Palladium hydrazonato complexes and their role in the Pd-catalyzed cross-coupling reactions of hydrazones as carbene precursors.

Hydrazones are common carbene precursors in many palladium-catalyzed cross coupling reactions of carbenes as a coupling partner, but their interaction with palladium has been overlooked. We have found that hydrazonato ligands readily coordinate to Pd aryl complexes leading to [PdAr(L-L){(TolSO2)N-NCHR}] (Ar = Ph, C6F5; L-L = dppe, dppf; R = CHCHPh, Ph). Ligand substitution reactions on [PdAr(dppe)X] (X = Br, TolSO2) show that the hydrazonato ligand coordinates preferentially so the hydrazonato complexes are likely resting states in catalytic carbene coupling reactions using hydrazones as reactants. The decomposition of the hydrazonato moiety to a diazoalkane is needed during the catalysis and the analysis of the evolution of the hydrazonato complexes shows that it is not promoted by coordination to the metal and it does not occur in the coordination sphere of palladium. The substitution of diazoalkane for the metal-bound hydrazonato is possible and the steps that follow to form a new C-C bond, including the carbene migratory insertion, are fast.

Diazo compounds and palladium-aryl complexes: trapping the elusive carbene migratory insertion organometallic products.

The reactions of Pd-aryl complexes with diazo compounds N2CH-CHCHPh and N2CHPh allowed us to isolate the organometallic products formed right after the migratory insertion of a non-stabilized CHR carbene into the Pd-aryl bond. η3-Allylic and η3-benzylic palladium complexes were formed respectively. This is compelling experimental evidence for the key step in the palladium-catalyzed cascade transformations of diazo derivatives leading to multiple C-C or C-X bond formation.

Relationship between sport and physical activity and alcohol consumption among adolescents students in Murcia (Spain).

INTRODUCTION: Sports and physical activity are major components of a healthy lifestyle. The objective of this study was to analyze the relationship between sport and physical activity and alcohol consumption among adolescent students based on gender. POPULATION AND METHODS: Descriptive, crosssectional, comparative study conducted in adolescent students (aged between 14 and 17 years old) from the Region of Murcia in 2014. Sport and physical activity was assessed using a validated, adapted survey that included both the International Physical Activity Questionnaire and the Monitoring the Future survey. Eleven school facilities from different districts of the Region of Murcia (Spain) participated. RESULTS: Five hundred and sixty-four adolescent students were included. Among boys, 51.8% reported to be regularly active, versus 21.8% of girls. Significant differences were observed in terms of alcohol consumption by gender (31.1% for boys versus 48.2% for girls, p = 0.000). A significant, reverse relationship between sport and physical activity and alcohol consumption was observed among both boys and girls. CONCLUSIONS: The level of sport and physical activity is higher among adolescent boys than girls. Sport and physical activity shows a positive association with a lower level of alcohol consumption among both genders.

INTRODUCCIÓN: La práctica físico-deportiva es un elemento importante de un estilo de vida saludable. El objetivo fue analizar la relación entre la práctica de actividad físico-deportiva y el hábito de consumo de alcohol en adolescentes escolarizados en función del género. POBLACIÓN Y MÉTODOS: Estudio descriptivo, transversal y comparativo realizado en adolescentes escolarizados (de entre 14 y 17 años de edad) de la Región de Murcia en 2014. Se evaluó la práctica de actividad físico-deportiva mediante una encuesta adaptada y validad que incluyó el International Physical Activity Questionnaire y Monitoring the Future. Participó un total de 11 centros escolares de diferentes localidades de la Región de Murcia (España). RESULTADOS: Se incluyeron 564 adolescentes escolarizados. El 51,8% de los varones se consideraron regularmente activos frente al 21,8% de las mujeres. El consumo de alcohol mostró diferencias significativas en función del género (31,1% en varones y 48,2% en mujeres, p= 0,000). Se encontró una relación inversa y significativa entre la práctica físico-deportiva y el consumo de alcohol en ambos géneros. CONCLUSIONES: Los adolescentes presentan un mayor nivel de práctica físico-deportiva que las mujeres. La práctica de actividad físico-deportiva se asocia positivamente a un menor consumo de alcohol en ambos géneros.

