad flap, was developed. The mystacial pad contains the whiskers follicles of the rat, and our aim was to investigate the effect of repairing the nerves on the whiskers function after mystacial pad allotransplantation in rats. A total of 56 animals were studied in 6 groups. In the main study group (VI), 16 semi-allogenic vascularized mystacial flaps were transplanted from Lewis-Brown-Norway (RT1(l+n)) to Wistar-Lewis (RT1(l)) rats. This group was divided in 2 subgroups; in subgroup VIa (nonneurotized alloflap transplant group, n = 8), alloflaps were transplanted without nerve repairs, whereas in subgroup VIb (neurotized alloflap transplant group, n = 8) the facial and trigeminal nerves were repaired. Animals were kept under tapered doses of tacrolimus immunosuppression monotherapy. Clinical and neurophysiological explorations were performed to evaluate sensitivity and motor voluntary activity of the mystacial region after 6 weeks. Animals were euthanized after 8 weeks and histologic studies were performed. In group VI, each procedure required an average of 3.5 hours, and 87.5% of the recipients survived for 8 weeks. Sensitivity, motor activity, and histologic signs of recovery were found in the mystacial pad allotransplants after 6 weeks. Mystacial pad allotransplants in which nerves were repaired showed clinical, neurophysiological, and histologic signs of recovery. A functional facial subunit was successfully transplanted and sensorimotor function recovery could be demonstrated in rats.

[Analysis of the current situation and outlook of thoracic surgery]. / Análisis de la situación actual y previsión de futuro de la especialidad de cirugía torácica.

OBJECTIVE: The objective of this descriptive study was to analyze the current situation and forecast the future requirements for specialists in thoracic surgery, taking into account the number of doctors entering and those possibly leaving this specialty. MATERIAL AND METHODS: The data for this study were taken from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) (n=304), Thoracic Surgeons' Club (n=122), and the Spanish Council of Medical Associations (n=225). We also took into account the current number of resident surgeons (n=84). Other specialists were included who are not recorded in these databases but who are known to be practicing (n=10). The total number of practicing specialists obtained was 211. RESULTS: There are currently 52 working thoracic surgery departments and the highest number of practicing specialists was recorded in Madrid (n=44), Catalonia (n=33), and Andalusia (n=33). The forecast number of retirements (at age 65 years) and incorporations of new specialists means that there will be a surplus of 57 thoracic surgeons in the next 5 years. CONCLUSIONS: Thoracic surgery needs to limit the intake of new trainee specialists for at least the next 5 years.

Análisis de la situación actual y previsión de futuro de la especialidad de cirugía torácica / Analysis of the Current Situation and Outlook of Thoracic Surgery

Introduccióncon objeto de analizar la situación actual y realizar una previsión de futuro de las necesidades de especialistas de cirugía torácica, se ha llevado a cabo un estudio descriptivo teniendo en cuenta las incorporaciones y posibles salidas del sistema de médicos de esta especialidad.Material y métodoscomo base de datos se han tomado las de la Sociedad Española de Neumología y Cirugía Torácica (n=304), Club de Cirujanos Torácicos (n=122) y Consejo Español de Colegios de Médicos (n=225). También se ha considerado el número actual de médicos residentes (n=84). Se han añadido otros especialistas no censados en esta base de datos de los que se tiene constancia de su ejercicio (n=10). El total de especialistas en ejercicio considerados ha sido de 211.Resultadosactualmente hay 52 unidades de cirugía torácica con actividad y el mayor número de especialistas activos se registra en Madrid (n=44), Cataluña (n=33) y Andalucía (n=33). La previsión de jubilaciones (edad de 65 años) y nuevas incorporaciones de médicos especialistas hace que se prevea un excedente de cirujanos torácicos de 57 en los próximos 5 años.Conclusionesla especialidad de cirugía torácica debería moderar su oferta de formación de nuevos especialistas en los próximos 5 años como mínimo(AU)

