A coupled modeling approach to assess the effect of forest policies in water provision: A biophysical evaluation of a drought-prone rural catchment in south-central Chile.

The effect of different forest conservation policies on water provision has been poorly investigated due to a lack of an integrative methodological framework that enables its quantification. We developed a method for assessing the effects of forest conservation policies on water provision for rural inhabitants, based on a land-use model coupled with an eco-hydrological model. We used as a case study the Lumaco catchment, Chile, a territory dominated by native forests (NF) and non-native tree farms, with an extended dry period where nearly 12,600 people of rural communities get drinking water through water trucks. We analyzed three land-use policy scenarios: i) a baseline scenario based on historical land-cover maps; ii) a NF Recovery and Protection (NFRP) scenario, based on an earlier implementation of the first NF Recovery and Forestry Development bill; and iii) a Pristine (PR) scenario, based on potential vegetation belts; the latter two based on Dyna CLUE, and simulated between 1990 and 2015. Impacts on water provision from each scenario were computed with SWAT. The NFRP scenario resulted in an increase of 6974 ha of NF regarding the baseline situation, and the PR scenario showed an increase of 26,939 ha of NF. Despite large differences in NF areas, slight increases in inflows (Q) were found between the NFRP and the PR scenarios, with relative differences with respect to the baseline of 0.3% and 2.5% for NFRP and PR, respectively. Notwithstanding, these small differences in the NFRP scenario, they become larger if we analyze the cumulative values during the dry season only (December, January, and February), where they reach 1.1% in a normal year and 3.1% in a dry year. Flows increases were transformed into water truck costs resulting in up to 441,876 USD (monthly) of fiscal spending that could be avoided during a dry period.

Características clínicas de los pacientes hospitalizados con COVID-19 en España: resultados del Registro SEMI-COVID-19 / Clinical characteristics of patients hospitalized with COVID-19 in Spain: Results from the SEMI-COVID-19 Registry

ANTECEDENTES: España ha sido uno de los países más afectados por la pandemia de COVID-19. OBJETIVO: Crear un registro de pacientes hospitalizados en España por COVID-19 para mejorar nuestro conocimiento sobre los aspectos clínicos, diagnósticos, terapéuticos y pronósticos de esta enfermedad. MÉTODOS: Estudio de cohorte retrospectiva, multicéntrico, que incluye pacientes consecutivos hospitalizados con COVID-19 confirmada en toda España. Se obtuvieron los datos epidemiológicos y clínicos, las pruebas complementarias al ingreso y a los 7 días de la admisión, los tratamientos administrados y la evolución a los 30 días de hospitalización de las historias clínicas electrónicas. RESULTADOS: Hasta el 30 de junio de 2020 se incluyeron 15.111 pacientes de 150 hospitales. Su mediana de edad fue 69,4 años (rango: 18-102 años) y el 57,2% eran hombres. Las prevalencias de hipertensión, dislipemia y diabetes mellitus fueron 50,9%, 39,7% y 19,4%, respectivamente. Los síntomas más frecuentes fueron fiebre (84,2%) y tos (73,5%). Fueron frecuentes los valores elevados de ferritina (73,5%), lactato deshidrogenasa (73,9%) y dímero D (63,8%), así como la linfopenia (52,8%). Los fármacos antivirales más utilizados fueron la hidroxicloroquina (85,6%) y el lopinavir/ritonavir (61,4%). El 33,1% desarrolló distrés respiratorio. La tasa de mortalidad global fue del 21,0%, con un marcado incremento con la edad (50-59 años: 4,7%; 60-69 años: 10,5%; 70-79 años: 26,9%; ≥80 años: 46%). CONCLUSIONES: El Registro SEMI-COVID-19 proporciona información sobre las características clínicas de los pacientes con COVID-19 hospitalizados en España. Los pacientes con COVID-19 hospitalizados en España son en su mayoría casos graves, ya que uno de cada 3 pacientes desarrolló distrés respiratorio y uno de cada 5 pacientes falleció. Nuestros datos confirman una estrecha relación entre la edad avanzada y la mortalidad

BACKGROUND: Spain has been one of the countries most affected by the COVID-19 pandemic. OBJECTIVE: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease. METHODS: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. RESULTS: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥80 years: 46.0%). CONCLUSIONS: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality

Clinical characteristics of patients hospitalized with COVID-19 in Spain: Results from the SEMI-COVID-19 Registry. / Características clínicas de los pacientes hospitalizados con COVID-19 en España: resultados del Registro SEMI-COVID-19.

