Portable single-lead electrocardiogram device is accurate for QTc evaluation in hospitalized patients.

BACKGROUND: Many commonly used drugs can prolong the QTc interval (QTc), which can lead to potentially life-threatening arrhythmias. In the current era of the COVID-19 pandemic, it is worth mentioning that the disease itself and several drugs used for its treatment have been associated with QTc prolongation. OBJECTIVE: To evaluate the agreement and clinical precision of a portable single-lead electrocardiogram (ECG) device to measure the QTc interval compared to the standard 12-lead ECG. METHODS: In sequential tests, QTc of ECG recordings obtained with the KardiaMobile (KM-1L) device (AliveCor, San Francisco, CA) were compared to QTc obtained with conventional 12-lead ECG. Agreement was evaluated using Bland-Altman plots and Lin's concordance coefficient. Consistency between the 2 devices in determining QTc prolongation (QTc ≥470 ms in males or ≥480 ms in females) was evaluated with kappa statistics. RESULTS: A total of 128 patients with a presumed or confirmed diagnosis of COVID-19 admitted to a university hospital were included. QTc intervals measured with KM-1L were similar to QTc measured with conventional ECG (442.45 ± 40.5 vs 441.65 ± 40.3 ms, P = .15). Bland-Altman analysis showed no significant difference in QTc values (average difference of -0.797, 95% limits of agreement:-13.179; 11.585). Lin's concordance coefficient showed an excellent agreement (0.988, P < .001). Concordance between the 2 devices for determining QTc prolongation was excellent (kappa >0.90). CONCLUSION: ECG recordings obtained with KM-1L allow an accurate QTc interval assessment. Considering its simplicity of use, this approach has advantages over conventional ECG and can provide an alternative for the evaluation of QTc in hospitalized patients, during the current time of the COVID-19 pandemic and beyond.

Start-up of an aerobic granular sludge system from stored granules: Evaluating the impact of storage period on biomass activity and stability and the effect of temperature on nitrification and phosphorus removal rates.

Aerobic granular sludge (AGS) has been considered a breakthrough within the wastewater treatment sector. However, the long reactor start-up for the formation of granules is challenging and may hinder the spread of this technology. To circumvent this obstacle, inoculation of the reactors with pre-formed granules from existing plants is an interesting approach. In this context, issues related to biomass storage becomes very relevant. In this study, reactivation of aerobic granular biomass after storage was evaluated in a sequencing batch reactor (SBR) designed for achieving simultaneous organic matter, nitrogen and phosphorus removal. Two different scenarios, short (40 days) and long (180 days) storage periods, were assessed, and their influence on the granules physical properties and bioactivity was addressed. The results revealed that the granules stored for a shorter period showed higher resistance to breakage and underwent smooth color changes. On the other hand, the biomass stored for a longer period acquired a dark color and was more susceptible to disruption during reactivation. The granules stored for 6 months become swollen and exhibited an irregular morphology and fluffy structure within the first days of reactivation. Consequently, their settling properties were adversely affected, and some parameters such as the food-to-microorganism ratio had to be adjusted to prevent granules disintegration. Regarding the bioactivity of important microbial functional groups, COD removal was rapidly restored within a few days of SBR operation with the biomass stored for a shorter period. However, it took longer for the biomass stored for 180 days to reach the same performance observed for the granules stored for 40 days. A similar trend is valid for nitrification. In the experiments with sludge stored for a longer time, it took almost twice as long to reach effluent ammonium concentrations lower than 1 mg NH4+-N L-1 compared to the test using biomass stored for 40 days. Phosphate removal was strongly affected by biomass storage, especially after 180 days of inactivity, a condition found to be detrimental for polyphosphate-accumulating organisms. Finally, cycle tests were also conducted to assess substrate conversion rates for comparison between different trials and evaluate the influence of temperature (10-35 °C) on nitrification and phosphate removal rates.

