Evolución del hábito tabáquico en embarazadas del Área de Gestión Sanitaria de Jerez / Evolution of smoking habit in pregnant women of the Health Management Area of Jerez

Objetivo.Existe poca información actualizada sobre el consumo de tabaco durante el embarazo. El objetivo de este trabajo fue determinar la prevalencia de tabaquismo durante el embarazo en mujeres que se atienden en los distintos centros de salud dentro del Área de Gestión Sanitaria Jerez, costa noreste y sierra de Cádiz. Material y método.Estudio transversal mediante entrevistas de gestantes captadas en la visita realizada durante el primer trimestre del embarazo. El cuestionario incluía preguntas sobre características sociode mográficas, edad, antecedentes obstétricos, consumo de tabaco anterior al embarazo y abandono durante la gestación, así como hábito tabáquico en la pareja. Resultados. Se obtuvieron respuestas de 1.173 pacientes con edad media de 31 años. Se confesaron fumadoras activas el 31,2% de ellas, siendo exfumadoras el 9,5% y nunca fumadoras el 59,3%. El consumo medio de cigarrillos fue de 11 ± 7 diarios. Al conocer su estado de gestación dejaron su hábito el 50,8% (abandono espontáneo, n = 186). El porcentaje de fumadora durante la gestación asciende a un 15,5% del global,con un consumo medio de cigarrillos de 5 ± 4/día. En cuanto a las parejas el porcentaje de fumadores activos fue del 41,4%. Aunque solo un 12,4% de estas parejas refirieron seguir fumando en el domicilio conyugal,únicamente el 2,07 % consiguió cesar el consumo por completo. La prevalencia de tabaquismo respecto a un estudio previo en 2009 se redujo significativamente (18,9vs. 15,5 %, p < 0,009).Conclusión.Fumar durante el embarazo sigue siendoun comportamiento frecuente en nuestra área sanitaria. A pesar de que las gestantes reducen su consumo, solo la mitad abandona por completo su hábito. Este comportamiento es muy inferior si consideramos a sus parejas, donde el porcentaje de cesación es ínfimo. (AU)

Objetive. There is little up-to-date information on tobacco 11 use during pregnancy. The objective of this work was to determine the prevalence of smoking during pregnancy in women who are cared for in the different Health Centers within the Jerez Health Management Area, northeast coast and sierra of Cadiz. Material and method. Cross-sectional study through interviews of pregnant women enrolled duringthe visit during the first trimester of pregnancy. The questionnaire included questions about sociodemo-graphic characteristics, age, obstetric history, tobacco consumption prior to pregnancy and cessation during pregnancy, as well as smoking habits in the couple. Results. Responses were obtained from 1,173 patients,with a mean age of 31 years. 31.2% of them confessed to being active smokers, 9.5% being ex-smokers and 59.3% never smokers. The average consumption ofcigarettes was 11 ± 7 per day. When knowing theirstate of pregnancy, 50.8% of them quit their habit(spontaneous quitters, n = 186). The percentage ofsmokers during pregnancy amounts to 15.5% of theglobal with an average cigarette consumption of 5 ±4/day. As for couples, the percentage of active smokerswas 41.4%. Although only 12.4% of these couples reported continuing to smoke at their marital home,only 2.07% managed to stop using them completely.The prevalence of smoking compared to a previousstudy in 2009 was significantly reduced (18.9 vs.15.5%, p < 0.009).Conclusion.Smoking during pregnancy continues tobe a frequent behavior in our healthcare area. Despitethe fact that pregnant women reduce their consump-tion, only half abandon their habit completely. Thisbehavior is much lower if we consider their partnerswhere the percentage of cessation is negligible. (AU)

Tuberculosis cutánea y pulmonar en paciente inmunocompetente / No disponible

La tuberculosis continúa siendo, en la actualidad, una enfermedad frecuente en nuestro medio debido principalmente a dos factores, la inmigración y la coinfección con el virus de la inmunodeficiencia humana. La afectación cutánea por Mycobacterium tuberculosis es muy poco habitual y, concretamente, la forma periorificial o ulcerosa, que se asocia a tuberculosis pulmonar extensa, es excepcional. Sin embargo, su incidencia puede aumentar en el futuro debido a los factores anteriormente citados junto a la inmunodepresión asociada al envejecimiento de la población y a los tratamientos inmunosupresores, por lo que se hace imprescindible incluir dicha enfermedad en el diagnóstico diferencial de las lesiones cutáneas en pacientes con tuberculosis pulmonar. Su diagnóstico requiere el aislamiento en el cultivo o la positividad en la técnica de reacción en cadena de la polimerasa de M. tuberculosis, y su tratamiento es el mismo que el de la tuberculosis pulmonar

