Virtual reality exposure with vibrotactile stimulation for the treatment of fear of flying: A pilot study.

BACKGROUND AND OBJECTIVES: Virtual reality (VR) interventions are becoming more prevalent in treating fear of flying (FoF). Since multisensory stimulation can enhance the sense of presence in a virtual environment, the present study compared virtual reality exposure with and without vibrotactile cues to determine its contribution to the realism of the virtual experience. METHODS: A repeated measures design was used. Thirty-one participants were exposed to two experimental conditions with a minimum of a one-week interval between them: one in which participants were exposed to the virtual environment with vibrotactile cues (smart chair, SC), and another in which participants were exposed to the virtual environment without vibrotactile cues (ordinary chair, OC). The administration order of both conditions was counterbalanced to avoid possible order effects. RESULTS: Participants felt higher levels of sense of presence when using the SC than the OC. However, the addition of vibrotactile stimulation partially influenced experienced anxiety. Some personality traits were also associated with participants' sense of presence and anxiety responses during the exposure. LIMITATIONS: The sample size was smaller than required. Moreover, only self-reported measures were used. Finally, a roller coaster instead of an airplane scenario was used for the exposure, which might not have been suitable enough for provoking anxiety in participants with FoF. CONCLUSIONS: Vibrotactile cues enhanced the sense of presence. However, the addition of vibrotactile stimulation did not have a consistent effect on anxiety experienced during exposure. Therefore, the benefits of incorporating vibrotactile cues in virtual reality environments for exposure therapy are not clear.

Whole-Genome Sequencing and De Novo Assembly of Malassezia pachydermatis Isolated from the Ear Canal of a Dog with Otitis.

We have de novo assembled the genome sequence of Malassezia pachydermatis isolated from a canine otitis sample with Nanopore-only long reads. With 99× coverage and 8.23 Mbp, the genome sequence was assembled in 10 contigs, with 6 of them corresponding to chromosomes, improving the scaffolding of previous genome assemblies for the species.

Whole-Genome Sequencing and De Novo Assembly of 61 Staphylococcus pseudintermedius Isolates from Healthy Dogs and Dogs with Pyoderma.

We have de novo assembled and polished 61 Staphylococcus pseudintermedius genome sequences with Nanopore-only long reads. Completeness was 99.25%. The average genome size was 2.70 Mbp, comprising 2,506 coding sequences, 19 complete rRNAs, 56 to 59 tRNAs, and 4 noncoding RNAs (ncRNAs), as well as CRISPR arrays.

Association between metabolic syndrome or its components and asymptomatic cardiovascular disease in the RIVANA-study.

OBJECTIVE: To assess the association between the metabolic syndrome (MetSd) and asymptomatic cardiovascular disease and determine if the MetSd or its single risk factors perform better in discriminating prevalent asymptomatic cardiovascular disease. METHODS: A total of 880 community-dwelling subjects (423 with and 457 without MetSd according to ATPIII) underwent a physical examination, an echocardiography and an ultrasound examination of carotid arteries and blood and urine samples were collected. Associations between the subclinical organ damage markers and the MetSd were addressed with non-conditional logistic regression. AUCs of ROCs were used to compare the models' ability to discriminate asymptomatic cardiovascular disease. RESULTS: The MetSd was independently associated with carotid subclinical atherosclerosis, increased left ventricular mass index and cardiac dysfunction. The MetSd did not discriminate prevalent increased carotid intima-media thickness better than abdominal obesity and impaired fasting glucose [AUC=0.75 (95% CI: 0.71-0.78) and 0.75 (0.71-0.79), respectively; p=0.55]. The MetSd performed worse than abdominal obesity in discriminating increased left ventricular mass index among males younger than 65 years [AUC=0.66 (95% CI: 0.62-0.69) and 0.69 (0.66-0.73), respectively; p=0.02]. No differences between the ability of MetSd or its components in discriminating increased left ventricular mass index were observed among older men or women. The discrimination ability for microalbuminuria for the MetSd or impaired fasting glucose was not statistically different [AUC=0.67 (95% CI: 0.60-0.74) and 0.69 (0.62-0.76), respectively; p=0.18]. CONCLUSION: This study supports the association between the MetSd and asymptomatic cardiovascular disease. The construct of the MetSd might not be better than its single components in addressing cardiovascular risk.