Relación entre la práctica físico-deportiva y el consumo de alcohol en adolescentes escolarizados de Murcia (España) / Relationship between sport and physical activity and alcohol consumption among adolescents students in Murcia (Spain)

Introducción. La práctica físico-deportiva es un elemento importante de un estilo de vida saludable. El objetivo fue analizar la relación entre la práctica de actividad físico-deportiva y el hábito de consumo de alcohol en adolescentes escolarizados en función del género. Población y métodos. Estudio descriptivo, transversal y comparativo realizado en adolescentes escolarizados (de entre 14 y 17 años de edad) de la Región de Murcia en 2014. Se evaluó la práctica de actividad físico-deportiva mediante una encuesta adaptada y validada, que incluyó el International Physical Activity Questionnaire y Monitoring the Future. Participó un total de 11 centros escolares de diferentes localidades de la Región de Murcia (España). Resultados. Se incluyeron 564 adolescentes escolarizados. El 51,8% de los varones se consideraron regularmente activos frente al 21,8% de las mujeres. El consumo de alcohol mostró diferencias significativas en función del género (31,1% en varones y 48,2% en mujeres, p= 0,000). Se encontró una relación inversa y significativa entre la práctica físico-deportiva y el consumo de alcohol en ambos géneros. Conclusiones. Los adolescentes presentan un mayor nivel de práctica físico-deportiva que las mujeres. La práctica de actividad físico-deportiva se asocia positivamente a un menor consumo de alcohol en ambos géneros.

Introduction. Sports and physical activity are major components of a healthy lifestyle. The objective of this study was to analyze the relationship between sport and physical activity and alcohol consumption among adolescent students based on gender. Population and methods. Descriptive, crosssectional, comparative study conducted in adolescent students (aged between 14 and 17 years old) from the Region of Murcia in 2014. Sport and physical activity was assessed using a validated, adapted survey that included both the International Physical Activity Questionnaire and the Monitoring the Future survey. Eleven school facilities from different districts of the Region of Murcia (Spain) participated. Results. Five hundred and sixty-four adolescent students were included. Among boys, 51.8% reported to be regularly active, versus 21.8% of girls. Significant differences were observed in terms of alcohol consumption by gender (31.1% for boys versus 48.2% for girls, p = 0.000). A significant, reverse relationship between sport and physical activity and alcohol consumption was observed among both boys and girls. Conclusions. The level of sport and physical activity is higher among adolescent boys than girls. Sport and physical activity shows a positive association with a lower level of alcohol consumption among both genders.

Diagnostico del sindrome compartimental inducido por el ejercicio mediante resonancia magnetica post-esfuerzo / Post-exercise MRI for diagnosis of chronic exertional compartmental syndrome

RESU MEN: El SCIE representa la causa del 27% de los cuadros de dolor anterior de pierna en atletas. El origen del dolor en este cuadro es aún discutido. La medición de la presión intracompartimental es el gold standard en el diagnóstico, aunque es un estudio invasivo. El desarrollo e interpretación de nuevas secuencias en RMN, aportaron una alternativa en el diagnóstico incruento del SCIE. La RMN post-esfuerzo es una opción atractiva y atraviesa en la actualidad su proceso de validación. MATERIAL Y MÉT ODOS Se evaluaron 22 pacientes con diagnóstico clínico de síndrome compartimental inducido por el ejercicio, con una media de seguimiento de 5 años (1-10 años). Todos fueron evaluados mediante examen clínico, RM pre y post actividad física y medición de presión intracompartimental pre y post actividad física. La resonancia magnética se realizó en reposo y luego de la prueba de esfuerzo. La medición de presión intracompartimental se realizó con la técnica de Whitesides, el diagnóstico se realizó con los criterios de Pedowitz. RESULTADOS De los 22 pacientes, 19 tuvieron una medición intracompartimental positiva (15 masculino, 4 femenino) y 3 una medición negativa. Todos los pacientes tuvieron una RMN normal en reposo. En los 3 pacientes que tuvieron medición intracompartimental negativa, la RMN post-esfuerzo fue normal. De los 19 pacientes restantes, la RMN detectó señal hiperintensa en T2 y STIR en 15 de ellos (78,95%). CONCLUSIONES La RMN podría tener un lugar en el diagnóstico, para lo cual debería mejorarse la sensibilidad de este método. No obstante, la medición intracompartimental pre y post-esfuerzo sigue siendo el gold-standard. Nivel de evidencia: IV

BACKGROUND: Chronic exertional compartment syndrome (CECS) is the cause of 27% of anterior leg pain in athletes. The source of pain in this condition is still debated. Measurement of intracompartmental pressure is the gold standard diagnosis, albeit an invasive study. The development and interpretation of new MRI sequences has provided a non-invasive alternative to CECS diagnosis. Post-exercise MRI is an attractive option which is currently undergoing its validation process. METHODS: 22 patients with a clinical diagnosis of CECS were included, with a median follow-up of 5 years (1-10 years). All the patients were evaluated by clinical examination, pre- and post-exercise MRI and pre-and post-exercise intracompartmental pressure measurement. Pressure was measured with Whitesides technique, and diagnosis was carried out by Pedowitz criteria. RESULTS: Out of the total 22 patients, 19 had positive intracompartmental measurement (15 male, 4 female) and 3 had negative measurement. All the patients had a normal MRI at rest. The three patients who had negative intracompartmental measurement had a normal post-stress MRI. Out of the remaining 19 patients, the MRI detected hyperintense signal in T2 and STIR weighted in 15 of them (78,95%). CONCLUSIONS: MRI could be relevant for diagnosis, for which case the sensitivity of this method should be improved. Nevertheless, pre- and post-stress intracompartmental measurement continues to be the gold-standard. Level of evidence: IV

[Tobacco consumption and its relationship to the level of regular physical activity and physical fitness in adolescents from the region of Murcia (Spain)]. / Consumo de tabaco y su relación con el nivel de actividad física habitual y la condición física en adolescentes de la Región de Murcia (España).