BACKGROUND: Spain has been one of the countries most affected by the COVID-19 pandemic. OBJECTIVE: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease. METHODS: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. RESULTS: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥80 years: 46.0%). CONCLUSIONS: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality.

[Clinical characteristics of patients hospitalized with COVID-19 in Spain: Results from the SEMI-COVID-19 Registry]. / Características clínicas de los pacientes hospitalizados con COVID-19 en España: resultados del Registro SEMI-COVID-19.

BACKGROUND: Spain has been one of the countries most affected by the COVID-19 pandemic. OBJECTIVE: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease. METHODS: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. RESULTS: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥ 80 years: 46.0%). CONCLUSIONS: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality.

Graphene oxide and graphene oxide functionalized with silver nanoparticles as adsorbents of phosphates in waters. A comparative study.

Phosphate removal is an important factor that must be taken into account in eutrophized waters. For this reason, many studies on different ways of removing phosphates from water have been published nowadays. In this work, a comparative study between the use of graphene oxide (GO) and graphene oxide functionalized with silver nanoparticles (GO@AgNPs) as adsorbents to remove phosphates from water samples has been carried out. Experimental conditions, including the pH, adsorbent dose, contact time and temperature, have been analyzed to achieve the highest adsorption efficiency. Although both adsorbents can be considered suitable for removing phosphates from aqueous solutions, GO@AgNPs provided a maximum removal efficiency of 100%, reaching the equilibrium conditions instantaneously under straightforward experimental conditions. Moreover, a much lower adsorbent dose was necessary than with graphene oxide. When GO was used, the maximum removal efficiency was 75%, 9 min were necessary to reach the equilibrium conditions and 20 mg of adsorbent were needed. Both adsorbents can be regenerated in an acid medium, giving recovery percentages of 98% and 80% for GO and GO@AgNPs respectively, which allows them to be recycled and used again.

Evaluación de características psicológicas implicadas en el desempeño de jóvenes gestores deportivos / Psychological characteristics assessment involved in youth sports managers’ performance

El propósito de este estudio ha sido evaluar las características psicológicas implicadas en el desempeño del colectivo de jóvenes gestores deportivos. Para la identificación de las variables psicológicas fue utilizado un procedimiento analítico de naturaleza inductiva donde los jóvenes participantes informaron de su experiencia como gestores deportivos en un formato de grupos de discusión. La información recogida sirvió como base para la elaboración del Cuestionario de Competencia Personal de Jóvenes Gestores Deportivos (CPJGD). Este instrumento presenta una alta consistencia interna (α = 0,72) y está compuesto por 14 items distribuidos en tres factores: compromiso con el rol de gestor deportivo; interés controlado; y persistencia hacia un objetivo. Finalmente se argumentan las implicaciones de los resultados de este estudio en la formación permanente y capacitación profesional de este colectivo de jóvenes gestores deportivos (AU)

The purpose of this study was to evaluate the psychological characteristics involved in the performance of a group of young sport managers. To identify the psychological variables, an analytical procedure of an inductive nature was used, where young participants reported their experience as sport managers in a discussion group context. The information gathered served as basis for the development of the questionnaire of «personal competence of young sport managers». This instrument has got a high internal consistency (α = 0.72) and comprises 14 items distributed in three factors: commitment to the role of «dynamicers»; controlled interest; and persistence toward a goal. Eventually, we discussed the implications of the results of this study on lifelong learning and training of this group of young sport managers (AU)

Incidencia de leptospirosis en España entre 2009-2012 / Incidence of leptospirosis in Spain, 2009-2012

No disponible

Evaluación de la violencia y deportividad en el deporte: un análisis bibliométrico / Evaluation of violence and sportsmanship in sport: bibliometric analysis / Avaliação da violência e desportivismo no desporto: uma análise bibliométrica