Unidad de Endocrinología y Diabetes Pediátrica / Pediatric endocrinology and diabetes unit

La Unidad de Endocrinología y Diabetes Pediátrica del Hospital Universitario Ramón y Cajal ha tenido siempre como objetivo conseguir los más altos estándares internacionales de calidad en la atención al niño y al adolescente. En particular y para el paciente con diabetes, las nuevas tecnologías, así como la educación diabetológica, son el centro de nuestro trabajo, implicando no solo a padres y pacientes sino a los profesores y a todos aquellos que conviven a su alrededor, buscando así el mejor control metabólico y la mejor calidad de vida (AU)

The objective of the Pediatric and Endocrinology Unit of the University Hospital Ramón y Cajal has always been that of achieving the highest international standards of quality in the care of children and adolescents. Specifically, and for the patient with diabetes, the new technologies and education in diabetes are the center of our work, this not only involving parents and patients but also the professors and all those within their surroundings, seeking in this way the best metabolic control and best quality of life (AU)

Enfermedad de Graves con predominio de T3 en la edad pediátrica / T3-predominant Graves' disease in paediatric patients

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Distribution of genetic variants of oxidative stress metabolism genes: Paraoxonase 1 (PON1) and Glutathione S-transferase (GSTM1/GSTT1) in a population from Southeastern Mexico.

BACKGROUND: Paraoxonase 1 (PON1) and glutathione S-transferases (GSTs) are involved in the biotransformation of xenobiotics. Variation in the enzyme concentration and activity suggests individual differences for the degree of protection against oxidative stress. AIM: This study analysed the distribution of SNPs Q192R, L55M (PON1) and variants in GSTM1 and GSTT1 genes in a population from Southeastern Mexico. SUBJECTS AND METHODS: One hundred and fifty-one Mexican Mestizo healthy volunteers were included. PON1 polymorphisms were determined by Taqman allele discrimination real time-PCR, whereas GSTM1 and GSTT1 genes were determined with a multiplex PCR-based method. RESULTS: All genotypes were in Hardy-Weinberg equilibrium, except for GSTM1. The genotypic distributions of Q192R and L55M were 22% QQ, 48% QR, 30% RR, 62% LL, 34% LM and 4% MM, respectively, whereas the allele frequencies were 0.46 (Q), 0.54 (R), 0.79 (L) and 0.21 (M). The most frequent haplotype was R/L (46.7%). It was found that 31% and 9% of the individuals had the GSTM1 and GSTT1 null genotype, respectively. The frequency of the combined null genotype GSTM1*0/GSTT1*0 was 4.64%. CONCLUSION: The results showed that the frequencies of polymorphisms of PON1, GSTM1 and GSTT1 in the Yucatán population differ to those observed in other ethnic groups and provide useful data for epidemiological studies.

Cerebral Hemodynamics Patterns by Transcranial Doppler in Patients With Acute Liver Failure.

INTRODUCTION: About half of patients with acute liver failure (ALF) show clinical signs of cerebral edema and intracranial hypertension. Neuroimaging diagnostics and electroencephalography have poor correlation with intracranial pressure measurement. OBJECTIVE: The objective of this study was to characterize the cerebral hemodynamics patterns with transcranial Doppler (TCD) sonography in patients with ALF. METHOD: We studied 21 patients diagnosed with ALF, admitted to the intensive care unit (ICU) at the Centro de Investigaciones Médico Quirúrgicas of Cuba. All of these patients had a TCD performed on arrival at ICU, evaluating the following: systolic (SV), diastolic (DV), and medium (MV) flows velocities and pulsatility index (PI) in right middle cerebral artery (RMCA) via temporal windows. RESULTS: The sonographic patterns of cerebral hemodynamics were as follows: low-flow, 12 patients (57.1%); high resistance, 5 patients (23.8%); and hyperemic, 4 patients (19%). Patients who died while waiting had lower MV RMCA (56.1 vs 58.1 cm/s) and higher PI (1.71 vs 1.41) than patients who could undergo transplantation (P = .800 and P = .787, respectively). CONCLUSIONS: In patients diagnosed with ALF admitted to the ICU the predominating cerebral hemodynamic pattern was low-flow with resistance increase. The TCD was shown to be a useful tool in the initial evaluation for prognosis and treatment.

Factores de riesgo cardiovascular en niños y adolescentes españoles con diabetes mellitus tipo 1: evolución a lo largo de 9 años / Nine-year longitudinal study of cardiovascular risk factors in spanish children and adolescents with type 1 diabetes

