Natural and anthropogenic radionuclides in airborne particulate samples collected in Barcelona (Spain).

Results for naturally occurring (7)Be, (210)Pb, (40)K, (214)Bi, (214)Pb, (212)Pb, (228)Ac and (208)Tl and anthropogenic (137)Cs in airborne particulate matter in the Barcelona area during the period from January 2001 to December 2005 are presented and discussed. The (212)Pb and (208)Tl, (214)Bi and (214)Pb, (7)Be and (210)Pb radionuclide levels showed a significant correlation with each other, with correlation coefficients of 0.99, 0.78 and 0.69, respectively, suggesting similar origin/behaviour of these radionuclides in the air. Caessium-137 and Potassium-40 were transported to the air as resuspended particle from the soil. The (7)Be and (210)Pb concentrations showed similar seasonal variations, with a tendency for maximum concentrations during the summer months. An inverse relationship was observed between the (7)Be, (210)Pb, (40)K and (137)Cs concentrations and weekly rainfall, indicating washout of atmospheric aerosols carrying these radionuclides.

Selection of the appropriate radionuclide source for the efficiency calibration in methods of determining gross alpha activity in water.

Measuring the gross alpha activity in water samples is a rapid, straightforward way of determining whether the water might contain a radionuclide concentration whose consumption would imply a total indicative dose (TID) greater than some reference limit - currently set at 0.1 mSv/y in Europe. There are several methods used for such measurements. Two of them are desiccation with the salts being deposited on a planchet, and coprecipitation. The main advantage of these two methods is their ease of implementation and low cost of preparing the source to measure. However, there is considerable variability in the selection of the most suitable radioactive reference standard against which to calculate the water's gross alpha activity. The goal of this paper is to propose the most appropriate reference radionuclides to use as standards in determining gross alpha activities with these two methods, taking into account the natural radioactive characteristics of a wide range of waters collected at different points in Spain. Thus, the results will be consistent with each other and representative of the sum of alpha activities of all the alpha-emitters contained in a sample.

[Program of hearing loss early detection in newborn infants in Cantabria. Results of the first year of activities]. / Programa de detección precoz de la hipoacusia en neonatos en Cantabria. Resultados del primer año de funcionamiento.

AIMS: To report the findings in the first year of follow-up of the Cantabrian Program to screen newborn babies for congenital permanent hearing loss. METHODS: The study population consisted of infants born during a year period in Cantabria (Spain). Universal hearing screening by transient evoked otoacoustic emissions (TEOAE) in 2 stage protocol was performed. Infants with failure scores in these 2 stages and those with risk factors for hearing loss were referred for diagnostic evaluation with auditory brainstem response. Hearing aids were recommended for those infants who had bilateral hearing loss and referrals to infant speech and language rehabilitation. RESULTS: Out of the 4117 eligible babies, 3987 were studied. One hundred and ten (2.6) had risk factors for hearing loss, 3.5% were referred for audiological assessment and 1.2/1000 were diagnosed as having a permanent hearing loss. The false-positive rate was 0.72% after the two-stage screening procedure was performed. Positive predictive value for permanent hearing loss was 10%. CONCLUSIONS: During the first year working with the Cantabrian Screening Program for congenital permanent hearing loss in newborn babies, the most part of the proposed aims have been achieved.

[Bipolar disorder. Follow-up of lithium therapy in a clinic]. / Trastorno bipolar. Seguimiento en una clínica de litio.

Lithium carbonate is the drug of choice in the prophylactic treatment of bipolar disorder. The purpose of this article is to describe the effective functioning of lithium in a clinical way in our hospital under the control of university graduates in nursing. During the first ten months of its use, 40 patients have been included which led to 122 appointments, absenteeism being 8.62%. 20% (8/40) of the lithium intoxications at the start of the follow-up were inferior to 0.5% mmol/l while at the end, only 5.3% (2/38) fell below 0.5% mmol/l. The average of the lithium intoxications at the end of the study period was significantly higher than in the moment of entrance to the program (p = 0.009). During the study period, three relapses were registered.

Validation of aerosol low-level activities by comparison with a deep underground laboratory.

The activities on air filters of the radionuclides (40)K and (137)Cs were measured in an above ground laboratory and compared with the activities measured in an underground laboratory. The average relative differences were lower than 20% for (137)Cs and (40)K. The temporal series of these radionuclides in the period 2006-2010 are also presented. These results form the baseline of these radionuclides in the studied period, and are particularly interesting because they correspond to the radioactive background in Barcelona before the Fukushima accident.

