Diagnosis of intestinal protozoan infections in patients in Cuba by microscopy and molecular methods: advantages and disadvantages.

Microscopy is the gold standard for diagnosis of intestinal parasitic diseases in many countries, including Cuba, although molecular approaches often have higher sensitivity as well as other advantages. Fecal samples from 133 patients were analyzed by light microscopy and also real-time multiplex qPCR targeting Giardia duodenalis, Cryptosporidium spp., and Entamoeba histolytica, and, separately, Dientamoeba fragilis. Microscopy revealed G. duodenalis occurred most commonly (17 patients), followed by Blastocystis spp. (12 patients). In a few patients, Entamoeba histolytica/E. dispar, Cryptosporidium spp., and Cyclospora cayetanensis were identified. Molecular analysis identified 4 more G. duodenalis infections and 2 more Cryptosporidium spp. infections; concordance between microscopy and PCR showed almost perfect agreement for G. duodenalis (κ = 0.88) and substantial agreement for Cryptosporidium (κ = 0.74). PCR indicated that E. dispar, rather than E. histolytica, had been identified by microscopy. Additionally, 16 D. fragilis infections were detected using molecular methods. Although both microscopy and molecular techniques have a place in parasitology diagnostics, for parasites such as D. fragilis, where microscopy can underestimate occurrence, molecular techniques may be preferable, and also essential for distinguishing between morphologically similar microorganisms such as E. histolytica and E. dispar. Although in resource-constrained countries such as Cuba, microscopy is extremely important as a diagnostic tool for intestinal parasites, inclusion of molecular techniques could be invaluable for selected protozoa.

Creencias y actitudes del alumnado universitario hacia la violencia de género / Beliefs and attitudes of university students towards gender violence

INTRODUCCIÓN: La violencia de género es un grave problema de salud pública que requiere la intervención, entre otros, de personal sanitario. Los profesionales señalan la falta de conocimientos como una de las dificultades para afrontarlo. Se han puesto de manifiesto actitudes y percepciones erróneas en el alumnado universitario debido a una formación inadecuada o insuficiente. Nuestro objetivo ha sido evaluar las creencias y actitudes sobre la violencia de género en estudiantes de la Universidad de Santiago de Compostela. MATERIAL Y MÉTODOS: Un total de 491 estudiantes de medicina, enfermería, derecho y criminología de la Universidad de Santiago de Compostela completaron un cuestionario de 30 preguntas, voluntario y anónimo. RESULTADOS: La mayoría de los participantes en la encuesta (70,9%) eran mujeres, con una edad media de 22,7 años. Aunque el 53,6% del alumnado había recibido formación previa, los datos muestran que los estudiantes tienen algunas ideas equivocadas sobre la violencia de género. Casi el 96% considera que es un problema importante en nuestra sociedad y cree que debe mejorarse la atención a las víctimas. Cerca del 90% se mostró en contra de que se considerase un asunto privado, apoyando la denuncia de estos casos por parte del personal sanitario. CONCLUSIONES: Se muestra la necesidad de ofrecer más oportunidades educativas sobre la violencia de género, sobre todo entre el alumnado de aquellas profesiones implicadas en el abordaje de este problema. Una correcta preparación de los futuros profesionales mejorará la detección precoz y el tratamiento de las víctimas

INTRODUCTION: Gender violence is a major public health problem that requires the intervention of health personnel, among others. Professionals indicate that lack of knowledge is one of the main difficulties of facing this problem. The attitudes and misperceptions among university students might be due to inadequate or insufficient training. The aim of this study was to evaluate the beliefs and attitudes towards gender violence among students of the University of Santiago de Compostela. MATERIAL AND METHODS: A total of 491 undergraduate students (Medicine, Nursing, Criminology and Law) of the University of Santiago de Compostela completed an anonymous 30-item questionnaire. RESULTS: Most (70.9%) participants in the survey were women, with a mean age of 22.7 years. Although 53.6% of students had received previous training, data show that they have some misperceptions on gender violence. Nearly 96% consider it as an important problem in our society, and believe that attention to the victims has to be improved. Almost 90% of respondents disagreed about considering it a private matter, supporting the legal complaint by health personnel. CONCLUSIONS: Data shows the necessity to offer more educational opportunities on gender violence, especially to students of those professions involved in this problem. An appropriate education of the future professionals would improve the detection and treatment of the victims