Este trabajo presenta un análisis bibliométrico de las publicaciones sobre los instrumentos de evaluación de la deportividad, la agresividad y la violencia en contextos deportivos profesionales y en edad escolar, durante el período 1996 a 2013. Los documentos fueron identificados en las bases de datos SportDiscus, PsycINFO, Psicodoc y Dialnet, así como en publicaciones e informes de federaciones e instituciones deportivas. Han sido 530 los documentos analizados, de los cuales 35 presentan instrumentos de evaluación. Los documentos obtenidos fueron clasificados en 5 categorías: método de evaluación, constructos evaluados, agentes sociales evaluados, período temporal y contexto deportivo. Los resultados muestran que la herramienta más utilizada ha sido el cuestionario (76.19%). En segundo lugar, los instrumentos analizados permiten evaluar variables psicológicas relacionadas con la deportividad (14.28%), con la no deportividad (28.57%) o con ambas (57.14%). En tercer lugar, tienden a centrarse en la evaluación del deportista (71.43%). En cuarto lugar, la mayoría permiten ser utilizados en un único momento temporal (85.71%). Finalmente, los instrumentos permiten ser utilizados tanto en ámbitos deportivos profesionales como en edad escolar (66.66%) o exclusivamente en edad escolar (33.33%)

This study presents a bibliometric analysis of printed publications on evaluation tools in sportsmanship, aggresivity and violence in a professional sports context and at school age during 2013. Records from databases SportDiscus, PsycINFO, Psicodoc and Dialnet, as well as printed publications and reports from federations and sports institutions have been used. 530 documents have been analized, out of which 35 show evaluation tools. The obtained records were classified into 5 catagories: methods of assessment, constructs and social actors assessed, seasonal period and sports context. The results show that the most used tool was the survey (76.19%). Secondly, the tools analized allowed the evaluation of psychological variables related to sportsmanship (14.28%), anti-sportsmanship (28.57%) and both (57.14%). Thirdly, nearly all the tools are centred on the assessment of the sportsman (71.43%). Fourthly, most of them are able to be used at any one single moment (85.71%). Finally, many of the tools allow evaluation in both the professional and school setting (66.66%) or entirely in the school setting (33.33%)

Este trabalho apresenta uma análise bibliométrica das publicações sobre os instrumentos de avaliação do desportivismo, da agressividade e da violência em contextos desportivos profissionais e em idade escolar, durante o período de 1996 a 2013. Os documentos foram identificados nas bases de dados SportDiscus, PsycINFO, Psicodoc e Dialnet, assim como em publicações e relatórios de federações e de instituições desportivas. Foram analisados 530 documentos, dos quais 35 apresentam instrumentos de avaliação. Os documentos obtidos foram classificados em 5 categorias: método de avaliação, modelos avaliados, agentes sociais avaliados, período temporal e contexto desportivo. Os resultados mostram que a ferramenta mais utilizada foi o questionário (76.19%). Em segundo lugar, os instrumentos analisados permitem avaliar variáveis psicológicas relacionadas com o desportivismo (14.28%), com o não desportivismo (28.57%) ou com ambos (57.4%). Em terceiro lugar, tendem a centrar-se na avaliação do desportista (71.43%). Em quarto lugar, a maioria permite ser utilizada num único momento temporal (85.71%). Por fim, os instrumentos permitem ser utilizados tanto em âmbitos desportivos profissionais como em idade escolar (66.66%) ou exclusivamente em idade escolar (33.33%)

Fatiga percibida y características psicológicas relacionadas con el rendimiento en la rehabilitación de una lesión futbolística: estudio de un caso / Perceived fatigue and psychological characteristics related to performance during recovery from a football injury: a case study

Objetivo. El objetivo de este estudio es observar los diferentes niveles de fatiga percibida de un sujeto, y la evolución de las diferentes variables psicológicas implicadas en el proceso de rehabilitación de una lesión futbolística, medidas al inicio y al final de este periodo. Método. Es un estudio de caso descriptivo, en el que se valoran los diferentes grados de fatiga a través del Cuestionario breve de fatiga, y las características psicológicas a través del Cuestionario de Características psicológicas relacionadas con el rendimiento deportivo, a lo largo de un período de doce semanas, durante la rehabilitación de una lesión e inicio de la práctica deportiva. Resultados. Los resultados muestran una fluctuación incremental en la fatiga percibida, y se observa con respecto al inicio, una disminución de las puntuaciones en los factores: control de estrés y motivación durante la reincorporación a la práctica deportiva. Conclusión. En el caso estudiado, la fatiga percibida aumenta y el control de estrés y motivación disminuyen como indicadores de la reincorporación a la actividad competitiva (AU)

