[Autism and intelligence quotient: stability?] / Autismo y cociente intelectual: estabilidad?

INTRODUCTION: Autism is a heterogeneous disorder. The possibility of determining its characteristics over time will have a great impact on the prognosis and predictions that can be made. In that regard, the intelligence quotient and its possible stability throughout the life cycle can help to better define the phenotype of the disorder and its associated needs. DEVELOPMENT: Longitudinal studies show a certain level of stability in intelligence quotient scores, especially starting from the school years. Before, in the preschool stage, there is greater variability, especially in those children who have a borderline intellectual functioning or moderate intellectual disability. CONCLUSION: More research should continue to be developed to know the cognitive profile of people with autism spectrum disorder and be able to make predictions based on their intellectual functioning.

TITLE: Autismo y cociente intelectual: estabilidad?Introduccion. El autismo es un trastorno heterogeneo. La posibilidad de determinar sus caracteristicas a lo largo del tiempo tendra una gran repercusion en el pronostico y las predicciones que se puedan hacer. En ese sentido, el cociente intelectual y su posible estabilidad a lo largo del ciclo vital pueden ayudar a definir mejor el fenotipo del trastorno y sus necesidades asociadas. Desarrollo. Los estudios longitudinales muestran cierta estabilidad en las puntuaciones del cociente intelectual, sobre todo a partir de los años escolares. Antes, en la etapa preescolar, existe mayor variabilidad, especialmente en aquellos niños que tienen un funcionamiento intelectual limite o discapacidad intelectual moderada. Conclusion. Debe seguirse desarrollando mas investigacion para conocer el perfil cognitivo de las personas con trastorno del espectro autista y poder realizar predicciones a partir de su funcionamiento intelectual.

[International adoption of children from Ethiopia and language: a pilot study]. / Adopcion internacional de niños de Etiopia y lenguaje: un estudio piloto.

INTRODUCTION: Children who have gone through international adoption offer a great and unique learning opportunity around language development. Time elapsed since the first international adoptions took place in Spain has given a unique opportunity to research and conclude whether learning the second language follows the same developmental patterns and outcomes as compared to acquiring tongue language. AIM: To verify whether the evaluated subjects have reached the expected use and language proficiency for their chronological age. SUBJECTS AND METHODS: This pilot study focuses on the evaluation of language acquired in the first years of adolescence of 7 Ethiopian children who have lived over 8 years in Spain. CELF-4 test and the verbal tests of the WISC-IV have been administered. Scores have been analyzed and compared to the control group (same age group). In order to generate qualitative information about parents' concerns an on-line questionnaire has been administered in a form of a semi-structured interview. RESULTS: Both the CELF-4 test and the WISC-IV verbal tests reflect average or low average results in language abilities. Qualitative interviews reflect deep concern about academic outcome. CONCLUSIONS: Subjects in this study are showing an average to low average proficiency in the Spanish language. The results, nevertheless, do not explain the academic difficulties shown.

TITLE: Adopcion internacional de niños de Etiopia y lenguaje: un estudio piloto.Introduccion. Los niños que han vivido una adopcion internacional ofrecen una oportunidad unica de conocer como ocurre el desarrollo del lenguaje. El tiempo que ha transcurrido desde que en nuestro pais se iniciaran las primeras adopciones internacionales esta permitiendo investigar si el desarrollo inicial del lenguaje culmina en una equiparacion real. Objetivo. Comprobar si se ha producido en los sujetos evaluados una equiparacion real en el lenguaje de acuerdo con lo esperado con su edad cronologica. Sujetos y metodos. En este estudio piloto se realiza una valoracion del lenguaje adquirido en los primeros años de la adolescencia de siete niños etiopes que han vivido ya mas de ocho años en España. Para ello se analizan las puntuaciones obtenidas por los siete sujetos en la prueba CELF-4 y en las puntuaciones de las pruebas verbales del WISC-IV, teniendo como referencia a su grupo normativo de edad (grupo control). Para obtener informacion cualitativa sobre las preocupaciones de los padres se ha administrado un cuestionario online a traves de una entrevista semiestructurada. Resultados. Tanto el CELF-4 como las pruebas verbales del WISC-IV estan reflejando un funcionamiento promedio o promedio-bajo en las competencias verbales analizadas. Las entrevistas cualitativas reflejan elevados niveles de preocupacion acerca del rendimiento academico. Conclusiones. Los sujetos del estudio parecen mostrar un funcionamiento promedio o promedio bajo en el uso del castellano. Las puntuaciones obtenidas, sin embargo, no parecen poder explicar las dificultades que estan manifestando en el ambito escolar.