Attitudes towards physician-assisted suicide and euthanasia in Spanish university students / Actitudes hacia la eutanasia y el suicidio medicamente asistido en estudiantes universitarios españoles / Atitudes em relação a eutanásia e suicídio medicamente assistido em estudantes universitários espanhóis

Abstract Attitudes toward physician-assisted death among medical students differ between populations. The aim of this study was to explore attitudes towards euthanasia and physician-assisted suicide among Spanish university students. A cross-sectional survey was conducted by asking undergraduate students (Medicine, Nursing and Law) of the University of Santiago de Compostela to complete an anonymous 17-item questionnaire. Most participants exhibited a positive attitude towards physician-assisted suicide (54%) and euthanasia (75%), as well as towards their legalization. Attitudes were consistent with the underlying ethical reasoning, with no differences in terms of age, gender or academic degree. In addition, consistency was found between attitudes and willingness to participate in physician-assisted suicide and euthanasia, should they be legal. The results showed that the attitudes of medical students towards euthanasia and physician-assisted suicide were positive and similar to non-medical students.

Resumen La actitud de los estudiantes de Medicina ante a la muerte médicamente asistida difiere entre poblaciones. El objetivo de este estudio ha sido explorar las actitudes hacia la eutanasia y el suicidio médicamente asistido en estudiantes universitarios españoles. Se realizó una encuesta transversal en estudiantes de grado (Medicina, Enfermería y Derecho) de la Universidad de Santiago de Compostela que completaron un cuestionario anónimo de 17 preguntas. La mayoría de los participantes mostraron una actitud positiva hacia el suicidio médicamente asistido (54%) y la eutanasia (75%), así como hacia su legalización. Las actitudes fueron coherentes con los argumentos éticos, no encontrando diferencias en relación con la edad, el sexo o la titulación. Asimismo, las actitudes estaban de acuerdo con la intención de participar en estos procedimientos, si fueran legales. Los resultados muestran que la actitud de los estudiantes de medicina hacia la eutanasia y el suicidio asistido es positiva y similar a la de estudiantes de enfermería y derecho.

Resumo A atitude dos estudantes de medicina ante a morte medicamente assistida difere entre populações. O objetivo deste estudo foi explorar as atitudes para a eutanásia e o suicídio medicamente assistido em estudantes universitários espanhóis. Foi realizada uma pesquisa transversal em estudantes de graduação (medicina, enfermagem e direito) da Universidade de Santiago de Compostela que completaram um questionário anônimo de 17 perguntas. A maioria dos participantes mostrou atitude positiva para o suicídio medicamente assistido (54%) e a eutanásia (75%), bem como para a sua legalização. As atitudes foram coerentes com os argumentos éticos, não encontrando diferenças em relação a idade, sexo ou titulação. Assim mesmo, as atitudes estavam de acordo com a intenção de participar nestes procedimentos, se fossem legais. Os resultados mostram que a atitude dos estudantes de medicina para a eutanásia e o suicídio assistido é positiva e similar à de estudantes de enfermagem e direito.

Radiographic Assessment Of Crestal Bone Loss In Tissue-Level Implants Restored By Platform Matching Compared With Bone-Level Implants Restored By Platform Switching: A Randomized, Controlled, Split-Mouth Trial With 3-Year Follow-Up.