This study looks at the relationship between tobacco consumption and the physical activity and fitness levels of adolescents. In a sample of 533 adolescents, both a questionnaire to obtain information regarding tobacco consumption and the International Physical Activity Questionnaire for information on physical activity were implemented; a battery of tests to assess physical fitness were also applied. Tobacco consumption was significantly higher in females (32.5%) than in males (25.7%). Levels of physical activity in both males and females were significantly associated with tobacco consumption (p<0.0005). Moreover, subjects who consumed tobacco showed lower overall averages in physical fitness tests than those who did not (4.26 vs. 5.77 in males and 4.54 vs. 6.71 in females). Tobacco consumption is therefore shown to be related to lower levels of physical activity and physical fitness in adolescents.

Consumo de tabaco y su relación con el nivel de actividad física habitual y la condición física en adolescentes de la Región de Murcia (España) / Tobacco consumption and its relationship to the level of regular physical activity and physical fitness in adolescents from the region of Murcia (Spain)

El presente estudio investiga la relación del consumo de tabaco con los niveles de actividad física y condición física. Sobre una muestra de 533 adolescentes de la Región de Murcia (España), se aplicó un cuestionario para la obtención de datos relativos al consumo de tabaco, el International Physical Activity Questionnaire para conocer la actividad física y una batería de test para evaluar la condición física. El consumo de tabaco fue significativamente mayor en las mujeres (32,5%) que en los varones (25,7%). Tanto en varones como en mujeres, los niveles de actividad física se relacionaban de forma significativa con el consumo de tabaco (p<0,0005). De igual modo, en los test de condición física, los sujetos que consumían mostraban medias globales inferiores (4,26 varones y 4,54 mujeres) a las de aquellos que no consumían (5,77 varones y 6,71 mujeres). El consumo de tabaco se muestra relacionado con un menor nivel de actividad física y condición física en los adolescentes.

This study looks at the relationship between tobacco consumption and the physical activity and fitness levels of adolescents. In a sample of 533 adolescents, both a questionnaire to obtain information regarding tobacco consumption and the International Physical Activity Questionnaire for information on physical activity were implemented; a battery of tests to assess physical fitness were also applied. Tobacco consumption was significantly higher in females (32.5%) than in males (25.7%). Levels of physical activity in both males and females were significantly associated with tobacco consumption (p<0.0005). Moreover, subjects who consumed tobacco showed lower overall averages in physical fitness tests than those who did not (4.26 vs. 5.77 in males and 4.54 vs. 6.71 in females). Tobacco consumption is therefore shown to be related to lower levels of physical activity and physical fitness in adolescents.

The relationship between segmental coordination, agility and physical activity in adolescents / Relação entre a coordenação segmentar, agilidade e atividade física em adolescentes / Relación entre la coordinación segmentaria, la agilidad y la actividad física en adolescentes

Motor competence (MC) may be related to youth physical activity (PA) level. In the last few years, MC has been studied as a possible determinant of children PA level, but has not been widely studied in adolescents. To analyze the relationship between MC and PA level 533 adolescents (271 men and 261 women) from the southeast of Spain were assessed. To register weekly PA was used the International Physical Activity Questionnaire (IPAQ) and for the MC, four coordination tests including throw and catch test, eye-hand and eye-foot coordination tests and agility circuit. Data were analyzed using ANOVA and binary logistic regression. The overall MC is consistently related with PA level. Eye-hand coordination test and the agility test define more accurately the tendency to high PA level. Programs to promote PA and focused on MC should be emphasized from early ages to adolescence.

A competência motora (CM) pode estar relacionada com o nível de atividade física (PA) dos jovens. Nos últimos anos, a CM infantil tem sido estudada como possivel determinante do nível de AF, mas ainda não foi extensivamente estudada em adolescentes. Para analisar a relação entre o nível de AF e competência motora foram avaliados 533 adolescentes (271 homens e 261 mulheres), no sudeste de Espanha. Para registar a AF semanal empregou-se o Questionário Internacional de Atividade Física (IPAQ), e para a CM quatro testes de coordenação, incluindo lançamento e recepção, coordenação óculo manual e óculo pedal e um percurso de agilidade. Os dados foram analisados usando a análise de variância e a análise de regressão logística binária. A competência global motora revelou-se consistentemente relacionada com o nível de AF. O teste de coordenação olho-mão e o teste de agilidade são os que definem mais precisamente uma tendência regular de alto nivel de atividade física. Programas voltados para aumentar a coordenação segmentar e agilidade devem ser incentivados desde tenra idade nas escolas.