Objectives. The objective of this study is to observe the different levels of perceived fatigue and the evolution of the psychological characteristics, during the period of rehabilitation after the recovery of a football injury measures at the beginning and the end of sport practice of this period. Method. This is a descriptive Case Study where the levels of perceived fatigue were assessed using the Brief fatigue inventory, and the psychological characteristics through the CPRD, in the rehabilitation period of three months when the sport practice has been begun. Results. The results shown an incremental fluctuation in the perceived fatigue, and there was a decrease in the scores on the control of the stress factors and motivation, during the sport practice with regard to the start. Conclusion. n the cases studied the perceived fatigue shows high levels, and the control of stress and motivation factors undergo variations us indicators of the return to competitive activity (AU)

[Quality analysis by external users of the non-medical health transport unit of Alicante]. / Análisis de la calidad percibida por los usuarios externos de la Unidad de Coordinación de Transporte Sanitario no Asistido de Alicante.

UNLABELLED: Non-medical health transport has great health, media and social repercussions and requires a very considerable amount of human and economic resources. OBJECTIVE: To describe the quality, evaluated by external users of our Health Department, in order to know what are the most important elements for external users. METHODS: Cross-sectional, descriptive observational study. Population to study: patients with a social security health card who come to the Hospital of Alicante and are non-medical health transport unit users. RESULTS: Waiting time to be delivered to hospital in 92.7% of the cases was less than an hour, and was between one and two hours for 7.2%. The most frequent destinations were rehabilitation service and outpatient clinics. When users were asked if the would recommend this service, 60.9% said "for sure" and 39.1% said "probably yes". CONCLUSIONS: This study allows us to know patient needs and expectations, as well as the factors they value the most and which of our work areas to improve.

Análisis de la calidad percibida por los usuarios externos de la Unidad de Coordinación de transporte sanitario no asistido de Alicante / Quality analysis by external users of the non-medical health transport unit of Alicante

La gestión del transporte sanitario conlleva una gran repercusión sanitaria, mediática y social y requiere una dotación elevadísima de recursos humanos y materiales. Objetivo. Describir la calidad percibida por los usuarios externos de la Unidad de Coordinación de Transporte Sanitario no Asistido de Alicante para conocer qué elementos valoran más los usuarios externos. Método. Estudio observacional transversal descriptivo basado en un cuestionario de calidad percibida respondido mediante entrevista por los usuarios externos de la Unidad de Coordinación de Transporte Sanitario no Asistido de Alicante con tarjeta sanitaria que acuden al Hospital General Universitario de Alicante. Resultados. El tiempo de espera para la recogida en el 92,7% de los traslados fue inferior a una hora y en el 7,2% de los casos se tardó entre 1 y 2h. Los traslados se realizaron en el servicio de rehabilitación y en consultas externas. Al preguntar si recomendarían este servicio, el 60,9% manifestó que “lo recomendaría seguro” y el 39,1%, que “quizá sí” lo recomendaría. Conclusiones. Este estudio nos ha permitido conocer las necesidades y expectativas de los clientes externos, los factores que más valoran y nuestras áreas de mejora(AU)

Non-medical health transport has great health, media and social repercussions and requires a very considerable amount of human and economic resources. Objective. To describe the quality, evaluated by external users of our Health Department, in order to know what are the most important elements for external users. Methods. Cross-sectional, descriptive observational study. Population to study: patients with a social security health card who come to the Hospital of Alicante and are non-medical health transport unit users. Results. Waiting time to be delivered to hospital in 92.7% of the cases was less than an hour, and was between one and two hours for 7.2%. The most frequent destinations were rehabilitation service and outpatient clinics. When users were asked if the would recommend this service, 60.9% said “for sure” and 39.1% said “probably yes”. Conclusions. This study allows us to know patient needs and expectations, as well as the factors they value the most and which of our work areas to improve(AU)

In vivo lamellar keratoplasty using platelet-rich plasma as a bioadhesive.