PURPOSE: This randomized, controlled, split-mouth trial with 3-year follow-up was carried out to compare radiologic changes of crestal bone level (CBL) between splinted tissue-level implants restored by platform matching and bone-level implants restored by platform switching. MATERIALS AND METHODS: Periapical radiographs were taken to evaluate the peri-implant crestal bone changes at baseline (implant restoration), at 1 year, and at 3 years after the definitive restoration. RESULTS: Thirty-five patients requiring a partial fixed dental prosthesis supported by two implants had their sites randomized according to receiving both implant types. Fifty tissue-level implants restored by platform matching, as control implants, and 50 bone-level implants restored by platform switching, as test implants, were placed. Crestal bone changes in the control group were: baseline to 3 years, 0.18 ± 0.46 mm (P = .043). In the test group, crestal bone changes were: baseline to 3 years, 0.14 ± 0.35 mm (P = .514). The mean differences between groups were: baseline to 1 year, 0.07 ± 0.23 mm (95% CI: -0.034, 0.185); 1 to 3 years, 0.01 ± 0.01 mm (95% CI: -0.055, 0.074); baseline to 3 years, 0.04 ± 0.11 mm (95% CI: -0.080, 0.150). No statistically significant differences in CBL at baseline to 1 year (P = .269), 1 year to 3 years (P = .811), and baseline to 3 years (P = .513) were observed. CONCLUSION: In this trial, CBL changes in the tissue level control group were statistically significant only between baseline and 3-year follow-up. Meanwhile, CBL changes in the bone-level test group were not statistically significant in the different times studied. No statistically significant difference in CBL between two implant types was observed.

Crestal Bone Level Around Tissue-Level Implants Restored with Platform Matching and Bone-Level Implants Restored with Platform Switching: A 5-Year Randomized Controlled Trial.

PURPOSE: The aim of this randomized clinical trial with a 5-year follow-up was to assess the differences in radiographic levels of peri-implant bone crest between tissue-level implants restored with platform matching (control group) and bone-level implants restored with platform switching (test group) in the posterior region. MATERIALS AND METHODS: To assess marginal bone level changes, periapical radiographs were taken at the moment of prosthesis delivery (baseline), at 1 year, and at 5 years after the definitive restoration. RESULTS: One hundred subjects, partially edentulous in the posterior region, were selected for this study. There were 54 men and 46 women between the ages of 25 and 70 years (mean = 50.5 years). A total of 202 implants were assigned to both groups using a randomized procedure (100 implants in the control group and 102 in the test group). The mean marginal bone level (MBL) changes for tissue-level implants restored with platform matching were 0.26 ± 0.55 mm at baseline to 1 year, 0.34 ± 0.54 mm at 1 year to 5 years, and 0.61 ± 0.73 mm at baseline to 5 years. The mean MBL changes for bone-level implants restored with platform switching were -0.03 ± 0.74 mm at baseline to 1 year, -0.17 ± 0.67 mm at 1 year to 5 years, and -0.20 ± 0.75 mm at baseline to 5 years. The mean difference between the two groups was 0.31 mm at baseline to 1 year, 0.53 mm at 1 year to 5 years, and 0.85 mm at baseline to 5 years. There was a statistically significant difference in MBL (P < .001). Both implant systems showed good and similar survival rates (98% for tissue-level implants restored with platform matching and 96.1% for bone-level implants restored with platform switching). CONCLUSION: In this randomized controlled trial, the following observations were made. Radiographic levels of peri-implant bone crest in tissue-level implants restored by platform matching were statistically significant in the three interval times. Meanwhile, MBL changes for bone-level implants restored with platform switching were not statistically significant in the different times studied. Nevertheless, the mean difference between the two groups was statistically significant.

