Intermediate snowpack melt-out dates guarantee the highest seasonal grasslands greening in the Pyrenees.

In mountain areas, the phenology and productivity of grassland are closely related to snow dynamics. However, the influence that snow melt timing has on grassland growing still needs further attention for a full understanding, particularly at high spatial resolution. Aiming to reduce this knowledge gap, this work exploits 1 m resolution snow depth and Normalized Difference Vegetation Index observations acquired with an Unmanned Aerial Vehicle at a sub-alpine site in the Pyrenees. During two snow seasons (2019-2020 and 2020-2021), 14 NDVI and 17 snow depth distributions were acquired over 48 ha. Despite the snow dynamics being different in the two seasons, the response of grasslands greening to snow melt-out exhibited a very similar pattern in both. The NDVI temporal evolution in areas with distinct melt-out dates reveals that sectors where the melt-out date occurs in late April or early May (optimum melt-out) reach the maximum vegetation productivity. Zones with an earlier or a later melt-out rarely reach peak NDVI values. The results obtained in this study area, suggest that knowledge about snow depth distribution is not needed to understand NDVI grassland dynamics. The analysis did not reveal a clear link between the spatial variability in snow duration and the diversity and richness of grassland communities within the study area.

The influence of the correlation-covariance structure of measurement errors over uncertainties propagation in online monitoring: application to environmental indicators in SUDS.

This paper presents a methodology to assess the influence of the correlation-covariance structure of measurement errors in online monitoring over the propagation of uncertainties, applied to wet-weather environmental indicators in sustainable urban drainage systems (SUDSs). The effect of auto-correlated and heteroskedastic errors in measured time-series over the estimated probability density function (PDF) of different environmental indicators is analyzed for a wide variety of possible error structures in the data. For this purpose, multiple correlation-covariance structures are randomly generated from exploring the parametric space of a linear exponent autoregressive (LEAR) model, employing a Bayesian-based Markov Chain Monte Carlo sampling technique. Significant differences tests are proposed to identify the most correlated parameters of the correlation-covariance error model with statistics of the environmental indicator PDFs. The method is applied to total suspended solids (TSS) and chemical oxygen demand (COD) time-series recorded during 13 rainfall events at the inlet and outlet of a SUDS train (stormwater settling tank-horizontal constructed wetland). In this case, results showed that the total error in the estimation of the analyzed environmental indicators is mostly explained by standard uncertainties (flattening of the PDFs) rather than bias contributions (displacement of the PDFs). The correlation-covariance model parameters related to the temporal delimitation of hydrographs/pollutographs and the intensity of the autocorrelation showed to have the strongest influence in the propagation of measurement errors (flattening/displacement of the PDFs).

Colorimetric Analysis of Hibiscus Beverages and their Potential Antioxidant Properties.

In food industry, roselle beverages and their subproducts could be functional ingredients since they are an excellent source of bioactive compounds with improved performance due to their important anthocyanins content. The aim of this study was to analyze anthocyanin content and antioxidant properties of aqueous infusions elaborated with color contrasting Hibiscus materials and design a mathematical model in order to predict color-composition relationship. Color measurements of beverages from roselle (Negra, Sudan and Rosa) were made by transmission spectrophotometry, anthocyanins quantification was determined by HPLC, and antioxidant potential was evaluated by in vitro methods (ABTS and FRAP assays). Beverages prepared with particle size minor of 250 µm presented until 4- and 2- times more anthocyanins content and antioxidant capacity respectively, in comparison to beverages prepared with powders with particle size major of 750 µm. Positive correlations among pigments composition and color parameters were found (p < 0.05), showing that anthocyanins content, antioxidant capacity, C*ab and hab values increased in relation with the smallest particle size of flours. Also, mathematical models were stablished to predict anthocyanin content (r ≥ 0.97) and antioxidant capacity (r ≥ 0.89) from color data; we propose equations for quick estimation of the antioxidant capacity in the Hibiscus beverages with high anthocyanin content. The obtained models could be an important tool to be used in food industry for pigment characterization or functional compounds with potential health benefits.