PURPOSE: The use of standard sutures has been replaced by platelet-rich plasma (PRP), a bioadhesive agent, in several surgical procedures. This prompted us to test PRP efficacy in experimental lamellar keratoplasty. METHODS: After lamellar anterior keratoplasty, PRP with a mean concentration of 807,564 platelets/mm(3) was used to attach the corneal flap to the stromal surface in 12 New Zealand white rabbits. 10-0 nylon sutures were used in one control group of 12 animals and no suture was used in a second control group of six rabbits. Animals were killed at days 2, 7, 30, and 90 for histological and smooth muscle actin (SMA) immunohistochemical analysis. RESULTS: The PRP group showed a tight corneal graft from the first postoperative hours until they were killed. A transparent cornea was seen at 30 days and remained clear until the end of the protocol. Histological specimens showed no signs of ocular inflammation in any animal within the PRP group. Electron microscopy showed normal morphological features on the flap and stromal bed, and a clear interface zone without cells or debris. The number of stromal myofibroblasts was lower than that seen in the suture group at 3 months postsurgery. The sutured group showed an attached cornea with signs of inflammation around the knots. All flaps without PRP or sutures were completely detached in the immediate postoperative period. CONCLUSIONS: PRP was useful for attaching the corneal flap and it was well tolerated by the rabbit corneal tissue. Corneal healing was satisfactory. Further studies on PRP adhesiveness in grafts with donor corneas should be performed before considering its use in patients.

Realidad social de los pacientes con isquemia crítica de miembros inferiores / The social reality of patients with critical lower limb ischaemia

Objetivo. Realizar una aproximación a la realidad social de los pacientes que alcanzan los estadios más avanzadosde isquemia crónica de miembros inferiores (MMII) (isquemia crítica). Pacientes y métodos. Se registran medianteentrevista a paciente y familiar, datos relacionados con la vivienda habitual, entorno sociofamiliar, recursos económicosy nivel de instrucción de 50 pacientes ingresados en nuestro servicio con el diagnóstico de isquemia crítica de MMII,entre el 1 de octubre y el 31 de diciembre de 2005. Se realiza una comparación posterior con los mismos datos de la Encuestade condiciones de vida del Instituto Nacional de Estadística (INE) correspondiente a la zona estudiada y al mismogrupo de edad. Resultados. La media de edad de los pacientes es de 69,1 años, siendo el 84% hombres y el 16% mujeres.Se constata una tasa de pobreza relativa del 50% en los pacientes con isquemia crítica frente al 24,8% en la poblaciónlocal correspondiente a la edad. El 26% de los pacientes estudiados son analfabetos, frente al 11,5% de la poblacióngeneral. Con respecto a la vivienda, el 32% de los pacientes viven en un piso alto sin ascensor, y este porcentaje semantiene en pacientes a los que se les somete a una amputación mayor. Conclusiones. Constatamos una tendencia a laexclusión social en los pacientes con isquemia grave de las extremidades. Dicha realidad social debe ser conocida por elcirujano vascular a la hora de tratar a estos pacientes, imponiéndose un abordaje multidisciplinar junto con trabajadoressociales, médicos de familia y personal de enfermería y asistencia domiciliaria

Aim. To further our understanding of the social reality of patients who reach the most advanced stages ofchronic ischaemia of the lower limbs (critical ischaemia). Patients and methods. Interviews were conducted withpatients and a relative in order to obtain data about the primary residence, socio-familial situation, economic resourcesand level of schooling of 50 patients admitted to our service with a diagnosis of critical lower limbs ischaemia, betweenOctober 1st and December 31st 2005. The information thus obtained was later compared with the same data from theLiving Standards Measurement Survey conducted by the National Institute of Statistics (INE) for the area under studyand in the same age group. Results. The mean age of the patients was 69.1 years and 84% of the subjects were males and16% females. The rate of relative poverty was found to be 50% in patients with critical ischaemia versus 24.8% in thelocal population of the same age. The rate of illiteracy among the patients studied was 26%, while the figure in thegeneral population was 11.5%. With regard to their residence, 32% of the patients live in a flat on one of the higherfloors of an apartment block without a lift, and this percentage remains the same in patients who undergo majoramputation. Conclusions. There was a tendency towards social exclusion in patients with severe ischaemia in the limbs.The vascular surgeon must be familiar with this social reality when it comes to treating these patients so that a multidisciplinaryapproach involving social workers, GPs, nursing staff and home-help workers can be implemented

Categorías de riesgo de los medicamentos utilizados durante el embarazo: Guía rápida de consulta / No disponible