Removal of radionuclides in drinking water by membrane treatment using ultrafiltration, reverse osmosis and electrodialysis reversal.

A pilot plant had been built to test the behaviour of ultrafiltration (UF), reverse osmosis (RO), and electrodialysis reversal (EDR) in order to improve the quality of the water supplied to Barcelona metropolitan area from the Llobregat River. This paper presents results from two studies to reduce natural radioactivity. The results from the pilot plant with four different scenarios were used to design the full-scale treatment plant built (SJD WTP). The samples taken at different steps of the treatment were analysed to determine gross alpha, gross beta and uranium activity. The results obtained revealed a significant improvement in the radiological water quality provided by both membrane techniques (RO and EDR showed removal rates higher than 60%). However, UF did not show any significant removal capacity for gross alpha, gross beta or uranium activities. RO was better at reducing the radiological parameters studied and this treatment was selected and applied at the full scale treatment plant. The RO treatment used at the SJD WTP reduced the concentration of both gross alpha and gross beta activities and also produced water of high quality with an average removal of 95% for gross alpha activity and almost 93% for gross beta activity at the treatment plant.

A comparative experimental study of gross alpha methods in natural waters.

The aim of the present work was to compare the results obtained with gross alpha methods such as evaporation, co-precipitation and total evaporation by liquid scintillation counting and to check whether these results are representative of the real total alpha activity concentration on the sample. The study was carried out on eight natural waters with very different radioactive characteristics. For all the samples uranium ((238)U, (235)U, and (234)U), radium ((226)Ra and (224)Ra), (210)Po, and (232)Th isotopes were also assayed by using radiochemical separation and alpha spectrometry in order to determine the sum of the activities of these alpha emitters. Precision (expressed as relative standard deviation) was below 28% for evaporation and below 18% for co-precipitation. In the case of total by liquid scintillation counting it was below 10% for samples with Total Alpha activity above 0.1 Bq/L (this value is about three times the MDA). Furthermore, for most of the studied waters, the Total Alpha activity and the gross alpha activity determined by the three methods were comparable. The obtained bias by the evaporation, co-precipitation, and total evaporation by liquid scintillation counting methods was lower than 40%, 25% and 20%, respectively. The ANOVA test was applied to find out if there was significant variability among the methods. For the samples with the most common radiochemical characteristics there were no significant differences among the three studied methods. However differences were detected for samples with a high saline content or with a very low activity level.

Actitud, hábitos de estudio y rendimiento académico: Abordaje desde la teoría de la acción razonada / Attitudes, study habits, and academic performance: Addressing them from the theory of the reasoned action / Atitude, hábitos de estudo e rendimento académico: Abordagem desde a teoria da ação racional

Introducción Las actitudes y los hábitos hacia el estudio y el aprendizaje son un factor de suma importancia en la determinación del rendimiento académico. Objetivo Analizar la correlación entre actitud y hábitos de estudio con el rendimiento académico en estudiantes universitarios. Metodología Es una investigación de corte cuantitativo, transversal, correlacional y analítico, participaron 286 estudiantes de manera voluntaria. Para medir las variables se utilizaron el Inventario de Hábitos de Estudio y el Cuestionario de Evaluación de Actitudes ante el Aprendizaje en Estudiantes Universitarios. Los datos se analizaron mediante el programa estadístico STATA v.11.1, se realizaron pruebas de comparación de frecuencias (chi-cuadrada), de correlación (r de Pearson) y análisis de regresión logística. Resultados Del total de los participantes (n=286), 75.8% fueron del sexo femenino; 43.7% (n=125) tuvieron alto rendimiento académico, con promedio general de 9 o más. En cuanto a los hábitos de estudio, 66.4% (n=190) obtuvieron puntajes en la clasificación de adecuados, 25.2% (n=72) presentaron actitudes positivas hacia el estudio; Se obtuvo una asociación altamente significativa (p=0.001,) entre hábitos y actitudes ante el estudio mediante una prueba de chi-cuadrada. La correlación entre hábitos de estudio y actitudes hacia el estudio fue moderada pero significativa (r=0.461, p < 0.05); el análisis de regresión logística, reveló asociaciones positivas entre actitudes y rendimiento académico. Conclusiones Este estudio demuestra que las actitudes y los hábitos de estudio, tienen un fuerte impacto en el rendimiento académico.

