[The influence of a healthy lifestyle on body mass index in a sample of 12-14 year old individuals in Murcia (Spain)].

BACKGROUND: Excess weight and obesity in childhood is directly related to comorbidities that can have serious conse-quences for health. This study set out to identify the main modifiable lifestyles that influence the development of excess weight and obesity in childhood. METHODS: A cross-sectional study was carried out at seven secondary schools in Area V, Murcia, Spain. Questionnaires completed by parents were used to gather information about healthy habits in adolescents (ENHASA), The surveys con-sisted of four dimensions made up of modifiable lifestyle factors: nutrition, physical activity, new technologies and schoolmates. The adolescents' somatometric data was measured and classified according to the WHO categories for body mass index (BMI). ANOVA was used to compare the score differences among the BMI groups. RESULTS: The questionnaire was completed by the parents of 421 adolescents with an average age of 12 years. 21.1% pre-sented excess weight and 19.7% obesity. The score obtained by adolescents in the physical activity dimension decreased in the increased BMI group (score in normal weight 6.36 vs. 4.45 in obesity; p<0.001). The other three dimensions showed insignificant differences in scores between normal weight and obesity groups. CONCLUSION: Excess weight was present in 40.8% of the sample. Physical activity was the modifiable lifestyle to be most markedly linked to BMI. This outcome may help in planning specific strategies for sedentary lifestyles to reduce this dietary epidemic.

Influencia de hábitos saludables sobre el índice de masa corporal en la población de 12-14 años en un área de Murcia (España) / The influence of a healthy lifestyle on body mass index in a sample of 12-14 year old individuals in Murcia (Spain)

FUNDAMENTO: El sobrepeso y la obesidad se relacionan directamente con comorbilidades con graves consecuencias para la salud. El objetivo del estudio fue identificar los principales hábitos de vida modificables que influyen en el desarrollo de la sobrecarga ponderal en adolescentes. Material y método. Estudio transversal, realizado en cuatro de los siete centros de educación secundaria del Área V de Murcia. Se recogió información a través de la Encuesta sobre Hábitos Saludables en Adolescentes (ENHASA), cumplimentada por los padres y que engloba cuatro dimensiones compuestas por hábitos de vida modificables: alimentación, actividad física, nuevas tecnologías, y colegio-amigos. Se obtuvieron los datos de somatometría de los adolescentes y se clasificaron según los referentes de índice de masa corporal (IMC) de la OMS. Las diferencias de puntuaciones entre categorías del IMC se analizaron con ANOVA. RESULTADOS: El cuestionario fue cumplimentado por los padres de 421 adolescentes con edad media de 12 años; el 21,1% presentaban sobrepeso y el 19,7% obesidad. A medida que aumentaba la categoría de IMC disminuía la puntuación obtenida en la dimensión de actividad física (6,36 en normopeso vs 4,45 en obesidad, p < 0,001). Las otras tres dimensiones también mostraron diferencias no significativas de puntuación entre normopeso y obesidad. CONCLUSIONES: Un 40,8% de la muestra estudiada presentó exceso de peso, siendo la actividad física la conducta modificable más relacionada con el IMC, lo que orienta a planear estrategias enfocadas especialmente en el sedentarismo que contribuyan a disminuir esta epidemia nutricional

BACKGROUND: Excess weight and obesity in childhood is directly related to comorbidities that can have serious consequences for health. This study set out to identify the main modifiable lifestyles that influence the development of excess weight and obesity in childhood. METHODS: A cross-sectional study was carried out at seven secondary schools in Area V, Murcia, Spain. Questionnaires completed by parents were used to gather information about healthy habits in adolescents (ENHASA), The surveys consisted of four dimensions made up of modifiable lifestyle factors: nutrition, physical activity, new technologies and schoolmates. The adolescents' somatometric data was measured and classified according to the WHO categories for body mass index (BMI). ANOVA was used to compare the score differences among the BMI groups. RESULTS: The questionnaire was completed by the parents of 421 adolescents with an average age of 12 years. 21.1% presented excess weight and 19.7% obesity. The score obtained by adolescents in the physical activity dimension decreased in the increased BMI group (score in normal weight 6.36 vs. 4.45 in obesity; p < 0.001). The other three dimensions showed insignificant differences in scores between normal weight and obesity groups. CONCLUSION: Excess weight was present in 40.8% of the sample. Physical activity was the modifiable lifestyle to be most markedly linked to BMI. This outcome may help in planning specific strategies for sedentary lifestyles to reduce this dietary epidemic