La competencia motora (CM) podría estar relacionada con el nivel de actividad física (AF) de los jóvenes. En los últimos años, CM ha sido estudiada como un posible determinante del nivel de AF de los niños, sin embargo no ha sido ampliamente estudiada en adolescentes. Para analizar la relación entre la CM y el nivel de AF, fueron evaluados 533 adolescentes (271 hombres y 261 mujeres) del sureste de España. Para registrar la AF semanal fue utilizado el International Physical Activity Questionnaire (IPAQ), y para la CM, cuatro test coordinativos que incluían el test de lanzar y coger, test de coordinación ojo-mano y ojo-pie y un circuito de agilidad. Los datos fueron analizados utilizando un ANOVA y una regresión logística binaria. La CM global está consistentemente relacionada con el nivel de AF. Los test de coordinación ojo-mano y de agilidad definen con más exactitud la tendencia a un nivel alto de AF. Programas para promocionar la AF centrados en la CM deberían ser enfatizados desde edades tempranas hasta la adolescencia.

Physical exercise, energy expenditure and tobacco consumption in adolescents from Murcia (Spain).

INTRODUCTION: Physical and sports activity is essential for a healthy lifestyle and is considered a prevention factor for several harmful habits on health. The purpose of this study was to establish the relationship between the level of physical activity, energy expenditure and tobacco consumption among adolescent students. POPULATION AND METHODS: Adolescent students aged 14 to 17 years old from the province of Murcia were included. Their level of physical activity was assessed using the International Physical Activity Questionnaire, and smoking was evaluated using the Youth Risk Behavior Surveillance. RESULTS: Out of 344 adolescents, 20.3% were overweight and 5.8%, obese. Of the total, 44.2% reported being active on a regular basis, while 55.8% were irregularly active or inactive. The level of physical exercise was higher among boys than girls. Tobacco was consumed by 20.3% of the sample, but no significant differences were observed based on sex. The highest energy expenditure from physical activity was positively associated with non consumption of tobacco. CONCLUSIONS: Among adolescents, a higher level of physical activity and a higher energy expenditure are positively associated with non consumption of tobacco.

Actividad físico-deportiva, gasto calórico y consumo de tabaco en adolescentes de Murcia (España) / Physical exercise, energy expenditure and tobacco consumption in adolescents from Murcia (Spain)

Introducción. La práctica físico-deportiva es un elemento primordial dentro de los estilos de vida saludables y está considerado uno de los factores preventivos para diversos hábitos nocivos para la salud. El objetivo de este estudio fue establecer la relación entre el nivel de actividad física realizado, el gasto calórico y el hábito de consumo de tabaco de los adolescentes escolarizados. Población y métodos. Se incluyeron adolescentes escolarizados de entre 14 y 17 años de la región de Murcia. Se valoró el nivel de actividad física realizada mediante el International Physical Activity Questionnaire y el hábito tabáquico mediante el Youth Risk Behavior Surveillance. Resultados. De un total de 344 adolescentes, 20,3% presentaban sobrepeso y 5,8%, obesidad. El 44,2% se consideraron regularmente activos, mientras que 55,8% fueron irregularmente activos o inactivos. El nivel de práctica de actividad física de los varones fue superior al de las mujeres. El 20,3% de la muestra consumía tabaco, sin diferencias signifcativas en función del sexo. El mayor gasto energético derivado de la práctica de actividad física se asoció positivamente a no consumir tabaco. Conclusiones. En los adolescentes, un mayor nivel de actividad física y un mayor gasto energético se asocian positivamente a no consumir tabaco.

Introduction. Physical and sports activity is essential for a healthy lifestyle and is considered a prevention factor for several harmful habits on health. The purpose of this study was to establish the relationship between the level of physical activity, energy expenditure and tobacco consumption among adolescent students. Population and Methods. Adolescent students aged 14 to 17 years old from the province of Murcia were included. Their level of physical activity was assessed using the International Physical Activity Questionnaire, and smoking was evaluated using the Youth Risk Behavior Surveillance. Results. Out of 344 adolescents, 20.3% were overweight and 5.8%, obese. Of the total, 44.2% reported being active on a regular basis, while 55.8% were irregularly active or inactive. The level of physical exercise was higher among boys than girls. Tobacco was consumed by 20.3% of the sample, but no signifcant differences were observed based on sex. The highest energy expenditure from physical activity was positively associated with non consumption of tobacco. Conclusions. Among adolescents, a higher level of physical activity and a higher energy expenditure are positively associated with non consumption of tobacco.