Introduction Attitudes and habits towards studying and learning are important factors while determining academic performance. Objective To analyze the correlation between attitude and study habits, with academic performance among university students. Methodology This is a quantitative, transversal, correlational and analytical research where 286 students voluntarily participated. In order to estimate the variables, the Study Habits Inventory, and the Assessment of Attitudes towards Learning among University Students scale were used. Data were analyzed using the STATA v.11.1 program. Frequency comparison tests (chi-square), correlations (Pearson r), and logistic regression were calculated. Results From the total of participants (n=286), 75.8% were female, while 43.7% (n=125) showed high academic performance with a 9/10 or higher grade average. Regarding the study habits, and 66.4% (n=190) obtained an adequate classification score; and 25.2% (n=72) showed positive attitudes towards studying. The correlation related to habits and attitudes towards studying was found to be r=0.461, p < 0.05; while the logistic regression analysis revealed positive associations between study attitudes and academic performance. Conclusions This study shows that attitudes and habits towards studying have a strong impact on academic performance.

Introdução As atitudes e os hábitos em direção ao estudo e à aprendizagem são um fator de suma importância na determinação do desempenho académico. Objetivo Analisar a correlação entre atitude e hábitos de estudo com o desempenho académico em estudantes universitários. Metodologia É uma pesquisa de corte quantitativo, transversal, correlacional e analítico, participaram 286 estudantes de maneira voluntária. Para medir as variáveis utilizaram-se o Inventario de Hábitos de Estudo e o Questionário de Avaliação de Atitudes ante a Aprendizagem em Estudantes Universitários. Os dados analisaram-se mediante o programa estatístico STATA v.11.1, realizaram-se provas de comparação de frequências (chi-quadrado), de correlação (r de Pearson) e análise de regressão logística. Resultados Do total dos participantes (n=286), 75.8% foram do sexo feminino; 43.7% (n=125) tiveram alto rendimento académico, com média geral de 9 ou mais. A respeito dos hábitos de estudo, 66.4% (n=190) obtiveram pontuações na classificação de adequados, 25.2% (n=72) apresentaram atitudes positivas para o estudo; obteve-se uma associação altamente significativa (p=0.001,) entre hábitos e atitudes ante o estudo mediante uma prova de chi-quadrado. A correlação entre hábitos de estudo e atitudes para o estudo foi moderada, mas significativa (r=0.461, p < 0.05); a análise de regressão logística, revelou associações positivas entre atitudes e rendimento académico. Conclusões Este estudo demonstra que as atitudes e os hábitos de estudo, tem um forte impacto no desempenho académico.

Experimental analysis of the mass efficiency curve for gross alpha activity and morphological study of the residue obtained by the co-precipitation method.

Gross alpha activity determination in drinking water is one of the radiological parameters that must be determined in order to decide whether further specific analyses of radionuclides in samples is required. This parameter can be determined by the co-precipitation method using a ZnS(Ag) scintillation detector or a proportional counter. The method consists of collecting all alpha emitters of interest using barium and iron as carriers as they provide more uniform and homogeneous residues than the evaporation method, especially for highly saline waters. In the course of our work, the efficiencies of the gas proportional and ZnS(Ag) detectors for alpha particle detection in water residues were studied in function of sample mass (precipitate) with residues ranging between 16.0 and 35.0mg. In addition, the structure and morphological composition of a residue collected by the co-precipitation method was studied with the aim of verifying whether the residue is a homogeneous mixture. The effect of alpha energy on the efficiency and stability of the calibration samples (mass and efficiency) was studied using (230)Th, natural uranium ((nat)U) and (241)Am radionuclides.

Behavior of natural radionuclides in wastewater treatment plants.

56 samples, including influent, primary effluent, secondary effluent and final effluent wastewater from two Spanish municipal wastewater treatment plants (WWTPs), were analyzed to assess both the occurrence and behavior of natural radioactivity during 12 sampling campaigns carried out over the period 2007-2010. Influent and final effluent wastewaters were sampled by taking into account the hydraulic residence time within the WWTP. A wide range of gross alpha activities (15-129 mBq/L) and gross beta activities (477-983 mBq/L) in liquid samples were obtained. A correlation analysis between radioactivity in liquid samples and the performance characteristics of the WWTPs was performed. The results in liquid samples showed that gross beta activities were not influenced by treatment in the studied WWTPs. However, gross alpha activities behave differently and an increase was detected in the effluent values compared with influent wastewater. This behavior was due to the increase in the total dissolved uranium produced during secondary treatment. The results indicate that the radiological characteristics of the effluents do not present a significant radiological risk and make them suitable for future applications.