Seguimiento en las consultas de Pediatría de Atención Primaria de los grandes prematuros: nacidos con menos de 32 semanas de gestación o menos de 1500 gramos / Follow-up in Primary Care Pediatric consultations of very premature babies: born at less than 32 weeks' gestation or weighing less than 1500 grams

Introducción: casi un 20% de los grandes prematuros abandona el seguimiento en los hospitales y tienen peor evolución que los que continúan el programa. Obtener datos sobre la implicación de los pediatras de Atención Primaria (PAP) en el seguimiento del prematuro de menos de 32 semanas o con peso < 1500 g es necesario para plantear estrategias de mejora. Material y métodos: estudio observacional, transversal, descriptivo, en el ámbito de las 17 comunidades autónomas españolas, a través PAPenRED (304 PAP). Se recogieron datos mediante encuestas cumplimentadas online acerca del número de grandes prematuros por pediatra, el tipo de seguimiento y las dificultades en su atención. Se describen las distribuciones de frecuencias, en porcentajes, de las variables cualitativas. Resultados: se incluyeron 870 grandes prematuros con una media por pediatra de 3,8. El 68,84% de los PAP no tienen programa común de seguimiento para el hospital y Atención Primaria (AP), y al 99% les gustaría tenerlo. El 84,27% manifiesta que estos niños tienen problemas más complejos y las patologías que presentan con mayor frecuencia en comparación con los nacidos a término son: la ansiedad familiar, la patología respiratoria y los problemas relacionados con el crecimiento, la alimentación, el desarrollo motor y los cognitivos y del comportamiento. Conclusiones: los PAP creen necesarios los programas conjuntos hospital-AP para el seguimiento de los grandes prematuros (AU)

Introduction: almost 20% of premature babies abandons the follow-up in hospitals and they have worse outcomes than those who continue the program. Obtaining data on the involvement of Primary Care pediatricians (PAPs) in monitoring premature babies born at less than 32 weeks or weighing less than 1500 g is necessary to propose strategies for improvement. Methods: it is an observational, transversal, descriptive study, in the area of ​​the 17 Spanish autonomous communities, through PAPenRED network (304 PAPs). Data were collected by questionnaires filled out online about the number of premature babies by pediatrician, the type of monitoring and the difficulties found in their attention. Frequency distributions, percentages, qualitative variables are described. Results: 870 very premature infants were included with an average of 3.8 per pediatrician. 68.84% of PAPs do not share a common monitoring program between hospitals and Primary Care centers, despite the fact that 99% of the pediatricians would like to have it. 84.27% say that these children have more complex problems. The diseases that occur more frequently compared to those born at term are family anxiety, respiratory disease and problems in relation to growth, feeding, motor development and cognitive and behavioral issues. Conclusions: PAPs believe necessary commmon programs between hospitals and Primary Care centers for monitoring the very premature babies (AU)

Entamoeba histolytica: the over expression of a mutated EhRabB protein produces a decrease of in vitro and in vivo virulence.

Vesicular trafficking, which is implicated in secretion of cytolytic molecules as well as in phagocytosis, plays an important role in the pathogenic mechanism of Entamoeba histolytica, the protozoan parasite causative of human amoebiasis. Thus, Rab GTPases, that are key regulators of vesicle trafficking, should be considered as molecules involved in the parasite virulence. EhRabB is a Rab protein located in cytoplasmic vesicles that are translocated to phagocytic mouths during ingestion of target cells, suggesting that this Rab protein is involved in phagocytosis. To prove this hypothesis, we over expressed the wild type EhrabB gene and a mutant gene encoding for a protein (RabBN118I) unable to bind guanine nucleotides and therefore constitutively inactive. The over expression of the mutated protein in E. histolytica trophozoites provoked a dominant negative effect, reflected in a significant decrease of both phagocytosis and cytopathic effect as well as in a failure to produce hepatic abscesses in hamsters. These results confirm that EhRabB is involved in phagocytosis and virulence of E. histolytica.

