The Cumulative and Differential Relation of Adverse Childhood Experiences and Substance Use During Emerging Adulthood.

Adverse childhood experiences (ACEs) have far-reaching effects on a wide range of health outcomes in adulthood, however, less is known about their consequences in emerging adulthood or in a geographically distinct sample. We examined the cumulative and individual relation of ACEs and two risky behaviors: alcohol and illegal drugs consumed by 490 Spanish emerging adults (mean age = 18.9). Participants answered the ACEs questionnaire, and two items about alcohol and illegal drugs consumption. Results showed that the overall experience of suffering different ACEs was a significant predictor of drug but not of alcohol consumption. Moreover, ACEs subtypes presented differential effects on substance use. Whereas some increased the likelihood of either drug or alcohol use, others reduced it. This study supports the importance of examining specific adverse experiences rather than only using an overall measure and provides some counterintuitive results that may be linked to resilient mechanisms.

Predictive Validity of the YLS/CMI in a Sample of Spanish Young Offenders of Arab Descent.

This study was conducted to assess the predictive validity of the Youth Level of Service/Case Management Inventory (YLS/CMI) in young offenders of Arab descent, living in Spain. To address this subject, the Inventory was administered to a sample of Arab minor offenders (N = 116), and results were compared to a sample of non-Arab minor offenders (N = 140), who were all aged between 14 and 17 years. The charges filed after the date of the first assessment carried out by the Youth Offending Team were coded during the follow-up period (2012-2017). The Inventory showed a similar predictive validity for both groups. However, the values were always slightly higher in the non-Arab group than in the Arab group. With subtle cultural differences, the YLS/CMI seems to be a risk instrument capable of predicting recidivism among Arab young offenders.

Effect of luteinizing hormone on rabbit ovarian superstimulation and embryo developmental potential.

Assisted reproduction technologies require ovarian stimulation to increase the number of oocytes and embryos. Currently, superstimulation is achieved by gonadotropin treatment, but the embryo yield and quality are highly variable. Commonly, commercial preparations derived from pituitary and urinary origin are used to superovulate. Hence, ovarian superstimulation protocols have usually included both FSH and LH. The appearance of recombinant gonadotropins manufactured by genetic engineering techniques has ensured high quality and batch-to-batch consistency. Moreover, this enables us to assess the importance of LH in the ovarian stimulation. The main aim of this study was to evaluate the effect of recombinant human LH supplementation (10%) on embryonic development produced by rabbit does superovulated with low or high concentration (18.75 or 37.50 IU) of recombinant human FSH (rhFSH). Females treated with rhFSH increased the ovulation rate, and it was significantly higher when the high FSH dose was supplemented with LH. The superstimulation treatment used did not significantly affect in vitro development rate until the expanded blastocyst stage. The results of this study seem to suggest that, in terms of superovulatory response, when rabbit does are treated with 37.5-IU rhFSH, the use of LH supplementation allows an increase in the number of follicles recruited and the quality of embryos, in terms of ability to develop in vitro until blastocyst, and the expression profile of OCT4, NANOG, and SOX2 genes is not affected.

Uso de la linfogammagrafía intraoperatoria en los casos dudosos de detección del ganglio centinela / Use of intraoperative lymphoscintigraphy in doubtful cases of sentinel node detection

La linfogammagrafía es una técnica ampliamente aceptada para la detección selectiva del ganglio centinela en el melanoma maligno. Presentamos el caso de un paciente intervenido de un melanoma inguinal y que fue remitido al Servicio de Medicina Nuclear para una linfogammagrafía preoperatoria. Existieron problemas técnicos para la detección del ganglio centinela debido a su cercanía con los puntos de inyección. Nosotros planteamos como objetivo la posibilidad de realizar una linfogammagrafía intraoperatoria como técnica válida y de ayuda en casos como el que describimos

Lymphoscintigraphy is a widely accepted method used to detect selectively the sentinel node in malignant melanoma. This is the case report of a patient who was operated on for an inguinal melanoma and who was referred to the Nuclear Medicine Section for preoperative lymphoscintigraphy. There were technical problems for sentinel node detection due to the proximity of injection points. We aimed to know the possibility to perform an intraoperative lymphoscintigraphy as a valid and useful technique in cases as this one

[Use of intraoperative lymphoscintigraphy in doubtful cases of sentinel node detection]. / Uso de la linfogammagrafía intraoperatoria en los casos dudosos de detección del ganglio centinela.

Lymphoscintigraphy is a widely accepted method used to detect selectively the sentinel node in malignant melanoma. This is the case report of a patient who was operated on for an inguinal melanoma and who was referred to the Nuclear Medicine Section for preoperative lymphoscintigraphy. There were technical problems for sentinel node detection due to the proximity of injection points. We aimed to know the possibility to perform an intraoperative lymphoscintigraphy as a valid and useful technique in cases as this one.

[Whole-body (67)Ga scintigraphy in a patient with thymus carcinoma]. / Gammagrafía corporal mediante 67Ga en un paciente con carcinoma tímico.

