Impact on health-related quality of life and perceived burden of informal caregivers of individuals with Alzheimer's disease.

This study assessed the impact on health-related quality of life (HRQL) and the perceived burden of informal caregivers of individuals with Alzheimer's disease (AD) on the Canary Islands (Spain). We utilized a multicenter, cross-sectional design, based on questionnaire responses of 237 informal caregivers of AD patients. Patients were classified according to the degree of severity utilizing the Clinical Dementia Rating Scale. Sociodemographic, HRQL (EQ-5D) and functional dependency data were gathered together with the degree of caregiver burden. Caregivers had a higher frequency of problems than did the general population for every EQ-5D dimension. Caregivers' HRQL was inversely associated with the subject dependency level and caregiver age. HRQL was higher for more educated caregivers. Variables with a negative and/or significant effect on caregivers' HRQL were high feelings of burden, more committed time to care, and older age. The caregiver burden quantified by the Zarit scale showed 83.3% of caregivers with a high level of burden.

Preoperative assessment.

Although anaesthetic and surgical procedures should be individualised for every patient, in practice many preoperative protocols and routines are used generally. In this article, we aim to emphasise: why preoperative assessment is important; how it should be done, and by whom; what can be expected; and the importance of test selection based on patients' needs and on scientific evidence of effectiveness. We outline the roles of preoperative medical assessment in otherwise healthy patients. Clinical history, preoperative questionnaires, physical examination, routine tests, individual risk-assessment, and fasting policies are investigated by review of published work. Cost of routine preoperative assessment, the anaesthetist's legal responsibility, and patients'views in the preoperative process are also considered. A thorough clinical preoperative assessment of the patient is more important than routine preoperative tests, which should be requested only when justified by clinical indications. Moreover, this practice eliminates unnecessary cost without compromising the safety and quality of care. Education and training of medical doctors should be more scientifically guided, emphasising the relevance of effectiveness, and cost-effectiveness in clinical decision-making and complemented by audit.

Postnatal development of the Ammon's horn (CA1 and CA3 fields). A karyometric and topographic study.

We have performed a karyometric study of the pyramidal neurons of CA1 and CA3 fields of the Ammon's horn, in male mice aged from the 5th to the 190th postnatal day. Nuclear sizes were measured with the aid of a Magiscan Analysis System, used in an interactive form, in both superficial and deep layers of the stratum pyramidal in those fields. The measurements were made at three different topographic levels: rostral; intermediate; and caudal, to detect any possible difference related to the topography of the neuron in the same field. We have found that both CA1 and CA3 fields are correlated in the postnatal development of their nuclear pyramidal sizes and that all topographic levels of the hippocampus reach their highest karyometric sizes at the 10th-15th postnatal day. Caudal levels show higher karyometric values than the other levels and some differences between neurons of the superficial and deep layers of both fields are also described here and analysed in relation to the different ontogenetic gradients of these cells.

[Smoking cessation programs at the worksite: the need for its implementation in Spain]. / Programas de cesación del tabaquismo en el medio laboral: la necesidad de su implementación en España.

Tobacco smoking is the most important health problem in Spain, as in the rest of the developed countries; been also recognized as the most preventable cause of premature morbidity and mortality in the western world. Interventions to reduce tobacco consumption in Spain, has been mainly addressed by means of physician-patient interaction, lacking the approach for community and workplace interventions. This article emphasize the need for the implementation of strategies of smoking cessation programs in the worksite, encouraging to health professionals to design, to apply and to evaluate these interventions. The most often used approaches to reduce tobacco smoking at the worksite are considered, addressing cost-effectiveness issues related with the characteristics of the Spanish Health System.

Postnatal development of the dentate gyrus: a karyometric and topographic study.

We have analysed the postnatal development of the nuclear sizes of the granular cells of the dentate gyrus in 5- to 190-day-old male mice. The study was performed in three topographic levels: rostral, intermediate and caudal. Three subdivisions were analysed in each level: suprapyramidal blade, infrapyramidal blade and the transition between them, the angular zone. Additionally, each of these subdivisions was measured in its external and internal layer, separately. Three gradients of postnatal karyometric development can be described: external-to-internal, suprapyramidal-to-infrapyramidal, and caudal-to-rostral, indicating that the external, suprapyramidal and caudal cells show higher karyometric sizes than the other subdivisions. These gradients are related to the ontogenetic gradients of these neurons.

Effects of hormone deprivation on the karyometric development of the medial and lateral preoptic area of the male mouse. I. Neonatal castration.

We have analysed the karyometric development of the nuclear neuronal sizes in the medial and lateral preoptic area of male albino mice castrated within 24 hours of birth. We have analysed six different age groups of animals: 10th, 20th, 35th, 45th, 55th and 85th postnatal day, and we have compared our results to those of a control group of male mice. Both hypothalamic areas respond to neonatal castration showing lower values of the nuclear sizes than those of the control group. The reaction of these areas to gonadal hormone deprivation at birth is more striking than that obtained after prepuberal castration of the animals, studied in a previous report. Neonatal gonadal hormone deprivation also produces changes of the nuclear shape of the nuclei towards sphericity.

Topographic organization of the karyometric response to neonatal castration of the male mouse in the paraventricular and ventromedial hypothalamic nuclei.

We have analysed the karyometric development of four topographic subdivisions of the paraventricular nucleus (rostral, medial, lateral and caudal) and three topographic subdivisions of the ventromedial nucleus (ventral, central and dorsal) of the hypothalamus in neonatally castrated male mice. Castration at birth produces a decrease of the nuclear sizes from the 10th to the 35th postnatal day, but after this age, no differences were detected in comparison with the sizes of the control male mice. Neonatal gonadal hormone deprivation also produces changes in the nuclear shape of the nuclei, that tend to be more spherical in both centres, as we could establish after the study of the form factor parameter (perimeter/area ratio). We have found differences in the response of both hypothalamic nuclei to neonatal castration and differences in the response of the topographic subdivisions of both of them.

Effects of gonadectomy on the karyometric development of the ventromedial nucleus of the hypothalamus in the mouse.

We studied the karyometric development of 3 subdivisions (ventral, central and dorsal) of the ventromedial nucleus in male albino mice from the 5th to the 190th day of life. All subdivisions exhibited a similar development pattern. Another group of animals were castrated at the 20th day of life and examined from the 25th to the 85th day. The increase of the nuclear size at the 35th day and the decrease at the 85th day, observed in the control group, were not present after castration.