Repercussions of absolute and time-rated BMI "yo-yo" fluctuations on cardiovascular stress-related morbidities within the vascular-metabolic CUN cohort.

Aims: The association between body mass index (BMI) fluctuation and BMI fluctuation rate with cardiovascular stress morbidities in a Caucasian European cohort was evaluated to ascertain the impact of weight cycling. Methods: A total of 4,312 patients of the Vascular-Metabolic CUN cohort (VMCUN cohort) were examined and followed up during 9.35 years ( ± 4.39). Cox proportional hazard ratio analyses were performed to assess the risk of developing cardiovascular stress-related diseases (CVDs) across quartiles of BMI fluctuation, measured as the average successive variability (ASV) (ASV = |BMIt0 - BMIt1| + |BMIt1 - BMIt2| + |BMIt2-BMIt3| +…+ |BMItn - 1 - BMItn|/n - 1), and quartiles of BMI fluctuation rate (ASV/year). Results: There were 436 incident cases of CVD-associated events involving 40,323.32 person-years of follow-up. A progressively increased risk of CVD in subjects with greater ASV levels was found. Also, a higher level of ASV/year was significantly associated with an increased risk of developing CVD stress independent of confounding factors with a value of 3.71 (95% CI: 2.71-5.07) for those in the highest quartile and 1.82 (95% CI: 1.33-2.50) for those in the third quartile. Conclusions: The BMI fluctuation rate seems to be a better predictor than BMI fluctuation of the potential development of cardiovascular stress morbidities. The time-rated weight fluctuations are apparently more determinant in increasing the risk of a CVD than the weight fluctuation itself, which is remarkable in subjects under "yo-yo" weight patterns for precision medicine.

[Animal sting and bites]. / Picaduras y mordeduras de animales.

Under the heading of this subject we deal with stings by arthropods, making reference to the differences that exist between the stings of wasps and bees, commenting on the composition of the poisons and the different local and general reactions that are caused by such stings. Also discussed are the stings/bites caused by scorpions, spiders, ticks, and marine animals, with the clinical picture they provoke and the treatment that must be administered. Finally, snakebites are considered, with reference to the most frequent types of ophidia to be found in Navarra, how to differentiate between the bites of snakes and vipers, the different clinical pictures they provoke and the treatment to be applied

[Enhanced suppression of cortisol after dexamethasone in borderline personality disorder. A pilot study]. / Hipersupresión de cortisol con dexametasona en el trastorno límite de la personalidad. Un estudio piloto.

INTRODUCTION: Some studies have suggested the etiological role of childhood traumatic events in borderline personality disorder (BPD), involving the stress response mechanisms and the activity of hypothalamic-pituitary adrenal (HPA) axis. Recent preliminary results show that BPD, similar to that found in post-traumatic stress disorder (PSD), might have a hypersensitive response to the dexamethasone test. METHODS: Fourteen BPD patients, diagnosed according to DSM-IV criteria, without a major depressive episode or history of bipolar or psychotic disorder, were compared with 10 patients with other personality disorders (OPD). Plasma cortisol was measured at baseline and following an oral test with 0.25 mg of dexamethasone. RESULTS: Nine out of 14 (64%) BPD patients were cortisol suppressors in the test versus only 2 out of 10 (20%) patients with other personality disorders (chi square 4.6, degree factors [df] 18, p<0.05). The degree of cortisol suppression was significantly greater for BPD patients (73% ) than for patients with other personality disorder (34 %). Baseline cortisol concentrations, although lower in BPD patients, were not significantly different among groups. CONCLUSIONS: BPD could be associated with hypersensitivity of feedback mechanisms of the HPA axis similar to PSD, which suggests a possible role for traumatic experiences in the pathogenesis of the disorder.

Picaduras y mordeduras de animales / Animal sting and bites

En este tema tratamos las picaduras por artrópodos. Se hace referencia a las diferencias que existen entre las picaduras de avispas y abejas, comentando la composición de venenos y las diferentes reacciones locales y generales que provocan dichas picaduras. Se exponen además las picaduras-mordeduras producidas por escorpiones, arañas, garrapatas, y animales marinos con la clínica que provocan y el tratamiento que es necesario administrar. Por último, se incluyen las mordeduras por serpientes, haciendo referencia a los tipos de ofidios más frecuentes en Navarra, la forma de diferenciar la mordedura de culebras de las víboras, la diferente clínica que provocan, y el tratamiento a aplicar (AU)

[Orbital cellulitis: review and presentation of 20 cases]. / Celulitis orbitaria. Revisión y presentación de una serie de 20 casos.

The orbital cellulitis is an infection of the soft tissues located behind of the orbital setum. It is presented as a complication of an acute sinusitis although it can appear as consequence of other infectious processes. We present a series of 20 cases diagnosed and treated in our center of orbital cellulitis. We expose the diagnostic criteria that we have followed, as well as the complementary tests used and the different treatments both medical and surgical.

[Esthesioneuroblastoma: report of 2 case]. / Estesioneuroblastoma. A propósito de dos casos.

The esthesioneuroblastoma is a very uncommon malignant growth arising from olfactory epithelium. Almost 400 cases have been published since its was first described. Owing to the meager figures of these series is not possible to drawn out conclusions in order to establish an unique protocol of treatment for this tumoral type. We present 2 cases diagnosed in our Department, each diversely treated and comment the results.

[Treatment with risperidone of a case of spontaneous orgasm]. / Tratamiento con risperidona en un caso de orgasmos espontáneos.

A case report is presented of a patient who had spontaneous orgasms following treatment with clomipramine and were successfully treated with risperidone. The relationship with previous reports on drug-induced spontaneous orgasm is analyzed.

[Arterial hypertension in pediatrics]. / Hipertensión arterial en pediatría.

Several aspects related to arterial hypertension in children are reviewed: definitions, frequency, classification, etiology, pathogenesis, symptomatology and the treatment that is available, stressing emphasis on available data in relative national literature. It is concluded that more investigations are needed to answer the questions and doubts that exist at present.

[Idiopathic membranous glomerulonephritis]. / Glomerulonefritis membranosa idiopática.

The only case of idiopathic membranous glomerulonephritis seen out of 106 nephropathic patients biopsied in the two last years at the C. H. 20 de Noviembre, I.S.S.S.T.E., is reported. Twenty-six showed nephrotic syndrome not associated to systemic disease, including the present case, which gave us an incidence of 3.8% of this entity. We were impressed by the low frequency of this disease, so we made a statistical epidemiological analysis localizing it geographically based on the available medical literature. On comparing the results of these studies we confirmed that this disease is significantly low in our environment.