Preliminary analysis of a shortened picture version of the Free and Cued Selective Reminding Test.

INTRODUCTION: A picture version of the Free and Cued Selective Reminding Test (FCSRT) would assist in the assessment of memory function in patients with low levels of schooling. A shortened version would improve the test's applicability. OBJECTIVES: To analyse the diagnostic usefulness of a shortened picture version of the FCSRT for distinguishing patients with amnestic mild cognitive impairment (aMCI) from controls, without excluding participants with a low level of schooling. METHODS: Phase I study of a diagnostic evaluation (convenience sampling; pre-test prevalence 50%). A blinded researcher independently administered the FCSRT to 30 patients with aMCI and 30 controls matched for age, sex, level of schooling and literacy, using images and omitting the usual 30-minutes delayed recall item. Three variables were recorded: free recall, total recall, and cue efficiency. Diagnostic accuracy was calculated using receiver operating characteristic curves and the area under the curve. The Youden index was used to identify optimal cut-off points. RESULTS: Of all participants, 41.7% had not completed primary education. There were no differences between groups as regards sociodemographic variables. Area under the curve was excellent for free recall (0.99), total recall (0.95), and cue efficiency (0.93). The optimal cut-off points were 21/22, 43/44, and < 0.77, respectively. CONCLUSIONS: This preliminary analysis shows that a shortened picture version of the FCSRT may be useful and applicable for the diagnosis of aMCI without excluding individuals with a low level of schooling.

Cuidados de enfermería en la elefantisis verrucosa nostra. A propósito de un caso / Nursing care in the treatment of elephantiasis nostras verrucosa and myiasis with 20% trichloroacetic acid: A case report

Introducción: La elefantiasis verrucosa nostra es una afección dermatológica deformante poco frecuente asociada al linfedema crónico. Se caracteriza por presentar edema de la parte afectada con fibrosis progresiva de aspecto leñoso de la dermis y el tejido subcutáneo, hiperqueratosis de la epidermis y lesiones papilomatosas y verrucosas que dan una apariencia de empedrado a la piel.Presentación del caso:La paciente, además de sufrir elefantisis verrucosa nostra en ambas extremidades, también sufría colonización por larvas de díptero, úlceras por presión en ambos talones y un estado general de salud muy deteriorado. Se realizó un plan de atención de enfermería (PAE), valorando a la paciente según las 14 Necesidades Básicas Humanas de Virginia Henderson, seguida de una fase diagnóstica según la North American Nursing Diagnosis Association (NANDA) realizando una planificación de objetivos basándonos en la Nursing Outcomes Classification (NOC) y llevando a cabo una serie de intervenciones con actividades específicas apoyándonos en la Nursing Interventions Classification (NIC), realizando una evaluación constante de la evolución de la paciente.Para apreciar la evolución del PAE focalizando en un mismo diagnóstico NANDA, “Deterioro de la integridad cutánea”, a lo largo de todo el proceso hospitalario de la paciente y como el tratamiento de la afección con ácido tricloracético al 20% (TCA 20%) mejoró el estado de la piel.Conclusiones:El tratamiento con ácido tricloroacético al 20% ha resultado efectivo frente a la elefantisis verrucosa nostra, reduciendo la hiperqueratosis hasta obtener una piel aceptablemente sana. El seguimiento del plan de atención a enfermería a lo largo del todo el proceso garantiza los cuidados necesarios para una correcta recuperación del paciente. (AU)

Introduction: Elephantiasis Verrucosa Nostra is a rare deforming dermatologic condition associated with chronic lymphedema. It is characterized by edema of the affected area with progressive woody fibrosis of the dermis and the subcutaneous tissue, hyperkeratosis of the epidermis, and papillomatous and verrucous lesions that give the skin a cobblestone appearance.Case presentation:The patient, in addition to suffering from elephantitisis verrucosa nostra on both limbs, also suffered from dipteran larvae colonisation, pressure ulcers on both heels and aexceptionally deteriorated health condition.A Nursing Care Plan (PAE) was carried out, Assessing the patient according to Virginia Henderson's 14 Basic Human Needs, followed by a diagnostic phase according to the North American Nursing Diagnosis Association (NANDA), carrying out a planning of objectives based on the Nursing Outcomes Classification (NOC) and accomplishing a series of interventions with specific activities based on the Nursing Interventions Classification (NIC), getting a constant evaluation of thepatient's evolution. In order to appreciate the PAE's evolution focusing on the same NANDA diagnosis, “Deterioration of Skin Integrity”, throughout the entire hospital process and how thedisease's treatment with 20% trichloroacetic acid (TCA 20%) improved the condition of the skin.Conclusions:Treatment with 20% trichloroacetic acid has been effective against elephantiasis verrucosa nostra, reducing hyperkeratosis to an acceptably healthy skin. The monitoring of the nursing care plan throughout the entire process guarantees the necessary care for the correct recovery of the patient. (AU)

Smoking-related interstitial lung disease.

