Resultados de la encuesta de tabaquismo en el Hospital de Alcañiz / Results of the smoking habit survey in the Hospital de Alcañiz

Introducción. En el hospital de Alcañiz y dentro de las iniciativas para el control de consumo de tabaco, hemos realizado una encuesta de prevalencia y opinión de tabaquismo en todos los servicios del hospital. Material y métodos. Hemos realizado una encuesta en formato cuestionario escrito dirigida a todos los trabajadores del hospital, tanto sanitarios como no sanitarios. La encuesta, voluntaria y anónima, fue entregada y recogida en los diferentes servicios del hospital por un responsable designado por el grupo de trabajo. Resultados. Participaron 283 encuestados, la mayoría, 221 (78,1%), mujeres. La prevalencia de tabaquismo activo fue de 78 (27,6%) trabajadores. El colectivo que más fumadores activos presentó fue enfermería, con un 37,4%, siendo el equipo de informática los que contaban con más personal nunca fumador 75%. El 71,7% de los fumadores reconocieron fumar en el horario de trabajo aunque solamente 2 (0,3%) lo hacían dentro del recinto hospitalario. Más de un 70% de los trabajadores estuvieron de acuerdo en la utilidad del proyecto Hospital de Alcañiz sin humo, así como en que tanto padres como profesionales sanitarios y no sanitarios debían dar ejemplo no fumando. Conclusión. La prevalencia de tabaquismo en centros sanitarios es elevada por lo que se debe seguir trabajando e implementando medidas en contra del tabaquismo (AU)

Introduction. In the hospital of Alcañiz and within the initiative to control smoking, we have conducted a survey on the prevalence and opinion regarding the smoking habit in all the hospital departments. Material and methods. We have carried out a survey in form of a written questionnaire addressed to all the hospital worker, both health care and non-health care workers. The voluntary and anonymous survey was distributed and collected in the different hospital departments by a responsible person designated by the work group. Results. A total of 283 persons surveyed participated, most, 221 (78.1%) being women. Active smoking prevalence was 78 (27.6%) workers. The most active smoking group present was nursing with 37.4%, the computer technology team being the group having the greatest amount of personnel who had never smoked 75%. A total of 71.7% of the smokers admitted having smoked during the work hour although only 2 (0.3%) did so within the hospital premises. More than 70% of the workers agreed with the utility of the smoke-free Hospital de Alcañiz project and that parents as well as health care and non-health care professionals should lead by example by not smoking. Conclusion. Prevalence of smoking the health care centers is elevated so that work must continue and measures implemented against the smoking habit (AU)

Ultrasensitive hydrogen sensor based on Pt-decorated WO3 nanorods prepared by glancing-angle dc magnetron sputtering.

In this work, we report an ultrasensitive hydrogen (H2) sensor based on tungsten trioxide (WO3) nanorods decorated with platinum (Pt) nanoparticles. WO3 nanorods were fabricated by dc magnetron sputtering with a glancing angle deposition (GLAD) technique, and decorations of Pt nanoparticles were performed by normal dc sputtering on WO3 nanorods with varying deposition time from 2.5 to 15 s. Crystal structures, morphologies, and chemical information on Pt-decorated WO3 nanorods were characterized by grazing-incident X-ray diffraction, field-emission scanning electron microscopy, energy-dispersive X-ray spectroscopy, and photoelectron spectroscopy, respectively. The effect of the Pt nanoparticles on the H2-sensing performance of WO3 nanorods was investigated over a low concentration range of 150-3000 ppm of H2 at 150-350 °C working temperatures. The results showed that the H2 response greatly increased with increasing Pt-deposition time up to 10 s but then substantially deteriorated as the deposition time increased further. The optimally decorated Pt-WO3 nanorod sensor exhibited an ultrahigh H2 response from 1530 and 214,000 to 150 and 3000 ppm of H2, respectively, at 200 °C. The outstanding gas-sensing properties may be attributed to the excellent dispersion of fine Pt nanoparticles on WO3 nanorods having a very large effective surface area, leading to highly effective spillover of molecular hydrogen through Pt nanoparticles onto the WO3 nanorod surface.