ObjectiveThe objective of this descriptive study was to analyze the current situation and forecast the future requirements for specialists in thoracic surgery, taking into account the number of doctors entering and those possibly leaving this specialty.Material and methodsThe data for this study were taken from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) (n=304), Thoracic Surgeons’ Club (n=122), and the Spanish Council of Medical Associations (n=225). We also took into account the current number of resident surgeons (n=84). Other specialists were included who are not recorded in these databases but who are known to be practicing (n=10). The total number of practicing specialists obtained was 211.ResultsThere are currently 52 working thoracic surgery departments and the highest number of practicing specialists was recorded in Madrid (n=44), Catalonia (n=33), and Andalusia (n=33). The forecast number of retirements (at age 65 years) and incorporations of new specialists means that there will be a surplus of 57 thoracic surgeons in the next 5 years.ConclusionsThoracic surgery needs to limit the intake of new trainee specialists for at least the next 5 years(AU)

Evaluation of noncompliance in schizophrenia patients using electronic monitoring (MEMS) and its relationship to sociodemographic, clinical and psychopathological variables.

BACKGROUND: Noncompliance is common in patients with schizophrenia and can have serious consequences; therefore research of the variables associated with noncompliance is a priority. Although the MEMS device is regarded as the "reference standard" for evaluating compliance, it has been used in very few published studies. METHODS: Compliance was evaluated in 102 outpatients diagnosed with schizophrenia according to ICD-10 criteria. Compliance was evaluated with the MEMS device for 3 months in 79 patients who were on oral antipsychotic treatments. Baseline evaluations included sociodemographic, clinical, treatment-related and psychopathological variables. The psychiatrist, patients and relatives also provided compliance estimates. RESULTS: Noncompliant behaviors were observed in 42.3% of patients. Agreement between estimations by the psychiatrist and the MEMS findings was fair, and agreements between those of both patients and relatives and the MEMS findings were slight. Noncompliant patients showed poor insight, conceptual disorganization, stereotyped thinking and poor attention as compared to compliant patients. CONCLUSIONS: A large percentage of schizophrenic patients failed to adequately comply with their prescribed treatment. Compliance was overestimated by the psychiatrist, by patients and by relatives. Poorer insight and increased conceptual disorganization were independently associated with noncompliance. Identification of factors associated with noncompliance and strategies to reduce these behaviors would help improve the prognosis of schizophrenia.

Usefulness of hyperemic venous return angiography for studying coronary venous anatomy prior to cardiac resynchronization device implantation.

INTRODUCTION AND OBJECTIVES: Implantation of electrodes via the coronary sinus (CS) can be very challenging because access to the target vessel is restricted by anatomical obstacles. Consequently, prior knowledge of coronary venous anatomy is crucial. The objective of this study was to evaluate the usefulness of hyperemic venous return angiography relative to that of occlusive retrograde venography prior to cardiac resynchronization device implantation. METHODS: Coronary venous anatomy was studied in 200 patients both by videoing venous coronary return, which was optimized by inducing hyperemia, and by occlusive venography. The visibility of different portions of the coronary venous system was scored. RESULTS: Overall, sufficient anatomic information was obtained in 99.5% of patients. Visibility scores for the CS and the lateral vein of the left ventricle were slightly higher in the group studied using occlusive venography, though there was no significant difference between the two techniques. In contrast, the middle cardiac vein and the anterior interventricular vein could be visualized in greater detail using venous return angiography. There were no complications in the group studied using venous return angiography whereas dissection of the great cardiac vein occurred in three patients studied using occlusive venous angiography, though this did not prevent electrode implantation. CONCLUSIONS: With venous return angiography, it was possible to visualize accurately the venous anatomy of the lateral wall of the left ventricle and, consequently, to anticipate the level of difficulty posed by electrode implantation.

Utilidad de la senovenografía de retorno con hiperemia para el estudio de la anatomía venosa coronaria previo al implante de dispositivos de resincronización cardiaca / Usefulness of hyperemic venous return angiography for studying coronary venous anatomy prior to cardiac resynchronization device implantation