Tuberculosis remains today a common disease in our daily lives mainly due to two causes, immigration and coinfection with the human immunodeficiency virus. Skin involvement by Mycobacterium tuberculosis is highly unusual, and particularly periorificial or ulcer form, which is associated with extensive pulmonary tuberculosis, is uncommon. However, its appearance may increase in the future due to the causes mentioned above, as well as immunosuppression associated with an aging population, and immunosuppressive treatments. Therefore, it is essential to include this disease in the differential diagnosis of skin lesions in patients with pulmonary tuberculosis. Diagnosis requires culture isolation or positivity of the M. tuberculosis polymerase chain reaction technique. Its treatment is the same as that of the pulmonary tuberculosis

[Melatonin and mental disorders. Review of neuro-endocrinologic aspects. II: Melatonin and depressive disorders]. / Melatonina y trastornos mentales. Una revisón de los aspectos neuroendocrinológicos. Parte segunda: melatonina y trastornos depresivos.

The authors have carried out a bibliography revision about the relation between Melatonin secretion in the pineal gland and mental disorders. In the introduction a revision is done of the aspects of the anatomical functions of Melatonin secretion regulation. After words they study from a chronological perspective' studies of literature with reference to mental disorders. Two stages in the evolution of knowledge about Melatonin. The first stage consists of pharmacologic studies and pharmacotherapeutic studies and pharmaco-endocrine studies. Beginning with the melatonin determinations in biological liquids during the 60's and 70's; and a second stage which began at the end of 70's up until the present date, namely Melatonin secretion endocrinal studies in mental disorders. Apart from this, the comparing of the other hormonal secretion endocrinal studies in mental disorders. Apart from this, the comparing of the other hormonal secretion rhythms such as corticoids with function tests in Hip- Hipof. axis using the Dexamethasone suppression Test (DST). The authors also compare their experimental results with previous bibliography publications. The importance of night levels of Melatonin secretions in some patients with major depressive disorders and with abnormal answers in the DST show a diminishing when compared with another depressive disorders and their normal controls. Lastly the possible pathophysiological implications of melatonin and the pineal gland in the affective disorders are discussed, such as the conceptual form and the use of future studies of chronobiological systems.

Radioimmunoassay for melatonin and its application to fowl pineal research.

A radioimmunoassay for melatonin has been developed after raising anti-melatonin antibodies in rabbit. Melatonin was extracted from serum or pineal gland of chickens (Gallus domesticus). The radioimmunoassay was performed by using 3H-melatonin as tracer. The standard curve covered the range 0.022-0.345 pmol/vial and the KD value for melatonin was estimated at 1.37 x 10(10) l/mol. The antiserum specificity has been analysed, none of the common melatonin analogues influencing this method of melatonin measurement. The intra-assay variability was 7.2% for serum samples and 8.6% for pineal extract. The inter-assay variability for this biological sample was 15.3% and 6.4% respectively.

Effects of acute hypobaric hypoxia on acid-base status of fowl blood.

Arterial blood Po/, Pco2, lactate levels and Cl- ion concentration as well as pH were measured on the time course in chickens (Gallus domesticus) as they settled in normoxic conditions and during exposure to acute hypobaric hypoxia (Pb = 450 Torr). Hypoxia provoked at first a CO2 increased output from blood and a brief stage of deep metabolic acidosis during which lactate levels suddenly increased. This acidosis was then compensated producing a return to the initial pH and a decrease in [HCO3-] + [CO3(2-)] after 60 min. Subsequently respiratory alkalosis associated with an increase in [HCO-3] + [CO3(2-)], a decrease in cl- ion concentration and a small decrease in lactate levels were observed. Prolonged exposure to hypoxia (16 h) resulted in a new return to the initial pH, a decrease in concentration of [HCO3-] + [CO3(2-)] and a high lactate level. The hematocrit value, the Hb concentration, and the plasma Na+, K+, Ca++ and Mg++ ion concentration did not change significantly.

[Electrophoretic pattern and activity of lactate dehydrogenase in Discoglossus pictus (Otth) and Rana ridibunda (Pallas) skeletal muscle and heart (author's transl)]. / Patrón electroforético y actividad de la enzima lactato deshidrogenasa de músculo esquelético y cardíaco de Discoglossus pictus (Otth) y Rana ridibunda (Pallas).

The electrophoretic isozyme patterns, total and specific activity of lactate dehydrogenase on skeletal and cardiac muscles in Discoglossus pictus and Rana ridibunda have been studied. The isozymes were separated out in polyacrylamide gels. The LDH activity bands were developed selectively. The percentage of the H subunits are significantly higher in Discoglossus than in Rana, probably becuase Rana is subjected to more severe anaerobic conditions during the hibernation time.