Stochastic optimal generation bid to electricity markets with emissions risk constraints.

There are many factors that influence the day-ahead market bidding strategies of a generation company (GenCo) within the framework of the current energy market. Environmental policy issues are giving rise to emission limitation that are becoming more and more important for fossil-fueled power plants, and these must be considered in their management. This work investigates the influence of the emissions reduction plan and the incorporation of the medium-term derivative commitments in the optimal generation bidding strategy for the day-ahead electricity market. Two different technologies have been considered: the high-emission technology of thermal coal units and the low-emission technology of combined cycle gas turbine units. The Iberian Electricity Market (MIBEL) and the Spanish National Emissions Reduction Plan (NERP) defines the environmental framework for dealing with the day-ahead market bidding strategies. To address emission limitations, we have extended some of the standard risk management methodologies developed for financial markets, such as Value-at-Risk (VaR) and Conditional Value-at-Risk (CVaR), thus leading to the new concept of Conditional Emission at Risk (CEaR). This study offers electricity generation utilities a mathematical model for determining the unit's optimal generation bid to the wholesale electricity market such that it maximizes the long-term profits of the utility while allowing it to abide by the Iberian Electricity Market rules as well as the environmental restrictions set by the Spanish National Emissions Reduction Plan. We analyze the economic implications for a GenCo that includes the environmental restrictions of this National Plan as well as the NERP's effects on the expected profits and the optimal generation bid.

Cognition and the risk of eating disorders in Spanish adolescents: the AVENA and AFINOS studies.

UNLABELLED: Eating disorders (ED) can arise from a combination of biological and psychological factors. Some studies suggest that intellectual factors might be important in the development of ED, although the evidence is still scarce. The aim of this study was to examine the association between cognition measurements (cognitive performance and academic achievement) and the risk of developing ED in adolescents considering their weight status. The sample consisted of 3,307 adolescents (1,756 girls), aged 13-18.5 years, who participated in the AVENA (n = 1,430; 783 girls) and AFINOS (n = 1,877; 973 girls) studies. Cognitive performance was measured by the TEA test in the AVENA study, and academic achievement was self-reported in the AFINOS study. ED risk was evaluated in both studies by using the SCOFF questionnaire. Body mass index was calculated to classify adolescents as non-overweight or overweight (including obesity). Overweight adolescents showed a higher risk of developing ED than non-overweight ones in both studies. In the AVENA study, overweight boys with low performance in reasoning ability showed increased risk of ED (p = 0.05). In the AFINOS study, overweight boys with low academic performance in physical education and non-overweight girls with low academic achievement in all the areas analyzed showed higher risk of ED than their peers (all p < 0.05). CONCLUSION: No association between cognitive performance and ED risk was found in adolescents, while academic achievement was associated with ED risk, especially in non-overweight girls. The non-cognitive traits that accompany academic achievement could influence the likelihood of developing ED in these girls.

Application of LC-MS and tristimulus colorimetry to assess the ageing aptitude of Syrah wine in the Condado de Huelva D.O. (Spain), a typical warm climate region.

The study of the evolutions of different wine pigment families, copigmentation/polymerisation processes and colour characteristics during the first year of ageing in oak barrel has allowed the assessment of the ageing aptitude of Syrah wines from "Condado de Huelva D.O.", a warm climate region. A total of 32 anthocyanic pigments were identified, including 14 major compounds from grape and 18 minor derivatives formed during the vinification. The anthocyanin profile changed towards more chemical complexity, being vitisin-like pyranoanthocyanins the predominant minor pigments during the first month of ageing. As wine became older, a progressive increase on the content of 4-vinylcatechin, 4-vinylphenol and 4-vinylcatechol compounds took place. Results showed that copigmentation occurred during the whole process of ageing inducing visual perceptible colour effects. Simultaneously to the copigmentation decrease, the degree of polymerisation increased during ageing, being maximum at 9 months old wines (77%). The colour of wines evolved progressively in a positive way from 3 to 9 months of ageing, becoming darker and with more vivid colour. However, from 9 to 12 months of ageing, the chemical structure of wines was negatively affected resulting in lighter, with more red-orange hues and less vivid colours. The inclusion of the chemical and colorimetric information on the PCA model allows us to reach very good discriminations among the Syrah wines with different wood contact period.