Introducción y objetivos. El implante de un electrodo a través del seno coronario (SC) puede ser dificultoso debido a obstáculos anatómicos que limitan el acceso a la vena. Por ello es fundamental conocer la anatomía venosa coronaria. El objetivo es analizar la utilidad de la senovenografía de retorno con hiperemia en el implante de dispositivos de resincronización cardiaca comparándolo con la senovenografía oclusiva retrógrada. Métodos. Se estudió la anatomía venosa coronaria en 200 pacientes, mediante la filmación del retorno venoso coronario optimizado con la inducción de hiperemia y mediante senovenografía oclusiva, puntuándose la visibilidad de las distintas porciones del sistema venoso coronario. Resultados. En general, se obtuvo una información anatómica adecuada en el 99,5% de los individuos. Las puntuaciones de visibilidad para el SC y la vena lateral fueron ligeramente superiores en el grupo estudiado mediante senovenografía oclusiva retrógrada, aunque no hubo diferencias significativas entre ambas técnicas. Por el contrario, la vena cardiaca media y la vena interventricular anterior se visualizaron con mayor detalle mediante la senovenografía de retorno. No hubo complicaciones en el grupo estudiado mediante senovenografía de retorno, mientras que en 3 pacientes estudiados con senovenografía oclusiva se produjo la disección de la gran vena cardiaca, aunque no impidió el implante del electrodo. Conclusiones. La angiografía coronaria de retorno define con precisión la anatomía venosa de la región lateral del ventrículo izquierdo y permite anticipar el nivel de dificultad del implante del electrodo (AU)

Introduction and objectives. Implantation of electrodes via the coronary sinus (CS) can be very challenging because access to the target vessel is restricted by anatomical obstacles. Consequently, prior knowledge of coronary venous anatomy is crucial. The objective of this study was to evaluate the usefulness of hyperemic venous return angiography relative to that of occlusive retrograde venography prior to cardiac resynchronization device implantation. Methods. Coronary venous anatomy was studied in 200 patients both by videoing venous coronary return, which was optimized by inducing hyperemia, and by occlusive venography. The visibility of different portions of the coronary venous system was scored. Results. Overall, sufficient anatomic information was obtained in 99.5% of patients. Visibility scores for the CS and the lateral vein of the left ventricle were slightly higher in the group studied using occlusive venography, though there was no significant difference between the two techniques. In contrast, the middle cardiac vein and the anterior interventricular vein could be visualized in greater detail using venous return angiography. There were no complications in the group studied using venous return angiography whereas dissection of the great cardiac vein occurred in three patients studied using occlusive venous angiography, though this did not prevent electrode implantation. Conclusions. With venous return angiography, it was possible to visualize accurately the venous anatomy of the lateral wall of the left ventricle and, consequently, to anticipate the level of difficulty posed by electrode implantation (AU)

Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients.

BACKGROUND: Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. OBJECTIVE: To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. METHODS: One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. RESULTS: Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. CONCLUSIONS: Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery because of severe CS. Informing patients of possible side effects before TS is essential.

Mannose-binding lectin and mannose-binding lectin-associated serine protease 2 in susceptibility, severity, and outcome of pneumonia in adults.

BACKGROUND: Community-acquired pneumonia (CAP) is the leading cause of death from infection in developed countries. Mannose-binding lectin (MBL) and MBL-associated serine protease 2 (MASP-2) deficiencies are common primary immunodeficiencies the clinical penetrance of which remains controversial. MBL is a serum lectin that mediates phagocytosis and activates the lectin pathway of complement involving MASP-2. OBJECTIVE: We sought to evaluate the significance of MBL deficiency (O/O genotypes) and insufficiency (O/O plus XA/O genotypes), as well as MASP-2 deficiency (D105G mutation), in the susceptibility to and severity and outcome of CAP in adults. METHODS: MBL and MASP-2 serum levels, as well as lectin pathway activity with regard to MBL2 and MASP2 genotypes, were measured in healthy control subjects. For susceptibility, 848 patients with CAP, 1447 healthy control subjects, and a control group of 519 patients without relevant infectious diseases were studied in a case-control study. Severity and outcome were evaluated in a prospective study of the 848 patients. RESULTS: We found similar frequencies of MBL2 and MASP2 alleles and genotypes among patients and control subjects. However, in a multivariate analysis MBL insufficiency was associated with the development of the most severe forms of sepsis (P = .007), acute respiratory failure (P = .009), multiorgan dysfunction syndrome (P = .036), intensive care unit admission (P = .020), and death (P = .003). CONCLUSION: Our large study suggests that MBL plays a redundant role in human defenses against primary infection, at least in adults with CAP, and provides, for the first time, evidence that MBL insufficiency predisposes to higher severity and fatal outcome in patients with CAP, irrespective of the causal microorganisms.

