[Predictive model and discriminant analysis of the development of dementia in patients with delirium in the emergency department]. / Modelo predictivo y análisis discriminante del desarrollo de demencia en pacientes con delirium en urgencias.

OBJECTIVE: The main aim of our study is to know the sociodemographic, clinical, analytical, and functional variables that predict the probability of developing dementia in patients with delirium who attend the emergency room. METHOD: All patients with delirium (n=45) from the emergency room who were admitted to the Geriatrics service of the General University Hospital of Ciudad Real (HGUCR) in 2016-2018 and met the inclusion and exclusion criteria were included. Subsequently, we ran a bivariate and multivariate analysis of the variables that predicted a diagnosis of dementia at six months and a discriminant analysis. RESULTS: 15.6% of patients presented dementia at six months of follow-up, 22.2% had developed cognitive impairment. We conducted a multivariate model (R2 Nagelkerke 0.459) for the probability of developing dementia, with elevated heart rate being the most crucial variable (OR=11.5). The model could excluded dementia with 100% accuracy. Finally, we achieved a discriminant function capable of correctly classifying 95.6% of the cases. It included the following variables of influence: pH, Lawton Brody index, calcium, urea, and heart rate. CONCLUSIONS: A few clinical and analytical variables that are easily detectable in the emergency room, especially tachycardia, could help us better identify those patients with delirium at higher risk of developing dementia, as well as formulate hypotheses about the variables involved in the development of dementia in patients with delirium.

[Evaluation of a school intervention program to modify sun exposure behaviour]. / Evaluación de un programa de intervención escolar para la modificación del comportamiento ante la exposición solar.

INTRODUCTION: Nonmelanoma skin cancer is the most prevalent and incident tumor in the world, being sun exposure the most important risk factor. Childhood and adolescence are the periods where sun exposure is greatest. An intervention to modify sun-related behaviours is essential for skin cancer prophylaxis. MATERIAL AND METHODS: We carried out a quasi-experimental study on a school population of Granada with ages ranging from 11-12 years. The control and study groups completed a questionnaire prior to the intervention with educational program and thereafter. We performed a random conglomerate sampling of 628 teenagers. Statistical analysis was carried out using the Mc Nemar and Wilcoxon tests. RESULTS: After the intervention, the study group showed marked improvement in the results concerning knowledge about sun exposure and skin (OR = 2.89), sun exposure and environment (OR = 2.23), and sun exposure and health (OR = 1.4) as well as in attitudes and healthy behaviour regarding sun exposure (OR = 4.2). This difference was statistically significant compared to the control group. CONCLUSIONS: 1. Before planning a campaign for primary prophylaxis of skin cancer it is necessary to know the information and knowledge of the target population. 2. The risk of acute, intermittent sun exposure and the use of different means of photoprotection should be stressed. 3. In our study group the rate of sun burn has decreased.

Evaluación de un programa de intervención escolar para la modificación del comportamiento ante la exposición solar / Evaluation of a school intervention program to modify sun exposure behaviour

Introducción. El cáncer de piel melanoma y no-melanoma es el tumor más prevalente y más frecuente en el mundo, la exposición solar es el factor de riesgo más importante. La infancia y la adolescencia es el periodo de la vida en el cual la exposición solar es mayor. La intervención para modificar hábitos ante el sol es fundamental para la prevención del cáncer cutáneo. Material y métodos. Realizamos un estudio cuasiexperimental sobre una población escolar de Granada capital de 11 y 12 años con un test previo a casos y controles, intervención con programa educativo a grupo de casos y test posterior a ambos grupos. Muestreo aleatorio por conglomerados. Cuestionario autocumplimentado. Muestra de 628 adolescentes de colegios e institutos de Granada. Estadístico utilizado: Test de Mc Nemar y Wilcoxon. Resultados. Tras la intervención, el grupo de casos mejoraba ampliamente los resultados tanto en conocimientos sobre sol y piel (OR = 2,89), sol y medio ambiente (OR = 2,23) y sol y salud (OR = 1,4) como en actitudes y conductas sanas con respecto al sol, (OR = 4,2), siendo esta diferencia estadísticamente significativa, frente al grupo control. Conclusiones. Antes de planificar una campaña de prevención primaria de cáncer de piel es necesario saber los conocimientos y comportamientos de la población a la que se dirige. En segundo lugar se debe insistir en el riesgo de la exposición solar intermitente aguda y en el uso de los diferentes medios de fotoprotección. Por último hay que señalar que en el grupo de nuestro estudio ha disminuido la frecuencia de quemadura solar

