Modelos ARIMA para la predicción del gasto conjunto de oxígeno de vuelo y otros gases en el Ejército del Aire / ARIMA models to predict the joint expense of in-flight oxygen and other gases in the Air Force

INTRODUCCIÓN: la realización de expedientes de contratación para gases y elementos afines empleados en el Ejército del Aire se realiza desde el año 1997. La dirección se asignó, desde el inicio, al Centro de Farmacia del Aire de Madrid (CEFARMA). Las divergencias durante los últimos años entre las concesiones económicas asignadas y el gasto real ejecutado han sido notables. La falta de modelos matemáticos de predicción puede ser uno de los motivos de la ausencia de ajuste entre lo presupuestado y lo ejecutado. La elaboración de estimaciones estadísticas y econométricas es la base para realizar una prospectiva eficiente al plantear expedientes de contratación de gases de una manera adecuada y no basada en incrementos inerciales de los presupuestos históricos. OBJETIVOS: realización de estimación matemática para la predicción económica en las asignaciones presupuestarias de los expedientes de contratación de gases utilizados en Ejército del Aire. MATERIALES Y MÉTODOS: recopilación de los datos económicos de las facturas y pagos efectuados. Los importes de facturación se han deflactado, tomando como base el año 2016. Para el tratamiento matemático, estadístico y gráfico se han utilizado las aplicaciones informáticas Microsoft(R) Excel (2016), Eviews(R)10, Gretl (2017c) y Statistica v12 (StatSoft inc.). RESULTADOS: se han obtenido diferentes modelos Autorregresivos Integrados de Media Móviles (ARIMA), siendo el que mejor valida los resultados anuales y trimestrales el ARIMA (3,1,0). CONCLUSIONES: los modelos ARIMA permiten efectuar pronóstico y predicción en el cálculo de asignaciones económicas en los expedientes de contratación de gases en el Ejército del Aire

INTRODUCTION: contract records of gases and similar elements used by the Air Force are being signed from 1997. The management of this activity was appointed, from the very beginning, to the Air Force Pharmacy of Madrid (CEFARMA). However, the last divergences between the asigned economic licenses and the actual execution have been noticeable. The lack of mathematical predictive models may account for the disadjustment between the budgeted and the executed. The elaboration of statistic and economeric estimates is retained as the main basis to efficiently forward-looking through contract records of gases properly done, that is, not based on the inertial increment of historical budgets. AIMS: mathematical estimates of budgetary prediction in budget allocations of contract records of gases used by the Air Force. MATERIALS AND METHOD: gathering of the economic data from invoicing and payments. Billing figures have been deflated taking 2016 as the basis. For the mathematical, graphic and statistical treatment of the data the following computing apps have been used: Microsoft(R) Excel (2016), Eviews(R)10, Gretl (2017c) and Statistica v12 (StatSoft inc.). RESULTS: different ARIMA models have been obtained, being ARIMA (3,1,0) the best in annual and quarterly result validation. CONCLUSIONS: ARIMA models allow to predict the economic allocations in the contract records of fases in the Air Force

[Cecal tuberculosis: the importance of a high diagnostic suspicion]. / Tuberculosis cecal: la importancia de una alta sospecha diagnóstica.

Intestinal tuberculosis is less common than pulmonary tuberculosis. Its clinical and endoscopic features are nonspe-cific, so diagnostic suspicion must be high in order to make an early diagnosis and prevent iatrogenia. Pharmacotherapy is often effective, with an excellent clinical and endoscopic evolution. Surgical treatment is reserved for complications. We present the case of cecal tuberculosis diagnosed endoscopically; this is the second case diagnosed in a few months in our center. In this case there were no risk factors, such as recent travel, risk of contacts or inmunosupression.

[Autoimmune pancreatitis: a case report]. / Pancreatitis autoinmune: a propósito de un caso.