A novel and enhanced approach for the assessment of the total carotenoid content of foods based on multipoint spectroscopic measurements.

We have devised a more sensible approach to estimate the carotenoid content of orange juices, which can be regarded as a model system of food with intricate carotenoid pattern. For this purpose spectroscopic information at several wavelengths and spectra of the juices and not from their carotenoid extracts were considered, such that more accurate and rapid quantitative assessments can be achieved. The wavelengths proposed on the basis of the characteristic vector method were 420, 455, 515, 545 and 610nm or 420, 445, 510, 545 and 605nm, depending on the measurement conditions. The correlations between the carotenoid content and the reflectances at these wavelengths were very good (R=0.94 and 0.90, respectively). Additionally, it was demonstrated that the colour of the juices could be assessed with very good accuracy considering them. Due to its simplicity and rapidity, this method is intended to facilitate the quality control of the carotenoid content of foodstuffs in the industry and/or in the field.

Atresia yeyunal con membrana duodenal de presentación tardía / Jejunal atresia with duodenal membrane

Presentamos el caso clínico de una niña que fue atendida en la Caja Petrolera de Santa Cruz de la Sierra, por una atresia yeyunal con membrana duodenal de presentación tardía. Aprovechamos el caso para hacer una revisión del tema.

We describe the clinical case of a female seen at “Caja Petrolera of Santa Cruz de la Sierra”, because a jejunal atresia with duodenal membrane. We used this case to revise the subject.

Behavioural therapy in the treatment of obesity (II): role of the Mediterranean diet.

OBJECTIVES: Obesity is the consequence of an imbalance between energy intake and expenditure, food intake being affected by multiple factors -psychological, social, work-related, etc. This revision discusses the role of diet in the behavioural treatment (BT) of obesity, which faces multiple approaches and focuses on patients' behaviour rather than their mere energy intake. SETTING: Recent literature has been revised that deals with the health benefits of Mediterranean diet in order to assess its suitability for obesity treatment based on BT. RESULTS: BT helps patients to develop skills and techniques in order to adopt proper habits and attain their healthiest weight. Patients learn to establish realistic goals, both as regards weight and behaviour, and to evaluate their progress in modifying eating and exercising habits. The application of the Mediterranean diet in obesity treatment presents various advantages which are based on the principles of this diet -wide variety of food, high carbohydrate content, or high satiating capacity, which prevents specific hunger and ketogenesis-, and has been demonstrated to be effective in reducing body weight. CONCLUSIONS: BT based on the Mediterranean diet is a useful tool for obesity treatment. The Mediterranean diet provides the patients with a diet established on widely recognised nutritional benefits, suitable to their social and daily life, and that can be easily followed in the long term, according to the objectives of BT. For these reasons, Mediterranean diet-based BT helps to prolong both the treatment and maintenance periods and therefore contributes to a more stable weight loss.