Necesidades y objetivos de los pediatras del País Vasco/Euskadi (España) / Needs and objectives of the paediatricians in the Basque Country

Objetivos: conocer la situación laboral, la carga de trabajo y las propuestas de mejora para los pediatras de la Comunidad Autónoma del País Vasco/Euskadi. Material y métodos: encuesta enviada por correo electrónico a todos los pediatras de Atención Primaria (PAP) del País Vasco/Euskadi (N=255). La encuesta contenía preguntas sobre el perfil socioprofesional y las expectativas de futuro. Resultados: han respondido a la encuesta 192 pediatras, el 75% de los encuestados. El 68% son mujeres; el 70%, mayores de 45 años, y un 30%, mayores de 55 años. El 20% tiene menos de 800 tarjetas individuales sanitarias (TIS), y el 25%, más de 1000. La mayoría (55%) tiene que compartir personal de Enfermería con otro pediatra. El 30% se siente quemado y, a pesar de ello, el 70% no cambiaría su puesto de trabajo de PAP. Hay una demanda de formación continuada y de menor burocratización de las consultas. Conclusiones: feminización del colectivo de PAP. El número de TIS excede el pactado con el Servicio de Salud Osakidetza (800 TIS/pediatra). El apoyo de Enfermería es insuficiente. La edad es elevada y los problemas detectados se acrecentarán en los próximos años. Hay un elevado porcentaje de pediatras quemados. La Administración debería facilitar la formación continuada de los profesionales(AU)

Objectives: to assess the social and working conditions and the needs of primary care paediatricians in the Autonomous Community of the Basque Country. Material and methods: a survey was carried out to the primary care paediatricians in February 2010. The questionnaire was sent to 255 paediatricians. It included questions about their social and working profile and future expectations. Results: the total number of answers was 192 (75%). There was a majority of women (68%) and aged more of 45 years (70%). The number of patients assigned to each paediatrician is more than 1000 (25%) and only 20% have less than 800 patients. Most paediatricians (55%) must share the nurse with another paediatrician. Thirty percent of paediatricians suffer burnout but 70% would not change his work in Primary Care. There is a great demand of continuous training and less bureaucratization. Conclusions: feminization is growing in Paediatric Primary Care. The number of patients assigned to each paediatrician is higher than agreed (800 patients) with the Sanitary Administration. The help of nursery is insufficient. The age of paediatricians is high and the detected problems will grow on in the next years. There is a high percentage of burnout paediatricians. The Sanitary Administration should provide continuous training for the paediatricians who work in Primary Care(AU)

Un caso raro de cervicalgia crónica: el síndrome de Klippel-Feil / A rare case of chronic cervical pain: the Klippel-Feil syndrome

Mujer de 36 años con dolor cervical mecánico y hombro izquierdo irradiado por extremidad superior, 4° y 5° dedos mano izquierda, crónico y discreta pérdida de fuerza y sensibilidad. No hay hipoacusia, síntomas urinarios ni cardiológicos. Exploración: orejas, implantación del pelo y longitud cervical normal. Dolor al palpar apófisis espinosas de vértebras y músculos cervicales. Disminución de sensibilidad táctil y dolorosa en zona cubital de mano izquierda, 4° y 5° dedos. Rx C. Cervical: fusión de vertebras C3-C4 y C7-D1. RMN C. Cervical: Fusión de vertebras C2-C3 y T1-T2. EMG: datos de atrapamiento del mediano en Túnel del Carpo. Diagnóstico: síndrome de Klippel-Feil. El síndrome de Klippel-Feil es una enfermedad rara, congénita del grupo de las malformaciones de la charnela craneocervical, que consiste en la fusión de dos o más vértebras cervicales; asociado a veces a defectos en sistema genitourinario, nervioso, cardiopulmonar y pérdida auditiva (AU)

A 36 year-old woman, with mechanical neck and left shoulder pain radiating to the arm, 4th and 5th fingers of the left hand, with a chronic and modest loss of strength and sensitivity. No loss of hearing; no urinary or cardiological symptoms. Physical Examination: Ears, hair implantation and neck length normal. Pain on palpation of vertebral spine apophyses and neck muscles. A decrease in tactile sensitivity and painful in the left hand cubital area, 4th and 5th fingers. Rx Spinal Column: Fusion of vertebrae C3-C4 y C7-D1. NMR Spinal Column: Fusion of vertebrae C2-C3 y T1-T2. EMG: signs of median nerve trapping in Carpal Tunnel. Diagnosis: Klippel-Feil Syndrome. Klippel-Feil Syndrome is a rare congenital disease of the group of craniocervical hinge malformation, which consists of the fusion of two or more vertebrae. It is occasionally associated with genitourinary system, nerve, cardiopulmonary defects and hearing loss (AU)