Exposure to smoke is associated with the development of diseases of the airways and lung parenchyma. Apart from chronic obstructive pulmonary disease (COPD), in some individuals, tobacco smoke can also trigger mechanisms of interstitial damage that result in various pathological changes and pulmonary fibrosis. A causal relation has been established between tobacco smoke and a group of entities that includes respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), desquamative interstitial pneumonia (DIP), Langerhans cell histiocytosis (LCH), and acute eosinophilic pneumonia (AEP). Smoking is considered a risk factor for idiopathic pulmonary fibrosis (IPF); however, the role and impact of smoking in the development of this differentiated clinical entity, which has also been called combined pulmonary fibrosis and emphysema (CPFE) as well as nonspecific interstitial pneumonia (NIP), remains to be determined. The definition of smoking-related interstitial fibrosis (SRIF) is relatively recent, with differentiated histological characteristics. The likely interconnection between the mechanisms involved in inflammation and pulmonary fibrosis in all these processes often results in an overlapping of clinical, radiological, and histological features in the same patient that can sometimes lead to radiological patterns of interstitial lung disease that are impossible to classify. For this reason, a combined approach to diagnosis is recommendable. This combined approach should be based on the joint interpretation of the histological and radiological findings while taking the clinical context into consideration. This paper aims to describe the high-resolution computed tomography (HRCT) findings in this group of disease entities in correlation with the clinical manifestations and histological changes underlying the radiological pattern.

Caracterización de autores que publicaron en la "Revista ANACEM" durante el periodo 2007 - 2018 / Characterization of authors who published in "Revista ANACEM" during 2007 - 2018

INTRODUCCIÓN: La producción científica ocupa un lugar importante en la formación de estudiantes de medicina. Siendo el objetivo de la Revista ANACEM la promoción temprana de la formación científica de los futuros profesionales médicos, es importante conocer quiénes publican en la revista y sus afiliaciones universitarias. OBJETIVO: Caracterizar a los autores de la revista ANACEM entre los años 2007 y 2018. Material y método: Estudio retrospectivo. La población estudiada fueron todos los autores con publicaciones en la revista ANACEM, excluyendo publicaciones dentro del mismo Volumen. Datos obtenidos directamente de los números publicados por ANACEM digitalmente. Se utilizó el programa Microsoft Excel® para el análisis estadístico. Resultados: Los Volúmenes 5, 6 y 7 fueron los que tuvieron más autores de pregrado. En la totalidad de los Volúmenes la mayoría de los autores fueron hombres, tanto estudiantes como docentes. Un 52,1% de los autores de pregrado fueron internos; mientras que la mayoría de los docentes, 43,7%, fueron médicos especialistas. La Universidad de Concepción fue la universidad con mayor cantidad de autores de pregrado y de docentes. Un 51,8% de los docentes informó afiliación a un hospital. La nacionalidad más común fue la chilena, con un 90,1% de la totalidad de los autores. Discusión: Se vio un aumento en la cantidad de autores de pregrado hasta el Volumen N°7, con un descenso posterior. Se atribuyó el cambio en la cantidad de autores a problemas en la gestión y divulgación de la revista. Las afiliaciones universitarias no fueron informadas siempre por los docentes. Las otras categorías siguen patrones esperados.

INTRODUCTION: Scientific production has an important place in the training of medical students, but there is no clear pictureof the authors in the ANACEM journal. For this reason, it is important to know who publishes in the magazine and their affiliations. OBJECTIVE: To characterize the authors of the ANACEM journal between 2007 and 2018. Material and method: Retrospective study. The population studied were all authors with publications in the ANACEM journal, excluding repeating publications within the same volume. The data was obtained directly from the numbers published by ANACEM digitally. The software used for statistical analysis was Microsoft Excel®. Results: Volumes 5, 6 and 7 had the most undergraduate authors. When analyzing all volumes, the majority of both student authors and professional authors were men. 52.1% of undergraduate authors were interns; while 43.7% of tutors were medical specialists. The university with the largest number of authors was Universidad de Concepción. 51.8% of professional authors reported affiliation to a hospital. The most common nationality was Chilean, with 90.1% of all authors. Discussion: There was an increase in the number of undergraduate authors up to volume n°7, with a subsequent decrease. Changes in the number of authors were attributed to problems in management and divulgation of the journal. Affiliation to universities was not always informed by professionals. The other categories follow expected patterns.