[Etiology of acute viral respiratory tract infections in children from Gran Canaria, the Canary Islands (Spain)]. / Diagnóstico etiológico de las infecciones respiratorias agudas de origen vírico en un hospital pediátrico de Gran Canaria.

OBJECTIVE: Acute respiratory tract infections (ARTI) of viral origin are a frequent cause of pediatric consultations and hospital admissions. The aim of this study was to investigate the etiology of these infections in Gran Canaria, the Canary Islands, (Spain). METHODS: From May 2002 through May 2005, 1957 nasopharyngeal washings were collected from 1729 children presenting with ARTI to the Pediatric Emergency Unit. A rapid antigen detection method was performed in every sample to identify respiratory syncytial virus (RSV). An immunofluorescence assay (IFA) and cell culture (CC) was used in RSV-negative samples. RESULTS: Median age was 2 months (range, 0.03-119). A viral agent was identified in 1032 children (59.7%). RSV was detected in 769 children (74.5%). Other viruses identified, in order of frequency, were parainfluenza viruses, rhinoviruses, adenoviruses, influenza viruses, enteroviruses, and coronaviruses. Statistical differences were found between age and the type of virus detected: Adenoviruses caused respiratory infections in older children (median age: 6 months; range: 1-74). There were 6 mixed infections. Sensitivity of IFA as compared to CC was 55.8%, and specificity was 99.2%. CONCLUSIONS: Respiratory viruses are responsible for a large number of ARTI cases in children from Gran Canaria, RSV being the major cause. Viral identification is determinant for managing these patients and making a proper use of antibacterial and antiviral drugs.

Diagnóstico etiológico de las infecciones respiratorias agudas de origen vírico en un hospital pediátrico de Gran Canaria / Etiology of acute viral respiratory tract infections in children from Gran Canaria, the Canary Islands (Spain)

Objetivo. Las infecciones respiratorias agudas (IRA) de origen vírico son una causa frecuente de consulta y hospitalización pediátrica. El objetivo de este estudio fue conocer la etiología de dichas infecciones en la isla de Gran Canaria. Métodos. Durante 3 años (de mayo de 2002 a mayo de 2005) se recogieron 1957 lavados nasofaríngeos de 1.729 niños atendidos en Urgencias con síntomas compatibles con IRA. En todas las muestras se realizó una técnica rápida de detección de antígeno de virus respiratorio sincitial (VRS) y, en las que se obtuvo resultado negativo, inmunofluorescencia (IF) y cultivo celular (CC). Resultados. La mediana de edad fue de 2 meses (intervalo: 0,03-119). Se identificó el agente causal del cuadro respiratorio en 1.032 niños (59,7%). El VRS se detectó en 769 niños (74,5%). Los demás virus identificados, por orden de frecuencia, fueron: virus parainfluenza, rinovirus, adenovirus, virus de la gripe, enterovirus y coronavirus. Se encontraron diferencias estadísticamente significativas al comparar la edad y el tipo de virus detectado: los adenovirus fueron responsables de cuadros en niños de mayor edad (mediana: 6 meses; intervalo: 1-74). Hubo 6 casos de infección mixta. La sensibilidad de la IF en relación con el CC fue del 55,8%, y la especificidad del 99,2%. Conclusiones. Los virus respiratorios son responsables de un alto número de casos de IRA, principalmente el VRS. Su identificación es determinante en el tratamiento clínico de los pacientes y en el empleo adecuado de antibacterianos y antivirales (AU)