Actividad físico-deportiva, gasto calórico y consumo de tabaco en adolescentes de Murcia (España) / Physical exercise, energy expenditure and tobacco consumption in adolescents from Murcia (Spain)

Introducción. La práctica físico-deportiva es un elemento primordial dentro de los estilos de vida saludables y está considerado uno de los factores preventivos para diversos hábitos nocivos para la salud. El objetivo de este estudio fue establecer la relación entre el nivel de actividad física realizado, el gasto calórico y el hábito de consumo de tabaco de los adolescentes escolarizados. Población y métodos. Se incluyeron adolescentes escolarizados de entre 14 y 17 años de la región de Murcia. Se valoró el nivel de actividad física realizada mediante el International Physical Activity Questionnaire y el hábito tabáquico mediante el Youth Risk Behavior Surveillance. Resultados. De un total de 344 adolescentes, 20,3% presentaban sobrepeso y 5,8%, obesidad. El 44,2% se consideraron regularmente activos, mientras que 55,8% fueron irregularmente activos o inactivos. El nivel de práctica de actividad física de los varones fue superior al de las mujeres. El 20,3% de la muestra consumía tabaco, sin diferencias signifcativas en función del sexo. El mayor gasto energético derivado de la práctica de actividad física se asoció positivamente a no consumir tabaco. Conclusiones. En los adolescentes, un mayor nivel de actividad física y un mayor gasto energético se asocian positivamente a no consumir tabaco.(AU)

Introduction. Physical and sports activity is essential for a healthy lifestyle and is considered a prevention factor for several harmful habits on health. The purpose of this study was to establish the relationship between the level of physical activity, energy expenditure and tobacco consumption among adolescent students. Population and Methods. Adolescent students aged 14 to 17 years old from the province of Murcia were included. Their level of physical activity was assessed using the International Physical Activity Questionnaire, and smoking was evaluated using the Youth Risk Behavior Surveillance. Results. Out of 344 adolescents, 20.3% were overweight and 5.8%, obese. Of the total, 44.2% reported being active on a regular basis, while 55.8% were irregularly active or inactive. The level of physical exercise was higher among boys than girls. Tobacco was consumed by 20.3% of the sample, but no signifcant differences were observed based on sex. The highest energy expenditure from physical activity was positively associated with non consumption of tobacco. Conclusions. Among adolescents, a higher level of physical activity and a higher energy expenditure are positively associated with non consumption of tobacco.(AU)

Physical exercise, energy expenditure and tobacco consumption in adolescents from Murcia (Spain). / Physical exercise, energy expenditure and tobacco consumption in adolescents from Murcia (Spain).

INTRODUCTION: Physical and sports activity is essential for a healthy lifestyle and is considered a prevention factor for several harmful habits on health. The purpose of this study was to establish the relationship between the level of physical activity, energy expenditure and tobacco consumption among adolescent students. POPULATION AND METHODS: Adolescent students aged 14 to 17 years old from the province of Murcia were included. Their level of physical activity was assessed using the International Physical Activity Questionnaire, and smoking was evaluated using the Youth Risk Behavior Surveillance. RESULTS: Out of 344 adolescents, 20.3

were overweight and 5.8

, obese. Of the total, 44.2

reported being active on a regular basis, while 55.8

were irregularly active or inactive. The level of physical exercise was higher among boys than girls. Tobacco was consumed by 20.3

of the sample, but no significant differences were observed based on sex. The highest energy expenditure from physical activity was positively associated with non consumption of tobacco. CONCLUSIONS: Among adolescents, a higher level of physical activity and a higher energy expenditure are positively associated with non consumption of tobacco.

[Relationship between tobacco consumption and physical exercise in adolescents. Differences between genders]. / Práctica de ejercicio físico y su relación con el consumo de tabaco en adolescentes. Diferencias entre géneros.

The objective of this study was to analyze the relationship between physical exercise and sport activities with respect to tobacco consumption in adolescents according to gender. A total of 845 adolescents (412 males and 433 females) between 14 and 17 years of age enrolled in compulsory secondary education in Murcia (Spain) participated in the study. The International Physical Activity questionnaire was administered to all of them to determine their physical activity patterns, also the Youth Risk Behavior Surveillance questionnaire was given to evaluate their smoking behaviors. The results show a significant relationship between physical exercise and sport activity and tobacco consumption. In addition, a clear gender difference was found on tobacco use. Among males, a positive and significant relation between practice of sports and physical activity and tobacco use was found; while no association between both variables was found among females. In conclusion, differences between men and women related to practice of physical exercise and sport and tobacco consumption are associated with the characteristics of the current models used to promote practice of sports as well as the different motivations among men and women to engage in physical exercise and sport activity.