Propuesta de una guía de práctica clínica para ruptura del tendón de Aquiles reparado percutáneamente / Proposal of a practical clinical guideline for physiotherapy after acute achilles tendon rupture using a percutaneous technique with tenolig

Introducción y objetivosElaborar una guía de práctica clínica basada en la evidencia para facilitar la toma de decisiones al profesional, disminuir la variabilidad en su práctica clínica y mejorar la atención de pacientes intervenidos de rotura aguda del tendón de Aquiles.Material y métodoLa inclusión de las recomendaciones en la guía se llevó a cabo mediante: * 1. Revisión de la evidencia disponible a partir de las bases de datos (Medline, PEDro, IME, EnFisPo, Cochrane) desde el año de su creación hasta enero de 2009. * 2. Análisis de la experiencia clínica del grupo de expertos. * 3. Síntesis final de la evidencia, experiencia clínica y razonamiento fisiopatológico.ResultadosSe establecieron 3 fases de tratamiento de fisioterapia determinadas a partir del razonamiento fisiopatológico (semanas: 2.a–8.a, 9.a–14.a, 15.a–17.a). Las recomendaciones que se basaron en la evidencia fueron las siguientes: programa de fisioterapia precoz; aplicación de corrientes BURST de 100Hz; campos electromagnéticos pulsátiles de 27MHz y 1 Gauss; aplicación de ultrasonido continuo de baja intensidad a 0,5w/cm2; programa de ejercicios activos del flexor largo del primer dedo del pie y trabajo excéntrico de la zona lesionada.ConclusionesLa presente guía de práctica clínica recoge el estado actual de conocimiento sobre las recomendaciones terapéuticas que el fisioterapeuta debería incluir en su programación. Once recomendaciones son incluidas, combinando la mejor evidencia con el razonamiento fisiopatológico y la experiencia de un grupo de expertos (AU)

Introduction and objectivesTo elaborate an evidence-based Clinical Practice Guideline to facilitate decision-making to the professional, to diminish the variability in their clinical practice and to improve attention of the patients operated on for acute Achilles tendon rupture.Material and methodInclusion of the recommendations in the Clinical Practice Guideline was carried out by: * 1. Review of the “best evidence” published based on a computerized literature search of Medline, PEDro, IME, EnFisPo and Cochrane, from the year they were created to January 2008. * 2. Analysis of the “best clinical experience” of the experts group. * 3. Final synthesis of the evidence, clinical experience and physiopathology reasoning.ResultsThree treatment phases of physiotherapy were established using the weeks 2nd–8th, 9th–14th, 15th–±17th. The recommendations included and that were based on scientific evidence were: early physiotherapy program; TENS burst 100Hz; pulsed magnetic field of 27MHz and 1 Gauss; application of continuous low intensity ultrasound at 0.5w/cm2; a program of active exercise by flexor hallucis longus and eccentric exercise of the injured area.ConclusionsThe present Clinical Guideline reflects the current status of knowledge on the therapeutic recommendations that physiotherapists should include in their programs. Eleven recommendations have been included, combining the best evidence with the physiopathology reasoning and consensus among a group of experts (AU)

Modelo de regresión logística para estimar la dependencia según la escala de Lawton y Brody / Logistic regression model for the calculation of dependence according to the Lawton and Brody scale