Objective. Acute respiratory tract infections (ARTI) of viral origin are a frequent cause of pediatric consultations and hospital admissions. The aim of this study was to investigate the etiology of these infections in Gran Canaria, the Canary Islands, (Spain). Methods. From May 2002 through May 2005, 1957 nasopharyngeal washings were collected from 1729 children presenting with ARTI to the Pediatric Emergency Unit. A rapid antigen detection method was performed in every sample to identify respiratory syncytial virus (RSV). An immunofluorescence assay (IFA) and cell culture (CC) was used in RSV-negative samples. Results. Median age was 2 months (range, 0.03-119). A viral agent was identified in 1032 children (59.7%). RSV was detected in 769 children (74.5%). Other viruses identified, in order of frequency, were parainfluenza viruses, rhinoviruses, adenoviruses, influenza viruses, enteroviruses, and coronaviruses. Statistical differences were found between age and the type of virus detected: Adenoviruses caused respiratory infections in older children (median age: 6 months; range: 1-74). There were 6 mixed infections. Sensitivity of IFA as compared to CC was 55.8%, and specificity was 99.2%. Conclusions. Respiratory viruses are responsible for a large number of ARTI cases in children from Gran Canaria, RSV being the major cause. Viral identification is determinant for managing these patients and making a proper use of antibacterial and antiviral drugs (AU)

Are there subtypes of suicidal schizophrenia? A prospective study.

BACKGROUND: Tragically, suicide is not uncommon in schizophrenia. The principal objective of this study was to examine possible subtypes of suicidal schizophrenic patients and identify their clinical and psychopathological profiles at long-term follow-up. METHOD: The study involved 62 patients diagnosed with schizophrenia according to ICD-10 criteria, who were consecutively admitted following a suicide attempt. Of these subjects, 47 (75.8%) could be re-evaluated after 1 year. Sociodemographic, general clinical, and psychopathological variables were evaluated. RESULTS: Two predominant subgroups were identified according to suicidal motivation: psychotic motivation and depressive motivation. At re-evaluation after 1 year, the depressive motivation subgroup showed higher depression and hopelessness scores. This subgroup also had greater educational level, age, and duration of illness, and more frequent existence of previous suicide attempts compared to the psychotic motivation subgroup. Of note in the psychotic motivation subgroup was the presence of hopelessness. The variables of educational level, duration of illness, and previous suicide attempts were the ones that best distinguished these subgroups. CONCLUSION: These findings reinforce the notion that meaningful subgroups occur among suicidal schizophrenic patients. The different psychopathological profiles of the two prominent subgroups suggest the need for a different management approach in each case. The identification of these profiles in both subtypes at long-term follow-up may facilitate their detection by clinicians and, therefore, foster the adoption of appropriate preventive measures against subsequent suicidal behavior.

Factores predictores del inicio y consolidación del consumo de tabaco en adolescentes / Analysis of factors related to smoking initiation and continued smoking in young adolescents

Objetivo: Analizar los factores que determinan la adquisición y posterior consolidación del consumo de tabaco en los jóvenes adolescentes. Material y método: Estudio longitudinal de 3 años de duración (2000-2002) sobre jóvenes estudiantes de enseñanza obligatoria, con una edad al inicio del estudio de 13-14 años. Los datos fueron recogidos mediante encuesta individual, cuyo ámbito de estudio era la isla de Gran Canaria, con una muestra final de 745 individuos. Se estimaron modelos de elección binaria condicional de efectos fijos para datos longitudinales, para determinar la probabilidad de probar por primera vez el tabaco («modelo de inicio»), así como sobre la probabilidad de ser fumador ocasional o habitual («modelo de experimentación»).Resultados: En el último año, el 57% de los adolescentes encuestados ha tenido contacto con el tabaco alguna vez, un 25% más que en el primer año, algunos de ellos (el 9%) de forma diaria. En el «modelo de inicio» los determinantes del consumo de tabaco son el interés por el colegio (odds ratio [OR] = 0,27; intervalo de confianza [IC] del 95%, 0,08-0,87, y OR = 0,14; IC del 95%, 0,03-0,58 para los que manifestaron bastante y mucho interés por el colegio, respectivamente), el consumo de tabaco por parte del mejor amigo (OR = 7,44; IC del 95%, 2,59-21,4), el consumo de alcohol (OR = 11,82; IC del 95%, 4,96-28,2, y OR = 15,42; IC del 95%, 4,68-50,7 para los que beben alcohol de manera ocasional o frecuente, respectivamente), y el dinero disponible (euros semanales) (OR = 1,13; IC del 95%, 1,07-1,19). Para el «modelo de experimentación», el consumo de tabaco por parte del mejor amigo (OR = 7,01; IC del 95%, 2,96-16,5), el consumo de alcohol (OR = 5,71; IC del 95%, 1,98-16,4, y OR = 5,22; IC del 95%, 1,56-17,5 para los que beben alcohol de manera ocasional o frecuente, respectivamente) y los años que lleva como fumador (OR = 1,44; IC del 95%, 1,11-1,86). Conclusiones: El estudio destaca, principalmente, los efectos del grupo de amigos, el consumo de bebidas alcohólicas y el poco interés por los estudios como factores asociados al consumo de tabaco