Epidemiología del cáncer de esófago en Hospitales Públicos de la Comunidad Autónoma de Madrid / Epidemiology of esophageal cancer in public hospitals of the Autonomous Community of Madrid

Antecedentes: El cáncer de esófago es uno de los tumores malignos más letales. Es el octavo más frecuente y el quinto más mortífero. En España es el carcinoma de células escamosas de esófago el más frecuente, pero en países desarrollados es el adenocarcinoma. Objetivo: Conocer la epidemiología del cáncer de esófago en hospitales públicos de la Comunidad de Madrid. Diseño: Estudio observacional descriptivo. Sujetos y métodos: Se estudiaron 725 pacientes con cáncer de esófago según el Sistema de Intercambio de Datos de Cáncer de la Comunidad de Madrid (del 1-1-1990 al 31-8-2006). Resultados: El cáncer esofágico fue más frecuente entre los hombres (88,7%), edad media de 64,2 años (DE:11,8); en las mujeres más frecuente a partir de 75 años. El carcinoma mayoritario fue de células escamosas (62%) vs. adenocarcinoma (24%). La forma localizada fue dominante (38%) vs. regional (34%) y diseminada (26%), con 4 in situ (0,4%). El tercio abdominal domina (24%) igualado con el torácico. Los tumores escamosos asientan en tercios torácico y cervical (46%) y los adenocarcinomas en el abdominal (49%). Conclusiones: El paciente estereotipo con cáncer de esófago en Hospitales Públicos de la Comunidad de Madrid es un varón mayor de 55 años con carcinoma de células escamosas, en los dos tercios inferiores del esófago y con extensión localizada. Coincidimos con series nacionales pero no con europeas o americanas (AU)

Antecedents: esophageal cancer is one of the most lethal malignant tumors. It is the eighth most common and the fifth most lethal cancer. In Spain the squamous cell carcinoma of the esophagus is the most common but in developed countries it is the adenocarcinoma. Objective: to study the epidemiology of the esophageal cancer in public hospitals of the Autonomous Community of Madrid. Design: observational descriptive study. Methods and subject: utilizing the Cancer Data Exchange System of the Community of Madrid (from 1st Jan 1990 to 31st Aug 2006) 725 patients with esophageal cancer were studied. Results: the esophageal cancer was more common among males (88,7%), mean age 64,2 years (SD: 11,8); in females it was more common after 75 years old. The most common carcinoma was the squamous cells (62%) vs adenocarcinoma (24%). The localized form was predominant (38%) versus regional (34%) and disseminated (26%) ones and 4 were in situ (0,4%). The abdominal third prevails (24%) matching the thoracic third. The squamous tumors are located in the thoracic and cervical thirds (46%) and the adenocarcinomas in the abdominal one (49%). Conclusions: the stereotype patient with esophageal cancer in public hospitals of the Community of Madrid is a male over 55 years old with squamous cell carcinoma in the lower two thirds of the esophagus and with localized extension. These results agree with national series but not with European or American ones (AU)

[Influence of the diet on the development of colorectal cancer in a population of Madrid]. / Influencia de la dieta en la aparición del cáncer colorrectal en una población de Madrid.