Insuficiencia renal aguda tras cirugía cardiaca: importancia de las técnicas de reemplazo renal continuo / No disponible

Existen diferentes técnicas de terapias de reemplazo renal, como la diálisis intermitente, hemofiltración continua, o formas híbridas que mezclan ventajas de ambas que están disponibles para su utilización en pacientes sometidos a cirugía cardiaca. La gravedad de la insuficiencia renal aguda, su estadio, etiología, el estado clínico y hemodinámico del paciente van a influir en la estrategia de terapia de reemplazo renal a seguir. La IRA representa un factor de riesgo independiente para complicaciones en el paciente crítico intervenido de cirugía cardiaca. Mientras que está demostrado que el inicio precoz de TRRC se relaciona con una mayor supervivencia, todavía no está claro la duración que estas terapias deberían tener (AU)

Various forms of renal replacement therapies are available to treat acute kidney injury (AKI), like the intermittent haemodialysis, continuous haemofiltration, or hybrid forms which combine advantages of both are now available for application in cardiac surgery patiens. The severity of AKI, the aetiology, clinical and haemodynamic status of the patient may all influence the choice of the RRT strategy. AKI represents an independent risk factor for adverse outcomes in critically ill patients after cardiac surgery. Whether early initiation of RRT is associated with improved survival, is still unknown the duration they must have (AU)

[Management of anxiety associated with oral surgery]. / Managementul anxietatii asociate terapiei in chirurgia dento-alveolara.

UNLABELLED: General and practical training, knowing of safe methods of preanesthesia, pain and anxiety control and establishing a good relation with the patient are some of the most important methods of patient management in the dental office. The final goals of the methods are to obtain a calm patient, haemodinamic equilibrated and safely prepared for the surgery. MATERIAL AND METHOD: Our study was performed on 448 patients. Different methods of preanesthesia were used by administrating per oral, intravenous, intramuscular, according with DAS score: Midazolam, Diazepam + Algocalmin, Xanax. RESULTS: 58% of our patients declared after surgery that their satisfaction score is 100% positive after one of our methods of preanesthesia. CONCLUSION: When choosing the appropiate premedication, the ability of the analgesic and anxiolytic drug to improve pain tolerance should be one of the most important criteria. Doses must be correlated with the anxiety score DAS, road use and the probable duration of surgery.

A propósito de un caso. Nódulo pulmonar solitario / No disponible

Los nódulos pulmonares solitarios (NPS) se identifican en la mayoría de las veces como un hallazgo radiológico casual. Sin embargo, es fundamental descartar su malignidad con celeridad, para no retrasar su tratamiento y conseguir unas mayores tasas de supervivencia en caso de malignidad. Para ello, aparte de una correcta anamnesis y de una radiología convencional, se dispone de pruebas complementarias más avanzadas como la tomografía por emisión de positrones (PET) antes de realizar la cirugía. Aproximadamente la mitad de los NPS corresponden a lesiones malignas, en su mayoría son carcinomas broncogénicos. Presentamos el caso de una mujer de 61 años sin hábitos tóxicos que coincidiendo con episodios de bronquitis sufría en alguna ocasión expectoración hemoptoica leve. En la radiografía de tórax se apreciaba una imagen nodular en el pulmón derecho. Por ello se realizó posteriormente una batería de pruebas encaminadas a descartar la malignidad del nódulo

Solitary pulmonary nodules (SPN) are mostly identified as an accidental radiological finding. However, it is fundamental to rule out discard its malignancy quickly in order to avoid delaying its treatment and to obtain greater survival rates in case of malignancy. To do so, not only a correct anamnesis and conventional radiology are necessary but also the most advanced complementary tests such as positron emission tomography (PET) prior to doing surgery. Approximately half of the SPNs correspond to malignant lesions, most of which are bronchogenic carcinomas. We present the case of a 61-year-old woman with no toxic habits who sometimes suffered mild hemoptoic expectoration during bronchitis attacks. The chest X-ray showed a nodular image in the right lung. Based on this, a battery of tests was conducted in order to rule out the nodule malignancy

Tumoración abscesificada en región inguinal izquierda / Tumor with abscess formation in the left inguinal area

No disponible

Tos crónica e infección urinaria de repetición / Chronic cough and recurrent urinarytract infection

