Synthesis and characterization of Ti-Ta-Nb-Mn foams.

The unprecedented increase in human life expectancy have produced profound changes in the prevailing patterns of disease, like the observed increased in degenerative disc diseases, which cause degradation of the bones. Ti-Nb-Ta alloys are promising materials to replace the damaged bone due to their excellent mechanical and corrosion resistance properties. In general metallic foams are widely used for medical application due to their lower elastic moduli compare to bulk materials. In this work we studied the synthesis of 34Nb-29Ta-xMn (x: 2, 4 and 6 wt.% Mn) alloy foams (50% v/v) using ammonium hydrogen carbonate as a space holder. Alloys were produced through mechanical alloying in a planetary mill for 50h. Green compacts were obtained by applying 430 MPa pressure. To remove the space holder from the matrix the green compacts were heated to 180 °C for 1.5h and after sintered at 1300 °C for 3h. Foams were characterized by x-ray diffraction, scanning, transmission electron microscopy and optical microscopy. The elastic modulus of the foam was measured as ~30 GPa, and the values are almost equal to the values predicted using various theoretical models.

[Reasons and determining factors for referrals between primary and specialised care]. / Motivos y condicionantes de la interconsulta entre atención primaria y especializada.

OBJECTIVES: To determine the reasons and characteristics of referrals from Primary to Specialised Care in the Health Area of Toledo (Spain). MATERIAL AND METHODS: A descriptive, cross-sectional study was conducted by reviewing a sample of the referrals to specialists made by 26 general practitioners from eight Teaching Health Centres during February 2011. All of them completed a questionnaire which recorded patient data, and reason and characteristics of the referral. RESULTS: A total of 332 referrals were recorded; the mean age of the patients was 51.3 years (SD; 17.9); 60.1% females; 30.7% pensioners; 54.8% had a chronic disease; 85.8% were from an urban environment. The most consulted specialists were: Traumatology (63), Gynaecology (53), and Ophthalmology (41). More than three-quarters (78.9%) were by the normal route, and 47.4% were first consultations. Around 12.7% were scheduled reviews, with a majority (51.4%) by a hospital specialist. More than two thirds (69.8%, 95% CI; 64.5-74.7%) required follow-up or treatment by the specialist. More than half (57.7%, 95% CI; 52.3-63.1%) required special diagnostic tests, and in 29.8% (95% CI; 25.0-35.1%) there was no clear diagnosis. There was a history of a repeated consultation for the same symptomatology in 28.9% of the referrals. Around 38.4% (95% CI; 33.0-43.7%) were requested specifically by the family or patient. Around 5.4% had a poor relationship with the patient. CONCLUSIONS: The majority of referrals are made by the normal route, and to surgical specialities. The need for hospital specialist follow-up and/or treatment, or the impossibility to request specific tests from Primary Care were the main reasons for requesting care from a second health care level. There were a high percentage of referrals requested by the family/patient.

Motivos y condicionantes de la interconsulta entre atención primaria y especializada / Reasons and determining factors for referrals between primary and specialised care

Objetivos. Conocer los motivos y características de las derivaciones desde atención primaria a especializada en el área de Salud de Toledo. Material y métodos. Estudio de tipo descriptivo transversal. Se revisó una muestra de las interconsultas a especializada realizadas por 26 médicos de familia, pertenecientes a 8 centros de salud docentes, en febrero de 2011. Por cada una, se cumplimentó un cuestionario que recogía datos del paciente, motivo y características de la derivación. Resultados. Se recogieron 332 interconsultas; la edad media de los pacientes fue de 51,3 años (DE 17,9); el 60,1% mujeres; el 30,7% pensionistas; el 54,8% presentaban patología crónica; el 85,8% procedía del medio urbano. Las especialidades más consultadas fueron: Traumatología (63), Ginecología (53) y Oftalmología (41). El 78,9% fueron vía normal y 47,4% fueron primeras consultas. Un 12,7% eran revisiones programadas, en su mayoría (51,4%) por el especialista hospitalario. El 69,8% (IC95% 64,5–74,7%) precisaba seguimiento o tratamiento por el especialista. El 57,7% (IC95% 52,3–63,1%) requería pruebas diagnósticas especiales. En el 29,8% (IC95% 25,0–35,1%) no estaba claro el diagnóstico. En el 28,9% de las derivaciones había antecedentes de consulta reiterada por esa sintomatología. En el 38,4% (IC95% 33,0–43,7%) hubo solicitud expresa por familia o paciente. El 5,4% tenía mala relación con el paciente. Conclusiones. La mayoría de las derivaciones se hacen por vía normal y a especialidades quirúrgicas. La necesidad de seguimiento y/o tratamiento por parte del especialista hospitalario o la imposibilidad de solicitar determinadas pruebas desde atención primaria fueron los principales motivos para solicitar la atención del segundo nivel asistencial. Existe un alto porcentaje de interconsultas inducidas por la familia/paciente(AU)