Autoimmune pancreatitis (AIP) is an infrequent pathology, although there is a growing incidence in Eastern countries, which might be due to a greater rate of detection. It can be associated with other auto immune pathologies and its association with IgG4-related systemic disease has been described.Its clinical presentation is varied and the normal treatment is medical, using corticoids.A diagnosed clinical case is described.

[Incidence and characteristics of eosinophilic esophagitis in adults]. / Incidencia y características de la esofagitis eosinofílica (EE) en adultos.

Eosinophilic esophagitis (EE) is a disease characterised by the infiltration of esophageal mucous by eosinophils, whose incidence in adults seems to have been increasing in recent years, in a way that is similar to what is occurring with other diseases of a probable immunoallergic aetiology. It predominates in young adults and is mainly expressed by dysphagia and esophageal food impactation. Treatment is based on eliminating the allergen that is potentially involved and the administration of corticoids. This article offers a retrospective review of EE cases diagnosed in the Hospital de Navarra between January 2002 and August 2008, with 25 patients found, which represents an incidence of 2.13 cases/105 inhabitants/year. Seventy-two percent of our patients showed dysphagia and 52% a history of food bolus impaction, with endoscopic alterations found in 23 of the 25 cases. Out of 24 patients studied, 76% showed an alimentary allergy or neumoallergens, which supports the immunoallergic basis of the disease and the need for an allergy exam in all patients with EE. The majority of our patients (22 out of 24 evaluated) presented a good clinical response to treatment, which was based on avoiding exposure to the potentially involved allergen and/or the administration of corticoids (topical or systemic) and/or the administration of proton pump inhibitors.

[Giant esophageal hematoma: possible association with low-dose aspirin]. / Hematoma esofágico gigante: posible relación con dosis pequeñas de aspirina.

Esophageal hematoma is a rare entity that usually presents as acute thoracic pain. It may occur spontaneously or in association with an underlying disease or direct esophageal damage. The presence of coagulation disorders plays an important role in the development of hematoma. We describe the case of a female patient treated with low-dose aspirin who was diagnosed through emergency gastroscopy. We also review the literature and discuss possible causes, findings in diagnostic tests and treatment.

¿Hasta qué punto es seguro el diagnóstico preoperatorio de la biopsia endoscópica en el tumor ampular? / How accurate is preoperative diagnosis by endoscopic biopsies in ampullary tumours?

Introducción: el carácter benigno o maligno del tumor ampular tiene implicaciones pronósticas y terapeúticas. Por otra parte es conocida la dificultad de llegar a un correcto diagnóstico preoperatorio en estas lesiones, incluso a pesar de contar con un estudio histológico prequirúrgico, obtenido mediante biopsias endoscópicas. Material y métodos: revisamos todas las CPRE en las que se realizó biopsia de la papila de enero de 1991 a septiembre de 2000. Analizamos la concordancia entre el diagnóstico preopera torio (biopsias endoscópicas obtenidas durante la CPRE mediante fórceps GIP 412.360-MEDIZIN TECHNIK GMBH IZASA) y definitivo (estudio de la pieza quirúrgica) n=32, así como la posible influencia de la papilotomía previa en nuestros resultados. Resultados: en los 32 pacientes estudiados la concordancia o precisión diagnóstica global entre los diagnósticos pre y postoperatorio fue del 68,7 por ciento. La concordancia fue claramente superior para el diagnóstico preoperatorio de cáncer de papila: 82,3 por ciento, e inferior para el diagnóstico preoperatorio de adenoma: 50 por ciento (p=0,12). En el grupo de pacientes con papilotomía la concordancia fue del 56,25 por ciento, ascendiendo hasta el 81,25 por ciento en el grupo de pacientes sin papilotomía, aunque sin alcanzar diferencias estadísticamente significativas (p=0,25).Conclusiones: en nuestra serie el rendimiento diagnóstico de la biopsia endoscópica es mejor en el grupo de adenocarcinoma de papila con respecto al de adenoma, obteniendo mejores resultados en pacientes sin papilotomía previa. La imposibilidad de determinar con certeza y de forma preoperatoria el carácter benigno o maligno de un tumor ampular obliga a ser cauto a la hora de decidir el tipo de intervención quirúrgica (AU)

How accurate is preoperative diagnosis by endoscopic biopsies in ampullary tumours?