25-Hydroxyvitamin D levels of children are inversely related to adiposity assessed by body mass index

Vitamin D deficiency is associated with wide range of pathologies. Some evidences have shown that low vitamin D circulating levels in children and adolescent are related to fat mass and obesity. The objectives of the present study were to characterize vitamin D status in children and adolescents and to determine if serum 25-hydroxyvitamin D (25(OH)D) concentration is related to adiposity assessed by body mass index (BMI). Serum 25(OH)D levels were measured by LIAISON method in 471 children and adolescents (2 to 18 years age) and analyzed according to gender, pubertal period, age, and BMI. An overall prevalence of 25(OH)D insufficiency and deficiency was present in the 67.1%. Lower 25(OH)D levels were found in females (25.56 ± 14.03 vs 29.71 ± 17.10 ng ml−1; P = 0.004) and pubertal children (25.52 ± 13.97 vs 29.21 ± 16.83 ng ml−1; P = 0.011). In addition, an inverse relation of BMI and age on 25(OH)D concentrations was observed in children. In conclusion, low vitamin D status was highly prevalent among children and adolescents. Of note, a non-lineal regression model showed that 39.6% of vitamin D levels variability was explained by BMI. These results indicate that adiposity assessed by BMI impacts vitamin D status

25-Hydroxyvitamin D levels of children are inversely related to adiposity assessed by body mass index.

Vitamin D deficiency is associated with wide range of pathologies. Some evidences have shown that low vitamin D circulating levels in children and adolescent are related to fat mass and obesity. The objectives of the present study were to characterize vitamin D status in children and adolescents and to determine if serum 25-hydroxyvitamin D (25(OH)D) concentration is related to adiposity assessed by body mass index (BMI). Serum 25(OH)D levels were measured by LIAISON method in 471 children and adolescents (2 to 18 years age) and analyzed according to gender, pubertal period, age, and BMI. An overall prevalence of 25(OH)D insufficiency and deficiency was present in the 67.1%. Lower 25(OH)D levels were found in females (25.56 ± 14.03 vs 29.71 ± 17.10 ng ml-1; P = 0.004) and pubertal children (25.52 ± 13.97 vs 29.21 ± 16.83 ng ml-1; P = 0.011). In addition, an inverse relation of BMI and age on 25(OH)D concentrations was observed in children. In conclusion, low vitamin D status was highly prevalent among children and adolescents. Of note, a non-lineal regression model showed that 39.6% of vitamin D levels variability was explained by BMI. These results indicate that adiposity assessed by BMI impacts vitamin D status.

Características y consecuencias de la violencia de género: estudio de casos confirmados por sentencia judicial / Features and consequences of gender violence: study of cases confirmed by a conviction

Introducción. La violencia de género constituye un importante problema de salud pública con un gran impacto sociofamiliar y económico. El objetivo de este estudio ha sido analizar las características y circunstancias del maltrato, incluyendo a los sujetos implicados (víctima y agresor) y su relación de pareja, así como las peculiaridades del abuso y sus consecuencias lesivas. Material y métodos. Estudio retrospectivo, de tipo descriptivo, de los casos clasificados como violencia de género por la Fiscalía de Área de Santiago de Compostela, durante el período 2005-2012. Se analizaron 398 casos de violencia de género con sentencia firme condenatoria. Resultados. Las víctimas eran, sobre todo, mujeres jóvenes (media 36,6 años), de nacionalidad española (82,91%), casadas (39,70%), con hijos (69,85%), empleo remunerado (40,45%) y nivel socioeconómico bajo (53,52%). Los agresores tenían una edad media de 39,5 años, con predominio de españoles (85,93%), de nivel socioeconómico bajo (37,44%). En el momento de la agresión, el 56,03% de las parejas convivían y un 62,22% compartía la vivienda con los hijos. El maltrato, fundamentalmente combinación de abuso físico y psicológico (43,72%), se produjo sobre todo en el domicilio (65,08%) y fue presenciado por terceras personas (64,57%). Como consecuencia de la agresión, el 53,02% de las mujeres sufrieron lesiones físicas, básicamente contusiones o hematomas (41,21%), localizadas principalmente en los miembros superiores (26,88%) y en la cara (24,37%). Conclusiones. La información obtenida sobre las características y circunstancias del maltrato es fundamental para adaptar, en base a la evidencia, las medidas de intervención y tratamiento de este problema (AU)