OBJETIVOS: Analizar la prevalencia, evolución de factores de riesgo cardiovascular (FRCV) y su relación con el control metabólico en pacientes pediátricos con diabetes mellitus tipo 1 (DM1). PACIENTES Y MÉTODOS: Estudio longitudinal ambispectivo en 75 niños y adolescentes españoles con DM1 diagnosticados en los años 1996-2003 y seguidos durante 9 años. Analizamos los FRCV y su evolución al segundo, sexto y noveno años tras el diagnóstico, y los antecedentes familiares (AF) de FRCV. RESULTADOS: El 46,6% tenía AF de FRCV. En el segundo, sexto y noveno años encontramos una prevalencia de HbA1c > 7,5% del 45,3, el 53,3 y el 56%, respectivamente; de obesidad (índice de masa corporal > 2 desviaciones estándar) del 5,3, el 5,3 y el 6,7%, y de HTA (presión arterial > p90) del 14,6, el 8 y el 13,3%. Colesterol total > 200 mg/dl en el 25,3, el 13,3 y el 16%; lipoproteína de alta densidad del colesterol (HDL-c) < 40 mg/dl en el 1,3, el 1,3 y el 4%; lipoproteína de baja densidad del colesterol (LDL-c) > 100 mg/dl en el 38,6, el 34,6 y el 38,6%; triglicéridos (TG) > 150 mg/dl en el 0, el 1,3 y el 2,6%, respectivamente. Encontramos un aumento significativo en la prevalencia de TG/HDL-c≥ 2 entre el sexto y el noveno años de evolución de la enfermedad (1,3% y 9,3%, p < 0,05). Una HbA1c≥ 7,5% en el segundo y el sexto años se asoció de forma significativa a una disminución en el HDL-c z-score de 0,94, y una HbA1c < 7,5% durante ese mismo periodo se asoció significativamente a un aumento del HDL-c z-score del 0,55(p = 0,015). CONCLUSIONES: El peor control metabólico de la DM1 en los primeros años de evolución se asocia a una disminución del HDL-c z-score. El cociente TG/HDL-c podría ser un marcador precoz de riesgo cardiovascular

OBJECTIVES: To analyse the prevalence, evolution of cardiovascular risk factors (CVRF) and their relationship with follow-up of metabolic control in pediatric patients with Type 1 Diabetes (T1DM). PATIENTS AND METHODS: Longitudinal ambispective study including 75 children and adolescents with T1DM diagnosed from 1996 to 2003 and followed-up for nine years. Family history of CVRF was registered. Data from the second, sixth and ninth year after diagnosis were analysed. RESULTS: Family history of CVRF was found in 46.6% of the patients. The prevalence of HbA1c > 7.5% in the second, sixth and ninth year after diagnosis was 45.3%, 53.3% y 56%, respectively. The prevalence of obesity (BMI > 2SDS) in the three visits was 5.3%, 5.3% y 6.7%, respectively. Hypertension (BP > p90) was found in 14.6%, 8% and 13.3% of the patients in the three visits, respectively. Total cholesterol > 200 mg/dl: 25.3%, 13.3% and 16%; high density cholesterol lipoprotein < 40mg/dl: 1.3%, 1.3% and 4%; low density cholesterol lipoprotein > 100mg/dl: 38.6%, 34.6% and 38.6%; triglyceride > 150 mg/dl: 0%, 1.3% and 2.6%, respectively. There was a significant increase in the prevalence of TG/HDL-C≥2 between the sixth and the ninth year after diagnosis (1.3% and 9.3%, P < .05). A persistent HbA1c≥7.5% showed a statistically significant relationship to a 0.94 decrease in HDL-C z-score between the second and the sixth year, and a persistent HbA1c < 7.5% was significantly associated with a 0.55 increase in HDL-C z-score (P = .015) in the same period. CONCLUSIONS: A non-optimal metabolic control in first years of DM1 is associated with a decrease in HDL-C z-score. TG/HDL-C ratio could be an early marker of cardiovascular risk

The Establishment of the Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS): A Pilot Project on Poultry Farms, Slaughterhouses and Retail Market.

The development of antimicrobial resistance among bacteria (AMR) is currently one of the world's most pressing public health problems. The use of antimicrobial agents in humans and animals has resulted in AMR which has narrowed the potential use of antibiotics for the treatment of infections in humans. To monitor AMR and to develop control measures, some countries, such as the USA, Canada and Denmark, have established national integrated surveillance systems (FDA, , CIPARS, 2007, DANMAP,2002). The components of these programs monitor changes in susceptibility/resistance to antimicrobial agents of selected zoonotic pathogens and commensal organisms recovered from animals, retail meats and humans. The rapid development of Colombia's animal production industry has raised food safety issues including the emergence of antibiotic resistance. The Colombian Integrated Surveillance Program for Antimicrobial Resistance (COIPARS) was established as a pilot project to monitor AMR on poultry farms, slaughter houses and retail markets.

