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The Editors of the Rev Clin Esp inform herein on their editorial activity in the last year (November 2009 to October 2010) according to three different sections: (a) Objectives and achievements during 2010, (b) editorial activity, and (c) objectives for 2011. During 2010, we have updated the editorial algorithm (manuscript time lag). We have developed the "E-case reports" section and we have linked the abstracts of the Annual Congress of the Spanish Society of Internal Medicine (SEMI) to a journal supplement (electronically available). Since 2010, the subscribers have been able to receive all of the contents of the Rev Clin Esp on-line and to perform self-evaluations in order to obtain 1.7 credits per each journal issue (continuing education). In 2010 we handled 402 manuscripts (7.2% more than in 2009), 35% of which were accepted for publication. We asked 186 reviewers for their expert opinion, 75% of whom sent their reports in less than two weeks. The mean time needed to reach an editorial decision concerning original manuscripts ("accepted / rejected") was 44.5 days and for papers not sent to external reviewers 19.5 days. Collaboration with the work groups produced good results (2.4 published manuscripts per issue), but this could be improved if all the groups collaborated in all the journal sections. Our objectives for 2011 are to complete the renewal of the Rev Clin Esp scientific committee, in accordance with the SEMI Council, and to continue to proceed with the actions initiated to increase the journal impact factor. Rev Clim Esp is an open forum for all internal medicine specialists. Responsibility falls on all of us to collaborate in order to make our journal a little better day by day., (Copyright © 2010. Published by Elsevier Espana.)

Background: difficult intubation is defined as the need for more than three attempts for intubation or more than 10 min to accomplish it, a situation that occurs in 1.5-8% of general anesthetic procedures. The aim of this study was to evaluate the predictive factors of difficult airway with known assessment scales., Methods: in a cross-sectional study conducted in 184 patients during the pre-anesthetic evaluation, we assessed the oral opening, viewing pharyngeal structures (Mallampati scale), condition of teeth, anatomic chin and neck, head extension and neck flexion (normal or limited), thyromental distance (Patil-Aldreti test) and the presence of obesity. We performed a calculation of sensitivity (S), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) using contingency tables., Results: we found that grades III and IV Mallapati (84%) and limited extension and flexion of the head and neck (99%) showed a high specificity for predicting difficult intubation. Other factors associated with difficult intubation were related to micrognathia, limited mouth opening and teeth with anatomic abnormalities., Conclusions: it is essential to take the necessary time to assess the airway with the greatest number of criteria predictive of difficult intubation for the person performing the procedure in order to take the necessary steps to face difficulties in this technique.

Introduction: Pigmented lesion clinics (PLC's) were developed as a quick referral system for patients with pigmented lesions. However, the most appropriate method of selecting patients who need to be seen in these units is not clearly defined. Teledermatology is a tool whose usefulness as a patient selection system for PLC's needs to be evaluated., Objective: To evaluate teleconsultation as a screening system for patients with pigmented lesions in terms of efficacy, accuracy and satisfaction., Method: Teleconsultations received at a PLC over a period of 12 weeks were evaluated. Teleconsultation patients reported changes in a pigmented lesion, a lesion that had recently appeared, multiple lesions, symptomatic lesions or concern about a nevus. We calculated the time intervals in sending the teleconsultation report and in patients being seen at the "physical" PLC consultation, the intraobserver, interobserver and pathologist kappa coefficients, as well as the degree of satisfaction of patients and Primary Care (PC) physicians., Results: 219 teleconsultations were evaluated, 49.3 % of which were referred to the "physical" consultation. The most frequent reason for the teleconsultation was concern about a nevus (37.0 %). The teleconsultations received responses in an average time of 43.9 hours, and patients were seen at the "physical" consultation within 2 weeks. The intraobserver agreement was kappa = 0.93 (95 % CI 0.87-0.98); interobserver agreement, kappa = 0.91 (95 % CI 0.87-0.96); and the agreement between the teledermatologist and the pathologist, kappa = 0.79 (95 % CI 0.70-0.89). 86 % of the patients and 91 % of the Primary Care physicians said that they were "very satisfied" with the implementation of this new system., Conclusions: Teleconsultation is an accurate screening system for patients with pigmented lesions. With this methodology, waiting times for patients with malignant lesions or those suspected of malignancy can be shortened at the same time as the PLC's excess workload is decreased. However, more experience is needed to establish the true usefulness of this filtering system in the early diagnosis of melanoma.

Bronchogenic cysts rarely affect the cutaneous surface, so they are difficult to diagnose clinically and are often confused with other types of cysts. We present the case of a young adult in whom a cystic lesion showing characteristics of a bronchogenic cyst was excised from the upper thorax area. We emphasize the fact that, in nearly all cases, the diagnosis of this pathology is made through a histopathological study, and we make special reference to the differential diagnoses.