Proximate causes of the red face of the bald uakari monkey (Cacajao calvus).

In social species, such as primates, facial appearances transmit a variety of social signals. Although it is suggested that the intense red colour of the face of the bald uakari monkey might be an indicator of health, this hypothesis still has not been verified. This study describes the histological structure of the skin of the face in the bald uakari, compared with other non-red neotropical primates, to better understand the maintenance of its colour. The facial skin of the bald uakari monkey is characterized by a thinner epidermis, absence of melanin pigments and a high density of vascular capillaries that spread below the epidermis. These vascular capillaries are larger and more tortuous than in other neotropical primates. The skin of the face of the bald uakari monkey allows a direct external assessment of haematological status, suggesting that the colour of the face would be an honest indicator of health, but could also signal sexual or behavioural states.

Morphological characteristics of the optic nerve evaluated by confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population from the city of Barcelona.

OBJECTIVE: To evaluate morphological parameters of optic disc and retinal nerve fiber layer (RNFL) examined with confocal laser tomography (HRT3) and laser polarimetry (GDx-VCC) in a normal population, and analyze correlations of these parameters with demographic variables. PATIENTS AND METHODS: Cross-sectional study in the context of a glaucoma screening campaign in the primary care center of Barcelona. The individuals selected were non-hypertensive Mediterranean Caucasians with risk for glaucoma development (individuals≥60 years old or≥40 years old with family history of glaucoma or intraocular pressure or myopia>3diopter). All subjects underwent a complete ophthalmic examination, confocal laser tomography (HRT3) and scanning laser polarimetry (GDX-VCC), subjects with results within normal limits only being included. Structural parameters were analyzed along with age, refraction, and pachymetry based on the Spearman rank correlation test. RESULTS: A total of 224 subjects included, with a mean age of 63.4±11.1 years. Disc areas, excavation and ring area were 2.14±0.52mm(2), 0.44±0.34mm (2) and 1.69±0.38mm(2), respectively. The mean RNFL (GDX) was 55.9±6.9µm. Age was correlated with lower ring volume, highest rate of cup shape measure, largest mean and maximum cup depth, lower nerve fiber index (NFI) and RNFL (all p-values below .05). CONCLUSION: The mean values and distribution of several parameters of the papilla and the RNFL in normal Mediterranean Caucasians population are presented. A loss of thickness of the RNFL, ring thinning, and enlarged cup was observed with increased age.

[Detection of glaucoma using SisGlaTel: acceptability and satisfaction among participants, and problems detected]. / Detección de glaucoma mediante telemedicina con SisGlaTel: satisfacción y aceptación entre los participantes y problemas detectados.

PURPOSE: To evaluate the problems, and the degree of acceptability and satisfaction among participants in a telemedicine screening program. This study forms part of a global project for the design, implementation and evaluation of SisGlaTel funded by the Fondo de Investigaciones Sanitarias (Spain) and Pfizer Ophthalmics. METHOD: A telemedicine system was built based on a specific program written in JAVA. The remote station was located at a Primary Care Center. Participants signed an informed consent, and completed a questionnaire and undertook different tests (frequency doubling perimetry-FDT, confocal scanning laser tomografy-HRT and tonometry). Test results and problems detected were analysed. Ninety-nine subjects completed a satisfaction questionnaire after voluntarily participating in the screening program among an at-risk population. The questionnaire included 7 questions, four of which required participants to categorise their responses, ranging from very bad (1) to excellent (5), to questions about the screening program, its usefulness, the care received and the installations. RESULTS: Six hundred and forty-one at-risk subjects were examined. After 2 exams per eye, 22.3% (143) presented abnormal FDT and 4.2% (27) had pathologic HRT. One hundred percent of respondents affirmed they would participate again in a similar program. The mean qualification (SD) was 4.5 (0.6), 4.5 (0.6), 4.8 (0.5), and 4.3 (0.7) for global opinion, usefulness, care and equipment. CONCLUSION: SisGlaTel allows integration of several diagnostic tests useful for glaucoma tele-screening. The global degree of satisfaction among participants was good.

