Validación de la versión en español de la prueba de control del asma infantil (ACT) para su uso en España / Validation of a Spanish version of the childhood asthma control test (Sc-ACT) for use in Spain

OBJETIVO: El cuestionario asthma control test (ACT) pediátrico es una herramienta validada para determinar el grado de control del asma. Sin embargo, no está valida en español para España, motivo de evaluar las propiedades psicométricas de la versión en español del cuestionario ACT pediátrico (c-ACT), dirigido a conocer el grado de control del asma en niños de 4 a 11 años de edad. MÉTODOS: Estudio nacional, prospectivo, multicéntrico, desarrollado en España en niños asmáticos y en sus padres. Los pacientes fueron evaluados en 3 visitas (basal, a las 2 semanas y a los 4 meses). Variables clínicas relacionadas: síntomas, exacerbaciones, FEV1, clasificación del asma, escalas de los cuestionarios PAQLQ y PACQLQ y control del asma percibido por el paciente, sus padres y por su médico. Se evaluaron la factibilidad, la validez, la fiabilidad y la sensibilidad del cuestionario ACT. RESULTADOS: Cohorte constituida por 394 niños. La duración media ± desviación estándar (DE) para completar el cuestionario fue 5,3 (4,4) min. La puntuación se correlacionó con el grado de control del asma percibido por su médico (-0,52), por el niño (-0,53) y por sus padres (-0,51), y con las puntuaciones de los cuestionarios PAQLQ (0,56) y PACQLQ (0,55). Se ha observado una estrecha asociación de la puntuación del cuestionario con la intensidad y la frecuencia de los síntomas relacionados con asma. Para todos los ítems, coeficiente alfa de Cronbach 0,81 y coeficiente de correlación intraclase ≥ 0,85. El punto de corte de 21 o más indican un muy buen control del asma y su MCID fue de 4 puntos. CONCLUSIÓN: La versión en español del cuestionario ACP pediátrico es fidedigno y válido para evaluar en control del asma en España, en niños de 4 a 11 años de edad

OBJECTIVE: The Childhood Asthma Control Test (c-ACT) is a validated tool for determining pediatric asthma control. However, it is not validated in the Spanish language in Spain. We evaluated the psychometric properties of the Spanish version of the Childhood Asthma Control Test (Sc-ACT) for assessing asthma control in children ages 4 to11. METHODS: This national, multicentre, prospective study was conducted in Spain with asthmatic children and their caregivers. Patients were assessed at 3 visits (Baseline, 2 Weeks, and 4 Months). Clinical variables included: symptoms, exacerbations, FEV1, asthma classification, PAQLQ and PACQLQ questionnaire scores, and asthma control as perceived by physicians, patients and caregivers. The Sc-ACT feasibility, validity, reliability, and sensitivity to change were assessed. RESULTS: A total of 394 children were included; mean (SD) time to complete the Sc-ACT was 5.3 (4.4) minutes. Sc-ACT score was correlated with asthma control as perceived by physician (-0.52), patient (-0.53), and caregiver (-0.51) and with the PAQLQ (0.56) and PACQLQ (0.55) scores. Sc-ACT was found to be significantly related to intensity and frequency of asthma symptoms. Cronbach alpha coefficient α was 0.81 and intraclass correlation coefficient was ≥0.85 for all of the items. The global effect size of Sc-ACT was 0.55. The cutoff point scores of 21 or higher indicated a good asthma control and their MCID was 4 points. CONCLUSION: The Spanish version of the c-ACT was found to be a reliable and valid questionnaire for evaluating asthma control in Spanish-speaking children ages 4 to 11 in Spain

Tratamiento precoz con estatinas en el infarto agudo de miocardio / Early statin therapy in acute myocardial infarction

OBJETIVOS: Evaluar el efecto de la administración precoz de estatinas durante la fase aguda del infarto de miocardio (IM). DISEÑO: Estudio de cohortes retrospectivo. Ámbito: Nacional. PACIENTES O PARTICIPANTES: Pacientes incluidos en el registro ARIAM desde enero de 1999 hasta diciembre de 2008 con diagnóstico de IM. INTERVENCIONES: Ninguna. Variables de interés principales: Se utilizaron análisis de regresión logística y de propensión para determinar si la administración de estatinas, durante las primeras 24h del IM, se comportaba como un factor protector frente a: 1) la mortalidad, 2) la incidencia de arritmias letales o 3) el shock cardiogénico. RESULTADOS: Se incluyeron 36.842 pacientes en el estudio. En un 50,2% de los pacientes las estatinas se administraron de forma precoz. Su administración se asoció a pacientes más jóvenes, con dislipidemia previa conocida, obesidad, antecedentes personales de cardiopatía isquémica, insuficiencia cardiaca, presencia de taquicardia inusal, uso de betabloqueantes, inhibidores de la enzima convertidora de angiotensina, trombolisis e intervencionismo coronario percutáneo. La mortalidad fue del 8,2% (13,2% sin estatinas vs. 3% con estatinas; p < 0,001). El análisis multivariante demostró que la administración de estatinas actuó como factor protector frente a la mortalidad (OR ajustada 0,518; IC 95% 0,447-0,601). La continuación de la administración de estatinas se asoció con una reducción en la mortalidad (OR ajustada 0,597; IC 95% 0,449-0,798), y el inicio del tratamiento fue un factor protector frente a la mortalidad (OR ajustada 0,642; IC 95% 0,544-0,757). El tratamiento con estatinas también fue factor protector contra la incidencia de arritmias letales y shock cardiogénico. CONCLUSIONES: Estos resultados sugieren que el tratamiento precoz con estatinas en los pacientes con IM se asocia con una reducción de la mortalidad