Objectives. To determine the reasons and characteristics of referrals from Primary to Specialised Care in the Health Area of Toledo (Spain). Material and methods. A descriptive, cross-sectional study was conducted by reviewing a sample of the referrals to specialists made by 26 general practitioners from eight Teaching Health Centres during February 2011. All of them completed a questionnaire which recorded patient data, and reason and characteristics of the referral. Results. A total of 332 referrals were recorded; the mean age of the patients was 51.3 years (SD; 17.9); 60.1% females; 30.7% pensioners; 54.8% had a chronic disease; 85.8% were from an urban environment. The most consulted specialists were: Traumatology (63), Gynaecology (53), and Ophthalmology (41). More than three-quarters (78.9%) were by the normal route, and 47.4% were first consultations. Around 12.7% were scheduled reviews, with a majority (51.4%) by a hospital specialist. More than two thirds (69.8%, 95% CI; 64.5–74.7%) required follow-up or treatment by the specialist. More than half (57.7%, 95% CI; 52.3–63.1%) required special diagnostic tests, and in 29.8% (95% CI; 25.0-35.1%) there was no clear diagnosis. There was a history of a repeated consultation for the same symptomatology in 28.9% of the referrals. Around 38.4% (95% CI; 33.0–43.7%) were requested specifically by the family or patient. Around 5.4% had a poor relationship with the patient. Conclusions. The majority of referrals are made by the normal route, and to surgical specialities. The need for hospital specialist follow-up and/or treatment, or the impossibility to request specific tests from Primary Care were the main reasons for requesting care from a second health care level. There were a high percentage of referrals requested by the family/patient(AU)

Valoración de la repercusión del tabaco en la función pulmonar según el sexo / No disponible

Objetivo: Valorar la posible existencia de diferencias, en función del sexo, de la repercusión del tabaco sobre la función pulmonar. Pacientes y método: Se realizó un estudio descriptivo transversal (primer trimestre 2010), en tres ZBS de Toledo. Los participantes fueron fumadores mayores de 18 años (se excluyeron los pacientes con patología oncológica pulmonar, fibrosis quística, enfermedad pulmonar profesional, disfunciones cognitivas, contraindicaciones para poder realizar una espirometría, y no ser hispano- hablantes). Tras contactar telefónicamente, se citó a los pacientes para realizar una espirometría aprovechando dicha situación para realizar el consejo antitabaco. Si padecían un proceso respiratorio agudo se retrasó la cita diez días tras resolución del cuadro. Se recogió: edad, sexo, edad de inicio de hábito tabáquico, índice tabáquico (IT), función pulmonar- espirometría. Resultados: N= 153. Edad media 49±13,59 años. 61,4% hombres. Edad media inicio del consumo de tabaco 18,18±5,95 (inferior en hombres sin diferencias signifi cativas). Índice tabáquico: mediana 25 (RI 36-15), con diferencias signifi cativas entre sexos (hombres 28 vs mujeres 23; z=-2,107 p<0,05). Los valores medios de los datos espirométricos fueron: CVF: 86,41 (DE 17,44); FEV1: 88,94 (DE 18,09); FEV1/CVF: 85,01 (DE 13,64); MEF25-75: 87,94 (DE 32,42). Existían diferencias signifi cativas entre sexos en los valores medios de CVF, FEV1 y MEF25-75. Un 39,1% tenía un FEV1/CVF < 80 y el 16,99% valores de MEF25-75 <60, sin diferencias por sexos en estos grupos. En hombres, el IT se correlaciona signifi cativamente con CVF (rho: -0,309; p<0,001), FEV1 (rho: -0,320; p<0,001) y MEF25-75 (rho: -0,211; p<0,05), no encontrándose correlaciones significativas entre estos parámetros y el IT en mujeres. Se creó un modelo de regresión lineal entre IT y FEV1 para cada sexo obteniéndose una B= -0,035 en mujeres y una B=-0.182 en varones. Conclusiones: En nuestra muestra, la afectación que produce el tabaco parece ser diferente entre hombres y mujeres, con mayor repercusión en los hombres. Sería necesario realizar nuevos estudios para contrastar estos resultados (AU)