Objetivo. Estimar mediante regresión logística la asociación de dependencia según escala de Lawton y Brody en mayores de 65 años y variables sociodemográficas. Material y métodos. Estudio transversal realizado en atención primaria en una zona de salud urbana de Badajoz, sobre una muestra de 125 personas mayores de 65 años mediante estratificación y muestreo aleatorio por sexo y grupos de edad. Las variables obtenidas son sociodemográficas (sexo y grupos de edad), estado civil, convivencia, vivienda, estudios y clase social. Clasificamos como dependientes para las actividades instrumentales de la vida diaria aquellos con menos de 8 puntos. Análisis estadístico: regresión logística multivariante por pasos hacia atrás. Resultados. Sexo: OR=1,276, el riesgo de dependencia en varones es mayor que en mujeres. El IC95% es muy preciso. Grupos de edad: OR=0,155–0,231 del cuarto paso indican menor riesgo en grupos de edad 1 y 2 frente a los mayores de 85 años. Resultados. Convivencia: es significativa (p=0,00) su asociación con la dependencia. Las categorías «En pareja» y «Vive solo/a» multiplican por 0,086 y 0,367 la probabilidad de dependencia comparadas con «Otros». Clase social: asociada a la dependencia y con mayor riesgo en la clase V. Vivienda, estudios y estado civil son eliminadas del modelo definitivo porque tienen coeficientes no significativos. Conclusiones. El modelo final incluye sexo, grupos de edad, convivencia y clase social, asociadas con la dependencia. Consideramos útil la escala en mayores de 65 años para detectar precozmente la dependencia (AU)

Objective. To calculate the association of dependence according to the Lawton and Brody scale in elderly subjects over 65 years of age and social-demographic variables using logistic regression. Material and methods. A cross-sectional study conducted in Primary Care in an urban health area of Badajoz in a sample of 125 elderly subjects over 65 years by stratification and random sampling by gender and age groups. The variables obtained are sociodemographic (gender and age groups), marital status, coexistence, housing, studies and social class. Subjects were classified as dependent by the Instrumental Activities of the Daily Living when they scored less than 8 points. Statistic analysis: binary logistic regression by backward step. Results. Gender: OR=1.267, risk of dependence is greater in men than in women. The 95% CI is very precise. Age groups: OR=0.155 and 0.231 from the fourth step indicates lower risk in the age groups 1 and 2 compared to those over 85 years. Results. Coexistence: its association with the dependence is significant (p=0.00). The categories “with partner” and “he/she lives alone” multiply by 0.086 and 0.367 the probabilities of dependence compared with “Others.” Social class: it is associated to dependence and with higher risk in class V. Housing, studies and marital status have been eliminated from the final model because there coefficients are non-significant. Conclusions. The final model includes gender, age groups, coexistence and social class, associated with dependence. We consider that the scale is useful in those over 65 years in order to detect dependence precociously (AU)

Prevalencia del síndrome metabólico y enfermedades clínicas asociadas en un grupo de población urbana del Centro de Salud Zona Centro de Badajoz / Prevalence of the metabolic syndrome and associated clinic diseases in a group of urban population of Central Area Health Center in Badajoz

INTRODUCCIÓN Y OBJETIVO. El síndrome metabólico (SM) comporta mayor morbilidad/mortalidad por enfermedades cardiovasculares, diabetes mellitus (DM) tipo 2 y mortalidad general. La prevalencia en España se estima en el 25%; la Encuesta Nutricional de Canarias (ENCA) encuentra una prevalencia del 24,4% y aumenta con la edad. El objetivo es conocer la prevalencia del SM definido por la combinación de 3 o más criterios en un cupo de población urbana. MATERIAL Y MÉTODO. Estudio descriptivo del SM en 907 pacientes mayores de 18 años. Variables: edad/sexo, antecedentes personales de DM tipo 2, cardiopatía isquémica (CI), enfermedad cerebrovascular (ECV), enfermedad vascular arterial periférica (EVAP) e hipertensión arterial (HTA); datos antropométricos/analíticos (perímetro abdominal [PA], índice de masa corporal [IMC], tensión arterial [TA], glucemia basal [GB], triglicéridos [TG] y lipoproteínas de alta densidad [HDL]). Se ha realizado estadística descriptiva de edad/sexo, comparación de proporciones e intervalo de confianza al 95% (IC 95%) de criterios diagnósticos y enfermedades clínicas asociadas (ECA) al SM aplicando la definición propuesta por la National Cholesterol Education Program (NCEP). RESULTADOS. Entre los criterios diagnósticos destacan: TA (16,3%), IMC (14%) y obesidad abdominal (OA) (12,2%); son más frecuentes en mujeres y GB y TG más frecuente en varones. Las ECA más prevalentes son HTA y DM tipo 2 en mujeres y CI, ECV y EVAP en varones. La prevalencia considerando 3 criterios es del 23,81%, con 4 del 5,84% y con 5 del 0,66%. CONCLUSIONES. El 25% de los pacientes que consultan en el centro de salud tienen SM; la prevalencia del 23,81% es similar a otros estudios. En hipertensos y diabéticos es donde más frecuentemente se presentan los criterios diagnósticos, principalmente OA, IMC, GB y TA. La prevalencia de la OA puede estar infravalorada. Es importante valorar qué combinaciones de criterios tienen más riesgo de asociarse a las ECA