Puntajes del Concurso Nacional de Ingreso al Sistema Nacional de Servicio de Salud por universidad. Periodo 2017 ­ 2020 / Scores of the National Entrance Contest to the National Health Service System by university. Period 2017 - 2020

INTRODUCCIÓN: El Concurso Nacional de Ingreso al Sistema Nacional de Servicio de Salud (CONISS) es una de las modalidades más conocidas para acceder a una especialización médica en Chile. Se basa en la evaluación de 5 rubros diferentes y en los últimos años no ha sido capaz de cubrir la demanda de los postulantes haciendo necesario un mejor conocimiento de este. El objetivo del estudio es describir los resultados del concurso CONISS de los últimos 4 años según las universidades de los participantes. Material y método: Estudio observacional, corte transversal, descriptivo. Asociación de puntajes obtenidos por los estudiantes con su respectiva universidad, obteniéndose datos de la página de superintendencia de Salud y utilizándose software Microsoft Excel® para su procesamiento. Resultados: El total de egresados fue de 6.092, provenientes de 22 universidades chilenas. Destaca la Pontificia Universidad Católica de Chile por liderar en el rubro 1 y el puntaje total durante los 4 años y la Universidad Pedro de Valdivia por encontrarse en el último puesto. Los rubros 4 y 5 fueron los que más se completaron. Las universidades con mejor desempeño en el rubro 1 fueron también las que obtuvieron mejor desempeño en el puntaje final. Discusión: El rubro 1 es el que posee mayor importancia en el resultado final del concurso y no se encuentra estandarizado entre universidades quedando sujeto al criterio de cada institución. No completar el resto de los rubros representa una desventaja comparativa pues la mayoría tiene buenos puntajes, pero estos resultados se ven limitados en gran medida por las calificaciones.

INTRODUCTION: The National Entrance Contest to the National Health Service System (CONISS) is one of the best known modalities to access a medical specialization in Chile. It is based on the evaluation of 5 different areas (items) and in recent years it has not been able to meet the demand of the applicants, making it necessary to know more about the subject. The objective of the study is to describe the results of the CONISS by university for the last 4 years. Material and method: Observational, cross-sectional, descriptive study. Association of scores obtained by students with their respective university, obtaining data from the Superintendency of Health page and using Microsoft Excel® software for processing. Results: The total number of graduates was 6,092, from 22 Chilean universities. The Pontificia Universidad Católica de Chile stands out for leading in item 1 and the total score during the 4 years and "Pedro de Valdivia" University for being in the last position. Items 4 and 5 were the most completed. The universities with the best performance in item 1 were also the ones that obtained the best performance in the final score. Discussion: Item 1 is the one that has the greatest importance in the final result of the contest and is not standardized among universities, being subject to the criteria of each institution. Not achieving the other items implies a comparative disadvantage as most participants have good scores, but these results are largely limited by grades.

Circuitos postoperatorios en los pacientes sometidos a craneotomía programada. Revisión narrativa / Postoperative circuits in patients undergoing elective craniotomy. A narrative review

En 2017 la sección de Neurociencias de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor publicó una encuesta nacional sobre los circuitos de atención y tratamiento postoperatorio en neurocirugía. La encuesta evidenció una gran heterogeneidad de respuestas en función del centro, el anestesiólogo y la afección del paciente. En la actualidad, no disponemos de un estándar de circuito postoperatorio y existe evidencia suficiente para no indicar de forma rutinaria el ingreso en Unidades de Cuidados Críticos Postquirúrgicos a todos los pacientes intervenidos de craneotomía programada. El objetivo de este estudio es hacer una revisión narrativa de los circuitos postoperatorios en la craneotomía programada, para intentar homogeneizar nuestra práctica clínica a la luz de los estudios publicados. Se ha hecho una revisión bibliográfica de los últimos diez años, fecha de actualización noviembre 2019, utilizando las palabras clave neurosurgery and postoperative care y craniotomyand postoperative care en MEDLINE (PubMed)