Diabetes mellitus tipo 2 en adolescentes en una unidad de diabetes pediátrica / Type 2 diabetes mellitus in adolescents in a pediatric diabetes unit

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Admixture and genetic relationships of Mexican Mestizos regarding Latin American and Caribbean populations based on 13 CODIS-STRs.

Short tandem repeats (STRs) of the combined DNA index system (CODIS) are probably the most employed markers for human identification purposes. STR databases generated to interpret DNA profiles are also helpful for anthropological purposes. In this work, we report admixture, population structure, and genetic relationships of Mexican Mestizos with respect to Latin American and Caribbean populations based on 13 CODIS-STRs. In addition, new STR population data were included from Tijuana, Baja California (Northwest, Mexico), which represents an interesting case of elevated genetic flow as a bordering city with the USA. Inter-population analyses included CODIS-STR data from 11 Mexican Mestizo, 12 Latin American and four Caribbean populations, in addition to European, Amerindian, and African genetic pools as ancestral references. We report allele frequencies and statistical parameters of forensic interest (PD, PE, Het, PIC, typical PI), for 15 STRs in Tijuana, Baja California. This Mexican border city was peculiar by the increase of African ancestry, and by presenting three STRs in Hardy-Weinberg disequilibrium, probably explained by recurrent gene flow. The Amerindian ancestry in Central and Southeast of Mexico was the greatest in Latin America (50.9-68.6%), only comparable with the North of Central America and Ecuador (48.8-56.4%), whereas the European ancestry was prevalent in South America (66.7-75%). The African ancestry in Mexico was the smallest (2.2-6.3%) in Latin America (≥ 2.6%), particularly regarding Brazil (21%), Honduras (62%), and the Caribbean (43.2-65.2%). CODIS-STRs allowed detecting significant population structure in Latin America based on greater presence of European, Amerindian, and African ancestries in Central/South America, Mexican Mestizos, and the Caribbean, respectively.

[Nine-year longitudinal study of cardiovascular risk factors in Spanish children and adolescents with type 1 diabetes]. / Factores de riesgo cardiovascular en niños y adolescentes españoles con diabetes mellitus tipo 1: evolución a lo largo de 9 años.

OBJECTIVES: To analyse the prevalence, evolution of cardiovascular risk factors (CVRF) and their relationship with follow-up of metabolic control in pediatric patients with Type 1 Diabetes (T1DM). PATIENTS AND METHODS: Longitudinal ambispective study including 75 children and adolescents with T1DM diagnosed from 1996 to 2003 and followed-up for nine years. Family history of CVRF was registered. Data from the second, sixth and ninth year after diagnosis were analysed. RESULTS: Family history of CVRF was found in 46.6% of the patients. The prevalence of HbA1c>7.5% in the second, sixth and ninth year after diagnosis was 45.3%, 53.3% y 56%, respectively. The prevalence of obesity (BMI>2SDS) in the three visits was 5.3%, 5.3% y 6.7%, respectively. Hypertension (BP>p90) was found in 14.6%, 8% and 13.3% of the patients in the three visits, respectively. Total cholesterol>200mg/dl: 25.3%, 13.3% and 16%; high density cholesterol lipoprotein< 40 mg/dl: 1.3%, 1.3% and 4%; low density cholesterol lipoprotein>100mg/dl: 38.6%, 34.6% and 38.6%; triglyceride>150 mg/dl: 0%, 1.3% and 2.6%, respectively. There was a significant increase in the prevalence of TG/HDL-C ≥ 2 between the sixth and the ninth year after diagnosis (1.3% and 9.3%, P<.05). A persistent HbA1c ≥ 7.5% showed a statistically significant relationship to a 0.94 decrease in HDL-C z-score between the second and the sixth year, and a persistent HbA1c<7.5% was significantly associated with a 0.55 increase in HDL-C z-score (P=.015) in the same period. CONCLUSIONS: A non-optimal metabolic control in first years of DM1 is associated with a decrease in HDL-C z-score. TG/HDL-C ratio could be an early marker of cardiovascular risk.

Ácido láctico como marcador pronóstico en hemorragia obstétrica posparto / Lactic acid as a prognostic marker in obstetric postpartum hemorrhage

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Pedigree analysis of Mexican families with Fabry disease as a powerful tool for identification of heterozygous females.