Introduction. Gender violence is a major public health problem with a significant socio-family and economic impact. The aim of this study was to analyse the characteristics and circumstances of abuse, including the subjects involved (victim and aggressor), their intimate relationship, as well as the peculiarities of abuse and its harmful consequences. Material and methods. Retrospective and descriptive study of cases classified as gender violence from the prosecutor's office of Santiago de Compostela between 2005 and 2012. A total of 398 cases of gender violence with a final conviction were analysed. Results. Victims were mainly young women (mean age 36.6 years), of Spanish nationality (82.91%), married (39.70%), with children (69.85%), employed (40.45%) and with low socioeconomic status (53.52%). Aggressors had an average age of 39.5 years, were predominantly Spanish (85.93%) and of low socioeconomic status (37.44%). At the time of abuse, 56.03% of the couples lived together and 62.22% shared the house with children. The maltreatment, mainly a combination of physical and psychological abuse (43.72%), occurred most often at home (65.08%) and was witnessed by others (64.57%). As a result of the aggression, 53.02% of women suffered physical injuries, generally bruises or haematomas (41.21%) located mainly on the upper limbs (26.88%) and face (24.37%). Conclusions. The information obtained on the characteristics and circumstances of abuse is an essential step in order to formulate evidence-based intervention and treatment strategies (AU)

Predictive models for the assessment of bodily harm.

The Spanish scale to quantify or qualify bodily harm resulting from any unintentional traffic accident prior to 1 January 2016 is established by Royal Legislative Decree (RDL) 8/2004. This scale assigns points to the sequelae, which are converted into Euros using a table that is updated annually. The objective of this study is to develop a predictive model of sequelae points that will enable the estimation of compensation a short time after the accident. This will facilitate the calculation of the money reserve and rapid access to compensation for the injured party. To conduct this study, we developed a database with information from 999 individuals who had suffered car crash injuries which were evaluated according to the scale contained in RDL 8/2004 for medical experts. Predictive models based on logistic regression models were designed on this database. To choose the best model, we calculated Mallow's Cp. The use of hurdle models made it possible to predict the points received by an injured party within a relatively short period of time after the accident. Once these points are known, it is a simple matter to calculate the corresponding compensation. The prediction models developed provide an easy way to predict the compensation to be awarded to the injured party. These models use days of hospitalization, sex, age and the results of international scales based on the Abbreviated Injury Scale. These variables can be used soon after the occurrence of the crash.

Molecular Characterization and Risk Factors of Giardia duodenalis among School Children from La Habana, Cuba.

Giardia duodenalis is considered the most common protozoan infecting humans worldwide. Molecular characterization of G. duodenalis isolates has revealed the existence of eight groups (assemblages A to H) which differ in their host distribution. A cross-sectional study was conducted in 639 children from La Habana between January and December 2013. Two assemblage-specific PCRs were carried out for the molecular characterization. The overall prevalence of Giardia infection was 11.9%. DNA from 63 of 76 (82.9%) samples was successfully amplified by PCR-tpi, while 58 from 76 (76.3%) were detected by PCRE1-HF. Similar results by both PCRs were obtained in 54 from 76 samples (71%). According to these analyses, assemblage B and mixed assemblages A + B account for most of the Giardia infections in the cohort of children tested. Our current study identified assemblage B as predominant genotype in children infected with Giardia. Univariate analysis indicated that omission of washing hands before eating and keeping dogs at home were significant risk factors for a Giardia infection. In the future, novel molecular tools for a better discrimination of assemblages at the subassemblages level are needed to verify possible correlations between Giardia genotypes and symptomatology of giardiasis.