Influence of the Fukushima Dai-ichi nuclear accident on Spanish environmental radioactivity levels.

This paper presents measurements of the effect of the atmospheric radioactive release from the Fukushima Dai-ichi nuclear power station at three sites belonging to the Spanish environmental monitoring system. Measured values varied depending on the locations of the sites in Spain and their respective climatic characteristics. (134)Cs, (136)Cs, (137)Cs, (131)I, and (132)Te activity concentrations in filter samples were studied and associated levels of (131)I fallout were estimated from wet and dry deposition. Particulate aerosol activity concentrations ranges, in µBq/m(3), were 1.63-3080 ((131)I), 2.8-690 ((137)Cs), 1.3-620 ((134)Cs) and 3.6-330 ((132)Te), while the associated (131)I fallout was roughly estimated to be less than 20 Bq/m(2), Gaseous (131)I was also detected and the (131)I-gaseous/(131)I-total ratio increased at the three stations from approximately 0.75 at the end of March to 0.85-0.9 during the first few days of April. Finally, the presence of (131)I in some crucial parts of the food chain was also studied. (131)I was detected in samples from goat's and cow's milk (maximum levels of 1.11 Bq/L) and in broadleaf plants (maximum level 1.42 Bq/kg).

Distribution of uranium isotopes in surface water of the Llobregat river basin (Northeast Spain).

A study is presented on the distribution of (234)U, (238)U, (235)U isotopes in surface water of the Llobregat river basin (Northeast Spain), from 2001 to 2006. Sixty-six superficial water samples were collected at 16 points distributed throughout the Llobregat river basin. Uranium isotopes were measured by alpha spectrometry (PIPS detectors). The test procedure was validated according to the quality requirements of the ISO17025 standard. The activity concentration for the total dissolved uranium ranges from 20 to 261mBqL(-1). The highest concentrations of uranium were detected in an area with formations of sedimentary rock, limestone and lignite. A high degree of radioactive disequilibrium was noted among the uranium isotopes. The (234)U/(238)U activity ratio varied between 1.1 and 1.9 and the waters with the lowest uranium activity registered the highest level of (234)U/(238)U activity ratio. Correlations between uranium activity in the tested water and chemical and physical characteristics of the aquifer were found.

Activity size distributions for long-lived radon decay products in aerosols collected in Barcelona (Spain).

The activity median aerodynamic diameters (AMADs) of long-lived radon decay product ((210)Pb, (210)Po) in aerosols collected in the Barcelona area (Northeast Spain) during the period from April 2006 to February 2008 are presented. The (210)Po mean AMAD was 420 nm, while the (210)Pb mean AMAD was 500 nm. The temporal evolution of (210)Pb and (210)Po AMADs shows maxima in autumn and winter and minima in spring and summer. (210)Pb AMAD are being used to estimate the mean-residence time of atmospheric aerosols.

Importancia quirúrgica de la celdilla etmoidal del Agger Nasi / Surgical importance of the Agger Nasi etmoidal cellule

La celdilla del Agger Nasi es la más anterior de las celdillas del complejo etmoidal y posee una relevante importancia gracias a su participación en la patogenia de la sinusitis frontal y etmoidal y a su papel de referencia quirúrgica debido a su estrecha relación con las estructuras adyacentes a la pared lateral nasal, como el receso y el seno frontál, el proceso unciforme, el etmoides anterior, la lámina papirácea, el cornete medio y la fosa lacrimal. El abordaje quirúrgico de la celdilla del agger nasi solo puede ser realizado de manera adecuada y detallada a través de endoscopia, y es fundamental tener conocimiento de la anatomía endoscópica y tomográfica rinosinusal

Uso de espaciadores para prevenir adherencias post-operatorias del meato medio / Use of spacers to prevent post operative adherence at the middle meadus