Práctica de ejercicio físico y su relación con el consumo de tabaco en adolescentes. Diferencias entre géneros / Relationship between tobacco consumption and physical exercise in adolescents. Differences between genders

El objetivo del estudio fue analizar la relación entre la práctica de actividad físico-deportiva y los hábitos de consumo de tabaco en adolescentes escolarizados, en función del género. Un total de 845 adolescentes (412 varones y 433 mujeres) representativos de la población adolescente escolarizada de la Región de Murcia, con edades comprendidas entre 14 y 17 años, participaron en el estudio. A todos ellos se les administró el International Physical Activity Questionaire para evaluar su práctica de actividad física, así como el cuestionario Youth Risk Behavior Surveillance para determinar su consumo de tabaco. Los resultados mostraron una relación significativa entre la práctica físico deportiva y el consumo de tabaco, además de una clara diferencia en función del género. En los varones, se apreció una relación positiva y significativa entre la práctica físico-deportiva y el consumo de tabaco. Por el contrario, en las mujeres no se encontró dicha asociación. En conclusión, las diferencias en la relación entre la práctica de actividad físico-deportiva y el consumo de tabaco entre varones y mujeres están asociadas a las características de los modelos de promoción deportiva existentes en la actualidad, así como a las diferentes motivaciones de varones y mujeres para implicarse en una actividad físico-deportiva(AU)

The objective of this study was to analyze the relationship between physical exercise and sport activities with respect to tobacco consumption in adolescents according to gender. A total of 845 adolescents (412 males and 433 females) between 14 and 17 years of age enrolled in compulsory secondary education in Murcia (Spain) participated in the study. The International Physical Activity questionnaire was administered to all of them to determine their physical activity patterns, also the Youth Risk Behavior Surveillance questionnaire was given to evaluate their smoking behaviors. The results show a significant relationship between physical exercise and sport activity and tobacco consumption. In addition, a clear gender difference was found on tobacco use. Among males, a positive and significant relation between practice of sports and physical activity and tobacco use was found; while no association between both variables was found among females. In conclusion, differences between men and women related to practice of physical exercise and sport and tobacco consumption are associated with the characteristics of the current models used to promote practice of sports as well as the different motivations among men and women to engage in physical exercise and sport activity(AU)

Preparación intestinal selectiva en un programa de rehabilitación multimodal. Influencia en el confort preoperatorio y resultados tras cirugía colorrectal / Selective intestinal preparation in a multimodal rehabilitation program. Influence on preoperative comfort and the results after colorectal surgery

Introducción: Pese a no haberse evidenciado ventajas de su empleo, la preparación mecánica anterograda (PMA) sigue siendo usual en cirugía colorrectal. Nuestro objetivo es analizar el impacto de su empleo selectivo respecto a confort y resultados en pacientes de un programa de rehabilitación multimodal perioperatoria (RHMM) o con cuidados convencionales (CC). Material y métodos: Estudio prospectivo de 108 pacientes propuestos para cirugía electiva, asignados consecutivamente 2:1 a un protocolo de RHMM que incluyo emplear solamente PMA en cirugía rectal con anastomosis baja o a CC en los que se empleo PMA, salvo en cirugía del colon derecho. Además se estudiaron dos grupos (A y B) en función de si se uso o no PMA. Se analizaron su tolerabilidad, sus resultados y las variables de recuperación postoperatoria. Resultados: Se incluyo a 39 pacientes en el grupo A y a 69 en el B; 69 siguieron el protocolo de RHMM. Los pacientes del grupo A presentaron más dolor abdominal, malestar anal, nauseas y sed, pero no hubo diferencias en lo que respecta a la tasa de muertes, complicaciones globales o su tipo, mientras que sý tuvieron menos complicaciones, fallos de sutura y muertes los pacientes del grupo RHMM (p < 0,05). Tampoco hubo ventajas del empleo de PMA respecto al inicio del tránsito intestinal, tolerancia a la dieta o estancias, pero estos parametros fueron favorables al grupo de RHMM. Conclusiones: La restricción de la PMA a casos seleccionados es segura, y asociada a un programa de RHMM contribuye a una recuperación mas rápida y cómoda sin incrementarlas complicaciones (AU)

Introduction: Despite there being no evidence of the advantages of its use, mechanical bowel preparation (MBP) continues to be routine in colorectal surgery. Our objective is to analyse the impact of its selective use, as regards patient comfort and results, comparing a perioperative multimodal rehabilitation program (MMRH) with conventional care (CC). Material and methods: A prospective study of 108 patients proposed for elective surgery, assigned consecutively 2:1 to an MMRH protocol which only included MBP in rectal surgery with low anastomosis, or to CC in whom MBP was used except in right colon surgery. We also studied two Groups (A and B) with and without the use of MBP. Their tolerance, results and postoperative recovery variables were analysed. Results: Thirty-nine patients were included in Group A, and 69 in Group B. A MMRH protocol was used in another 69 patients. The Group A patients had more abdominal pain, anal discomfort, nausea and thirst, but there were no differences as regards, death, overall or local complications, whilst there was less complications, suture failures and death in the MMRH when compared with CC Group (P < .05). There were no advantages observed in the use of MBP as regards the start of bowel movements, tolerance to diet or hospital stay, but these parameters were favourable to the MMRH when compared with CC Group. Conclusions: The restriction of MBP is safe, and associated with an MMRH program, contributes to a faster and more comfortable recovery, without increasing complications (AU)

[Selective intestinal preparation in a multimodal rehabilitation program. Influence on preoperative comfort and the results after colorectal surgery]. / Preparación intestinal selectiva en un programa de rehabilitación multimodal. Influencia en el confort preoperatorio y resultados tras cirugía colorrectal.