Morbilidad por Blastocystis spp. en el Hospital Pediátrico Universitario William Soler / Morbidity from Blastocystis spp. at William Soler university pediatric hospital

Introducción: Blastocystis spp. se considera actualmente un posible nuevo patógeno intestinal, y se reconoce su existencia en edad pediátrica.Objetivo: identificar el patrón clínico y epidemiológico de infección por Blastocystis spp.Métodos: estudio descriptivo en 98 pacientes cuyas heces fueron recepcionadas en el Departamento de Parasitología del Hospital Pediátrico William Soler (2008 a 2009), en La Habana.Resultados: Blastocystis spp. se manifestó de forma única en 59,2 por ciento, significativamente superior (p= 0,000) respecto a su presentación en coinfección (26,7 por ciento), principalmente con Giardia lambia (17,3 por ciento) y Entamoeba histolytica/E. dispar (11,2 por ciento). En infección solo por Blastocystis spp. (n= 58), la tasa de infección se incrementó de 47,2 por ciento (1 y 4 años), a 83,3 por ciento (13 a 18 años), y en el sexo masculino hubo mayor riesgo de contraer el parásito (razón o cociente de tasas= 0,7). La razón de tasa de Blastocystis spp., según zona de residencia y abasto de agua, fue menor que 1; mientras que, para la tenencia de animales en la casa y el origen del agua para consumo, fue superior a 1. La sintomatología se expresó en 96,6 por ciento, básicamente por dolor abdominal y diarrea.Conclusiones: la infección por Blastocystis spp. de forma única es típica en este estudio de 13 a 18 años, con riesgo incrementado en el sexo masculino, por la tenencia de animales en la casa, consumo de agua sin hervir, zona de residencia urbana y consumo de agua de acueducto. Los principales síntomas corresponden a dolor abdominal y diarrea(AU)

Morbilidad por blastocystis spp. en el hospital pediátrico universitario "William Soler" / Morbidity from blastocystis spp. at "William Soler" university pediatric hospital

INTRODUCCIÓN: blastocystis spp. se considera actualmente un posible nuevo patógeno intestinal, y se reconoce su existencia en edad pediátrica. OBJETIVO: identificar el patrón clínico y epidemiológico de infección por Blastocystis spp. MÉTODOS: estudio descriptivo en 98 pacientes cuyas heces fueron recepcionadas en el Departamento de Parasitología del Hospital Pediátrico "William Soler" (2008 a 2009), en La Habana. RESULTADOS: Blastocystis spp. se manifestó de forma única en 59,2 %, significativamente superior (p= 0,000) respecto a su presentación en coinfección (26,7 %), principalmente con Giardia lambia (17,3 %) y Entamoeba histolytica/E. dispar (11,2 %). En infección solo por Blastocystis spp. (n= 58), la tasa de infección se incrementó de 47,2 % (1 y 4 años), a 83,3 % (13 a 18 años), y en el sexo masculino hubo mayor riesgo de contraer el parásito (razón o cociente de tasas= 0,7). La razón de tasa de Blastocystis spp., según zona de residencia y abasto de agua, fue menor que 1; mientras que, para la tenencia de animales en la casa y el origen del agua para consumo, fue superior a 1. La sintomatología se expresó en 96,6 %, básicamente por dolor abdominal y diarrea. CONCLUSIONES: la infección por Blastocystis spp. de forma única es típica en este estudio de 13 a 18 años, con riesgo incrementado en el sexo masculino, por la tenencia de animales en la casa, consumo de agua sin hervir, zona de residencia urbana y consumo de agua de acueducto. Los principales síntomas corresponden a dolor abdominal y diarrea.