El cuidado en el tratamiento quirúrgico de la mucosa nasal durante la cirugía funcional endoscópica de los senos paranasales, es considerado un factor importante en la prevención de adherencias cicatriciales y sinequias post-operatorias del meato medio, ya que alteran el drenaje y clearence mucociliar de los senos tributarios al complejo ostio-meatal, ocasionando sinusitis obstructiva post-operatoria. La clave para prevenir las adherencias y sinequias post-operatorias es evitar y/o reducir la formación de cicatriz entre la pared lateral nasal y el cornete medio. Para prevenir tal situación, se han propuesto una variedad de espaciadores y stents. Sin embargo, la aspiración y el retiro endoscópico meticuloso y progresivo de material fibrinoide y costroso, y la instilación frecuente y periódica de solución salina, minimizan la formación de sinequias. Los cuidados pre-operatorios, la técnica intra-operatoria utilizada y los cuidados endoscópicos post-operatorios, son todos los elementos del tratamiento integral de la sinusitis crónica quirúrgica y de la prevención de adherencias y sinequias post-operatorias indeseables del meato medio. Palabras clave: adherencias de meato medio, sinequias, espaciadores, cirugía funcional endoscópica, senos paranasales

¿Por qué fracasa la cirugía del septum nasal? / Why does nasal septum surgery fail?

La septoplastia es una de las intervenciones endonasales más frecuentemente practicada por los otorrinolaringólogos. La inspección directa de las cavidades nasales y los senos paranasales han sido durante mucho tiempo, un importante inconveniente para el diagnóstico y la erradicación detalladas de las alteraciones obstructivas del septum nasal, sobre todo aquellas de localización más confinada.Tradicionalmente la septoplastia ha sido practicada a través de los orificios nasales,con visión limitada, asistida por frontoluz y con maniobras y procedimientos practicados a ciegas.La limitación de una inspección detallada, trae como resultado que muchas alteraciones obstructivas nasales septales y extraseptales, puedan pasar inadvertidas. El diagnóstico preciso es clave para aplicar un tratamiento exitoso. Una cirugía conservadora con escisión mínima de los componentes esqueléticos septales, es lo más prudente y recomendado en la actualidad para tratar la patología del tabique nasal. La septoplastia con asistencia endoscópica o cirugía funcional endoscópica del septun nasal permite un mejor resultado postoperatorio, ya que es posible evaluar y erradicar o reparar menos cruenta, con escisión mínima de los componen-tes esqueléticos septales, las deformidades y desviaciones, bajo visón directa. En el presente estudio, se hace una revisión de los diversos factores (anatómicos, fisiopatológicos e histopatológicos) de los componentes del septum nasal, responsables de las alteraciones que éste puede sufrir y que deben ser considerados en razón de un manejo quirúrgico con resultados más satisfactorios Realizaremos un repaso de los factores biomecánicos de los componentes del septum nasal que explican que un septum nasal desviado persista en esa posición después de operado y finalmente nos referiremos a nuestra experiencia y seguimiento en 2.730 casos de patología septal obstructiva, operados por cirugía funcional endoscópica del septum nasal con abrader electromecánico

Valoración endoscópico-tomográfica de la concha bullosa / Endoscopic-tomographic assessment of the concha bullosa

La concha bullosa o neumatización excesiva del cornete medio, es una anormalidad morfológica atribuible a sinusitis crónica. Sin embargo, esta condición se encuentra a menudo en pacientes con obstrucción nasal debido a la rinitis hipertrófica. El predominio de concha bullosa y su relación con las enfermedades nasales fue investigado en este estudio con la evaluación endoscópica de las cavidades nasales y tomografía computarizada coronal de los senos paranasales. El predominio de concha bullosa detectada en la tomografía computadorizada coronal de los senos paranasales, varia de 14 por ciento a 53 por ciento entre los estudios consultados. Esta variación obedece a la muestra de individuos escogidos en cada una de las investigaciones, por ejemplo, pacientes escogidos con sintomatología nasal o escogidos al azar. En el presente estudio se analizaron los resultados obtenidos de 1.059 pacientes con sintomas rinosinusales, a quienes se les practicó un estudio endoscopico nasal y una tomografía computadorizada de los senos paranasales, seleccionados de la práctica otorrinolaringológica privada del Instituto Médico La Floresta (Caracas-Venezuela), desde enero de 1997 a diciembre de 1999. La presencia/ausencia, el predominio y la morfología de la concha bullosa así como los presencia/ausencia de cambios patológicos asociados, fueron estudiados en este trabajo. La concha bullosa se encontró en 240 pacientes de 1.059 casos que refirieron sintomas rinosinusales recurrentes o persistentes. La tomografía computarizada coronal demostró ser más útil que la endoscopia nasal en el diagnóstico de la concha bullosa. No obstante, el estudio endoscópico de las cavidades nasales permite apreciar en detalle la relación de la concha bullosa con el meato medio. Por ello, es importante señalar que la endoscopia nasal y la tomografía computarizada de los senos paranasales son, junto con la historia clínica del paciente, los elementos más relevantes en el diagnóstico rinosinusal. El estudio presente en concha bullosa con coronal CT, reveló que se encuentra más frecuentemente en pacientes con rinitis hipertrófica, donde los senos no se ventilan adecuadamente, predisponiendo a la sinusitis. Por lo tanto, la concha bullosa es una variación anatómica que podría causar una perturbación importante de la ventilación en el meato medio