[Quality of the information supplied to patients by outpatient clinical units through multilevel model analysis]. / Análisis de la calidad de la información proporcionada a los pacientes por parte de unidades clínicas especializadas ambulatorias mediante análisis po.

BACKGROUND: The influence of the information received by patients on their satisfaction is of great importance since, amongst other aspects, it can improve patients' adherence to treatment and contribute to improving their state of health. The study aimed to determine, on the basis of satisfaction questionnaires, the percentage of variability in patients' perception of the information received concerning way of life and medicines, attributed to the following levels: patient, clinical unit and specialisation. It also aimed to identify the variables that influence the results. METHODS: Telephone interviews were conducted with 6,922 patients treated in outpatient units in the Navarre Health Service in the year 2005 (rate of reply, 92.4%). An evaluation was made of whether the patients had received medical prescription and information on way of life and, where affirmative, their evaluation of the quality of this information. Ninety-four outpatient clinics and 34 medical specialisations were analysed. A hierarchical statistical analysis at three levels was made. RESULTS: In the items studied, the variability explained by clinical unit and medical specialisation oscillated between 0 and 12.6%, and explained by the patient between 87.4 and 99.3%. CONCLUSIONS: Variability was detected in the behaviour of the different clinical units in relation to medical prescription and information provided on way of life. However, the greater part of the variability was localised at the "patient" level.

[Clinical interventions on the major vascular risk factors (RIVANA study)]. / Intervención clínica sobre los principales factores de riesgo vascular (estudio RIVANA).

BACKGROUND: To describe the diagnostic frequency of classical vascular risk factors, dietary and therapeutic interventions and their control. METHODS: Within the project Vascular Risk in Navarre (RIVANA), a transversal study was made of a random sample of 4,354 people between the ages of 35 and 84; antecedents were gathered by interview and clinical and analytical exploration was carried out. The subjects were classified for each risk factor into: diagnosed by information--when health personnel had informed them that they presented a risk factor; by intervention--when they take medication for it; and by detection in asymptomatic people. The variables of intervention were identified by dichotomic trees expressed by relative frequencies. RESULTS: Forty-five point three percent of the subjects are hypertense: 27% previously diagnosed and 18.3% at the time of the exploration. Thirty-nine percent are hypercholesterolemic: 33.4% previously diagnosed and 5.6% at the time of the exploration. Twenty-one point two percent presented hyperglycemia: 9.7% previously diagnosed and 11.6% at the time of the exploration. Sixty-five point six percent were diagnosed as overweight or obese: 25.9% previously and 39.6% at the time of the exploration. They received dietary counselling and pharmacological treatment respectively: 79.8% and 70.3% of the hypertense; 75.4% and 35% of the hypercholesterolemic; 83.1% and 47.4% of those who presented hyperglycemia and 68.5% and 4% of those who showed overweight or obesity. CONCLUSIONS: The frequency of cardiovascular risk factors is high. There is a margin for significant improvement in the detection, intervention and control of the risk factors.

[Study of vascular risk in Navarre: objectives and design. Prevalence of metabolic syndrome and of vascular risk factors]. / Estudio de riesgo vascular en Navarra: objetivos y diseño. Prevalencia del síndrome metabólico y de los factores mayores de riesgo vascular.