We report a case of a 50 year old man referred to our department with a history of mild cough, dyspnea and dysphagia. The thoracic CT scan showed a large solid mass in the anterior mediastinum, corresponding to the findings in the chest radiographs.A 67Ga scintigraphy was performed and showed high pathological accumulation in the anterior mediastinum. A subsequent fine needle aspiration biopsy (FNAB) showed the presence of malignant cells, suggesting thymic carcinoma. Although this type of tumour is uncommon, it should be taken into account in order to establish the differential diagnosis of gallium-avid mediastinal masses.

Gammagrafía corporal mediante 67Ga en un paciente con carcinoma tímico / Body 67Ga scintigraphy in a patient with thymus carcinoma

Presentamos el caso de un varón de 50 años, remitido a nuestro departamento con una historia de tos, disnea y disfagia leves. La TAC torácica mostró una gran masa sólida en mediastino anterior, coincidente con los hallazgos en la radiología de tórax. Se realizó una gammagrafía con 67Ga, presentando un intenso acúmulo patológico en mediastino anterior. Posteriormente se practicó una punción-aspiración con aguja fina (PAAF), con presencia de células malignas sugestivas de carcinoma tímico. Aunque este tipo de tumor es poco frecuente, debería ser tenido en cuenta para establecer el diagnóstico diferencial de las masas mediastínicas captantes de 67Ga (AU)

[Appendicitis in the elderly: delay between the first symptoms and surgical procedure]. / Apendicitis en el anciano. Retraso desde el inicio de los síntomas hasta la cirugía.

Acute appendicitis is the most frequent etiology of abdominal laparotomy, and although it's thought that is a pathology of young patients, not only it isn't infrequent in elderly patients but it's increasing its incidence in the last decades, in part due to longer expectative of life in the general population. We studied the particularity of presentation and evolution in a group of 73 patients older than 60-year old, in comparason with a younger group. The clinical findings were typical in the most of patients, unrelated to the age, but problems as: delay in the clinical assistance, to have associated another diseases, and delayed diagnosis and operation, make the appendicitis in the older patient to have an increased incidence of complications. Moreover, post-operative complications occurred much more frequently, specially at the surgical incision, with a higher morbidity and hospital stay.

[A comparative study of the effects on the left ventricular function of 2 methods of noninvasive ventilation: NIPPV and EFHO-NB]. / Estudio comparativo de la repercusión sobre la función ventricular izquierda de dos métodos de ventilación no invasiva: NIPPV y EFHO-NB.

BACKGROUND: Among the non-invasive ventilatory methods, the Nasal Intermittent Positive Pressure Ventilation (NIPPV) can cause important effects on circulation since a positive intrathoracic pressure is obtained and thus in the transmural cardiac pressure. In contrast, the External High Frequency Oscillation around a Negative Baseline (EHFO-NB) obtains a negative thoracic pressure. Therefore, the opposite circulatory changes should be expected. OBJECTIVE: To study and compare the effects on the left systolic and diastolic ventricular functions derived from the application of both NIPPV and EHFO-NB ventilatory support methods in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Nine patients with COPD were studied. The investigation was carried out from the third to the seventh day of follow-up at the ICU. For each patient three equilibrium radionuclide angiocardiography (ERA) were performed. With the patient breathing room air spontaneously, 45 minutes after ventilatory support with NIPPV and also 45 minutes after ventilatory support with EHFO-NB. Measurements of radionuclide activity (counts) and derived parameter of left systolic and ventricular functions were determined following a previously reported protocol. RESULTS: During ventilatory support with NIPPV a significant increase in the time elapsed since the end of the diastole to the peak systolic ejection was observed. During ventilatory support with EHFO-NB a significant decrease in cardiac radioactivity (counts) in tele-systole was observed together with an increase in the ejection velocity measured in the first third of the systolic phase. These findings occurred both with respect to the basal situation and to the ventilatory phase with NIPPV: CONCLUSIONS: Under the study conditions, none of the non-invasive ventilatory support methods compromised hemodynamic parameters in patients studied. Ventilation with EHFO-NB improved the left ventricular function.

[Indicators of follow-up activities undertaken by an arterial hypertension unit over a 5 year period]. / Indicadores de actividad en el seguimiento de una unidad de hipertensión arterial durante 5 años.

OBJECTIVE: To assess the efficacy and effectiveness of an AHT programme by means of indicators which analyse the coverage, results and attendance. SETTING: AHT unit at the Health Centre in Novelda, Alicante. DESIGN: A quasi-experimental design of internal comparison with temporal series. The years analysed were 1985, '87, '88 and '90. The following were assessed: support, therapeutic compliance, risk level, weight, monitoring, visits per year, therapy, risk factors. PATIENTS: A cohort of 266 hypertense patients (175 women and 91 men). MEASUREMENTS AND MAIN RESULTS: The Unit significantly increased the number of patients being monitored and treated (WHO 46.7% and JNC 9.1%), but never exceeded 60%. Serious risk was eliminated and moderate risk went down (27.7%). Visits to the Centre were reduced by 2.8 per year. Of risk factors, weight did not go down, but hypercholesterolaemia diminished by 48.4%, hypertriglyceridaemia by 9.8%, hyperglycaemia by 4.4%, hyperuricaemia by 7.9% and tobacco addiction by 19.9%. CONCLUSIONS: These figures contain extremely interesting information. They reveal the achievements and difficulties of clinical practice and point to practical strategies.