OBJECTIVE: Although the genetic component in colorectal carcinoma (CRC) is well established, some environmental factors, mainly dietary, can favor its development. The objective of this study is to evaluate the relationship between daily consumption of specific food groups and development of CRC. METHODS: We carried out a case-control study in an area of Madrid; 196 patients with diagnosis of CRC with confirmed histology and registered to May 1998 in the Community of Madrid tumor register were included, and they were compared with 196 controls matched by age, sex, and geographical area. All of them filled out a questionnaire with information on diet, substance abuse, physical activity, drugs, and family history of CRC. RESULTS: The logistic regression analysis showed a weakly positive association with meat (OR: 1.02; CI: 1.01-1.04), viscera (OR: 1.12; CI: 1.02-1.23), and sausage (OR: 1.07; CI: 1.03-1.1) consumption, and a modest inverse association with consumption of yogurt (OR: 0.97; CI: 0.95-0.98), tomato (OR: 0.99; CI: 0.98-0.99), strawberries and cherries (OR: 0.97; CI: 0.95-0.99), oranges, grapefruits, and natural fruit juices (OR: 0.99; CI: 0.98-1). CONCLUSIONS: These results are an additional empirical evidence that must be confirmed through prospective studies.

[The autistic spectrum. An epidemiological study and analysis of possible subgroups]. / Espectro autista. Estudio epidemiológico y análisis de posibles subgrupos.

INTRODUCTION: Although the concept of autistic spectrum may be useful to explain and describe the heterogeneity of the syndrome, its aetiology is still unknown. Different disorders have been reported as the biological basis of autism. Early diagnosis and a multi disciplinary approach to the condition are essential for effective psychopaedagogic treatment. OBJECTIVE: To determine whether there is a relationship between the severity of the syndrome of autism and the course of the disorder, as a function of the presence or absence of neurological features, and to define homogeneous subgroups by detecting etiological variables which may be common to them. PATIENTS AND METHODS: 46 children defined as being within the spectrum of autism, in whom the diagnosis was confirmed on the autistic spectrum inventory (IDEA/Rivi re 97). Parameters studied: family history, perinatal risk, age of onset, complementary investigations and neurological features. RESULTS: The diagnosis was confirmed in 18 children; of the others 14 had a specific defect of the development of language. There was an almost complete absence of underlying neurological disorders, although this may have been due to dispersion of the complementary investigations done. CONCLUSIONS: Specific disorders of the development of language are the main differential diagnoses to be considered together with the autistic spectrum. The diagnosis of autism is clinical, but the heterogeneity of the medical approach interferes with the overall assessment of the spectrum favoring behavioural and underestimating the biological aspects. This means that the problem should be reconsidered so as to obtain uniform guidelines for action.

Physical exercise, use of Plantago ovata and aspirin, and reduced risk of colon cancer.

To evaluate certain risk and protective factors for colon cancer in our population, we conducted a paired case-control study where cases were all people diagnosed with colon cancer who were registered at the Cancer Data Exchange Systems of the Community of Madrid between January 1995 and December 1996, and controls were randomly taken from electoral lists. The study population consisted of 424 persons. Using SPSS for Windows, variables were adjusted by multiple logistic regression. The results indicate that lack of physical exercise is associated with an increased risk of colon cancer, with an odds ratio (OR) of 2.8 (95% confidence interval (CI) 1.28-6.21) as compared with moderate activity 1-2 days a week. The risk decreases linearly with increasing physical exercise, and this association remains after stratifying the analysis for the existence of constipation. The consumption of is associated with a reduced risk of colon cancer in constipated patients, with an OR of 0.094 (0.014-0.639), as is aspirin use, with an OR of 0.980 (0.898-0.999). These results were obtained after adjusting all the ORs for diet, smoking, alcohol consumption, family history and socio-demographic factors such as marital status and educational level.

Espectro autista. Estudio epidemiológico y análisis de posibles subgrupos / The autistic spectrum. An epidemiological study and analysis of possible subgroups