En Atención Primaria, la tos es un síntoma de consulta frecuente. Por ello debemos realizar un correcto diagnóstico diferencial de diversas patologías que cursan con tos como síntoma inicial. Presentamos el caso de una mujer en tratamiento crónico con nitrofurantoína para profilaxis de infección urinaria de repetición que había comenzado en el último mes con un cuadro de tos y disnea progresiva que empeoró a pesar de los distintos tratamientos iniciados. Tras las diferentes pruebas complementarias realizadas se diagnostica de neumonitis intersticial originada por exposición crónica a nitrofurantoína. Con este caso pretendemos recordar las afecciones intersticiales del pulmón, que suelen cursar todas ellas con una sintomatología típica (tos sin expectoración, disnea progresiva, crepitantes a la auscultación,...) y cuya etiología en ocasiones es conocida (exposición a fármacos, ambiente laboral, radioterapia...). En el tratamiento hay que evitar la exposición de los agentes causales y largas pautas con tratamiento corticoideo o inmunosupresor si no hay respuesta a corticoides

Cough is a frequently consulted symptom in primary care consultations. Thus, we must make a correct differential diagnosis of different diseases that occur with cough as the initial symptom. We present the case of a woman under chronic treatment with nitrofurantoin for prevention of recurrent urinary tract infections who had begun with a picture of cough and progressive dyspnea in the last month which had become worse in spite of the different treatments initiated. After performing the different complementary tests, interstitial pneumonitis caused by chronic exposure to nitrofurantoin was diagnosed. With this case, we aim to bring to mind the interstitial lung diseases that generally occur with typical symptoms (cough without expectoration, progressive dyspnea, crackling rates on auscultation, etc.) and whose etiology is sometimes known (exposure to drugs, work environment, radiotherapy, etc.). Exposure to causal agents and long treatment regimes with corticosteroids or immunosuppressants if there is no response to corticosteroids should be avoided

Cancellous bone homograft storage with aluminium-polyethylene bags.

In order to transport and cryopreserve human tissues, it is essential to have an easy-to-use recipient where tissues can be kept in sterile conditions. Here we show the results obtained by using Macopharma's tissue freezing bags, an aluminium-polyethylene multilayer bag, in our tissue bank of the Centro Comunitario de Sangre y Tejidos de Asturias. Five hundred and twenty-seven cancellous bone homografts were obtained from hospitals located 120 km around our Bank. The homografts were submitted to bacteriological controls and sent to our bank in these bags. They were stored at -70 degrees C and sent in dry ice to about 50 hospitals, where the tissue was bacteriologically controlled and grafted. Furthermore, the behaviour of these bags at -140 degrees C (vapour nitrogen) or -196 degrees C (liquid nitrogen) was tested. Our results indicate that Macopharma aluminium-polyethylene bags are suitable for the transporting and cryopreserving of cancellous bone homografts. These bags could also be used for keeping tissues in nitrogen containers.

Paciente joven con pérdida visual brusca / Young patient with sudden slight loss

Los trastornos oclusivos vasculares son relativamente frecuentes en personas de edad avanzada y tanto más si presentan algún factor de riesgo cardiovascular (hipertensión, diabetes, dislipidemia, tabaquismo, etc.). Presentamos el caso de una paciente joven sin factores de riesgo clásicos que sufre un evento oclusivo arterial, concretamente de la arteria central de la retina, que se manifestó con una disminución brusca de la agudeza visual. Desde hace algunos años se están relacionando nuevos factores, entre ellos la homocisteína, con el riesgo de padecer cuadros oclusivos arteriales. Tras estudio, y habiendo descartado las principales causas capaces de originar una oclusión arterial, se decide estudio genético hallándose mutación del gen de la MTHFR (metil-tetrahidrofolato reductasa) lo que origina un aumento de homocisteína en sangre. Es importante sospechar una hiperhomocisteinemia en aquellos pacientes jóvenes que sin factores de riesgo sufren algún episodio vascular, ya que con un tratamiento con ácido fólico encaminado a normalizar los niveles de homocisteína podemos evitar la aparición de un nuevos episodios

Occlusive vascular disorders are relatively frequent in the elderly and even more so if they have any cardiovascular risk factor (hypertension, diabetes, dyslipidemia, smoking, etc.). We present the case of a young patient without classical risk factors who suffered an occlusive arterial event, specifically of the central retinal artery that was manifested as a sudden decrease of visual acuity. For some years, new factors, among them homocysteine, are being related with the risk of suffering occlusive arterial pictures. After a study, and having ruled out the main causes capable of causing arterial occlusion, it was decided to conduct a genetic study. Mutation of the MTHFR gene (methyltetrahydrofolate reductase) was found, which causes an increase of homocysteine in blood. It is important to suspect a hyperhomocysteinemia in those young patients who suffer any vascular episode without risk factors since treatment with folic acid aimed at normalizing the homocysteine levels could prevent the appearance of new episodes