In 2017, the Neurosciences section of the Spanish Society of Anaesthesiology, Critical Care and Pain Therapy published a national survey on postoperative care and treatment circuits in neurosurgery. The survey showed that practices vary widely, depending on the centre, the anaesthesiologist and the pathology of the patient. There is currently no standard postoperative circuit for cranial neurosurgical procedures in Spanish hospitals, and there is sufficient evidence to show that not all patients undergoing elective craniotomy should be routinely admitted to a postsurgical critical care unit. The aim of this study is to perform a narrative review of postoperative circuits in elective craniotomy in order to standardise clinical practice in the light of published studies. For this purpose, we searched MEDLINE (PubMed) to retrieve studies published in the last ten years, up to November 2019, using the keywords neurosurgery and postoperative care, craniotomyand postoperative care

Postoperative circuits in patients undergoing elective craniotomy. A narrative review. / Circuitos postoperatorios en los pacientes sometidos a craneotomía programada. Revisión narrativa.

In 2017, the Neurosciences section of the Spanish Society of Anaesthesiology, Critical Care and Pain Therapy published a national survey on postoperative care and treatment circuits in neurosurgery. The survey showed that practices vary widely, depending on the centre, the anaesthesiologist and the pathology of the patient. There is currently no standard postoperative circuit for cranial neurosurgical procedures in Spanish hospitals, and there is sufficient evidence to show that not all patients undergoing elective craniotomy should be routinely admitted to a postsurgical critical care unit. The aim of this study is to perform a narrative review of postoperative circuits in elective craniotomy in order to standardise clinical practice in the light of published studies. For this purpose, we searched MEDLINE (PubMed) to retrieve studies published in the last ten years, up to November 2019, using the keywords neurosurgery and postoperative care, craniotomyand postoperative care.

Allergy to strawberry in children from the Mediterranean area: is it really allergy?

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Psychosocial and Ergonomic Conditions at Work: Influence on the Probability of a Workplace Accident.

Today, the economic and social importance of occupational accidents is undeniable worldwide. Hence, research aimed at reducing this type of accident is considered a discipline of great interest for society in general. In this environment, working conditions play a fundamental role in the occurrence of accidents, and from their study, results can be obtained that provide information for decision-making that guarantee optimum conditions for the development of the employees' tasks. Organizing the conditions of work execution is also a task that constitutes an essential aspect for a firm's productivity, therefore, affecting their viability and results. In this work, a model is proposed for the study of different groups of working conditions and their influence on the probability of occupational accidents, in accordance with the data provided by the 7th National Survey of Working Conditions (VII NSWC). The survey sampled 8892 workers active in all sectors of national production and is the last nation-wide survey administered in Spain. Bayesian networks (BNs) are used to generate a network that analyzes working conditions in all areas (27 variables have been included in addition to those corresponding to the sector and accident), and then, more specifically, the relationship that is established between ergonomic factors in the workplace, psychosocial factors of the worker, and the probability of an accident. The results are achieved through the network obtained by highlighting some of the proposed variables. The dependencies generated by the chosen variables are analyzed, and subsequently, the probability of accident for each of the productive sectors is determined. It is concluded that the ergonomic risks associated with physical strains in the workplace, together with the lack of job satisfaction on the employer's behalf, both pose a very significant increase in the probability of being involved in an occupational accident, above the other variables of study.

Interchromosomal effect in carriers of translocations and inversions assessed by preimplantation genetic testing for structural rearrangements (PGT-SR).