Introduction. Nonmelanoma skin cancer is the most prevalent and incident tumor in the world, being sun exposure the most important risk factor. Childhood and adolescence are the periods where sun exposure is greatest. An intervention to modify sun-related behaviours is essential for skin cancer prophylaxis. Material and methods.We carried out a quasi-experimental study on a school population of Granada with ages ranging from 11-12 years. The control and study groups completed a questionnaire prior to the intervention with educational program and thereafter. We performed a random conglomerate sampling of 628 teenagers. Statistical analysis was carried out using the Mc Nemar and Wilcoxon tests. Results. After the intervention, the study group showed marked improvement in the results concerning knowledge about sun exposure and skin (OR = 2.89), sun exposure and environment (OR = 2.23), and sun exposure and health (OR = 1.4) as well as in attitudes and healthy behaviour regarding sun exposure (OR = 4.2). This difference was statistically significant compared to the control group. Conclusions. 1. Before planning a campaign for primary prophylaxis of skin cancer it is necessary to know the information and knowledge of the target population. 2. The risk of acute, intermittent sun exposure and the use of different means of photoprotection should be stressed. 3. In our study group the rate of sun burn has decreased

Psicofarmacología de la nicotina y conducta adictiva / Psycopharmacology of nicotine and addiction

Objetivo: El principal objetivo de este trabajo es describir los aspectos fundamentales de la psicofarmacología de la nicotina para poder comprender las peculiares propiedades adictivas de esta sustancia. Material y métodos: Se revisa la psicofarmacología de la nicotina. En primer lugar, se analizan los mecanismos esenciales de actuación de la nicotina en el cerebro que parecen explicar los procesos de dependencia, tolerancia y abstinencia asociados al tabaquismo. Se describen también los mecanismos de acción y los efectos de varias de las terapias sustitutivas de la nicotina del tabaco. Finalmente, se comentan algunos recientes hallazgos acerca de la relación entre nicotina y ciertos trastornos psiquiátricos y neurodegenerativos, que pueden ayudar a entender la compleja e imbricada acción de esta sustancia en nuestro cerebro. Resultados: El tabaco es una droga adictiva, como lo es la cocaína, la heroína, las anfetaminas y algunos derivados, o el alcohol. La nicotina presente en esta droga es la responsable de tal conducta adictiva al inducir numerosos cambios bioquímicos y estructurales en el sistema nervioso central. La insidiosa e intensa dependencia a la nicotina que provoca el consumo de tabaco tiene serias repercusiones médicas, debidas no sólo a los efectos indeseables de la propia nicotina, sino también a los de los numerosos compuestos tóxicos que contiene el tabaco. Conclusiones: Las características farmacológicas de la nicotina, muy diferentes a las de otras drogas, explican el distintivo perfil adictivo de esta sustancia

Objective: The main aim of this work is to describe the fundamental aspects of the psychopharmacology of nicotine, in order to understand the addictive properties peculiar to this substance. Material and methods: The psychopharmacology of nicotine and addiction it is reviewed. Firstly, this review will show the essential mechanisms of the action of nicotine on the brain, which seem to explain the processes of dependence, tolerance and abstinence associated to smoking. For this reason, and also because this addiction causes serious health problems, this report will also describe the action mechanisms and the effects of some of the therapeutic substitutes for nicotine in tobacco. Finally, there is a breakdown of some recent finds regarding the relation between nicotine and certain psychiatric and neurodegenerative disorders, which can help the understanding of the complex action of this substance on the brain. Results: Tobacco is an addictive drug, like cocaine, heroine, amphetamines and various derivatives, or alcohol. The nicotine present in this drug is responsible for this addictive behaviour as it induces numerous biochemical and structural changes in the central nervous system. On another level, the insidious and intense dependence on nicotine which provokes the consumption of tobacco has serious medical repercussions, not only due to the unwanted effects of the nicotine itself, but also due to the numerous toxic compounds contained in tobacco. Conclusions: The pharmacological characteristics of nicotine -- very different from those of other drugs -- explain the distinctive addictive profile of this substance