Fabry disease (FD) is an X-linked lysosomal storage disease caused by α-galactosidase A deficiency; in contrast to other X-linked diseases, heterozygous females can be as affected as men. The construction and analysis of a family pedigree is a powerful tool to aid clinicians in diagnosis, establishment of inheritance pattern, and early detection of potentially affected relatives. The present study highlights the importance of pedigree analysis in families with FD for identifying other possibly affected relatives and investigating the clinical manifestations. This clinical report included 12 Mexican index cases with confirmed FD diagnosis. We constructed and analyzed their pedigree, and diagnosed FD in 24 affected relatives. Clinical features were similar to those reported for other populations. Pedigree analysis further identified an additional 30 women as possible carriers. We conclude that pedigree construction and analysis is a useful tool to help physicians detect and diagnose relatives at risk for FD, particularly heterozygous females, so that they can receive genetic counseling and early treatment. Mexican families with FD were similar to other populations reported in the literature, and our findings confirmed that heterozygous females can have signs and symptoms ranging from subtle manifestations to the classical severe presentation described in males.

El personal no sanitario de hospitales españoles y latinoamericanos ante la donación de vivo renal relacionada / Ancillary Personnel in Spanish and Latin-American Hospitals Faced With Living Related Kidney Donation

Introducción: Los profesionales no sanitarios de centros hospitalarios son un grupo de opinión con credibilidad para la población, por el hecho de trabajar en un hospital. Sin embargo, no tienen preparación ni formación sanitaria en la mayoría de los casos, por lo que su actitud puede estar basada en el desconocimiento o miedos no fundados. Objetivo: Analizar la actitud hacia la donación renal de vivo (DVR) de los profesionales no sanitarios de centros hospitalarios españoles y latinoamericanos, y analizar las variables que influyen en dicha actitud. Pacientes y método: Del «Proyecto colaborativo internacional donante» se selecciona una muestra aleatoria entre el personal no sanitario de los distintos centros hospitalarios de España, México y Cuba. La actitud hacia la DVR se valoró mediante una encuesta validada, cumplimentada de forma anónima y autoadministrada. Resultados: Fueron encuestados 951 profesionales (277 de España, 632 de México y 42 de Cuba). El 89% (n = 850) está a favor de la DVR relacionada, descendiendo hasta un 31% (n = 298) cuando se trata de una donación no relacionada. Del resto el 8% (n = 78) no está a favor y el 3% (n = 23) está indeciso. Por país los cubanos (98%) y mexicanos (91%) tienen una actitud más favorable que los españoles (84%) (p = 0,001). Dicha actitud favorable hacia la DVR se asocia con el sexo femenino (p = 0,017), tener formación universitaria (p = 0,010), trabajar en servicios sanitarios (p = 0,035), tener estabilidad laboral (p = 0,016), haber tenido experiencia personal con la donación y el trasplante (p = 0,001), estar a favor de la donación de cadáver (p < 0,001), considerar la posibilidad de necesitar un trasplante en el futuro (p < 0,001), estar a favor de la donación de vivo hepática (p < 0,001), aceptar un riñón procedente de donante vivo si fuese necesario (p < 0,001), haber comentado con la familia sobre la donación y el trasplante (p < 0,001), la actitud a favor de la pareja hacia el tema (p < 0,001), el realizar actividades prosociales (p = 0,002) y no preocuparle la posible mutilación del cuerpo tras la donación (p < 0,001). Conclusiones: La actitud hacia la DVR relacionada entre el personal no sanitario de centros hospitalarios españoles y latinoamericanos es favorable. Esta predisposición tan favorable de los profesionales hospitalarios puede ser utilizada como fuente de promoción de la donación de vivo, la cual supone una fuente potencial de órganos

Introduction: Ancillary hospital personnel represent an important body of opinion because as they work in a hospital their opinion has more credibility for the general public as a result of their activity in hospitals. However, in most cases they do not have any health care training which means that their attitude could be based on a lack of knowledge or unfounded fears. Objective: To analyze the attitude toward living kidney donation (LKD) among ancillary personnel in Spanish and Latin-American hospitals and to analyze the variables that might influence such attitude. Patients and method: from "International Collaborative Donor Project" a random sample was taken among ancillary personnel in Spain, Mexico and Cuba hospitals. Attitude toward LKD was evaluated using a validated, anonymously filled and self-administered survey. Results: 951 professionals were surveyed (Spain: 277, Mexico: 632, Cuba: 42). 89% (n = 850) are in favor of related kidney donation, lowering to 31% (n = 289) in non-related donation. Of the rest, 8% (n = 78) are not in favor and the 3% (n = 23) are unsure. By country, Cubans (98%) and Mexicans (91%) are more in favor than Spanish (84%) (P = 0.001). The following variables are related to favorable attitude toward LKD: female sex (P = 0.017), university degree (P = 0.010), work in health services (P = 0.035), labor stability (P = 0.016), personal experience in donation and transplantation (P = 0.001), positive attitude toward cadaveric donation (P < 0.001), belief that he or she might need a transplant in the future (P < 0.001), positive attitude toward living liver donation (P < 0.001), a willingness to receive a donated living liver if needed (P < 0.001), having discussed the subject of organ donation and transplantation within the family (P < 0.001), partner's positive attitude toward the subject (P < 0.001), participation in voluntary type pro-social activities (P = 0.002) and not being concerned about possible mutilation after donation (P < 0.001). Conclusions: The attitude toward living related kidney donation is favorable among ancillary personnel in Spanish and Latin-American hospitals. Because living donation is a better source of organs than cadaveric ones, this favorable predisposition can be used as promoting agent of living donation in order to develop it in Spanish-speaking countries

