A morphological and molecular approach to investigating infectious disease in early medieval Iberia: The necropolis of La Olmeda (Palencia, Spain).

OBJECTIVE: Here we investigate infectious diseases that potentially contribute to osteological lesions in individuals from the early medieval necropolis of La Olmeda (6th-11th c. CE) in North Iberia. MATERIALS AND METHODS: We studied a minimum number of 268 individuals (33 adult females; 38 adult males, 77 unknown/indeterminate sex; and 120 non-adults), including articulated and commingled remains. Individuals with differential diagnoses suggesting chronic systemic infectious diseases were sampled and bioinformatically screened for ancient pathogen DNA. RESULTS: Five non-adults (and no adults) presented skeletal evidence of chronic systemic infectious disease (1.87% of the population; 4.67% of non-adults). The preferred diagnoses for these individuals included tuberculosis, brucellosis, and malaria. Ancient DNA fragments assigned to the malaria-causing pathogen, Plasmodium spp., were identified in three of the five individuals. Observed pathology includes lesions generally consistent with malaria; however, additional lesions in two of the individuals may represent hitherto unknown variation in the skeletal manifestation of this disease or co-infection with tuberculosis or brucellosis. Additionally, spondylolysis was observed in one individual with skeletal lesions suggestive of infectious disease. CONCLUSIONS: This study sheds light on the pathological landscape in Iberia during a time of great social, demographic, and environmental change. Genetic evidence challenges the hypothesis that malaria was absent from early medieval Iberia and demonstrates the value of combining osteological and archaeogenetic methods. Additionally, all of the preferred infectious diagnoses for the individuals included in this study (malaria, tuberculosis, and brucellosis) could have contributed to the febrile cases described in historical sources from this time.

[Risk factors for metabolic syndrome in a population with sleep apnea; evaluation in a population of Granada; the Granada study]. / Factores de riesgo para el síndrome metabólico en una población con apnea del sueño; evaluación en un grupo de pacientes de Granada y provincia; estudio GRANADA.

INTRODUCTION: The Metabolic Syndrome is one of the first health problems in the public health of the century. It's consider that the beginning of the syndrome is determined by numerous factors that developed two main metabolic disturbances: the insulin resistance and the central obesity. This relationship is concentrating the scientific world. As the cause-effect relationship has to be answered, the epidemiologic research has focused on without results. MATERIAL AND METHODS: 1,016 subjects were recruited in the sleep disorders laboratory in San Cecilio Hospital with sleep apnea suspicion. RESULTS: Significant correlation (p < 0,001) was found between sleep apnea severity and nocturnal saturation values and the different metabolic disturbances related to the metabolic syndrome (Hypertension, Diabetes and obesity). By the contrary, we doesn't found significant differences between No-Sleep apnea group and moderate sleep apnea group in the majority of the variables. CONCLUSIONS: Subjects with sleep apnea have significantly more possibilities to develop metabolic syndrome, and cardiovascular pathology. These subjects had to be evaluated in this sense to reduce the impact associated to this pathology.

Factores de riesgo para el síndrome metabólico en una población con apnea del sueño; evaluación en un grupo de pacientes de Granada y provincia; estudio GRANADA / Risk factors for metabolic syndrome in a population with sleep apnea; evaluation in a population of Granada; the Granada study