Behavioural therapy in the treatment of obesity (II): role of the Mediterranean diet / La terapia de comportamiento en el tratamiento de la obesidad (II): papel de la dieta mediterránea

Objectives: Obesity is the consequence of an imbalance between energy intake and expenditure, food intake being affected by multiple factors -psychological, social, work-related, etc. This revision discusses the role of diet in the behavioural treatment (BT) of obesity, which faces multiple approaches and focuses on patients' behaviour rather than their mere energy intake. Setting: Recent literature has been revised that deals with the health benefits of Mediterranean diet in order to assess its suitability for obesity treatment based on BT. Results: BT helps patients to develop skills and techniques in order to adopt proper habits and attain their healthiest weight. Patients learn to establish realistic goals, both as regards weight and behaviour, and to evaluate their progress in modifying eating and exercising habits. The application of the Mediterranean diet in obesity treatment presents various advantages which are based on the principles of this diet -wide variety of food, high carbohydrate content, or high satiating capacity, which prevents specific hunger and ketogenesis-, and has been demonstrated to be effective in reducing body weight. Conclusions: BT based on the Mediterranean diet is a useful tool for obesity treatment. The Mediterranean diet provides the patients with a diet established on widely recognised nutritional benefits, suitable to their social and daily life, and that can be easily followed in the long term, according to the objectives of BT. For these reasons, Mediterranean diet-based BT helps to prolong both the treatment and maintenance periods and therefore contributes to a more stable weight loss (AU)

Objetivos: La obesidad es consecuencia del desequilibrio entre gasto energético e ingesta, y la ingesta está influida por múltiples factores (psicosociales, laborales, etc.) Esta revisión analiza el papel de la Dieta Mediterránea en la terapia de comportamiento (TC) para la obesidad, una terapia multidisciplinar que prioriza los hábitos del paciente sobre la mera ingesta energética. Ámbito: Se ha revisado la literatura reciente relacionada con las propiedades saludables de la Dieta Mediterránea, para determinar la idoneidad de su uso en el contexto de la TC. Resultados: La TC ayuda a desarrollar habilidades y técnicas para adquirir hábitos apropiados y conseguir un peso saludable. El paciente aprende a establecer metas realistas en relación a su peso y comportamiento, y a evaluar su progreso con respecto a los cambios de hábitos alimentarios. El empleo de la Dieta Mediterránea en el tratamiento de la obesidad presenta varias ventajas derivadas de los principios de esta dieta -variedad, alto contenido en carbohidratos, o alta capacidad saciante, previniendo hambres específicas y cetogénesis-, demostrándose efectiva en la pérdida de peso. Conclusiones: La TC basada en la Dieta Mediterránea es una herramienta útil en el tratamiento de la obesidad. Esta dieta proporciona beneficios nutricionales ampliamente reconocidos, es compatible con la vida social, y se puede seguir a largo plazo, cumpliendo así los objetivos de la TC. Por ello, las terapias basadas en la Dieta Mediterránea ayudan a prolongar los periodos de tratamiento y mantenimiento, contribuyendo a una pérdida de peso más estable (AU)

Behavioural therapy in the treatment of obesity (I): new directionsfor clinical practice / Terapia de comportamiento en el tratamiento de la obesidad (I): Nuevas direcciones en la práctica clínica

Objectives: Behavioural therapy (BT) in obesity treatment helps individuals to develop skills to achieve healthier body weights. Instead of helping to decide what to change, it helps to identify how to change; lifestyle modification is essential for any treatment of obesity, be it dieting, medication, surgery, etc. Physicians often tend to be unwilling to use BT considering it time-consuming and skill-intensive. However, BT can be standardized and used more readily in clinical practice. Besides, new approaches have been developed which contribute to increase the success of the treatments, like non face-to-face techniques, or the new cognitive therapy. Setting: Classical knowledge on BT has been updated with recent publications and information on these new approaches, combined with our own experience in the clinical treatment of obesity. Results: Most research on BT has been conducted in university-based programs which, despite their importance, tell us little about its effectiveness in actual clinical practice. Future research might focus on determining how BT can be best applied in a real-world setting. Examples of new directions are increased maintenance periods, use of Internet, and new cognitive therapy. Besides, elucidating the genetic component in the prognosis of weight management -the nutrigenomic approach- could assist in the development of more effective and individually tailored therapeutic strategies; indeed, single nucleotide polymorphisms in candidate genes have been related with eating patterns. Conclusions: This review gives a renewed perspective of BT for obesity, offers key-pointers and describes specific ways in which medical professionals can promote and encourage self-care of patients (AU)