Cirugía de recuperación prolongada / Prolonged recuperation surgery

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Personal hospitalario: Número y retribución (Monográfico: Personal Hospitalario) / No disponible

Además de proveer de los medios económicos adecuados y establecer la organización más correcta de acuerdo con el ámbito, función y dependencia patrimonial del hospital, el cálculo de la plantilla del hospital, su retribución y selección son las actividades más importantes de la gestión hospitalaria. En efecto, en muchos hospitales, especialmente los de mayor tamaño, el coste del personal representa el 70& del coste total de mantenimiento del hosptial y ello como consecuencia de su número y retribución (AU)

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[Programme to introduce and develop minor out-patient surgery in primary care]. / Programa de implantación y desarrollo de la cirugía menor ambulatoria en atención primaria.

INTRODUCTION: Despite the priority placed on it, minor surgery is not performed enough in primary care (PC). OBJECTIVE: To create and evaluate a programme to introduce and develop minor out-patient surgery in primary care in a way that matches our health areas needs. DESIGN: Prospective, longitudinal and descriptive study. SETTING: Health Area 19 (Valencian Health Service): Surgery Department of Elche Hospital and 3 health centres (HC) (Altabix, Crevillente and Santa Pola). PARTICIPANTS: PC doctors and specialist surgeons. STAGES: a) Selection of HC. Working out protocol of kind of patient, pathology, paper-work and establishment of work circuits; b) surgical sessions at the HC, performed by two surgeons assisted by PC doctors (surgical leaders) and with surgical instruments from the hospital; c) surgery performed by PC doctors supervised by a surgeon, with instruments and the sterilisation circuit in the HC. The programme ends up with the PC doctors surgical autonomy and with use of the HCs own resources. RESULTS: 41 surgical sessions took place (14 in Altabix, 14 in Crevillente and 13 in Santa Pola). 335 patients were operated on in 398 surgical procedures (55.5% excisions, 34.9% electrocoagulation, 9.6% others). There were no immediate complications. The monthly evolution in the number of patients was constant, with a mean of 10.22 interventions per session. 36 doctors referred patients and 24 of them performed a surgical procedure. CONCLUSIONS: A practical and safe programme to introduce and develop minor surgery in PC, to the satisfaction of doctors and patients.

Programa de implantación y desarrollo de la cirugía menor ambulatoria en atención primaria / Programme to introduce and develop minor out-patient surgery in primary care

Introducción. A pesar de su priorización, la realización de la cirugía menor (CM) en atención primaria (AP) es deficitaria. Objetivo. Creación y evaluación de un programa de implantación y desarrollo de CM en AP adecuado a los problemas de nuestra área sanitaria. Diseño. Prospectivo, longitudinal y descriptivo. Emplazamiento. Área Sanitaria 19 (Servicio Valenciano de Salud): Servicio de Cirugía del Hospital de Elche y tres centros de Salud (CS) (Altabix, Crevillente y Santa Pola).Participantes. Médicos de AP y médicos especialistas en cirugía. Fases. Se establecieron las siguientes fases: a) selección de CS. Protocolización del tipo de paciente, patología, documentación y establecimiento de circuitos de trabajo; b) realización de sesiones quirúrgicas en los CS a cargo de dos cirujanos ayudados por médicos de AP ("líderes quirúrgicos"), con instrumental quirúrgico de hospital, y c) realización de la cirugía por médicos de AP supervisados por un cirujano, con instrumental y circuito de esterilización en los CS. El programa finaliza con la autonomía quirúrgica del médico de AP y de los medios del CS. Resultados. Se han realizado 41 sesiones quirúrgicas (14 en Altabix, 14 en Crevillente y 13 en Santa Pola). Se intervino a 335 pacientes, practicándose 398 procedimientos quirúrgicos (un 55,5 por ciento escisiones, un 34,9 por ciento electrocoagulación y un 9,6 por ciento, otras). No se presentó ninguna complicación inmediata. La evolución mensual del número de pacientes fue constante, con una media de 10,22 programaciones/sesión. Remitieron pacientes 36 médicos y de ellos 24 realizaron actividad quirúrgica. Conclusiones. Se consiguió un programa práctico y seguro de implantación y desarrollo de la CM en AP, con satisfacción tanto del médico como del paciente (AU)

Evaluación de la calidad percibida en el servicio de oftalmología de un hospital universitario / Assessment of perceived quality in the opthalmology departament of the universitary hospital