Introducción: El síndrome metabólico se está convirtiendo en uno de los principales problemas de salud pública del siglo XXI. Se considera que la aparición del síndrome metabólico está determinada por la interacción de factores genéticos, ambientales y nerviosos centrales (disfunción de los centros hipotalámicos de hambre y saciedad) que generan dos alteraciones metabólicas importantes: la resistencia a la acción de la insulina y la obesidad visceral. La relación de este síndrome, que concentra en la actualidad al mundo científico, con las alteraciones del sueño sigue siendo un punto sin esclarecer. Aunque se ha teorizado sobre la relación causa efecto, se desconoce aún su interrelación convirtiéndose su estudio en un objetivo primario de la investigación epidemiológica. Muestra y métodos: Se reclutaron 1016 sujetos que acudieron al servicio de Fisiología Respiratoria del Hospital Universitario "San Cecilio" de Granada (España) por sospecha de Apnea de Sueño. Resultados: Se encontró una correlación significativa (p < 0,001) entre los valores de apneas hipopneas y los valores de saturación de Oxigeno nocturna con las diferentes alteraciones metabólicas asociadas al síndrome metabólico (Hipertensión, Diabetes y Obesidad). Por el contrario, no se encontraron diferencias estadísticamente significativas test (t-Student) en la mayoría de las variables entre el grupo NO-Apnea y el grupo Apnea moderada. Conclusiones: Los sujetos con apnea de sueño poseen significativamente más riesgo de desarrollar síndrome metabólico, y por lo tanto de presentar patología cardiovascular. Estos sujetos deben ser evaluados en este sentido para reducir la morbimortalidad asociada a estas patologías (AU)

Introduction: The Metabolic Syndrome is one of the first health problems in the public health of the century. It's consider that the beginning of the syndrome is determined by numerous factors that developed two main metabolic disturbances: the insulin resistance and the central obesity. This relationship is concentrating the scientific world. As the cause-effect relationship has to be answered, the epidemiologic research has focused on without results. Material and methods: 1,016 subjects were recruited in the sleep disorders laboratory in San Cecilio Hospital with sleep apnea suspicion. Results: Significant correlation (p < 0,001) was found between sleep apnea severity and nocturnal saturation values and the different metabolic disturbances related to the metabolic syndrome (Hypertension, Diabetes and obesity). By the contrary, we doesn't found significant differences between No-Sleep apnea group and moderate sleep apnea group in the majority of the variables. Conclusions: Subjects with sleep apnea have significantly more possibilities to develop metabolic syndrome, and cardiovascular pathology. These subjects had to be evaluated in this sense to reduce the impact associated to this pathology (AU)

La función pulmonar, factores físicos que la determinan y su importancia para el fisioterapeuta / Pulmonary function. the physical factors that determine it and its importance for the physiotherapist

Introducción. El fisioterapeuta emplea, dentro de sus herramientas de valoración, aquellas destinadas a la medición de la función pulmonar. Todos los factores que afectan la función pulmonar deben ser conocidos de manera exhaustiva por el fisioterapeuta. Este trabajo pretende esclarecer aquellos factores, de carácter físico, que condicionan la función pulmonar. Objetivo. Revisar la bibliografía disponible que relacione los factores físicos que influyen en la función pulmonar. Estrategia de búsqueda. Revisión bibliográfica sistemática en las bases de datos: CINAHL, ScienceDirect, Ovid, Scopus y PubMed. Con antigüedad inferior a 25 años. Síntesis de resultados. Se obtuvo un número total de 90 artículos. Los autores han reconocido que entre los factores físicos de la función pulmonar se encuentran la edad, el sexo, la talla, el peso y el grupo étnico. A estos factores se han sumado en los últimos años, gracias a numerosos autores, los musculoesqueléticos, como la morfología de la caja torácica y el desarrollo muscular. Conclusiones. Los diferentes estudios asocian la edad, el sexo, la raza, el peso y la altura, y los factores musculoesqueléticos torácicos a la función pulmonar. Sin embargo, son necesarios más estudios que expliquen esta influencia (AU)