PURPOSE: Balanced carriers of structural rearrangements have an increased risk of unbalanced embryos mainly due to the production of unbalanced gametes during meiosis. Aneuploidy for other chromosomes not involved in the rearrangements has also been described. The purpose of this work is to know if the incidence of unbalanced embryos, interchromosomal effect (ICE) and clinical outcomes differ in carriers of different structural rearrangements. METHODS: Cohort retrospective study including 359 preimplantation genetic testing cycles for structural rearrangements from 304 couples was performed. Comparative genomic hybridisation arrays were used for chromosomal analysis. The results were stratified and compared according to female age and carrier sex. The impact of different cytogenetic features of chromosomal rearrangements was evaluated. RESULTS: In carriers of translocations, we observed a higher percentage of abnormal embryos from day 3 biopsies compared with day 5/6 biopsies and for reciprocal translocations compared with other rearrangements. We observed a high percentage of embryos with aneuploidies for chromosomes not involved in the rearrangement that could be attributed to total ICE (aneuploid balanced and unbalanced embryos). No significant differences were observed in these percentages between types of rearrangements. Pure ICE (aneuploid balanced embyos) was independent of female age only for Robertsonian translocations, and significantly increased in day 3 biopsies for all types of abnormalities. Furthermore, total ICE for carriers of Robertsonian translocations and biopsy on day 3 was independent of female age too. High ongoing pregnancy rates were observed for all studied groups, with higher pregnancy rate for male carriers. CONCLUSION: We observed a higher percentage of abnormal embryos for reciprocal translocations. No significant differences for total ICE was found among the different types of rearrangements, with higher pure ICE only for Robertsonian translocations. There was a sex effect for clinical outcome for carriers of translocations, with higher pregnancy rate for male carriers. The higher incidence of unbalanced and aneuploid embryos should be considered for reproductive counselling in carriers of structural rearrangements.

Incidencia de enfermedad pulmonar obstructiva crónica en pacientes con el virus de la inmunodeficiencia humana. Análisis post-hoc del estudio viva / Incidence of chronic obstructive pulmonary disease in patients with human immunodeficiency virus. Post-hoc analysis of the viva study

Introducción: desde la aparición de la terapia antiretroviral la supervivencia de los pacientes infectados por el virus de la inmunodeficiencia humana (VIH) ha aumentado considerablemente tomando importancia la aparición de otras patologías crónicas en estos pacientes como puede ser la enfermedad pulmonar obstructiva crónica (EPOC). Nuestro objetivo fue conocer la incidencia de EPOC en una cohorte de pacientes VIH derivados en un programa de detección de hipertensión pulmonar (HTP). Material y Métodos: análisis post-hoc, de un prospectivo, pseudo-experimental de pacientes con infección del VIH a los que se les preguntaba por disnea y en caso afirmativo eran derivados a consultas de neumología para despistaje de HTP. Resultado: desde 2014 hasta 2016, reclutamos un total de 32 pacientes, con un predominio de varones (75%). La disnea según la mMRC (Medical Reserach Council) fue grado 1, 2 y 3 en el 37,5%, 43,8% y 18,8%, respectivamente. La prevalencia de tabaquismo fue del 87,1% (intervalo de confianza [IC] 95%: 71- 96,4%), y 18 pacientes fueron catalogados de EPOC (62%; IC95%: 42,2 - 79,3%). Conclusión: la incidencia de EPOC en nuestra serie fue muy superior a la de la población general. Es necesario plantear estrategias de búsqueda activa de EPOC en estos pacientes para un diagnóstico y tratamiento precoz

Introduction: Since the advent of antiretroviral therapy, the survival of patients infected with the human immunodeficiency virus (HIV) has considerably increased, with the occurrence of other chronic diseases such as chronic obstructive pulmonary disease (COPD) gaining importance in these patients. Our objective was to find out the incidence of COPD in a cohort of HIV patients that were referred to a program to detect pulmonary hypertension (PH). Materials and Methods: Post hoc analysis of a prospective, quasi-experimental study on HIV-infected patients who were asked whether they had dyspnea. If this was the case, they were referred to a pulmonologist for PH screening. Results: From 2014 to 2016, we recruited a total of 32 patients, with a predominance of male recruits (75%). According to the mMRC (Modified Medical Research Council) Dyspnea Scale, 37.5%, 43.8% and 18.8% were classified as Grade 1, 2 and 3, respectively. The prevalence of smoking was 87.1% (95% confidence interval [CI]: 71 - 96.4%), and 18 patients were classified with COPD (62%; 95% CI: 42.2 - 79.3%). Conclusion: The incidence of COPD in our sample was much higher than that of the general population. It is necessary to plan active search strategies for COPD in these patients for early diagnosis and treatment

Preliminary analysis of a shortened picture version of the Free and Cued Selective Reminding Test. / Evaluación preliminar de una versión pictórica y abreviada del Free and Cued Selective Reminding Test.