Objetivos: La terapia conductual (TC) en la obesidad busca desarrollar habilidades que promuevan un peso saludable. En lugar de qué cambiar, se trata de identificar cómo cambiar, pues modificar el estilo de vida es esencial para cualquier tratamiento de la obesidad, ya sea dietético, farmacológico, quirúrgico, etc. Los profesionales médicos suelen ser reacios a emplearla, considerando que exige tiempo y habilidades específicas. Sin embargo, la TC puede ser fácilmente estandarizada y aplicada en la práctica clínica, y nuevos enfoques y técnicas contribuyen a un mayor éxito del tratamiento. Ámbito: Se ha actualizado el conocimiento existente sobre TC, combinando información sobre los nuevos enfoques con nuestra propia experiencia en el tratamiento clínico de la obesidad. Resultados: Los estudios sobre TC provienen principalmente del ámbito académico y, aunque son importantes, dan poca información sobre la efectividad de la TC en la práctica clínica. Investigaciones futuras deberían determinar cómo la TC puede ser aplicada en un contexto clínico realista. Ejemplos de los nuevos enfoques son: el incremento del período de mantenimiento, el uso de internet, o la nueva terapia cognitiva. Asimismo, considerar el componente genético en la prognosis del control del peso corporal podría ayudar a desarrollar estrategias terapéuticas más efectivas y personalizadas; de hecho, ciertos polimorfismos génicos se han relacionado con la adopción de determinados patrones alimentarios. Conclusiones: Esta revisión presenta una perspectiva renovada de la TC para la obesidad, ofrece puntos clave y describe vías específicas por las que el profesional médico puede promover la participación activa de los pacientes (AU)

Adiponectin is associated with serum and adipose tissue fatty acid composition in rats.

The objective of the present work is to analyse the relationships between changes in adiponectin and fatty acid composition in serum and adipose tissue in rats. Samples from serum and different adipose depots (periovarian, mesenteric and subcutaneous) were obtained from ageing rats (14- and 20-month-old) to determine fatty acid composition (gasliquid chromatography). In serum, insulin (radioimmunoassay) and adiponectin levels (enzyme-linked immunosorbent assay) were also measured, while adiponectin gene expression was analysed (real time-qPCR) in all fat depots. There were significant age-related reductions in adipose tissue saturated (SFA) and trans fatty acids and increases in monounsaturated fatty acids in parallel with diminished adiponectin expression in periovarian and mesenteric adipose tissue (p<0.05). Age-independent negative correlations were found between adiponectin gene expression in mesenteric adipose tissue and C12:0, C14:0 and C18:2 trans fatty acids (p<0.05). There was a positive association between serum adiponectin and adipose tissue oleic acid, while palmitoleic acid was negatively associated with adiponectin expression and positively correlated with insulin concentration. For the first time, positive relationships are reported between the proportion of n-6 polyunsaturated fatty acids (PUFA) in adipose tissue and adiponectin concentration and expression. In summary, adiponectin expression and serum levels are associated with fatty acid composition, with SFA, trans and palmitoleic fatty acids appearing as negative markers for adiponectin, and oleic acid and n-6 PUFA as positive ones. In addition, most associations were found in the visceral depots, highlighting the importance of visceral fat in the metabolic status.

Behavioural therapy in the treatment of obesity (I): new directions for clinical practice.