No disponible

Cambios en la dieta y tendencia del cáncer colorrectal en España durante 1951-2007 / Dietary changes and colorectal cancer trends in Spain during 1951-2007

Objetivos: análisis de la evolución del cáncer colorrectal enEspaña durante el periodo 1951-2007 y su relación con la dieta.Material y métodos: cálculo de tasas de incidencia, mortalidady años potenciales de vida perdidos ajustadas (población mundial),así como de consumos per capita de distintos alimentos.Resultados: el consumo de carnes rojas y procesadas, pollo,pescado y frutas ha aumentado y el de hortalizas, cereales y legumbresha descendido.La incidencia de cáncer colorrectal ha experimentado un aumentoconstante en ambos géneros, más marcado en varones, entodos los grupos de edad, en contraposición con lo ocurrido enotros países. La mortalidad aumentó durante el periodo 1951-2000, pero desde ese momento hasta 2007 se ha estabilizado envarones y decrecido en mujeres.Los años potenciales de vida perdidos muestran una distribuciónsimilar a la mortalidad.Los coeficientes de correlación presentan valores cercanos auno para el consumo de carnes rojas, pollo, pescado, hortalizas yfrutas y valores fuertemente negativos para el consumo de cerealesy legumbres con la incidencia y la mortalidad, en ambos géneros,y con los años potenciales de vida perdidos, aunque sólo envarones, con correlaciones débiles en mujeres.Conclusiones: en el cáncer colorrectal es necesario un mínimode diez-quince años para que cambios en la exposición a factoresde riesgo y protección puedan modificar su incidencia. Porello, se deben aplicar medidas legislativas y educativas en materiade Promoción de la Salud respecto a dieta por parte del Estado ylos Gobiernos Regionales de forma urgente(AU)

Objectives: analysis of the evolution of colorectal cancer inSpain during the period 1951-2007 and its relationship with diet.Material and methods: calculation of incidence rates, standardizedmortality and years of potential life lost (world population)and per capita consumption of different foods.Results: red and processed meats, poultry, fish and fruits intakehas increased and consumption of vegetables, cereals andlegumes has decreased.The incidence of colorectal cancer has steadily increased inboth genders, more markedly among men, and across all agegroups, in contrast to what has been observed in other countries.Mortality increased during the period 1951-2000, but from thattime until 2007 these rates have kept steady in men and fallen inwomen.The years of potential life lost (YPLL) shows a similar distributionto mortality.The correlation coefficients have values close to one for consumptionof red meat, poultry, fish, vegetables and fruits andstrongly negative values for the consumption of cereals andvegetables with the incidence and mortality in both genders,and the YPLL, but only among men, with weaker correlationsfor women.Conclusions: in colorectal cancer, a minimal time span often-fifteen years is necessary for changes in exposure to risk factorsto be able to modify the incidence of this tumour. Therefore,Spanish State and Regional Governments should implement legislativeand educational measures in the field of Health Promotionregarding the diet urgently(AU)

Neodymium nanoparticles: biosynthesis and structural analysis.

Small metallic nanoparticles of neodymium are obtained by a facile route based on the biosynthesis and the pH conditions that demonstrate the possibility of obtaining particles of 1-8 nm. The size is controlled by synthesis conditions. Smaller clusters were obtained with pH = 5, while for pH = 10 evidences of nanorods productions are found and this opens the perspective to use this rare-earth element for zero and one dimensional based applications. Using transmission electron microscopy techniques, the size distribution and structure are studied. Density functional theory-based calculations allow the determination of the lowest energy configuration, which is based on the hexagonal bulk symmetry. Theoretical models are used to simulate the high resolution transmission electron microscopy to identify the experimental image, determining that the synthesized nanoparticles reach the lowest energy hexagonal configurations.