BACKGROUND: To determine in a representative sample of the population the prevalence of risk factors and metabolic syndrome; their association with sub-clinical atherosclerotic lesions and their impact on cardiocerebrovascular disease 10 years after. MATERIAL AND METHODS: (Phase 1) Cross sectional survey of a random sample stratified by age and sex of the population of Navarre aged between 35 and 84. Antecedents, risk factors, physical and analytical exploration. (Phase II) Ten year follow-up cohort study, in 500 exposed to MS and 500 not exposed persons, aged between 45 and 74 years; with an 82.25% power to detect a risk ratio of 2; with analytical and image markers of sub-clinical atherosclerosis. (Phase III) Follow up of vascular events at ten years. RESULTS: The subjects recruited were 6,553; excluded or not found 871; the final sample was 5,682 (2,644 men and 3,038 women); 4,168 (73,4%) took part in the study. The prevalence of MS was 22.1% (95%CI 20.5 - 23.7) for men and 17,2% (95%CI 15.8 - 18.5) for women. The main cardiovascular RF were high compared to other geographical areas except for HDL cholesterol. The rate was 8.5% (95%CI 7.4 - 9.6) for men and 1.7% (95%CI 1.3 - 2.2) CONCLUSIONS: There are important differences in risk between sex, being worst for men. The high figures for HDL cholesterol and the low prevalence of MS might mean a lower risk of vascular events in Navarra.

[Effect of birth cohort, period of diagnosis and age on cancer incidence in Navarra, 1973-1997]. / Efecto de la cohorte de nacimiento, período de diagnóstico y de la edad en la incidencia de cáncer en Navarra, 1973-1997.

BACKGROUND: Population-based registers are one source of information about cancer incidence. Systematic study of its incidence in a specific population is a fundamental tool for estimating the present-day and future magnitude of cancer and provides elements for taking decisions with regard to the allocation of health resources. The aim of this article was to investigate the time trend in the incidence pattern of cancer in Navarre during the period 1973-1997, and to identify the components of age, diagnosis period and birth cohort as determinants of the time trend of cancer incidence. METHODS: Descriptive study of cancer incidence through age-period-cohort models. Monitoring of dynamic cohort over 25 years. Classical incidence summarizing indicators were analysed. Log-linear Poisson models were developed to quantify cancer risk and the relative annual trend. Age-period-cohort models were adjusted in order to ascertain the effect on the time trend exerted by the respective age, diagnosis period and birth cohort components. RESULTS: The age-standardized rate incidence for all sites -except non melanoma skin tumours- is maximum in the five-year period 1993-1997, in men: 304,1 new cases per 100,000 person-years, and in women: 190,6 new cases per 100,000 person-years. The average incidence changes for each of the 25 years of monitoring of the set data studied is 1.88% (95% CI 1.69 to 2.07) in men and 1.32% (95% CI 1.09 to 1.54) in women. The cancer increase in women is more pronounced from 35 to 64 years, a fact which should alert health authorities about the future evolution of cancer incidence in women. In the analysis of the trend components sharp increases are observed for the consecutive generations of males born in Navarre since 1900. In women, the risk associated with the year of birth increases markedly in the generations born after 1930-1940. CONCLUSIONS: There was an important increase in cancer incidence in Navarre from 1973 to 1997, in men and women. The cancer incidence pattern in Navarre does not yet show signs of stabilization.

[Smallpox vaccinations in Navarre (Spain) between September and November 1801]. / Las vacunaciones antivariólicas en Navarra (España) entre septiembre y noviembre de 1801.

We communicate the discovery in the Archive of D. Gaspar Castellano de Gastón of a document providing evidence of the first inoculations with lymph vaccine in Errazu, a village in the Baztán Valley (Navarre). These were carried out on November 2nd 1801, by a doctor from San Juan Pie de Puerto (France), Dr. Iribarren Ayzin, from the arm of a French girl aged 18, personally brought by him at the request of D. Josef Juaquin Gastón, Mayor of the Baztán Valley. The new finding serves as homage, 200 hundred years later, to the first Public Health expedition, carried out between 1803 and 1806, which travelled around the world in order to spread the vaccine amongst all the races and areas of the known world. The expedition was led by D. Francisco Xavier Balmis, a doctor from Alicante.

[Population-based epidemiology of colorectal cancer: causality review]. / Epidemiología poblacional de cáncer colorrectal: revisión de la causalidad.