OBJECTIVES: Behavioural therapy (BT) in obesity treatment helps individuals to develop skills to achieve healthier body weights. Instead of helping to decide what to change, it helps to identify how to change; lifestyle modification is essential for any treatment of obesity, be it dieting, medication, surgery, etc. Physicians often tend to be unwilling to use BT considering it time-consuming and skill-intensive. However, BT can be standardized and used more readily in clinical practice. Besides, new approaches have been developed which contribute to increase the success of the treatments, like non face-to-face techniques, or the new cognitive therapy. SETTING: Classical knowledge on BT has been updated with recent publications and information on these new approaches, combined with our own experience in the clinical treatment of obesity. RESULTS: Most research on BT has been conducted in university-based programs which, despite their importance, tell us little about its effectiveness in actual clinical practice. Future research might focus on determining how BT can be best applied in a real-world setting. Examples of new directions are increased maintenance periods, use of Internet, and new cognitive therapy. Besides, elucidating the genetic component in the prognosis of weight management -the nutrigenomic approach- could assist in the development of more effective and individually tailored therapeutic strategies; indeed, single nucleotide polymorphisms in candidate genes have been related with eating patterns. CONCLUSIONS: This review gives a renewed perspective of BT for obesity, offers key-pointers and describes specific ways in which medical professionals can promote and encourage self-care of patients.

The mariner transposable element in natural populations of Drosophila simulans.

In cosmopolitan species, geographical variations in copy number and/or level of transposition activity have been observed for several transposable elements (TEs). Environment, history and population structure can contribute to such variation in ways that are difficult to tease apart. For the mariner element, previous studies of the geographic variation of its somatic activity in natural populations of Drosophila simulans have shown contradictory results (latitudinal clines of divergent orientations or no apparent structure). To try and resolve these inconsistencies, we gathered all available data on the mariner somatic activity of worldwide natural populations. This includes previously published results by different groups and also new data. The correlations between the level of activity and several geoclimatic factors were tested. Although no general effect of temperature was found, a relationship with the invasion history was detected. It was also shown that recent invasive populations have a higher level of activity than the putative ancestral ones. Our results strongly suggest that variability of the mariner somatic activity among natural populations of D. simulans is mainly due to populational and historical factors probably related to the recent world colonization of this species. Indeed, this activity is correlated to the main route out of Africa (the Nile route) and the recent colonization of continents such as Australia and South America.

[Guidelines for the clinical management of neuropathic pain (II)]. / Guías de práctica clínica del dolor neuropático (II).

INTRODUCTION: Up to 5% of the population suffers from neuropathic pain (NP). A bibliographical search in several databases revealed that, to date, there are no protocols to guide physicians who are not specialists in pain that enable them to treat NP and thus improve patients' quality of life. AIMS: The aim of this study is to provide Spanish-speaking physicians who are not specialists in pain with a set of guidelines for the treatment of NP. A bibliographical search was performed in order to base the results and conclusions on the evidence-based medicine methodology. DEVELOPMENT: First, we review the most effective clinical and paraclinical methods for diagnosing NP, and the LANSS pain scale is reported as the most appropriate method of clinically evaluating NP. The anatomical paths and the physiology of pain are then described and we review the molecular variables involved. Finally, we point out the current therapeutic options and propose an algorithm for the treatment of NP. CONCLUSIONS: There is no specific set of guidelines for the treatment of NP. At the present time, the keystone of NP treatment consists in the use of antidepressant and anticonvulsive drugs. There is a need for further clinical trials to prove the effectiveness of using combined medication.

[Guidelines for the clinical management of neuropathic pain (I). Protocol]. / Guías de práctica clínica del dolor neuropático (I). Protocolo.

AIMS: The aim of this study is to develop a set of guidelines for the clinical management of neuropathic pain (NP), a disorder suffered by up to 5% of the population, specifically for use by the Spanish-speaking community, in order to improve the quality of medical care and to standardise the treatments offered in medical centres. DEVELOPMENT: The paper describes the methodology used to search for guidelines concerning the clinical management of NP in databases, written communications and other resources, and the results of this search are presented. The research group is split into three groups: anatomical-physiological, diagnosis and therapeutic approach, each of which defines the nature of the papers that used to design the protocol.