OBJECTIVES: To evaluate the effects of the early administration of statins during acute myocardial infarction (MI). DESIGN: A retrospective cohort study was carried out. Setting National (Spain). PATIENTS OR PARTICIPANTS: Patients included in the ARIAM registry from January 1999 to December 2008 with a diagnosis of MI. INTERVENTIONS: None MAIN VARIABLES: We used logistic regression analysis and propensity scoring to determine whether the administration of statins during the first 24h of MI acts as a protective factor against: 1) mortality, 2) the incidence of lethal arrhythmias, or 3) cardiogenic shock. RESULTS: A total of 36 842 patients were included in the study. Statins were administered early in 50.2% of the patients. Statin administration was associated with younger patients with known previous dyslipidemia, obesity, a history of ischemic heart disease, heart failure, presence of sinus tachycardia, use of beta-blockers, angiotensin-converting enzyme inhibitors, thrombolysis and percutaneous coronary intervention. Mortality was 8.2% (13.2% without statin versus without statin versus 3% with statin, P < .001). Multivariate analysis demonstrated that statin administration acted as a protective factor against mortality (adjusted OR 0.518, 95%CI 0.447 to 0.601). Continued use of statins was associated with a reduction in mortality (adjusted OR 0.597, 95%CI 0.449 to 0.798), and the start of treatment was a protective factor against mortality (adjusted OR 0.642, 95%CI 0.544 -0.757). Statin therapy also exerted a protective effect against the incidence of lethal arrhythmias and cardiogenic shock. CONCLUSIONS: These results suggest that early treatment with statins in patients with MI is associated with reduced mortality

Infarto agudo de miocardio en el paciente trasplantado cardiaco: un reto diagnóstico y terapéutico / Acute myocardial infarction in the heart transplant patient: A diagnostic and therapeutic challenge

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Evolution of invertase activity in honey from Castanea sativa and Rosmarinus officinalis collected in Granada

The content of α-glucoxidase in two varieties of honey covered by the Granada Honey Protected Denomination of Origin Regulatory Board is studied. The evolution of invertase activity was followed for 10 months, in 12 monofloral chestnut honey samples collected in the Alpujarra area of Granada and 9 monofloral rosemary honey samples collected in la Resinera, Valle de Lecrin and in the Sierra de Baza for 10 months. The invertase was measured in the months of June 2005, September 2005, January 2006 and finally in the month of April 2006. We obtained an invertase activity in fresh chestnut honey of 194.6±3.6 U/kg, with a range between 188.7 U/kg and 199.5 U/kg. After 10 months at ambient temperature, the chestnut honey lost between 28.3% and 39.8% of the initial values of α-glucosidase, with an average of 33.4%±3.3%. In the rosemary honey we obtained average invertase values of 69.4±14.9 U/kg, with a range between 56.9 U/kg and 91.9 U/kg. After 10 months at ambient temperature, the rosemary honey lost between 19.3% and 32.3% of the initial α-glucosidase values, with an average of 28.1%±4.4%(AU)

Molecular approach to the interpretation of the dielectric relaxation spectrum of a molecular glass former

The frequency-dependent dielectric function of ethanol at temperatures within the normal liquid range is evaluated by means of computer molecular dynamics simulations and compared with recent experimental data. The calculated spectra show a similar structure to those reported from experimental measurements and the temperature dependence of its most prominent bands also follows the experimental estimates. An attempt is also made to assign the most intense bands to specific molecular reorientations.

Quantum effects on liquid dynamics as evidenced by the presence of well-defined collective excitations in liquid para-hydrogen

The origin of the well-defined collective excitations found in liquid para-H2 by recent experiments is investigated. The persistence of their relatively long lifetimes down to microscopic scales is well accounted for by calculations carried out by means of path-integral-centroid molecular dynamics. In contrast only overdamped excitations are found in calculations carried within the classical limit. The results provide fully quantitative evidence of quantum effects on the dynamics of a simple liquid.

Persistence of well-defined collective excitations in a molten transition metal

Well-defined microscopic collective excitations are found in liquid Ni at 1763 K by means of inelastic neutron scattering. Such excitations are supported by the liquid despite an anharmonic character of its thermodynamic functions. Consideration of the detailed shape of the interionic pair potential provides a way to understand why atomic motions at microscopic scales behave in a way much closer to the alkali metals than to the liquefied rare gases.