[Precision of arthroscopic surgeons using ultrasound for the first time to measure tendon structures]. / Precisión de los cirujanos artroscopistas al medir por ecografía estructuras tendinosas sin tener experiencia previa en la utilización de este método.

BACKGROUND: The precision of a group of arthroscopic surgeons using ultrasound for the first time was assessed when measuring shoulder and hip tendon structures. METHODS: Twenty-two students and 3 professors participated in a one-day theoretical-practical course. Two measurement rounds were conducted, during which each student identified the greater and lesser axes and the cross-sectional area of the biceps tendon, the supraspinous depth, as well as the lesser and greater axes and the cross-sectional area of the iliac psoas. The mean of the two measurements made by each of the course professors was considered as the reference value. RESULTS: When the 2 measurements made by each of the students of each of the structures were assessed, no significant correlation was found in any of the cases, with a p 0.05. With the exception of the cross-sectional area of the biceps, where there was a significant undersizing of the structure, in the remaining 7 measurements a marked trend to oversize the structures was seen in both the first and second measurements, with a high statistical significance (p 0.05). CONCLUSIONS: Ultrasound is a useful method through which arthroscopic surgeons can identify structures. However, the marked trend to oversize structures compared to the reference values leads to think that the training courses and the daily practice are essential to improve the method.

Se evalúa la precisión de un grupo de cirujanos artroscopistas sin experiencia en la utilización de la ecografía al medir estructuras tendinosas en el hombro y la cadera.

Association between folate, vitamin B(6) and vitamin B(12) intake and depression in the SUN cohort study.

BACKGROUND: An association between low blood levels of folate, vitamins B(6) and B(12) and a higher prevalence of depressive symptoms has been reported in several epidemiological studies. The present study aimed to assess the association between folate, vitamins B(6) and B(12) intake and depresion prevalence in the SUN cohort study. METHODS: The study comprised a cross-sectional analysis of 9670 participants. A validated semi-quantitative food frequency questionnaire was used to ascertain vitamin intake. The association between the baseline intake of folate, vitamins B(6) and B(12) categorised in quintiles and the prevalence of depression was assessed. The analyses were repeated after stratifying by smoking habits, alcohol intake, physical activity and personality traits. RESULTS: Among women, odds ratios (OR) [95% confidence interval (CI)] for the third to fifth quintile for vitamin B(12) intake were 0.58 (0.41-0.84), 0.56 (0.38-0.82) and 0.68 (0.45-1.04), respectively. Among those men with a low level of anxiety and current smokers, a significant positive association between low folate intake and the prevalence of depression was found. The OR (95% CI) for the first quintile of intake was 2.85 (1.49-5.45) and 2.18 (1.08-4.38), respectively, compared to the upper quintiles of intake (Q2-Q5) considered as a group. CONCLUSION: Low folate intake was associated with depression among currently smoking men and men with low anxiety levels. Low intake of vitamin B(12) was associated with depression among women. No significant associations were found for vitamin B(6) intake.

Nutritional determinants of plasma total homocysteine distribution in the Canary Islands.

OBJECTIVE: We sought to define plasma homocysteine reference values in healthy individuals in the Canary Islands and to determine its relations to folate and vitamin B12 intakes and concentrations. DESIGN: Cross-sectional study. SETTING: Population-based representative sample of 557 participants, aged 18-65 years, from the Canary Islands Nutrition Survey (ENCA). SUBJECTS: All participants completed two 24-h dietary recalls and a general questionnaire collecting socio-demographic and health-related lifestyle information. INTERVENTIONS: Plasma homocysteine and serum vitamin B12 levels were measured by immunoassay, whereas folate levels through an automated ionic capturing method. RESULTS: Median plasma homocysteine was 11.9 micromol/l, higher in men (13.1 micromol/l) than in women (10.9 micromol/l) (P<0.001) and positively associated with age in both sexes (P<0.001). The prevalence of hyperhomocysteinaemia (> or = 15 micromol/l), 21.4%, was also greater in men (32.2%) than in women (13.4%). There were significant negative correlations between plasma homocysteine and serum (r=-0.32, P<0.001) and erythrocyte (r=-0.26, P<0.001) folate, as well as serum vitamin B12 (r=-0.28, P<0.001) concentrations. When divided in quartiles of vitamin intakes or concentrations, men with the lowest vitamin B12 and folate serum values had significantly higher plasma homocysteine concentrations than those in the other three quartiles. In women, hyperhomocysteinaemia was higher in the lowest quartiles of folate intake and serum and erythrocyte folate concentrations. CONCLUSIONS: These data provide further evidence that hyperhomocysteinaemia is a sensitive marker of inadequate folate and vitamin B12 status, allowing for the identification of those with greatest need for nutritional interventions.

Mediterranean diet and depression.

OBJECTIVE: The adherence to a Mediterranean Dietary Pattern ensures an adequate intake of B vitamins and w-3 fatty acids. A protective role on depression has been suggested for both nutrients. DESIGN: Cross-sectional analysis from the SUN (Seguimiento Universidad de Navarra) prospective cohort study. Data from 9670 participants (4211 men and 5459 women) were analised. Logistic regression analyses were fitted to assess the association between B-vitamins and w-3 fatty acids intake (quintiles) and the prevalence of depression. RESULTS: Folate intake was inversely associated with depression prevalence among men, especially smokers. Among women, B12 vitamin intake was inversely associated with depression, especially among smokers and physically active women. No significant associations were observed for w-3 fatty acids intake. CONCLUSIONS: The adherence to a Mediterranean Dietary Pattern ensures an adequate intake of fruits, nuts, vegetables, cereals, legumes or fish, important sources of nutrients linked to depression prevention.

