Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study.

The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

[Direct stenting in saphenous vein grafts. Immediate and long-term results]. / Implante de stent directo en puentes de safena. Resultados inmediatos y a largo plazo.

INTRODUCTION AND OBJECTIVES: Percutaneous interventions on saphenous vein grafts are associated with a worse outcome than in native vessels, mainly because of the risk of embolization. Direct stenting may diminish aggression to the vessel. This study reports the results of direct stenting in saphenous vein grafts. PATIENTS AND METHOD: We compared 2 cohorts of consecutive patients treated with direct stenting (DS) and stenting with predilatation (PD) in saphenous vein grafts between September 1998 and March 2003. In-hospital and long-term results and predictors of mortality were analyzed. RESULTS: The DS group contained 71 patients with 83 lesions, and the PD group contained 46 patients with 54 lesions. There were no differences in age, risk factors, age of the graft, ejection fraction, stent length, need for postdilatation or number of stents per lesion, although the DS group contained more women (DS=38%, PD=17%, P=.02), and stent diameter was larger (DS=3.59 [0.59] mm, PD=3.21 [0.59] mm, P=.001) in the DS group. Creatine phosphokinase elevation was > or =2-fold in 10% (DS=7%, PD=16%, P=.1). One patient died in the hospital. Median follow-up time was 36.1 months. Survival was 94+/- 2% at 12 months, 87+/-3% at 24 months, 82+/-17% at 36 months, 67+/-8% at 48 months and 58+/-7% at 60 months. Revascularization rate was 14% for the target lesion and 20.5% for the target vessel, with no differences between groups in mortality or revascularization success rate. Predictors of mortality were ejection fraction and smoking habit. CONCLUSIONS: Survival after stenting in saphenous vein grafts is similar with direct and conventional techniques, although there was a tendency toward a lower incidence of myocardial infarction with the former. Although the in-hospital results were favorable, long-term survival was less favorable with both techniques.

Implante de stent directo en puentes de safena. Resultados inmediatos y a largo plazo / Direct stenting in saphenous vein grafts. Immediate and long-term results

Introducción y objetivos. Las intervenciones percutáneas en los injertos de vena safena se asocian con peores resultados que las efectuadas en los vasos nativos, fundamentalmente por el riesgo de embolización. El stenting directo puede disminuir la agresión sobre el vaso. Se estudian los resultados del stenting directo en las safenas. Pacientes y método. Se comparan 2 cohortes de pacientes consecutivos conimplante de stent en las safenas mediante técnica directa (SD) y predilatación (PD) realizado entre septiembre de 1998 y marzo de 2003. Se analizan los resultados intrahospitalarios y a largo plazo y los predictores de mortalidad. Resultados. Se utilizó la SD en 71 pacientes con 83 lesiones y la PD en 46pacientes con 54 lesiones. No hubo diferencias en cuanto a la edad, los factores de riesgo, la edad del injerto, la fracción de eyección, la longitud del stent, la situación pos-dilatación y número de stents por lesión, aunque sí en las mujeres (SD en el 38% y PD en el 17%; p = 0,02) y el diámetro del stent (SD, 3,59 ± 0,59 mm; y PD, 3,21 ± 0,59 mm; p = 0,001).Se observó una elevación del doble de los valores normales de lacreatincinasa en el 10% de los pacientes (el 7% en el grupo SD y el 16% enel grupo PD; p = 0,1). Se produjo un caso de mortalidad intrahospitalaria.La mediana de seguimiento fue de 36,1 meses. La supervivencia global de laserie a los 12, 24, 36, 48 y 60 meses fue del 94 ± 2, el 87 ± 3, el 82 ± 17,el 67 ± 8 y el 58 ± 7%, respectivamente. La tasa de revascularización de la lesión tratada fue del 14% y la del vaso tratado del 20,5%, sin diferencias entre los grupos en la mortalidad y la revascularización. Los predictores de mortalidad fueron la fracción de eyección y el tabaquismo. Conclusiones. La supervivencia después de implante de un stent en injertos de safena es similar con SD y PD, aunque se observa una menor tendencia hacia la incidencia de infarto con la primera. Aunque los resultados intrahospitalarios son favorables, la supervivencia a largo plazo es menos favorable con ambas técnicas

Introduction and objectives. Percutaneous interventions on saphenous vein grafts are associated with a worse outcome than in native vessels, mainly because of the risk of embolization. Direct stenting may diminish aggression to the vessel. This study reports the results of direct stenting in saphenous vein grafts. Patients and method. We compared 2 cohorts of consecutive patients treated with direct stenting (DS) and stenting with predilatation (PD) in saphenous vein grafts between September 1998 and March 2003. In-hospital and long-term results and predictors of mortality were analyzed. Results. The DS group contained 71 patients with 83 lesions, and the PD group contained 46 patients with 54 lesions. There were no differences image, risk factors, age of the graft, ejection fraction, stent length, need for post dilatation or number of stents per lesion, although the DS group contained more women (DS=38%, PD=17%, P=.02), and stent diameter was larger(DS=3.59 [0.59] mm, PD=3.21 [0.59] mm, P=.001) in the DS group. Creatine phosphokinase elevation was ?2-fold in 10% (DS= 7%, PD=16%, P=.1). One patient died in the hospital. Median follow-up time was 36.1 months. Survival was 94± 2% at 12 months, 87±3% at 24 months, 82±17% at 36 months,67±8% at 48 months and 58±7% at 60 months. Revascularization rate was 14%for the target lesion and 20.5% for the target vessel, with no differences between groups in mortality or revascularization success rate. Predictors of mortality were ejection fraction and smoking habit. Conclusions. Survival after stenting in saphenous vein grafts is similar with direct and conventional techniques, although there was a tendency toward a lower incidence of myocardial infarction with the former. Although the in-hospital results were favorable, long-term survival was less favorable with both techniques

Percutaneous intervention over the origin of a saphenous vein graft anastomosed with the St. Jude Medical Symmetry Aortic Connector System.

We describe a percutaneous intervention performed over the proximal anastomoses of an aortocoronary saphenous vein graft that had been attached to the aorta 3 months before with the St. Jude Medical Symmetry Aortic Connector System. Technical aspects of procedure are discussed, and the experience previously reported in the literature related to this issue is reviewed.

Hialinosis cutáneo-mucosa en tres hermanos / Mucocutaneous hyalinosis: report of 3 brothers

La hialinosis cutáneo-mucosa es un desorden raro, autosómico y recesivo, que afecta la piel, mucosas y órganos internos, cuya característica esencial es el depósito de un material hialino en y alrededor de la membrana basal de los capilares, seguido de infiltración difusa y a veces masiva del tejido intersticial. Presentamos el caso de tres hermanos con manifestaciones clásicas: cicatrices atróficas, pérdida de elasticidad palpebral, infiltración de labios, glotis y cuerda vocal. Se enfatiza en los escasos casos familiares de esta entidad

Hialinosis cutáneo-mucosa en tres hermanos / Mucocutaneous hyalinosis: report of 3 brothers

La hialinosis cutáneo-mucosa es un desorden raro, autosómico y recesivo, que afecta la piel, mucosas y órganos internos, cuya característica esencial es el depósito de un material hialino en y alrededor de la membrana basal de los capilares, seguido de infiltración difusa y a veces masiva del tejido intersticial. Presentamos el caso de tres hermanos con manifestaciones clásicas: cicatrices atróficas, pérdida de elasticidad palpebral, infiltración de labios, glotis y cuerda vocal. Se enfatiza en los escasos casos familiares de esta entidad (AU)