INTRODUCTION: blastocystis spp. is presently considered a possible new intestinal pathogen and its presence is recognized at pediatric ages. OBJECTIVE: to identify the clinical and epidemiological pattern of infection caused by Blastocystis spp. METHODS: descriptive study of 98 patients whose feces were collected at the department of parasitology in "William Soler" pediatric hospital (2008-2009) in Havana. RESULTS: Blastocystis spp. manifested in 59.2 % of cases, significantly higher (p= 0.000) rate than in co-infection (26.7 %) mainly with Giardia lambdia (17.3 %) and Entamoeba histolytica/E. dispar (11.2 %). Regarding infection just by Blastocystis spp. (n= 58), the infection rate rose from 47.2 % (1 and 4 years-old) to 83.3 % (13 to 18 years-old) and males had higher risks of acquiring the parasites (ratio rate= 0.7). The rate ratio of Blastocystisspp., according to the area of residence and water supply system, was lower than 1 whereas having pets at home and origin of the drinking water was over 1. Abdominal pain and diarrheas were the basic symptoms found in 96.6 % of the sample. CONCLUSIONS: single Blastocystis spp. infection is typical in this study in the 13-18 years old group, with increased risk for males, pets at home, taking water that is not boiled, urban area of residence and consumption of tap water. The main symptoms were abdominal pain and diarrheas.

High variation in hypoxanthine determination after analytical treatment of vitreous humor samples.

In the field of legal medicine the correct determination of the time of death is of great importance because an error in calculating the post-mortem interval (PMI) could be crucial in a criminal investigation. The quantification of hypoxanthine (Hx) concentration in the vitreous humor (VH) as a means to estimate PMI is useful when dealing with a recent time interval of death and has several advantages over other biological matrices. However, due to its viscous nature, VH has to be liquefied prior to its analysis, and the different procedures to liquefy it may cause alterations in Hx concentration, and hence in estimation of PMI. The aim of this study was to determine differences in Hx concentration after applying several pre-analytical treatments to different aliquots of the same VH sample. Enzymatic digestion, sonication, centrifugation and heat were the liquefying methods applied to reduce the viscosity of 105 VH samples. Analysis was performed using solid phase extraction and liquid chromatography in tandem with mass spectrometry. Statistically significant differences in the measured Hx concentrations were found between enzymatic digestion and the other three methods analyzed (sonication, centrifugation, and heat). Additionally, high data dispersion was found under heat treatment but was not observed for centrifugation or sonication, where similar and more moderate results were found. We conclude that high variations in Hx determination are observed when enzymatic digestion or heat treatment is used and we therefore recommend sonication or centrifugation to quantify Hx concentration in the VH.

University students' attitudes towards Voluntary Interruption of Pregnancy.

An evaluation of the future professional trends was performed by analyzing the attitudes of university students to the Voluntary Interruption of Pregnancy (VIP). An anonymous questionnaire was distributed to 300 students (Medicine, Nursing and Law) of the University of Santiago de Compostela, with questions on their personal beliefs, opinion on the law and intention to participate in VIP. Of the 245 respondents (response rate 82%), 66.5% were pro-abortion and their attitudes towards VIP were consistent with their opinion on the beginning of life and with the ethical arguments related to the fetus and the mother. No differences were found with age, sex or degree. The students showed to be well informed on the VIP law, and the majority of them considered unsuitable termination of pregnancy in minors without parental consent. Students' intentions to take part in abortion provision were influenced by their views on abortion, level of participation and circumstances of pregnancy. Although the majority of participants would be willing to perform VIP in situations that affect fetus and mother's life or health (87-66%), their intentions clearly diminished in other situations, such as abortion on demand (17%). These data suggest that conscientious objection of health professionals can even increase with the new policy, a fact that might affect VIP availability. It is important to stress the need of ethical training to help in the solution of conflicts between patient and health professional values.

Risk factors associated with the development of ischemic colitis.