Guías de práctica clínica del dolor neuropático (II) / Guidelines for the clinical management of neuropathic pain (II)

Introducción. El dolor neuropático (DN) se presenta hasta en el 5% de la población. Después de una búsqueda bibliográfica en varias bases de datos, se determinó que hasta la fecha no existen protocolos que orienten al médico que no es especialista en dolor para tratar el DN y mejorar la calidad de vida de los pacientes. Objetivo. Presentar unas guías de tratamiento del DN dirigidas a médicos no especialista en dolor de habla hispana. Se realizó una búsqueda bibliográfica para fundamentar los resultados y las conclusiones con la metodología de la medicina basada en la evidencia. Desarrollo. En primera instancia se revisan los métodos clínicos y paraclínicos más eficaces para el diagnóstico del DN y se describe la escala de LANSS como la opción más adecuada para la evaluación clínica del DN. Posteriormente, se describen las vías anatómicas y la fisiología del dolor y se revisan las variables moleculares involucradas. Finalmente, se señalan las opciones terapéuticas actuales y se propone un algoritmo de tratamiento del DN. Conclusiones. No existe un esquema específico para el tratamiento del DN. Actualmente, los antidepresivos y los anticonvulsionantes son la piedra angular del tratamiento. Se requieren ensayos clínicos que evidencien la eficacia del uso de medicamentos combinados

Introduction. Up to 5% of the population suffers from neuropathic pain (NP). A bibliographical search in several databases revealed that, to date, there are no protocols to guide physicians who are not specialists in pain that enable them to treat NP and thus improve patients’ quality of life. Aims. The aim of this study is to provide Spanish-speaking physicians who are not specialists in pain with a set of guidelines for the treatment of NP. A bibliographical search was performed in order to base the results and conclusions on the evidence-based medicine methodology. Development. First, we review the most effective clinical and paraclinical methods for diagnosing NP, and the LANSS pain scale is reported as the most appropriate method of clinically evaluating NP. The anatomical paths and the physiology of pain are then described and we review the molecular variables involved. Finally, we point out the current therapeutic options and propose an algorithm for the treatment of NP. Conclusions. There is no specific set of guidelines for the treatment of NP. At the present time, the keystone of NP treatment consists in the use of antidepressant and anticonvulsive drugs. There is a need for further clinical trials to prove the effectiveness of using combined medication

Guías de práctica clínica del dolor neuropático (I). Protocolo / Guidelines for the clinical management of neuropathic pain (I). Protocol

Objetivo. Desarrollar unas guías de práctica clínica para el dolor neuropático (DN), un trastorno que se manifiesta hasta en el 5% de la población, específicamente para la comunidad de habla hispana, con el fin de mejorar la calidad del cuidado médico y estandarizar los tratamientos en los centros clínicos. Desarrollo. Se describe la metodología de búsqueda de guías de práctica clínica de DN en bases de datos, comunicaciones escritas y otros recursos, y se muestran los hallazgos. El grupo investigador se distribuye en tres grupos: aproximación anatomofisiológica, aproximación diagnóstica y aproximación terapéutica, cada uno de los cuales define la pertinencia de los artículos que se utilizarán para diseñar el protocolo

Aims. The aim of this study is to develop a set of guidelines for the clinical management of neuropathic pain (NP), a disorder suffered by up to 5% of the population, specifically for use by the Spanish-speaking community, in order to improve the quality of medical care and to standardise the treatments offered in medical centres. Development. The paper describes the methodology used to search for guidelines concerning the clinical management of NP in databases, written communications and other resources, and the results of this search are presented. The research group is split into three groups: anatomical-physiological, diagnosis and therapeutic approach, each of which defines the nature of the papers that used to design the protocol

Estudio epidemiológico del suicidio en Sevilla en 2004 / Epidemiological study of suicide in Seville in 2004