INTRODUCTION: The benign or malignant nature of ampullary tumours has prognostic and therapeutic implications. On the other hand the difficulty of reaching a correct preoperative diagnosis in these lesions is well known, even when we have a histological study obtained by endoscopic biopsies. MATERIAL AND METHODS: We review all ERCP's in which biopsies of the papilla were taken, performed between January 1991 and September 2000. We analyse the concordance rate between preoperative diagnosis (endoscopic biopsies obtained during ERCP) and definitive diagnosis (surgical specimen) (n = 32), and the possible influence of previous sphincterotomy in our results. RESULTS: In the 32 patients studied global accuracy between pre- and postsurgical diagnosis was 68.7%. This accuracy was markedly higher in the group with ampullary cancer (82.7%) than in the group with ampullary adenoma (50%) (p = 0.12). In the group of patients with sphincterotomy accuracy was 56.25% and increased up to 81.25% in the group of patients without sphincterotomy, although statistical significance was not reached (p = 0.25). CONCLUSIONS: In our series, the accuracy of endoscopic biopsies is higher in the adenocarcinoma group than in the adenoma group, obtaining better results in patients without previous sphincterotomy. The impossibility of a preoperative and absolutely certain confirmation of the benign or malignant nature of ampullary tumours forces us to be cautious in deciding type of surgical resection.

Epidemiological aspects of inflammatory bowel disease in the Pamplona area.

OBJECTIVES: to analyze retrospectively our hospital records on patients diagnosed during the period from 1983 to 1993 as having Crohn's disease or ulcerative colitis, and to estimate the incidence and epidemiological characteristics of these diseases in the Pamplona health administration area. METHODS: 246 patients were diagnosed has having inflammatory bowel disease (147 with ulcerative colitis, 97 with Crohn's disease, and 2 with indeterminate colitis. RESULTS: mean incidence was 2.47 +/- 0.96 per 100 000 inhabitants for Crohn's disease, and 3.75 +/- 1.5 per 100 000 inhabitants for ulcerative colitis (p < 0.05). There was a nonsignificant increase in incidence during the study period. Age, sex, alcohol intake, smoking habit and familial aggregation were analyzed. CONCLUSIONS: mean estimated incidence of Crohn's disease and ulcerative colitis in our setting during 1983-1993 was similar to that reported more recently for other parts of Spain. In our setting, ulcerative colitis was significantly more frequent that Crohn's disease, and familial aggregation was lower among patients who had the former disease. Crohn's disease was diagnosed at earlier ages, and cigarette smoking was more frequent among patients with this disease.

[Chronic non granulomatous ulcerative jejunitis]. / Yeyunoileítis ulcerative crónica no granulomatosa.

Chronic non granulomatous ulcerative jejunoileitis a very infrequentity characterized by malabsorption and ulcerations of the small intestine which usually involve the jejunum and ileum. A case of a woman diagnosed with malabsorption syndrome requiring laparotomy due to worsening of a picture of malabsorption and the presence of stenosis and ileal ulceration, demonstrating villous atrophy and lymphoplasmocytic infiltration in the histology compatible with this disease is presented.

Endoscopic diagnosis of gastric peptic ulcer penetrating into the liver.

A 61-year-old man was admitted with upper gastrointestinal bleeding. Endoscopy showed a large gastric peptic ulcer with a pseudotumoral mass protruding from the ulcer bed. Histological examination of biopsies taken from the mass revealed distorted hepatic tissue and inflammatory changes. Hepatic penetration was diagnosed as the cause of bleeding. Surgery findings confirmed the endoscopic diagnosis.