Introducción. Aunque el concepto de espectro autista permite explicar y describir la heterogeneidad del síndrome la etiología del trastorno sigue siendo desconocida. Diferentes patologías han sido documentadas en la aproximación a las bases biológicas del autismo. El diagnóstico temprano y un abordaje multidisciplinar del trastorno son básicos para la eficacia de la intervención psicopedagógica. Objetivo. Determinar si existe relación entre la gravedad del síndrome autista y la evolución del trastorno, en función de la presencia o no de patología neurológica, y definir subgrupos homogéneos detectando posibles variables etiológicas comunes. Pacientes y métodos. Se incluyen en el estudio 46 niños diagnosticados de espectro autista, cuyo diagnóstico se confirmó mediante el inventario de espectro autista (IDEA/ Riviére-97). Parámetros revisados: antecedentes familiares, riesgo perinatal, edad de inicio, exámenes complementarios y patología neurológica. Resultados. Se confirmó el diagnóstico en 18 niños; del resto de pacientes, 14 presentaban un trastorno específico del desarrollo del lenguaje. Práctica ausencia de patología neurológica subyacente, pero este dato puede estar condicionado por la dispersión de exámenes complementarios efectuados. Conclusiones. Los trastornos específicos del desarrollo del lenguaje constituyen el primer diagnóstico diferencial del espectro autista. El diagnóstico de autismo es clínico, pero la heterogeneidad del abordaje médico interfiere en la consideración global del espectro, primando los aspectos conductuales e infravalorando los biológicos, y hace necesaria una reflexión para consensuar un protocolo unitario de actuación (AU)

Risk of oral cancer associated with tobacco smoking, alcohol consumption and oral hygiene: a case-control study in Madrid, Spain.

Oral cancer is a disease whose principal etiological factors are tobacco and alcohol consumption, which if controlled could help avoid many tumors. However, consumption has continued to grow for years. We have studied the risk of the principal factors established in the development of oral cancer and the influence of the oral hygiene level on the appearance of these tumors. Seventy-five cases of oral cancer and 150 controls from the Madrid community were interviewed on tobacco and alcohol consumption habits and their oral hygiene level. The Odds Ratio (OR) for consumption of 6-20 cigarettes/day is 3.1 and 7.96 for more than 20 cigarettes/day. When more than 50 g of alcohol/day is consumed the risk results in an OR of 5.3. Daily brushing is a protective factor (OR, 0.41). In conclusion, the most important risk factor for developing oral cancer is tobacco consumption followed by alcohol consumption.

[The general criteria and recommendations for the elaboration of programs for the early detection of breast cancer and cervical cancer in Spain. The Working Group for the Early Detection of Breast Cancer and Cervical Cancer]. / Criterios generales y recomendaciones para la elaboración de programas de detección precoz de cáncer de mama y cáncer de cervix uterino en España. Grupo de Trabajo de Detección Precoz de Cáncer de Mama y de Cervix Uterino.

Cancer screening and primary prevention of cancer are effective strategies to reduce cancer morbidity and mortality. The experience gained in several European countries about breast and cervical cancer has been growing in the last decades. This fact facilitates the adoption of the most convenient strategies to implement screening programmes in Spain. The Spanish Ministry of Health and Consumer Affairs set up a work group of experts and health managers to make recommendations and to define the basic criteria to take into account when planning and implementing these programmes. The article describes those recommendations as well as the priorities to be established regarding the target population, and the strategies to increase efficiency of those programmes. Recommendations were made according with scientific evidences and the current situation and resources in Spain.

Intrathecal opiates for chronic pain in cancer patients.

A total of 20 cancer patients suffering chronic pain were treated with morphine chloride by intrathecal administration through a subcutaneous implanted reservoir. Pain evaluation was done using our INO scale, McGill questionnaire and the visual analogue scale. A morphine intrathecal test was done previously to disclose if this method of administration would be effective. In nearly all patients the initial dose of morphine chloride was 2 mg/day and according to the pain relief the dose was modified if necessary. In 14/20 patients the initial dose was maintained during all treatment until their death. One patient treated during 370 days required a final dose of 6 mg/day. In all patients the analgesia obtained and evaluated with the INO scale was statistically significant using the t-Student (P less than 0.001) with a pretreatment mean value of 12.4 +/- 1.81 (mean +/- sigma) and 6.85 +/- 0.99 (mean sigma) in the final evaluation. The mean period of treatment was 62.8 days (range 10-370 days). Side effects are comparable with those described by others, and respiratory depression did not occur in our series. This method of treatment can alleviate pain in cancer patients not suitable to be treated by other methods, including ablative neurosurgical procedures, permitting home care which can be more comfortable to patients and their families.

[Metastases in the cerebellum]. / Metástasis en cerebelo.

The authors make a short study of fourteen cerebellar metastases from non neurological primitive tumors.