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Background and Objective: Spain has been one of the countries most affected by the SARS-CoV-2 pandemic. The objective of this study is to describe the characteristics of the patients treated for COVID-19 at Guadarrama Hospital and to identify the associated mortality factors in those admitted in an acute situation., Material and Methods: Retrospective observational study of COVID-19 patients admitted from 3/15 to 5/15/2020. Sociodemographic, mental, functional, analytical, clinical, radiological and therapeutic variables were collected. Factors associated with mortality were analysed using a bivariate and multivariate study., Results: Two hundred eleven patients were included: 102 (48.3%) in an acute situation and 109 (51.7%) in the convalescent phase, the median (interquartile range) age was 82 (72, 85) years. The most frequent symptoms were fever, cough and respiratory failure. The 89.9% had pneumonia. An acute mortality rate of 26.5% (27/102) was detected and the associated factors were: respiratory failure (P 0.002), Charlson index (ChI)≥3 (P<0.001), CURB≥2 (P 0.011), low SatO 2 /FiO 2 ratio (<0.001), elevated urea (P<0.001) and creatinine (P 0.036), hypoproteinemia (P 0.037) and age (P<0.018). The deceased had a worse functional situation than the survivors (P 0.025). In the multivariate analysis, SatO 2 /FiO 2 ratio (OR: 2.23; 95% CI: 1.07-4.63; P 0.031) and ChI≥3 (OR: 4.25; 95% CI: 1.06-17.04; P 0.041) were independent factors of mortality., Conclusions: The COVID-19 patients treated were mostly severe cases. The variables associated with mortality were age, respiratory failure, comorbidity, kidney failure, and malnutrition. Respiratory failure and comorbidity outweigh age as independent risk factors for mortality., (Copyright © 2021 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

Cardiovascular diseases currently have a major social and economic impact, constituting one of the leading causes of mortality and morbidity. Personalized computational models of the heart are demonstrating their usefulness both to help understand the mechanisms underlying cardiac disease, and to optimize their treatment and predict the patient's response. Within this framework, the Spanish Research Network for Cardiac Computational Modelling (VHeart-SN) has been launched. The general objective of the VHeart-SN network is the development of an integrated, modular and multiscale multiphysical computational model of the heart. This general objective is addressed through the following specific objectives: a) to integrate the different numerical methods and models taking into account the specificity of patients; b) to assist in advancing knowledge of the mechanisms associated with cardiac and vascular diseases; and c) to support the application of different personalized therapies. This article presents the current state of cardiac computational modelling and different scientific works conducted by the members of the network to gain greater understanding of the characteristics and usefulness of these models., (Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Weight stigmatization is defined as the devaluation of others based on weight, a visible and specific characteristic that cannot be hidden. The consequences of weight stigmatization have been studied in victims and healthcare providers. This narrative literature review describes the consequences of weight stigmatization in victims and healthcare practitioners. According to several studies, high levels of psychological dysfunction in victims coexist with negative stereotypes in healthcare professionals, since the latter are exposed to the same negative media messages about obesity. Thus, weight stigmatization contributes to increase the burden of obesity, since when obese patients perceive that they are discriminated by healthcare professionals, their unhealthy behaviors persist and they have a low adherence to obesity treatment and medical recommendations.