INTRODUCTION AND OBJECTIVE. Metabolic syndrome (MS) has greater morbidity/mortality due to cardiovascular diseases, type 2 diabetes mellitus and general mortality. Its prevalence in Spain is estimated at 25%. The Canary Island Nutritional Survey (ENCA) has obtained a prevalence of 24.4% which increases with age. This study aimed to discover the prevalence of MS defined by the combination of 3 or more criteria in a quota of urban population. MATERIAL AND METHOD. Descriptive study of MS in 907 patients over 18 years. Variables: age/gender, personal backgrounds of type 2 diabetes mellitus, ischemic heart disease, cerebrovascular disease, peripheral arterial vascular disease and arterial hypertension; anthropometric/analytic facts (abdominal perimeter, body mass index, blood pressure, basal glycemia, triglyceride and high-density lipoprotein). Descriptive statistic was made on age/gender, comparison of proportions and 95% CI of diagnosis criteria and clinical diseases associated to the MS, applying the definition proposed by the National Cholesterol Education Program (NCEP). RESULTS. The following stand out among the diagnosis criteria: Blood pressure (16.3%), body mass index (14%) and abdominal obesity (12.2%), which are more frequent in women and basal glycemia and triglyceride which are more frequent in men. The most prevalent associated clinical diseases are arterial hypertension and type 2 diabetes mellitus in women, and ischemic heart disease, cerebrovascular disease and peripheral arterial vascular disease in men. Considering 3 criteria, prevalence is 23.81% with 4 (5.84%) and 5 (0.66%). CONCLUSIONS. A total of 25% of the patients who consult in the health center have MS. This prevalence of 23.81% is similar to others studies. The diagnosis criteria, mainly abdominal obesity, body mass index, basal glycemia and blood pressure, appeared more frequently among subjects with high blood pressure and diabetics. Prevalence of the abdominal obesity may be underestimated. It is important to evaluate what combinations of criteria have more risk of being associated to the ECA

Estudio de concordancia entre profesionales en un procedimiento de fisioterapia / Study of concordance between professionals in a procedure of Physical Therapy

Presentamos un estudio de concordancia entre dos fisioterapeutas que realizan la medición de los niveles de percepción de una corriente TENS. El objetivo principal es comprobar que la diferencia entre las medidas obtenidas en la dosificación de la corriente TENS no se debe a la incidencia de los profesionales que efectúan las mediciones. Se trata de un diseño experimental de dos factores con medidas repetidas en un factor. La muestra la conforman 804 mediciones realizadas en 134 estudiantes de Fisioterapia. Los resultados obtenidos señalan una alta fiabilidad entre las medidas y la consistencia del procedimiento utilizado, demostrándose, mediante el ANOVA, la inexistencia de una influencia sistemática de los profesionales en su aplicación. Podemos concluir que dicho procedimiento constituye una herramienta útil para emplearse en los diversos protocolos de actuación profesional y en estudios de investigación con las corrientes TENS

We present a study of concordance between the measurements carry out by two Physiotherapists of the perception levels of a TENS current. The main objective is to check that the difference between the measurements obtained when administrating TENS, is not due to de incidence of the professionals who take them. It is an experimental design of two factors with repeated measures in one of them. The sample is formed by 804 measurements taken on 134 Physiotherapy students. The results point to a high reliability between the measurements and the method used, proving, through the ANOVA, the nonexistence of a sistematic influence of the professionals in its application. We can conclude this procedure is an useful tool to use in the several protocols of professionals actions and the investigation studies with TENS currents

Escala de Aprensión Psicológica Personal (EAPP) en Fisioterapia / Personal Psychological Apprehension Scale (EAPP) in Physical Therapy