En este artículo se realiza un estudio epidemiológico descriptivo de las muertes de etiología suicida ocurridas en Sevilla en el año 2004 y los datos obtenidos se comparan con otros estudios previos realizados en la misma zona. La tasa de suicidio fue de 8,36 por 100.000 habitantes con una relación hombre/mujer de 2,6:1. La edad media global ha sido de 54,3 años (52,7 años en varones y 58,7 años en mujeres). El mayor número de suicidios (58,5%) se producen en el segundo y tercer trimestre del año (primavera y verano). En cuanto al estado civil, la mayor frecuencia se produce en personas casadas (31,2%). Solo en el 9,5% de los suicidas existían antecedentes de intentos autolíticos previos. La ahorcadura ha sido el mecanismo más empleado en los varones (50,9%) mientras que en las mujeres el mecanismo más frecuente ha sido la precipitación (41,5%). Un 57,1% de los sujetos tenía antecedentes psiquiátricos siendo los trastornos más frecuentes la depresión o los síntomas depresivos (65,5%) y la esquizofrenia (15,5%). Se efectuaron análisis químico-toxicológicos en el 78,2% de los casos de los cuales fueron positivos el 69,6%. El alcohol etílico fue la sustancia más detectada (24,3%), seguido de las benzodiazepinas (18,3%) y los antidepresivos (11,3%). Se observa una cierta estabilización en la tasa de suicidios en Sevilla desde mediados del siglo XX hasta la actualidad

In this paper, we present an epidemiological descriptive study of the suicides occurred in Seville in 2004 and the results are compared with data obtained in previous studies in the same area. Suicide rate was 8,36 per 100.000 inhabitants with a male/female ratio of 2,6:1. The medium age has been 54,3 years (52,7 years in males and 58,7 years in females). Suicides predominate in the second and third trimester of the year (spring and summer). Taking into account the civil status, the mayor frequency appears in married (31,2%). Only 9,5% of the cases had antecedents of previous autolysis intents. Hanging was the most frequent mechanism to commit suicide in men (50.9%) while in women was jumping (41,5%). In 57,1% of cases there were antecedents of mental disorder mainly depression of depressive symptoms (65,5%) followed by schizophrenia (15,5%). Toxicological analyses were performed in 78,2% of cases with positive results in 69,6%. Ethanol was the toxic most detected (24,3%) followed by benzodiazepines (18,3%) and antidepressants (11,3%). According to the results of the study, we observe a certain stabilization of the suicide rates in Seville from the middle of the XXth century up to now

Differential diagnosis in fetuses with absent septum pellucidum.

OBJECTIVE: To elucidate the characteristic morphological features that may help in the prenatal differential diagnosis of absent septum pellucidum as demonstrated by ultrasound. METHODS: Twenty-six fetuses were referred to the fetal neurology clinic due to mild to severe ventriculomegaly and a connection between the lateral ventricles. The following ultrasonographic features were evaluated: place and extent of the ventricular communication, non-cleavage of the hemispheres and deep gray nuclei, callosal anomalies, position of the choroid plexus, and other central nervous system and facial or body anomalies. A flowchart was created in order to facilitate the final diagnosis. RESULTS: The presence of non-cleavage and/or characteristic facial anomalies prompted the diagnosis of holoprosencephaly (HPE) in 14 fetuses, including two fetuses with the middle interhemispheric variant. Ten fetuses were diagnosed as having hydrocephalus based on the lack of the same features and the observation that the communication between the lateral ventricles was at the level of the third ventricle with almost normal anterior and posterior segments. In two fetuses the diagnosis of septo-optic dysplasia vs. isolated agenesis of the cavum septi pellucidi was contemplated. CONCLUSIONS: The use of the proposed flowchart enabled differentiation between hydrocephalus and HPE. The communication between the ventricles in hydrocephalic fetuses may be due to a disruption of the septum pellucidum or to a pathological enlargement of the foramen of Monro. Published by John Wiley & Sons, Ltd.