INTRODUCTION: A picture version of the Free and Cued Selective Reminding Test (FCSRT) would assist in the assessment of memory function in patients with low levels of schooling. A shortened version would improve the test's applicability. OBJECTIVES: To analyse the diagnostic usefulness of a shortened picture version of the FCSRT for distinguishing patients with amnestic mild cognitive impairment (aMCI) from controls, without excluding participants with a low level of schooling. METHODS: Phase I study of a diagnostic evaluation (convenience sampling; pre-test prevalence 50%). A blinded researcher independently administered the FCSRT to 30 patients with aMCI and 30 controls matched for age, sex, level of schooling and literacy, using images and omitting the usual 30-minute delayed recall item. Three variables were recorded: free recall, total recall, and cue efficiency. Diagnostic accuracy was calculated using receiver operating characteristic curves and the area under the curve. The Youden index was used to identify optimal cut-off points. RESULTS: Of all participants, 41.7% had not completed primary education. There were no differences between groups as regards sociodemographic variables. Area under the curve was excellent for free recall (0.99), total recall (0.95), and cue efficiecy (0.93). The optimal cut-off points were 21/22, 43/44, and < 0.77, respectively. CONCLUSIONS: This preliminary analysis shows that a shortened picture version of the FCSRT may be useful and applicable for the diagnosis of aMCI without excluding individuals with a low level of schooling.

Lectin-like transcript 1 (LLT1) expression is associated with nodal metastasis in patients with head and neck cutaneous squamous cell carcinoma.

The interaction of lectin-like transcript 1 (LLT1) with CD161 inhibits Natural Killer cell activation. Overexpression of LLT1 contributes to the immunosuppressive properties of tumor cells. However, there are little data about LLT1 expression in human solid tumors. The objective of this paper is to investigate the relationship between LLT1 expression with the clinicopathologic features and its impact on the prognosis of head and neck cutaneous squamous cell carcinoma (cSCC). LLT1 expression was analyzed on paraffin-embedded tissue samples obtained from 100 patients with cSCC by immunohistochemistry. The estimator of Fine and Gray was used to estimate the cumulative incidence curves for relapse. Proportional Hazard models and Hazard ratios (HRs) were used for studying the risk of tumor relapse and mortality. LLT1 strong expression was a significant risk factor for nodal metastasis with crude and adjusted ratios (HRs) of 3.40 (95% CI 1.39-9.28) and 3.25 (95% CI 1.15-9.16); and for cSCC specific death of 6.17 (95% CI 1.79-21.2) and 6.10 (95% CI 1.45-25.7). Strong LLT1 expression is an independent predictor of nodal metastasis and poor disease-specific survival and it might be helpful for risk stratification of patients with cSCC.

Identification and expression analysis of the Spodoptera exigua neuropeptidome under different physiological conditions.

Neuropeptides are small signalling molecules acting as neurohormones, neurotransmitters and neuromodulators. Being part of the chemical communication system between cells within an organism, they are involved in the regulation of different aspects of animal physiology and behaviour such as feeding, reproduction, development and locomotion. Transcriptomic data from larval and adult tissues have been obtained and mined to generate a comprehensive neuropeptidome for the polyphagous insect pest Spodoptera exigua. Sixty-three neuropeptides have been identified and described based on their tissue specificity and their regulation in response to different abiotic perturbations. Expression analyses have identified those neuropeptides involved in ingestive and digestive behaviour of S. exigua larvae and revealed a general pattern of upregulation in the midgut during larval starvation. Our results represent a comprehensive neuropeptidome of a lepidopteran species that will be highly relevant to future studies and provide novel information of the insect's perception of its environment.

Linfagioma quístico mesentérico en el diagnóstico diferencial de la enfermedad in-flamatoria pélvica / Mesenteric cystic lymphangioma in the differential diagnosis of pelvic inflammatory disease

RESUMEN La enfermedad inflamatoria pélvica (EIP) es un síndrome clínico que incluye todas aquellas alteraciones inflamatorias e infecciosas que comprenden los órganos de la pelvis menor. La infección es habitualmente polimicrobiana y está asociada a mujeres jóvenes con vida sexual activa, nulíparas y usuarias de dispositivo intrauterino (DIU Los abscesos tubo-ováricos son una complicación aguda o crónica, asociada a dicho proceso.). CASO CLÍNICO Presentamos el caso de una mujer de 47 años con dolor abdominal intenso, usuaria de DIU. La primera sospecha diagnóstica fue de EIP con presencia de absceso tuboovárico anexial. Sin embargo la exploración física no orientó en este sentido, por lo que se solicitó TAC abdominopélvico, en el que se informó de la posibilidad de linfangioma quístico mesentérico. Por ello, se contactó con el servicio de Cirugía General que procedió a su resección satisfactoria y sin incidencias. El estudio anatomopatológico confirmo la sospecha radiológica. CONCLUSIÓN Una adecuada exploración física es fundamental en el diagnóstico de la EIP y el absceso tuboovárico. El linfangioma quístico mesentérico puede formar parte del diagnóstico diferencial de las masas anexiales en este contexto.