The estimated number of new cases of colorectal cancer per year in Spain (no. 19,166) is higher than other tumour locations. 1.56 times more cases of colon cancer are registered than of the rectum, and there are 1.44 times more cases in men than in women. Incidence and mortality are lower than the average for European countries; in historical series (1973-1999) an increase can be observed by age, period and birth cohorts between 1898 and 1932. On the contrary, in the USA a reduction of mortality can be observed from 1973 to 1999 (-20.8%) and of incidence from 1985 to 1999 (-7.4%). In Spain, the average duration of the disease in years is 4.29, lower than that of the European Community (4.57), and 72% of the figure for the most favourable country (5.93). Relative survival after five years in Spain is lower than in the USA (61.9% vs. 54%). Several dietary, environmental and lifestyle factors appear to be associated with colorectal cancer, but the risk or protection of these factors are of little weight and the results of studies are at times contradictory. The reduction of incidence in the USA indicates that intervention is possible to bring about a change of trend, predictably by means of secondary prevention.

XX Congreso de la Sociedad Española de Calidad Asistencial. Cuatro días de calidad en Navarra / XX Congress of the Spanish Society of Quality of Care. Four days of quality in Navarre

Objetivo: El objetivo de este artículo es compartir la experiencia y los resultados de la celebración del XX Congreso de la Sociedad Española de Calidad Asistencial (SECA) que tuvo lugar en Pamplona durante los días 8, 9, 10 y 11 de octubre de 2002.Material y métodos: Se trata de un estudio descriptivo que utiliza como fuentes de información las distintas bases de datos de los comités del congreso. Resultados: Se recibió un total de 612 trabajos científicos, y se aceptaron 519 (85 por ciento). Fueron presentados oralmente 259, elevándose 5 a ponencia y 267 en forma de póster. Se celebraron 7 talleres, 15 ponencias, una conferencia inaugural y una de clausura. Asistieron al congreso 672 personas, de las que el 23 por ciento pertenecía a alguna de las distintas sociedades de calidad de España. Conclusiones: Continúa la tendencia creciente tanto en número de asistentes como en número de trabajos recibidos. La celebración del Congreso de la Sociedad Española de Calidad Asistencial sigue siendo el foro de debate más importante en temas de calidad asistencial en el ámbito nacional (AU)

[Prevalence of CYPD6 mutations in sporadic Parkinson's disease: case-control study]. / Prevalencia de mutaciones CYP2D6 en enfermedad de Parkinson esporádica: estudio caso-control.

Genetic factors seem to play an important role in the development of Parkinson's disease. The degeneration of the sustantia nigra, characteristic of this disease, might be due to the toxic effect of substances derived from cellular metabolism. The CYP2D6 gene codifies for the metabolising enzyme debrisoquie-4-hydroxilase involved in the detoxification of part of these products. The presence of determinate mutations in the gene implies a lack of enzymatic activity and generates the "poor metaboliser" phenotype. By means of the PCR-RFLP technique, the presence of the genetic mutations CYP2D6 3, CYP2D6 4, CYP2D6 6 and CYP2D6 8 has been analysed in a group of 46 patients with PD and in 54 controls, with the aim of studying the possible value of genotype CYP2D6 as a risk factor for Parkinson's disease in the population of Navarra. The alleles CYP2D6 3, 6 and 8 are not represented in the sample studied. We have not obtained a greater presence of CYP2D6 4 mutations in the patients with respect to the controls (30.43% vs. 44.44%). There is no correlation between Parkinson's disease and the presence of CYP2D6 4 mutations (odds ratio 0.55; 95% CI 0.24 to 1.25), in homozygosis (odds ratio 0.38; 95% CI 0.04 to 3.76) or in heterozygosis (odds ratio 0.62; 95% CI 0.27 to 1.44). In conclusion, the genotype CYP2D6 does not constitute a risk factor in PD.

[Time trends in ovarian cancer incidence in Navarra (1973-1995): effect of age, birth cohort and period of diagnosis]. / Tendencia temporal de la incidencia de cáncer de ovario en Navarra (1973-1995): efecto de la edad, cohorte de nacimiento y período de diagnóstico.