Evaluación de marcadores bioquímicos cardiacos en el Servicio de Urgencias. Utilidad diagnóstica / Evaluation of heart biochemical markers in the emergency room. Utility in diagnosis

Objetivo. Los marcadores bioquímicos de necrosis miocárdica forman parte de los criterios definidos por la Organización Mundial de la Salud y de los de la Joint European Society of Cardiology/American College of Cardiology para el diagnóstico de IAM. El objetivo de nuestro estudio fue realizar una evaluación de los marcadores bioquímicos de necrosis miocárdica solicitados por el servicio de urgencias de nuestro hospital para valorar su utilidad en el diagnóstico de IAM. Material y métodos. Estudiamos un total de 440 pacientes, 302 varones, y 138 mujeres, que ingresaron en el Servicio de Urgencias durante un mes y a los que se les solicitó determinaciones de marcadores bioquímicos cardíacos (mioglobina, CK-MB masa, troponina I) Resultados. Se realizaron un total de 712 determinaciones: 292 mioglobinas (41,0 por ciento), 109 CK-MB) masa (15,3 por ciento) y 311 cTnI (47,7 por ciento). En los pacientes en que se detectó la CK-MB en rango patológico, la cTnI también presentó concentraciones patológicas. Con respecto a la mioglobina, encontramos un 14,2 por ciento de pacientes con valores normales de mioglobina y concentraciones patólogicas de cTnI, debido a que presentaban infartos evolucionados. Conclusiones. La cTnI es el marcador que presentó una mayor utilidad diagnóstica en nuestro estudio, presentando ventajas con respecto a la CK-MB masa en el diagnóstico de IAM. La mioglobina en los pacientes con insuficiencia renal no tiene utilidad diagnóstica, ya que se encontró elevada en un 100 por ciento de los casos. (AU)

Marcadores bioquímicos cardíacos en el diagnóstico del infarto agudo de miocardio / Biochemical cardiac markers infarction, CK-MB mass, myoglobin, troponins

Los marcadores bioquímicos de necrosis miocárdica forman parte de los criterios diagnósticos del infarto agudo de miocardio definidos por la OMS, desempeñando un papel esencial en el diagnóstico en aquellos pacientes que se presentan con síntomas atípicos y/o con trazados electrocardiográficos inespecíficos. El marcador bioquímico ideal debe ser sensible y altamente específico de necrosis miocárdica, de positivización precoz tras el inicio de los síntomas y detectable con una metodología simple que permita su uso en el laboratorio clínico de urgencias, con un tiempo de procesado total inferior a una hora. En la actualidad ningún marcador bioquímico cumple todas y cada una de estas características, hecho que determina que deban utilizarse de forma secuencial y/o combinada. La isoenzima 2 creatina-cinasa medida por inmunoanálisis más prometedores actualmente (AU)

Prevalence of micro- and macroalbuminuria in a Canarian population of type 2 diabetic patients. Relationship with blood pressure, lipid profile, obesity and metabolic control.

We performed a cross-sectional study on the prevalence of micro- and macroalbuminuria in a population of 288 Type 2 diabetic patients from Northern Gran Canaria Island (age 59 +/- 9.5, years; 48% male): 179 unselected patients referred by their family physicians, and 109 from our diabetes clinic. Sex, age, duration of diabetes and hypertension, blood pressure, body mass index, waist-hip ratio, HbA1c, creatinine, cholesterol (total and HDL), triglycerides, lipoprotein (a), and the presence of retinopathy, polyneuropathy, and coronary and cerebrovascular disease were assessed. The prevalences of micro- and macroalbuminuria were 28.5% and 11.8%. Among the patients referred by their family physicians, 32.4% were micro- and 6.1% macroalbuminuric. In our diabetes clinic, there were respectively 22% and 21% (with a higher prevalence of macroalbuminuria than in primary care, p < 0.05). Seventy-three percent were hypertensive in both settings. Prevalence was 31.5% for diabetic retinopathy, 21.0% for diabetic polyneuropathy, 8.1% for cerebrovascular disease, and 20.2% for coronary heart disease. The albumin excretion rate was significantly correlated with plasma creatinine levels, diastolic blood pressure, total cholesterol and the presence of coronary heart disease and diabetic retinopathy, but not with age, duration of diabetes or hypertension, body mass index, waist/hip ratio, glycated haemoglobin or triglycerides.

Suicide in the Canary Islands: standardized epidemiological study by age, sex, and marital status.

The authors analyze the distribution of suicides according to the variables of sex, age and marital status in the Canary Islands, during the period 1977-1983, by means of a register that they themselves created in order to correct serious deficiencies in the official data. There were notable differences between men and women, and the tendencies observed in each case are also very different. The authors argue that this makes it necessary to separate the sexes in the epidemiological studies on suicide. The advantages and disadvantages of the direct and indirect methods in the standardization of the specific suicide rates are discussed. The specific rates related to marital status are standardized according to age and, likewise, the specific rates related to age are standardized according to marital status, for each sex. Once confounding factors are controlled, it becomes clear that there is a direct relationship between age and suicide. After adjusting for age, it is noted that the pattern of risk for different marital status categories varies by sex.

Suicide in the Canary Islands, 1977-1983.

We studied suicide in the Canary Islands between 1977 and 1983 and found 775 cases, twice the official number of 381. This indicates the lack of validity and reliability of official figures for suicide in Spain today. The figures reveal an upward trend in the Canary Islands, with the annual rate of 6.81 per 100,000 in 1977 having increased to 10.64 per 100,000 in 1983. There were no significant differences in the frequency of suicide according to season, month or day of the week.