Objetivo: El objetivo de este estudio es conocer la Calidad Percibida por los enfermos atendidos en el Servicio de Oftalmología del Hospital Clínico Universitario de Barcelona, entre el 1 de Octubre y el 30 de Noviembre de 2000.Material y método: Para la realización de este estudio, los pacientes debían responder una encuesta de opinión de forma voluntaria. Dicha encuesta constaba de una pregunta abierta con el fin de poder recoger posibles comentarios, y 29 preguntas cerradas en relación con la filiación, características del ingreso y permanencia en el hospital, trato e información recibida, habitabilidad y hostelería, así como la valoración general del servicio. Resultados: Se han valorado 66 cuestionarios de un total de 343 encuestas entregadas (19,24 per cent de participación), y se ha objetivado un elevado grado de satisfacción, de manera que más del 90 per cent de los pacientes encuestados han valorado como excelente o buenos los aspectos referentes al trato recibido, habitabilidad y hostelería, siendo este porcentaje ligeramente inferior en los aspectos relativos a la información recibida. El 93 per cent de los encuestados volverían a ingresar en el mismo centro y la puntuación media del servicio recibido ha sido de 7,77.Conclusiones: El aumento de la satisfacción del usuario en un hospital público universitario, está condicionado por la mejora de las condiciones ambientales y de hostelería del centro (AU)

[Do physicians know the cost of the treatments and tests they prescribe?]. / Conocen los médicos el coste de los tratamientos y pruebas que solicitan?

OBJECTIVE: To determine the degree of knowledge among physicians regarding the cost of diagnostic tests and commonly used drugs. INDIVIDUALS AND METHODS: An interview was obtained with a representative sample of 164 physicians from a total of 338 (accuracy +/- 3.55), distributed in interns/residents (n:119) and staff members (n:45) from the divisions of Surgery (n:81) and Medicine (n:83) at Hospital Clinic i Provincial, Barcelona. The questionnaire included 15 questions, 10 regarding drugs and 5 diagnostic tests, with 5 possible answers. An arbitrary scoring system was used (correct answer: 5 points; approximate; 3 points; mistake: 1 point) and the percentage of right answers (correct and approximate answers) was also evaluated versus mistakes. The Student "t" test, the analysis of variance and the chi 2 test were used to compare the results. RESULTS: The overall score reached was 2.72 +/- 0.41. Differences between residents vs staff and medicine vs surgery were not significant. The score in questions regarding diagnostic tests was significantly higher than that obtained for drug cost among all group. The percentages of right answers (correct and approximate answers) were 58.8%-61.7% (drugs) and 58.3-60.8% (tests), with no differences among groups. Differences regarding year of residence were also not significant. CONCLUSIONS: The knowledge degree on costs of some drugs and diagnostic tests among physicians is deficient. It is necessary to find standards that contribute to increase the level of information regarding costs derived from the health care delivery process among health care professionals.

[Expression of pS2 protein in breast cancer and its relationship with estrogen and progesterone receptors]. / Expresión de la proteína pS2 en el cáncer de mama y su relación con los receptores de estrógenos y progesterona.

BACKGROUND: We studied pS2 protein in breast tumors and its relation with estrogen and progesterone receptors and with anatomopathological characteristics of the tumors. MATERIAL AND METHODS: We measured the pS2 content (by IRMA) and steroid receptors content (by EIA) in 151 breast tumors. Results were compared and correlated with tumoral characteristics. RESULTS: 53% of tumors were pS2+. Among them, 91% were estrogen receptors +.86% of estrogen receptors negative tumors were pS2-. We observed correlation between pS2 and estrogen receptors values (r = 0.56; p < 0.0001) and between pS2 and progesterone receptors values (r = 0.53; p < 0.0001). Distributing the tumors in pS2+ and pS2-, we observed association between pS2+ and estrogen receptors + (chi 2 = 45.6; p < 0.0001) and pS2+ and progesterone receptors + (chi 2 = 43.1; p < 0.0001). However, we found a 18.5% of estrogen receptors + pS2- tumors. We observed a significant difference between GII and GIII tumoral grades (chi 2 = 5.51; p < 0.019), with a majority of pS2+ tumors in GII and pS2- tumors in GIII. CONCLUSIONS: The estrogen receptors in estrogen receptors + ps2- tumors may be non functional. The presence of pS2 protein alternative to that of progesterone receptors may indicate a functional heterogeneity of the estrogen receptors system, which is of interest in evaluating prognosis and response to the hormonal therapy.