BACKGROUND: Ovarian cancer is the sixth most common malignancy and the first killer among gynaecologic cancers in women of the European Union. Five years after diagnosis relative survival rates were less than 35%. The aims of the present study are to describe the time trends in ovarian cancer incidence in Navarra over the period 1973-1995, and to identify the age, period-of-diagnosis and birth-cohort components underlying the trend's evolution. METHODS: Standard summary indexes of incidence were calculated. Log-linear Poisson models to quantify risks of ovarian cancer and the relative annual trend were used. Age-period-cohort models were adjusted in order to ascertain the effects on time trend exerted by the respective age, period-of-diagnosis and birth-cohort components. RESULTS: Ovarian cancer incidence has showed annual rises of 2.1% over the period 1973-1995, with stabilisation over the period 1988-1995. A 54% increase in the risk of ovarian cancer was shown for the period 1993-1995 vs.1973-1977. The more recent generations of women born in Navarra do not show significant changes in the risk of ovarian cancer. CONCLUSIONS: A considerable rise in ovarian cancer incidence in Navarra over the period 1973-1995 was found, less pronounced in the last decade. The risk of ovarian cancer shown in the more recent generations of women born in Navarra is stable.

[Study of the accumulation of lead in the primary teeth]. / Estudio de la acumulación de plomo en dientes primarios.

The purpose of the study was to determine the accumulation of lead in deciduous teeth in children living in the area of Pamplona (Spain). In this manner, we tried to make a relationship between the quantity of lead accumulated in the tooth against certain factors of exposure that were documented on a questionnaire carried out at the time that the tooth was presented. We analysed 457 deciduous teeth using a technique of microwave digestion follow by Atomic Absorption Spectrometry (AAS), to determine the concentration of lead in the sample. The mean lead concentration was 2.60+/-1.36 microg/g (range 0.25-10.71 microg/g). The lead concentration in our study is inferior to those observed in other European studies.

[Dr. D. Nicasio Landa, official epidemic doctor during the cholera epidemic of 1854-1855]. / El Dr. D. Nicasio Landa, médico oficial de epidemias en la de cólera de 1854-1855.

In this unpublished work from 1861, which we have transcribed, Dr. Nicasio Landa (1830-1891) is revealed to have been at the forefront in carrying out epidemiological studies in Spain. He traced the medical topography, or geographical pathology, of cholera by provinces, by means of calculating the incidence rate ("millesimal proportion of those infected") and lethality rates ("millesimal proportion of the dead") using the official data on the sick and deceased in the cholera epidemic of 1854-1855, published by the General Directorate of Health and Charity, as well as the data of the population census of 1857. He worked with an infectionist conception and, besides tracing the epidemiological map, he proposed an association of cholera with the geographical constitution of the terrain in order to explain the anomalous distribution of the disease. That same "anomalous" distribution was repeated in the cholera epidemic in Spain in 1885, and in that of 1971, which is in accordance with the environmental characteristics of certain terrains that make possible the maintenance and persistence of the vibrio cholerae, according to recent research explaining the varied endemo-epidemic distribution of cholera.

[Incidence of idiopathic and secondary Parkinson disease in Navarre. Population-based case registry]. / Incidencia de la enfermedad de Parkinson idiopática y secundaria en Navarra. Registro poblacional de casos.

AIM: To determine the incidence of Parkinson's disease in Navarra, province of Spain. PATIENTS AND METHODS: All patients diagnosed as suffering from Parkinson's disease or related disorders for the neurologists of the region during the period 1994-1995 inclusive were referred to the study. EUROPARKINSON protocol and an epidemiological questionnaire were employed for the assessment. RESULTS: A total of 132 cases of idiopathic (86) and secondary (45) Parkinson's disease were diagnosed during that period. Among men the age adjusted incidence of idiopathic Parkinson's disease was 10.06 x 10(5), while for women it was 4.92 x 10(5). Total adjusted incidence was 7.36 x 10(5). The average age at onset was 67.5 years in men and 72.6 years in women (p < or = 0.007). Men showed an age adjusted incidence of secondary parkinsonism of 3.34 x 10(5) and women of 4.23 x 10(5). Age at onset was earlier in women than in men (71.2 and 74.8 years, respectively). CONCLUSIONS: The incidence of idiopathic Parkinson's disease in Navarra is higher in men than in women, also supported for an earlier age at onset in men. The epidemiological pattern of secondary Parkinson's disease differs from that of the idiopathic disease.