INTRODUCTION: Despite there being no evidence of the advantages of its use, mechanical bowel preparation (MBP) continues to be routine in colorectal surgery. Our objective is to analyse the impact of its selective use, as regards patient comfort and results, comparing a perioperative multimodal rehabilitation program (MMRH) with conventional care (CC). MATERIAL AND METHODS: A prospective study of 108 patients proposed for elective surgery, assigned consecutively 2:1 to an MMRH protocol which only included MBP in rectal surgery with low anastomosis, or to CC in whom MBP was used except in right colon surgery. We also studied two Groups (A and B) with and without the use of MBP. Their tolerance, results and postoperative recovery variables were analysed. RESULTS: Thirty-nine patients were included in Group A, and 69 in Group B. A MMRH protocol was used in another 69 patients. The Group A patients had more abdominal pain, anal discomfort, nausea and thirst, but there were no differences as regards, death, overall or local complications, whilst there was less complications, suture failures and death in the MMRH when compared with CC Group (P<.05). There were no advantages observed in the use of MBP as regards the start of bowel movements, tolerance to diet or hospital stay, but these parameters were favourable to the MMRH when compared with CC Group. CONCLUSIONS: The restriction of MBP is safe, and associated with an MMRH program, contributes to a faster and more comfortable recovery, without increasing complications.

Tratamiento local de la fisura anal crónica con diltiazem vs. nitroglicerina. Estudio comparativo / Local treatment of a chronic anal fissure with diltiazem vs. nitroglycerin. A comparative study

Objetivo Investigar el valor de la utilización de fármacos relajantes de la musculatura lisa y analizar los resultados de la utilización tópica de diltiazem 2% como alternativa a la nitroglicerina 0,2% en el tratamiento de la fisura anal crónica (FAC).Métodos Revisión de las FAC contenidas en una base de datos de fisuras anales con recogida prospectiva, incluyendo 145 pacientes tratados con medidas estándar en 2 periodos de tiempo consecutivos. Durante el primer periodo, se asignaron alternativamente a no recibir más tratamiento (Grupo EST) o a tratarse con nitroglicerina local (Grupo NTG). En un segundo periodo, todos fueron tratados con diltiazem local (Grupo DTZ). Se analizan los resultados después de un mes de tratamiento y las recidivas. Resultados Inicialmente hubo diferencias significativas en las tasas de mejoría (45% EST, 62,5% NTG y 80% DTZ; p<0,01), pero no en la curación (27% EST, 40% NTG y 39% DTZ) y el tratamiento fue completado por 124 pacientes (85,5%). Ocurrieron más efectos adversos y más abandonos en el grupo NTG. En el seguimiento posterior, durante una mediana de 2 años, hubo un 25% de recidivas y casi todas respondieron al tratamiento médico reiterado. Conclusiones Aunque los fármacos relajantes de la musculatura lisa no consiguen más curaciones que las medidas tradicionales en las FAC, brindan más alivio sintomático, ofreciendo una oportunidad para evitar la cirugía. El diltiazem local carece de efectos secundarios y es mejor aceptado que la nitroglicerina. Las recidivas son frecuentes, pero responden bien al tratamiento médico repetido (AU)

Aim To assess the value of using smooth muscle relaxants drugs and assess the results of the topical use of 2% diltiazem as an alternative to 0.2% nitroglycerin in the treatment of chronic anal fissure (CAF).Methods Review of the CAF contained in a prospectively collected database of anal fissures including one hundred forty-five patients diagnosed with CAF and treated with standard measures (ST) in two consecutive periods. During the first period they were allocated alternatively to not receive further treatment (ST group) or to be treated with nitroglycerin ointment (NTG group). In the second period all were treated with local diltiazem (DTZ group). One hundred forty-five patients entered the study and 124 completed it. Results Initially there were significant differences in improvement rates (45% ST, 62.5% NTG and 80% DTZ, p<0.01), but not in the cure rates (27% ST, 40% NTG and 39% DTZ) and the treatment was completed by 124 patients (85.5%). There were more side effects and more dropouts in the NTG group. In the subsequent follow-up for a median period of 25 months there were 25% recurrences and almost all responded to repeated medical treatment. Conclusions Smooth muscle relaxant drugs do not achieve a higher cure rate than the traditional measures used in CAF, but offer more symptomatic relief, providing an opportunity to avoid surgery. Topical diltiazem does not have the side effects of the nitroglycerin and is better accepted by patients (AU)