La administración de fármacos en la mujer embarazada y especialmente durante el primer trimestre de lagestación representa un riesgo potencial. La información disponible es limitada y basada fundamentalmenteen la práctica clínica ya que no se realizan ensayos clínicos en mujeres gestantes. En este trabajo se hanestudiado 828 principios activos comercializados en España clasificándolos según su factor de riesgo (deacuerdo con la clasificación de la FDA) para ayudar al profesional sanitario en la toma de decisiones

The administration of drugs to the pregnant woman, especially during the first trimester of gestation, represents a potential risk. The available information is limited and is mainly based on clinical practice, since clinical trials are not carried out in pregnant women. For this report, 828 active ingredients marketed in Spain were studied and classified according to the risk factors (in accordance with the U.S. Food and DrugAdministration classification) in order to aid health care professionals in decision-making

Comparative analysis of the results of orthotopic liver transplantation in patients with and without portal vein thrombosis.

INTRODUCTION: Portal vein thrombosis (PVT), which had been considered an absolute contraindication to orthotopic liver transplantation (OLT), is currently considered a risk factor that increases morbi-mortality. The objective of this study was to compare OLT outcomes in patients with vs without PVT. MATERIALS AND METHODS: Between April 1986 and December 2003, a sample of 83 patients with PVT was compared with another sample of 83 patients without PVT among 962 OLT performed in our department. RESULTS: Both groups were homogeneous in terms of epidemiological variables, surgical technique, immunosuppression, and donor-related variables. There were no differences with respect to graft function during the first week following surgery. Surgical time and anhepatic phase duration was longer in the PVT group, albeit the differences were not significant. PVT patients also required more transfusions; a strong statistical association was observed with respect to blood (P = .12) and plasma (P = .11) transfusions and statistically significant differences regarding platelet transfusions (P = .02). Time on mechanical ventilation and the length of stay in the ICU were longer but not significant among PVT patients. The only statistically significant difference was the incidence of portal rethrombosis (P = .02). With respect to mean and global patient and graft actuarial survivals after 1, 3, 5, and 10 years, we have observed no significant intergroup differences, although both patient (P = .48; NS) and graft (P = .96, NS) survivals were lower among PVT cases. CONCLUSIONS: PVT should not only cease to be considered a contraindication for OLT, but there were no significant differences between the outcomes despite this finding.

Ehlers-Danlos tipo IV con complicaciones vasculares precoces. Descripción de un caso y revisión bibliográfica / Type IV Ehlers-Danlos syndrome with early vascular complications. Description of a case and review of the literature

Introducción. El síndrome de Ehlers-Danlos es una displasia mesenquimatosa congénita caracterizada por laxitud cutánea y articular. Se han descrito muchos tipos clínicos; de ellos destaca el EhlersDanlos tipo IV equimoticovascular por el riesgo de rotura arterial, intestinal y uterina, que acorta la vida de los pacientes. Las roturas arteriales ocurren sobre todo en aorta y arterias viscerales, menos en arterias de las extremidades, cervicales e intracraneales, y aparecen con mínimos traumatismos. Estas roturas arteriales tienen un tratamiento quirúrgico complicado por la fragilidad de las arterias; por eso, se prefiere un tratamiento conservador. Caso clínico. Presentamos el caso de una paciente diagnosticada previamente de Ehlers-Danlos, que a la temprana edad de 11 años tuvo un hematoma retroperitoneal espontáneo, así como roturas (con consecuentes seudoaneurismas) de femoral superficial y humeral sin antecedente traumático, y otro seudoaneurisma de femoral común poscateterismo; todas ellas evolucionaron favorablemente con tratamiento médico. Conclusión. Ante una rotura arterial o un aneurisma en pacientes jóvenes hay que pensar en una enfermedad del tejido conectivo. Se prefiere un tratamiento conservador a una cirugía de elevado riesgo. En caso de realizar una cirugía, se recomienda el uso de técnicas sencillas a complejas reconstrucciones (AU)

Fórmulas de nutrición enteral / Enteral formulae

En este trabajo se revisan las fórmulas de nutrición enteral atendiendo a diversos parámetros: composición, características galénicas, osmolaridad, tipos de dieta, etc.Se revisa asimismo la legislación sobre nutrición enteral domiciliaria desde la publicación de la orden ministerial de 2 de junio de 1998 que incluye la nutrición enteral domiciliaria como una prestación sanitaria con cargo al Sistema Nacional de Salud. (AU)