Programa de detección precoz de la hipoacusia en neonatos en Cantabria. Resultados del primer año de funcionamiento / Early hearing loss detection program for newborn babies in Cantabria. First year results

Objetivos: Evaluar los hallazgos obtenidos en el primer año de funcionamiento del Programa Cántabro para la Detección Precoz de la Hipoacusia Neonatal. Métodos: El ámbito de estudio incluyó a todos los recién nacidos en la Comunidad Autónoma de Cantabria (España) entre el 1 de abril de 2001 y 31 de marzo de 2002. El programa se dividió en 4 fases; las 3 primeras son las que se incluyen en este estudio: fase de screening con otoemisiones acústicas automatizadas (OAE), fase de diagnóstico con potenciales evocados auditivos (neonatos con OAE negativas y/o factores de riesgo de hipoacusia) y fase de tratamiento (adaptación de prótesis auditivas y rehabilitación logopédica). Resultados: Durante el periodo de estudio nacieron 4.117 niños, de los que 110 (2,6%) tenían factores de riesgo. Un 0,8 por ciento de los neonatos sin factores de riesgo y un 3,5 por ciento del total de los incluidos en el programa fueron remitidos a la fase de diagnóstico. 3.987 niños (96,8%) completaron el estudio. La incidencia de hipoacusia permanente fue de 1.2/1000. El valor predictivo positivo en los neonatos sin factores de riesgo fue del 10% y el porcentaje de falsos positivos respecto a la población sometida a screening del 0,72%. Conclusiones: En el primer año de funcionamiento del Programa Cántabro de Detección Precoz de la Hipoacusia Infantil se han cumplido la mayor parte de los objetivos de calidad propuestos (AU)

AIMS: To report the findings in the first year of follow-up of the Cantabrian Program to screen newborn babies for congenital permanent hearing loss. METHODS: The study population consisted of infants born during a year period in Cantabria (Spain). Universal hearing screening by transient evoked otoacoustic emissions (TEOAE) in 2 stage protocol was performed. Infants with failure scores in these 2 stages and those with risk factors for hearing loss were referred for diagnostic evaluation with auditory brainstem response. Hearing aids were recommended for those infants who had bilateral hearing loss and referrals to infant speech and language rehabilitation. RESULTS: Out of the 4117 eligible babies, 3987 were studied. One hundred and ten (2.6) had risk factors for hearing loss, 3.5% were referred for audiological assessment and 1.2/1000 were diagnosed as having a permanent hearing loss. The false-positive rate was 0.72% after the two-stage screening procedure was performed. Positive predictive value for permanent hearing loss was 10%. CONCLUSIONS: During the first year working with the Cantabrian Screening Program for congenital permanent hearing loss in newborn babies, the most part of the proposed aims have been achieved (AU)

Trastorno bipolar: seguimiento en una clínica de litio / Bipolar disorder: follow-up of the use of lithium in a clinic

El carbonato de litio es el fármaco de elección en el tratamiento profiláctico del trastorno bipolar. Este artículo pretende describir el eficaz funcionamiento de la Clínica de litio de nuestro hospital, controlada por diplomados universitarios de Enfermería. En los diez primeros meses de funcionamiento se han incluido 40 pacientes que han generado 122 visitas, con un absentismo del 8,62 por ciento. El 20 por ciento (8/40) de las litemias al inicio del seguimiento fueron inferiores a 0,5 mmol/l, mientras que al final sólo un 5,3 por ciento (2/38) estaban por debajo de 0,5 mmol/l. La media de las litemias al final del periodo de estudio fue significativamente más elevada que en el momento de la inclusión (p=0,009). Durante el periodo de estudio se registraron tres recaídas (AU)