Introduction: Within their assessment tools, the physical therapist uses those designated for the measurement of lung function. Having extensive knowledge about the physical factors affecting normal lung function is important for the physical therapist. This paper aims to clarify those physical factors that condition pulmonary function. Aims: To review the bibliography available that relate the physical factors having an influence on pulmonary function. Search strategy: The search was made with the following databases: CINAHL, Ovid, Scopus, ScienceDirect and PubMed, with time antiquity limited to the last 25 years. Synthesis of results: A total of 90 articles were obtained from the search. The authors have stated that physical factors of pulmonary function include age, sex, height, weight and ethnic group. In recent year, many authors have also added musculoskeletal factors, morphology of the thoracic cavity and muscle development. Conclusions: The different studies associate age, sex, race, height and weight and thoracic musculoskeletal factors to pulmonary function. However, more studies are needed to explain this influence (AU)

Impacto de la densidad mamaria mamográfica en el funcionamiento de un sistema de detección asistido por ordenador en una unidad de patología mamaria / Impact of mammographic breast density on computer-assisted detection (CAD) in a breast imaging department

Objetivo. Evaluar si la densidad mamaria influye en la sensibilidad (global y por marcas) para la detección del cáncer de mama de un sistema de detección asistido por ordenador (CAD). Materiales y métodos. Estudio prospectivo de 8.750 mamografías digitales con un sistema CAD asociado. Se clasificaron las densidades mamarias según los criterios BI-RADS. Calculamos la sensibilidad global del radiólogo y del CAD, la sensibilidad por proyección, por hallazgo, en relación con la densidad mamográfica y analizamos los carcinomas de intervalo. Para el análisis estadístico utilizamos el programa SPSS vs 11. Resultados. Sensibilidad global del CAD 88,5% IC del 95% (IC95% 83,2-92,7%), sensibilidad del radiólogo 93,5% IC95% (84,4-95,5%), sensibilidad de la proyección craneocaudal 81,6% IC95% (76,5-90,7%) vs 76,5% IC95% (69,3-89,3%) para oblicuomediolateral, sensibilidad para microcalcificaciones 98,6% IC95% (96,5-99,7%), sensibilidad de marca masa 83,4% IC95% (81,2-91,7%). Detectamos discrepancias menores del 20% tanto para las microcalcificaciones presentes en los 4 tipos de densidades como para las masas con densidades 1 y 2; mientras en las masas con densidad 3 la discrepancia fue 20,8% y en la 4 fue 55%. El CAD solo dejó de marcar el 9,1% (9/94) de los cánceres diagnosticados como masas propiamente dichas. El 50% de los carcinomas de intervalo se produjo en densidad tipo 4 y el 75% se manifestaron como masas, asimetrías y distorsiones. El 35,7% de los carcinomas de intervalo fueron marcados previamente por el CAD. Conclusiones. La sensibilidad fue mayor en la proyección craneocaudal pero no significativamente. La sensibilidad del CAD fue alta para microcalcificaciones presentes en los 4 tipos de densidades, sin embargo, para la marca masa fue baja en densidades 3 y 4. El CAD sólo dejó de marcar el 9,1% de los cánceres diagnosticados como masas propiamente dichas pero fue muy poco sensible para los otros 2 hallazgos radiológicos incluidos en esta marca. El 50% de los carcinomas de intervalo se produjeron en densidades tipo 4 y el 35,7% fueron marcados previamente por el sistema de detección asistido por ordenador (AU)