Autoevaluación de una vía clínica para mejora del proceso quirúrgico carcinoma de recto / Self-evaluation of a clinical pathway to improve the results of rectal cancer

Objetivo Analizar si la autoevaluación de una vía clínica mejora los resultados del tratamiento del cáncer de recto (CR).Pacientes y método Pacientes intervenidos de CR divididos en 3 grupos según modificaciones bianuales de una vía clínica analizando diversos indicadores. Resultados Ciento sesenta y seis pacientes: grupo A: 2002–2003, n=50; B: 2004–2005, n=53 y C: 2006–2007, n=63; sin diferencias en edad, sexo o comorbilidad. El estudio preoperatorio mejoró con la introducción de TC toracoabdominopélvico: un 76% en el grupo C frente a un 6% del A (p<0,001). Todos los tumores del grupo C fueron estadificados mediante RM, ECO rectal o ambas, frente a un 84% del A (p<0,001). La tasa de amputaciones de recto pasó del 42% en el grupo A, al 17% en el C (p=0,007). Un 48% de cirujanos del grupo A frente al 94% en el C (p<0,001) tenían dedicación específica a la coloproctología. La media de adenopatías analizadas fue: grupo A: 6,2±4,5 frente a 13±6,5 en el C (p<0,001) y se informó del margen circunferencial en un 24% del grupo A frente al 76% en el C (p<0,001). Parámetros como la transfusión perioperatoria de hemoderivados, ingreso en UCI, uso de sonda nasogástrica, tolerancia precoz o analgesia epidural también mejoraron progresivamente. La mortalidad operatoria descendió de forma no significativa hasta el 4,7% y las dehiscencias anastomóticas del 24% al 9,5%, reduciéndose la estancia postoperatoria de 15–11 días (p=0,029).Conclusiones Se han mejorado múltiples indicadores de forma significativa en un período relativamente corto al efectuar autoevaluaciones del proceso (AU)

Objectives To analyse whether the self-evaluation of a clinical pathway improves the results of rectal cancer (RC) treatment. Patients and method Patients operated on for RC were divided into 3 groups according to biannual modifications of a clinical pathway analysing several indicators.Results166 patients: Group A: 2002–3 n=50, B: 2004–5 n=53 and C: 2006–7 n=63, without any differences in age, gender or comorbidity. Preoperative study improved with the introduction of CT scan: 76% in Group C vs. 6% in Group A (P<0.001). All Group C tumours were staged using MR, rectal ultrasound or both, compared to 84% in Group A (P<0.001). The rate of abdominal-perineal resections was reduced from 42% (Group A) to 17% (Group C); (P=0.007) and about 48% of surgeons in Group A vs. 94% in the C had a specific activity in coloproctology (P<0.001). The average lymph node count was: Group A=6.2±4.5 vs. 13±6.5 in the C and circumferential margin analysis was reported in 24% of Group A vs. 76% in Group C (P<0.001). Parameters such as perioperative blood transfusion, ICU admission, use of nasogastric tube, early feeding or epidural analgesia also improved progressively. Operative mortality decreased non-significantly to 4.7% and anastomotic leaks from 24% to 9.5% with a reduction in postoperative stay from 15 to 11 days during the period analysed (P=0.029).Conclusions Several indicators have significantly improved in a relatively short period of time due to self-evaluations of the process (AU)

[Local treatment of a chronic anal fissure with diltiazem vs. nitroglycerin. A comparative study]. / Tratamiento local de la fisura anal crónica con diltiazem vs. nitroglicerina. Estudio comparativo.

AIM: To assess the value of using smooth muscle relaxants drugs and assess the results of the topical use of 2% diltiazem as an alternative to 0.2% nitroglycerin in the treatment of chronic anal fissure (CAF). METHODS: Review of the CAF contained in a prospectively collected database of anal fissures including one hundred forty-five patients diagnosed with CAF and treated with standard measures (ST) in two consecutive periods. During the first period they were allocated alternatively to not receive further treatment (ST group) or to be treated with nitroglycerin ointment (NTG group). In the second period all were treated with local diltiazem (DTZ group). One hundred forty-five patients entered the study and 124 completed it. RESULTS: Initially there were significant differences in improvement rates (45% ST, 62.5% NTG and 80% DTZ, p<0.01), but not in the cure rates (27% ST, 40% NTG and 39% DTZ) and the treatment was completed by 124 patients (85.5%). There were more side effects and more dropouts in the NTG group. In the subsequent follow-up for a median period of 25 months there were 25% recurrences and almost all responded to repeated medical treatment. CONCLUSIONS: Smooth muscle relaxant drugs do not achieve a higher cure rate than the traditional measures used in CAF, but offer more symptomatic relief, providing an opportunity to avoid surgery. Topical diltiazem does not have the side effects of the nitroglycerin and is better accepted by patients.