ABSTRACT Pelvic inflammatory disease (PID) is a clinical syndrome involving all those inflammatory and infectious alterations affecting the minor pelvis organs. Any infection is often multibacterial and more frequent in sexually active nulliparous young women and intrauterine device (IUD) users. Tuboovarian abscesses can be an acute or chronic complication associated to that process. Our patient was a 47 year old IUD user consulting about intense abdominal pain. The initial clinical suspicion pointed at a case of PID associated to a tubo-ovarian anexial abscess. However, a physical examination did not support this suspicion and an abdominopelvian CAT scan was therefore requested, reporting a possible mesenteric cystic lymphangioma. The General Surgery service was reached for treatment, successfully excising the growth without further incident. Histological analysis confirmed the radiological diagnosis. An adequate physical examination is instrumental while diagnosing PID and tuboovarian abscesses. A mesenteric cystic lymphangioma should be included in a differential diagnosis of anexial growths in such a context

Data on the working population in Spain related to training, workplace conditions and accident rates.

Obtaining data on worker accident rates is necessary in order to analyze the causes and variables involved in the occurrence of said accidents. The majority of these data, collected after the accident occurs, do not consider the employee׳s working conditions. Here are presented the data on workplace accidents and the conditions of the workers by analyzing the generic data supplied as part of the 7th National Survey of Workplace Conditions (EWCS) in Spain, conducted in 2011. These data will yield the variables needed to determine if the information on workplace risks provided by the survey respondents has an appreciable effect on the occurrence of occupational accidents in the working population, and will also be used to explore other variables.

Data on the main working conditions with influence on the development of hearing loss amongst the occupational population in Spain.

Obtaining reliable and objective data on certain working conditions is necessary to analyse the causes and variables that can influence the development of hearing loss amongst the working population. Objective occupational data have been collected from a heterogeneous sample of 1418 workers in Spain, see "How activity type, time on the job and noise level on the job affect the hearing of the working population. Using Bayesian networks to predict the development of hipoacusia" (Barrero et al., 2018) [1]. Among the main factors analysed are the noise levels to which these workers are exposed, measured at their respective workstations, and the assessment of their hearing status, evaluated by audiometric medical tests. These factors provide information to predict the development of hypoacusia.

Assessment of dyspnea and dynamic hyperinflation in male patients with chronic obstructive pulmonary disease during a six minute walk test and an incremental treadmill cardiorespiratory exercise test.

The six minute walk test (6MWT) is a standardized test that provides information on exercise capacity in patients with COPD. It is considered a submaximal test in opposition to incremental cardiopulmonary exercise tests (CPET) that provide valuable information on all the systems involved in exercise. OBJECTIVES: 1. To compare the perceptive, physiological responses and degree of dynamic hyperinflation during two exercise tests: the 6MWT and the incremental CPET on a treadmill. 2. To evaluate how dyspnea is related to dynamic hyperinflation (DH) and other functional parameters in both tests. METHODS: 29 stable COPD male patients, age 68±5.8 years, mean post-bronchodilator FEV1 57±11%, were recruited. To evaluate dynamic hyperinflation, inspiratory capacity (IC) was measured at rest and upon completing each one of the tests. At the same time, perceived dyspnea and leg discomfort were rated on specific modified Borg scales. RESULTS: The mean walk distance in 6MWT was 494±88m. The Borg scale rating for shortness of breath upon completing the test was 4.7±2, whilst 2.9±2 for leg discomfort. IC changed from 2.53±0.63l before to 2.34±0.60l after completion of the test. In the treadmill CPET, maximal oxygen consumption (V˙O2max) was 21.8±5mL/kg/min with 6.6±2 dyspnea and 4.3±2 leg discomfort on Borg scales. IC changed from 2.17±0.53l to 1.20±0.43l. CONCLUSIONS: Dynamic hyperinflation occurs in male COPD patients during submaximal exercise such as the 6MWT. This phenomenon is more pronounced after incremental CPET on a treadmill. Despite being dyspnea the dominant limiting symptom for both tests, we observed different physiological responses.