Objective: To analyse the determining of the acquisition and later consolidation of the tobacco consumption in young adolescents. Material and method: Longitudinal study of three years of duration (2000-2002). Subjects were students of secondary education between 13 and 14 years old at the beginning of the study. The research was performed in Gran Canaria Island with a final sample of 745 subjects. Models of conditional binary election were considered for longitudinal data where the dependent variable reflects decisions of the adolescents through time, with regard to the probability of beginning to smoke, «beginning model», and the probability of being occasional or habitual smoker, «experimentation model». Results: In the last year, 57% of the young teenagers surveyed use tobacco, a 25% more than in the first year, some of them, 9% on a daily basis. In the «beginning model» the determining of the tobacco consumption are interest in studies (odds ratio [OR] = 0.27; 95% confidence interval (CI), 0.08-0.87 and OR = 0.14; 95% CI, 0.03-0.58 for the students having enough and much interest in studies, respectively), to have a smoker as the best friend (OR = 7.44; 95% CI, 2.59-21.4), the alcohol consumption (OR = 11.82; 95% CI, 4.96-28.2 and OR=15.42; 95% CI, 4.68-50.7 for youngs who drink alcohol occasionally or frequently) and having more pocket money (euros per week) (OR = 1.13; 95% CI, 1.07-1.19). For the «experimentation model», to have a smoker as the best friend (OR = 7.01; 95% CI, 2.96-16.5), the alcohol consumption (OR = 5.71; 95% CI, 1.98-16.4 and OR = 5.22; 95% CI, the 1.56-17.5 for youngs who drink alcohol occasionally or frequently) and the number of years since the student started smoking (OR = 1.44; 95% IC, 1.11-1.86). Conclusions: Our study emphasizes, peer group effect, drinking alcoholic beverages and lack of interest in studies as factors associated to the tobacco consumption

[Analysis of factors related to smoking initiation and continued smoking in young adolescents]. / Factores predictores del inicio y consolidación del consumo de tabaco en adolescentes.

OBJECTIVE: To analyse the determining of the acquisition and later consolidation of the tobacco consumption in young adolescents. MATERIAL AND METHOD: Longitudinal study of three years of duration (2000-2002). Subjects were students of secondary education between 13 and 14 years old at the beginning of the study. The research was performed in Gran Canaria Island with a final sample of 745 subjects. Models of conditional binary election were considered for longitudinal data where the dependent variable reflects decisions of the adolescents through time, with regard to the probability of beginning to smoke, "beginning model", and the probability of being occasional or habitual smoker, "experimentation model". RESULTS: In the last year, 57% of the young teenagers surveyed use tobacco, a 25% more than in the first year, some of them, 9% on a daily basis. In the "beginning model" the determining of the tobacco consumption are interest in studies (odds ratio [OR] = 0.27; 95% confidence interval (CI), 0.08-0.87 and OR = 0.14; 95% CI, 0.03-0.58 for the students having enough and much interest in studies, respectively), to have a smoker as the best friend (OR = 7.44; 95% CI, 2.59-21.4), the alcohol consumption (OR = 11.82; 95% CI, 4.96-28.2 and OR=15.42; 95% CI, 4.68-50.7 for youngs who drink alcohol occasionally or frequently) and having more pocket money (euros per week) (OR = 1.13; 95% CI, 1.07-1.19). For the "experimentation model", to have a smoker as the best friend (OR = 7.01; 95% CI, 2.96-16.5), the alcohol consumption (OR = 5.71; 95% CI, 1.98-16.4 and OR = 5.22; 95% CI, the 1.56-17.5 for youngs who drink alcohol occasionally or frequently) and the number of years since the student started smoking (OR = 1.44; 95% IC, 1.11-1.86). CONCLUSIONS: Our study emphasizes, peer group effect, drinking alcoholic beverages and lack of interest in studies as factors associated to the tobacco consumption.