AIM: To ascertain the role of cardiovascular risk factors, cardiovascular diseases, standard treatments and other diseases in the development of ischemic colitis (IC). METHODS: A retrospective, case-control study was designed, using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003. IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible histology. Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy, excluding those with diagnosis of colitis. Cases were matched with controls (ratio 1:2), by age and sex. A conditional logistic regression was performed. RESULTS: A total of 483 patients (161 cases, 322 controls) were included; mean age 75.67 ± 10.03 years, 55.9% women. The principal indications for colonoscopy in the control group were lower gastrointestinal hemorrhage (35.4%), anemia (33.9%), abdominal pain (19.9%) and diarrhea (9.6%). The endoscopic findings in this group were hemorrhoids (25.5%), diverticular disease (30.4%), polyps (19.9%) and colorectal cancer (10.2%). The following variables were associated with IC in the univariate analysis: arterial hypertension (P = 0.033); dyslipidemia (P < 0.001); diabetes mellitus (P = 0.025); peripheral arterial disease (P = 0.004); heart failure (P = 0.026); treatment with hypotensive drugs (P = 0.023); angiotensin-converting enzyme inhibitors; (P = 0.018); calcium channel antagonists (P = 0.028); and acetylsalicylic acid (ASA) (P < 0.001). Finally, the following variables were independently associated with the development of IC: diabetes mellitus [odds ratio (OR) 1.76, 95% confidence interval (CI): 1.001-3.077, P = 0.046]; dyslipidemia (OR 2.12, 95% CI: 1.26-3.57, P = 0.004); heart failure (OR 3.17, 95% CI: 1.31-7.68, P = 0.01); peripheral arterial disease (OR 4.1, 95% CI: 1.32-12.72, P = 0.015); treatment with digoxin (digitalis) (OR 0.27, 95% CI: 0.084-0.857, P = 0.026); and ASA (OR 1.97, 95% CI: 1.16-3.36, P = 0.012). CONCLUSION: The development of an episode of IC was independently associated with diabetes, dyslipidemia, presence of heart failure, peripheral arterial disease and treatment with digoxin or ASA.

Cyclospora cayetanensis. Presentación de 20 casos / Cyclospora cayetanensis infection. Report of 20 cases

Se presentan 20 pacientes (0,2 por ciento) de un total de 7 956 que acudieron de enero de 2000 a julio de 2001 a la Consulta de Parasitología del Hospital Pediátrico Universitario ôWilliam Solerö con un cuadro de diarreas acuosas y otras manifestaciones clínicas, y donde se aisló en muestras de heces frescas el protozoario Cyclospora cayetanensis. Las diarreas estuvieron presentes en 17 enfermos (85 por ciento), los vómitos y la anorexia en 9 pacientes (45 por ciento), el dolor abdominal en 7 (35 por ciento), el decaimiento y la fiebre se evidenciaron en 3 pacientes (15 por ciento). El estado nutricional de estos niños fue normal. El Cyclospora cayetanensis es un parásito que puede observarse en edades pediátricas y uno más que se tendrá en cuenta en la etiología de las diarreas acuosas

Cyclospora cayetanensis. Presentación de 20 casos / Cyclospora cayetanensis infection. Report of 20 cases

Se presentan 20 pacientes (0,2 por ciento) de un total de 7 956 que acudieron de enero de 2000 a julio de 2001 a la Consulta de Parasitología del Hospital Pediátrico Universitario ôWilliam Solerö con un cuadro de diarreas acuosas y otras manifestaciones clínicas, y donde se aisló en muestras de heces frescas el protozoario Cyclospora cayetanensis. Las diarreas estuvieron presentes en 17 enfermos (85 por ciento), los vómitos y la anorexia en 9 pacientes (45 por ciento), el dolor abdominal en 7 (35 por ciento), el decaimiento y la fiebre se evidenciaron en 3 pacientes (15 por ciento). El estado nutricional de estos niños fue normal. El Cyclospora cayetanensis es un parásito que puede observarse en edades pediátricas y uno más que se tendrá en cuenta en la etiología de las diarreas acuosas