Este estudio analiza el factor de la personalidad denominado neuroticismo (aprensión psicológica), y se encuadra en una investigación más amplia que desarrolla el escalamiento de las autopercepciones (sensibilidad, contracción y tolerancia) de los individuos ante distintos niveles de aplicación de la corriente TENS. Dicha investigación requiere controlar esta variable de la personalidad, pues podría influir en las auto-valoraciones que realizan los sujetos y, por tanto, afectar al diseño metodológico. Presentamos la construcción, estudio de validación y análisis de fiabilidad, de un nuevo instrumento tipo encuesta que denominamos "Escala de Aprensión Psicológica Personal (EAPP)", y que deriva del cuestionario de Eysenck EPQ-RS 1, de amplia divulgación y aplicación en psicología. La EAPP es una adaptación, tanto en su vertiente léxica como de contenido, de los ítems que miden el factor N (neuroticismo) del cuestionario de Eysenck. La metodología empleada es de carácter correlacional. Hemos utilizado el análisis factorial en su vertiente de extracción por el método de componentes principales, y los coeficientes alfa y alfa estandarizado de Cronbach. La muestra útil la conforman 133 estudiantes de fisioterapia. Los resultados obtenidos señalan que hemos elaborado un instrumento de calidad, que se muestra válido y fiable para el análisis del factor N. La EAPP constituye una herramienta útil en los estudios que requieran las apreciaciones de los propios sujetos investigados. Situación muy frecuente en el ámbito de conocimiento de la Fisioterapia y de las Ciencias de la Salud en general

This study analyzes the factor of the personality "neuroticism (psychological apprehension)". It is fit in inside a more extensive investigation that develops a method of scaling of the self-perceptions (sensibility, contraction and tolerance) before different levels of application of current TENS. Said work requires to control this variable of the personality, that can affect to this type of research method. We present the construction and validation of a new survey type instrument that we denominated: "Scale of Personal Psychological Apprehension (EAPP)". This drift of the questionnaire of Eysenck EPQ-RS 1, of extensive disclosure and application in environments as the psychology. The EAPP is an adaptation, so much in its side léxica as of content, of the ítems that measure the factor N (neuroticismo) that is one of the dimensions collected inside the questionnaire of Eysenck. Especially the study of validation is undertaken and analysis of the reliability of said scale EAPP. Consequently, the methodology is of character correlacional, extensively employee in all the studies on the quality of the measures. The useful sample 97 students of Physiotherapy they conform it. The conclusions to the ones that have arrived imply the quality of the instrument, being shown valid and reliable for the analysis of this factor N, that would be able to influence in the car-appraisals of the subjects. In final, we include an useful instrument "scale EAPP", to be employed in the very diverse studies of the environment of knowledge of the Physiotherapy and, therefore, of the Sciences of the Health that need the appreciations of the own subjects investigated

[Idiopathic catastrophic epileptic encephalopathy: an untreatable convulsive malady in infancy]. / Encefalopatía epiléptica catastrófica idiopática: una forma intratable de estado de mal convulsivo en la infancia.

AIM: To present a case of catastrophic childhood epileptic syndrome with multifocal status epilepticus. CASE REPORT: A 4 years old boy with a multifocal status epilepticus of unknown origin which could only be controlled along some days with thiopentone enough to cause electrical suppression, and relapsed again after having stopped it. CONCLUSION: But for very high doses of barbiturates, any antiepileptic drug could control or improve the convulsions. MRI, initially normal, was followed by a progressive cerebral and cerebellar atrophy and the boy survived with heavy neurological secuelae.

Encefalopatía epiléptica catastrófica idiopática: una forma intratable de estado de mal convulsivo en la infancia / Idiopathic catastrophic epileptic encephalopathy: an untreatable convulsive malady in infancy

Objetivo. Presentar un caso de estado de mal intratable con crisis multifocales de origen desconocido. Caso clínico. Niño de 4 años de edad, sano y con buen desarrollo psicomotor, que desarrolla un estado de mal incontrolable, excepto cuando se logra silencio electroencefalográfico mediante coma barbitúrico, y que reinicia el estado convulsivo al disminuir la intensidad del mismo. Conclusión. Pese al correcto tratamiento utilizado, ningún fármaco es capaz de controlar el estado convulsivo. Aparece una atrofia cerebral progresiva a lo largo de los meses y el paciente queda con gravísimas secuelas psicofísicas. Este tipo de proceso se ha identificado recientemente en la bibliografía como encefalopatía epiléptica catastrófica idiopática (AU)

Aim. To present a case of catastrophic childhood epileptic syndrome whit multifocal status epilepticus. Case report. A 4 years old boy with a multifocal status epilepticus of unknown origin which could only be controlled along some days with thiopentone enough to cause electrical suppression, and relapsed again after having stopped it. Conclusion. But for very high doses of barbiturates, any antiepileptic drug could control or improve the convulsions. MRI, initially normal, was followed by a progressive cerebral and cerebellar atrophy and the boy survived with heavy neurological secuelae (AU)

An Entamoeba histolytica rab-like encoding gene and protein: function and cellular location.