Objective. To evaluate whether breast density influences the sensitivity of a computer-assisted detection (CAD) system for the detection of breast cancer. Material and methods. We prospectively studied 8750 digital mammograms with an associated CAD system. We used BI-RADS criteria to classify breast density. We calculated the overall sensitivity of the radiologist and of the CAD system, as well as the sensitivity for each projection and type of finding in relation to the mammographic density of the breast. Finally, we analyzed the interval carcinomas. We used SPSS 11 for all statistical analyses. Results. The overall sensitivity of the CAD system was 88.5% (95% CI: 83.2-92.7%), and the overall sensitivity of the radiologist was 93.5% (95% CI: 84.4%-95.5%). The sensitivity of the craniocaudal view was 81.6% (95% CI: 76.5-90.7%) vs 76.5% (95% CI: 69.3-89.3%) for the mediolateral oblique view. The sensitivity for microcalcifications was 98.6% (95% CI: 96.5-99.7%), and the sensitivity for masses 83.4% (95% CI: 81.2-91.7%). We detected discrepancies smaller than 20% both for microcalcifications present in the four types of densities and for masses with densities 1 and 2. In masses with density 3 the discrepancy was 20.8% and in those with density 4 it was 55%. The CAD system failed to mark only 9.1% (9/94) of the cancers presenting as masses. Half of the interval carcinomas were found in type 4 density and 75% manifested as masses, asymmetries, and distortions. The CAD system had marked 35.7% of the carcinomas. Conclusions. The craniocaudal view was more sensitive, although this difference was not statistically significant. The sensitivity of CAD was high for microcalcifications in all four density types; however, CAD's sensitivity for masses was low in density types 3 and 4. The CAD system only failed to mark 9.1% of the cancers presenting as masses but was not sensitive for the other two radiological findings included in this marking. Half of the interval carcinomas occurred in type 4 densities and 35.7% had been marked by the CAD sysem (AU)

[Impact of mammographic breast density on computer-assisted detection (CAD) in a breast imaging department]. / Impacto de la densidad mamaria mamográfica en el funcionamiento de un sistema de detección asistido por ordenador en una unidad de patología mamaria.

OBJECTIVE: To evaluate whether breast density influences the sensitivity of a computer-assisted detection (CAD) system for the detection of breast cancer. MATERIAL AND METHODS: We prospectively studied 8750 digital mammograms with an associated CAD system. We used BI-RADS criteria to classify breast density. We calculated the overall sensitivity of the radiologist and of the CAD system, as well as the sensitivity for each projection and type of finding in relation to the mammographic density of the breast. Finally, we analyzed the interval carcinomas. We used SPSS 11 for all statistical analyses. RESULTS: The overall sensitivity of the CAD system was 88.5% (95% CI: 83.2-92.7%), and the overall sensitivity of the radiologist was 93.5% (95% CI: 84.4%-95.5%). The sensitivity of the craniocaudal view was 81.6% (95% CI: 76.5-90.7%) vs 76.5% (95% CI: 69.3-89.3%) for the mediolateral oblique view. The sensitivity for microcalcifications was 98.6% (95% CI: 96.5-99.7%), and the sensitivity for masses 83.4% (95% CI: 81.2-91.7%). We detected discrepancies smaller than 20% both for microcalcifications present in the four types of densities and for masses with densities 1 and 2. In masses with density 3 the discrepancy was 20.8% and in those with density 4 it was 55%. The CAD system failed to mark only 9.1% (9/94) of the cancers presenting as masses. Half of the interval carcinomas were found in type 4 density and 75% manifested as masses, asymmetries, and distortions. The CAD system had marked 35.7% of the carcinomas. CONCLUSIONS: The craniocaudal view was more sensitive, although this difference was not statistically significant. The sensitivity of CAD was high for microcalcifications in all four density types; however, CAD's sensitivity for masses was low in density types 3 and 4. The CAD system only failed to mark 9.1% of the cancers presenting as masses but was not sensitive for the other two radiological findings included in this marking. Half of the interval carcinomas occurred in type 4 densities and 35.7% had been marked by the CAD system.

Suicidio por decapitación con sierra mecánica / Suicide by decapitation using a tapesaw

Se expone un caso de decapitación suicida realizada con una sierra de cinta para cortar metales. Precisó una laboriosa preparación previa en el taller de metalistería donde se ubicaba la máquina. El corte se realizó de delante a atrás con dirección oblicua, seccionando la escama del occipital en gran parte (AU)

A suicide decapitation case is presented that was committed using a tapesaw to cut metals. It required a previous laborious preparation at the metalwork place where the machine was located. Cut was made from the front to back with an oblique direction which caused the cut of a large part of the occipital squama (AU)