Association of the FTO gene SNP rs17817449 with body fat distribution in Mexican women.

Polymorphisms in the FTO gene are associated with obesity, body mass index, hip circumference, and visceral and subcutaneous fat area. The objective of this study was to analyze the association of the FTO rs17817449 genetic variant (T>G polymorphism) with body fat distribution patterns in women. We included 65 women and 71 healthy subjects in this study. Anthropometric parameters were determined and laboratory studies were performed. The polymorphism was detected by a PCR-RFLP method. The groups were categorized by type of body fat distribution: gynoid (N = 29) and android (N = 36). We found that the FTO gene polymorphism was not associated with body fat distribution according to the type of obesity (P > 0.05). The contribution of G and T alleles among groups indicated no statistically significant differences between the reference and gynoid group [P = 0.93; odds ratio (OR) = 0.97; 95% confidence interval (CI) = 0.46-2.02] and the reference and android group (P = 0.56; OR = 1.20; 95%CI = 0.54-2.82). Thorax circumference and thorax breast circumference were significantly different between the two groups (P = 0.009 and 0.021, respectively) with the genotype TT. We conclude that the FTO rs17817449 TT genotype predisposes individuals to fat deposition in the thoracic and breast region; individuals carrying this genotype had a decrease in thoracic and breast dimensions indirectly causing the gynoid phenotype in Mexican women.

Ancillary personnel in Spanish and Latin-American hospitals faced with living related kidney donation.

INTRODUCTION: Ancillary hospital personnel represent an important body of opinion because as they work in a hospital their opinion has more credibility for the general public as a result of their activity in hospitals. However, in most cases they do not have any health care training which means that their attitude could be based on a lack of knowledge or unfounded fears. OBJECTIVE: To analyze the attitude toward living kidney donation (LKD) among ancillary personnel in Spanish and Latin-American hospitals and to analyze the variables that might influence such attitude. PATIENTS AND METHOD: from «International Collaborative Donor Project¼ a random sample was taken among ancillary personnel in Spain, Mexico and Cuba hospitals. Attitude towards LKD was evaluated using a validated, anonymously filled and self-administered survey. RESULTS: 951 professionals were surveyed (Spain: 277, Mexico: 632, Cuba: 42). 89% (n=850) are in favor of related kidney donation, lowering to 31% (n=289) in non-related donation. Of the rest, 8% (n=78) are not in favor and the 3% (n=23) are unsure. By country, Cubans (98%) and Mexicans (91%) are more in favour than Spanish (84%) (P=.001). The following variables are related to favourable attitude towards LKD: female sex (P=.017), university degree (P=.010), work in health services (P=.035), labour stability (P=.016), personal experience in donation and transplantation (P=.001), positive attitude toward cadaveric donation (P<.001), belief that he or she might need a transplant in the future (P<.001), positive attitude towards living liver donation (P<.001), a willingness to receive a donated living liver if needed (P<.001), having discussed the subject of organ donation and transplantation within the family (P<.001), partner's positive attitude towards the subject (P<.001), participation in voluntary type pro-social activities (P=.002) and not being concerned about possible mutilation after donation (P<.001) CONCLUSIONS: The attitude toward living related kidney donation is favourable among ancillary personnel in Spanish and Latin-Americans hospitals. Because living donation is a better source of organs than cadaveric ones, this favourable predisposition can be used as promoting agent of living donation in order to develop it in Spanish-speaking countries.

Diabetes latente autoinmune en el joven / Latent autoimmune diabetes in the young

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