We identified here a 576 bp rab-like gene (EhrabB) in Entamoeba histolytica. EhrabB is located 332 bp upstream from the start codon of the Ehcp112 encoding gene, but is transcribed from the complementary strand. The EhrabB open reading frame predicts a 192 amino acid polypeptide (EhRabB) with 40-42% identity to Rab proteins, involved in vesicle docking regulation in endo and exocytic pathways of eukaryotic cells. Transcripts of 0.6 and 0.97 kb were detected by the EhrabB probe in northern blot assays. Using specific antibodies, EhRabB was located in small cytoplasmic vesicles by confocal microscopy. During phagocytosis, EhRabB was initially translocated to the plasma membrane and to the phagocytic mouths. The protein diminished after 10 min phagocytosis, suggesting that EhRabB could be participating in the regulation of the endocytosis process.

[Leiomyoma of the bladder]. / Leiomioma vesical.

OBJECTIVE: To present an additional case of leiomyoma of the bladder, a rare tumor that is frequently discovered incidentally, and to review the few cases reported in the Spanish literature, with special reference to the clinical aspects, complementary tests and treatment. METHODS: A case of leiomyoma of the bladder in a patient who had come to deliver after a full-term pregnancy is presented. Routine physical examination on admission revealed a tumor in the anterior aspect of the vagina. Ultrasound, radiological and endoscopic studies were performed. The Spanish literature is reviewed with special reference to the clinical aspects, complementary tests and treatment. RESULTS: After the diagnosis of a bladder tumor had been confirmed and the effects on the adjacent structures determined, TUR biopsy was performed. The anatomopathological analysis demonstrated leiomyoma of the bladder. CONCLUSION: The ultrasound and radiological images of leiomyoma localized to the bladder are sufficient to suspect the nature of the lesion, but the definitive diagnosis is based on the anatomopathological findings. The choice of the type of surgery, open or endoscopic, is based on tumor localization and size.

The pyruvate:ferredoxin oxidoreductase enzyme is located in the plasma membrane and in a cytoplasmic structure in Entamoeba.

This work investigated the cellular location of the pyruvate:ferredoxin oxidoreductase (PFO) enzyme in Entamoeba. A 1.9 kb fragment located at the 3' end of the Ehpfo gene was cloned in the pRSETB vector and expressed. The recombinant peptide was purified and inoculated in rabbits. By Western blot assays the antibodies detected a single 130 kDa band in all E. histolytica strains tested and in E. moshkovskii. By immunofluorescence, the antibodies showed the presence of PFO in the plasma membrane and in a cytoplasmic structure that appeared as a ring or as a compact small body in E. histolytica strains. In E. invadens and E. moshkovskii (strains FIC and Laredo) PFO was located in the plasma membrane showing different fluorescence patterns. Immunofluorescence on E. histolytica synchronized cultures showed that the cytoplasmic structure appeared in 85, 60, 20 and 10% of the trophozoites in mitosis, G1, S and G2 phases, respectively. By in situ hybridization the Ehpfo gene was found in the nuclei and the trophozoites of the clone A, strain HM1:IMSS, differed in the Ehpfo gene content.

[Control of overweight children in primary care]. / Control del sobrepeso infantil en atención primaria.

The results obtained in the program "Control of overweight in children" in the programmed nurse clinic were evaluated in 25 children distributed for age and degree of overweight. The activities carried out were: control of the number of calories based on carbohydrate and fat reduction, health education using the audiovisual techniques of the program EDALNU of the Ministry of Health, and theoretical program based on it. The group with a greater overweight (higher than 20%) followed, in addition, a 1,500 calories diet. It was concluded that a balanced diet and physical exercise proved to be highly effective for the reduction of overweight in children without additional drug intervention. Obesity in children is a health problem that can be addressed in a primary care context; the role of the nursing staff is crucial through health education activities.