Unlabelled: Residents in our country have achieved a homogenous surgical training by following a structured residency program. This is due to the existence of specific training programs for each specialty. The current program, approved in 2007, has a detailed list of procedures that a surgeon should have performed in order to complete training. The aim of this study is to analyze the applicability of the program with regard to the number of procedures performed during the residency period., Material and Methods: A data collection form was designed that included the list of procedures from the program of the specialty; it was sent in April 2014 to all hospitals with accredited residency programs. In September 2014 the forms were analysed, and a general descriptive study was performed; a subanalysis according to the resident's sex and Autonomous region was also performed. The number of procedures performed according to the number of residents in the different centers was also analyzed., Results: The survey was sent to 117 hospitals with accredited programs, which included 190 resident places. A total of 91 hospitals responded (53%). The training offered adapts in general to the specialty program. The total number of procedures performed in the different sub-areas, in laparoscopic and emergency surgery is correct or above the number recommended by the program, with the exception of esophageal-gastric and hepatobiliary surgery. The sub-analysis according to Autonomous region did not show any significant differences in the total number of procedures, however, there were significant differences in endocrine surgery (P=.001) and breast surgery (P=.042). A total of 55% of residents are female, with no significant differences in distribution in Autonomous regions. However, female surgeons operate more than their male counterparts during the residency period (512±226 vs. 625±244; P<.01). The number of residents in the hospital correlates with the number of procedures performed; the residents with more procedures trained in hospitals where there were less residents (669±237 vs. 527±209; P=.004)., Conclusion: The surgical activity performed by spanish surgeons is adequate to the specialty program, except in hepatobiliary and esophageal-gastric surgery. The distribution is homogeneous in the different autonomous regions, although there are differences that depend on the number and sex the of residents in each hospital. This information is essential to evaluate the quality of the specialty program and to design new training programs., (Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To describe the relationship between personal values and personality traits in cocaine-using patients and analyze their specificity in the explanation of different types of constructs., Method: A study was carried out to explore the association between these variables in a group of 230 patients receiving treatment for cocaine dependence. The Portrait Values Questionnaire was used for measuring personal values, while the Big-Five Factors Questionnaire was used to measure personality traits. In addition, we explored the relationship of values and traits with the variables "degree of satisfaction with life" (life satisfaction) and "belonging to a religious association" (religiosity)., Results: A significant association was found between personal values and personality traits. At the same time, their conceptual and empirical differences were revealed, as it was demonstrated that personal values better explain "belonging to a religious association", whilst personality traits better explain "degree of satisfaction with life". Thus, it was found that personal values better explain behaviours that depend on greater cognitive control, while personality traits would have more influence on tendencies and behaviours that are subject to lower cognitive control levels., Conclusions: Considering the relationship between the two constructs, and given that cocaine use is associated with both high and low cognitive control, in explanations of cocaine use it would be appropriate to take into account the explanatory contribution of personal values and personality traits in a complementary way.

Objective: To describe factors related to prescription on discharge of treatment for Chronic Heart Failure(CHF)-Stage C and to analyse whether this is related to 12month-mortality., Material and Methods: Observational follow-up study of patients over 85 hospitalized during 2006/7 with Stage C-Chronic Heart Failure in an outskirt support hospital. Drug-prescription adherence was assessed according to the American Heart Society 2005-Guidelines and recommendations of the American Geriatrics Society-2007. A multivariate analysis of logistic regression was performed to obtain odds for 12-month mortality for each recommended therapy, adjusting by mortality risk factors., Results: 104 patients aged 90+/-3yr were followed on discharge, 85% of which were women. NYHA-classes were distributed NYHA I-28,2%, II-37,9%, III-30,1%, IV-3,9%. Most frequently prescribed drugs were loop diuretics (83,3%) and IACEs/ARB (62%), and the less frequent beta-blockers (19,1%). IACEs/ARB were prescribed to those with lower functional impairment (p=0.04), and beta-blockers to those with worse NYHA class (p=0.02). All recommended prescriptions had a tendency to 12 month mortality risk reduction, even adjusted by age, functional status, co-morbidity, NYHA class and co-morbid atrial fibrillation, except for spironolactone (OR-1,8; IC95% 0,48-17,19)., Conclusions: Treatment with CHF disease-modifying therapies except for spironolactone can reduce 12 month risk mortality, also in the oldest old. There exists room for improvement in frequency of drug prescription in this group of age.

Introduction: The relationship between frontal lobe damage and criminality is especially complex. The neural substrates of psychopathic behavior seem to involve structural and functional abnormalities in the frontal lobes and the limbic system. AIM. To analyze the repercussions that brain structural and functional abnormalities in psychopathic individuals may have for forensic neuropsychology., Development: Consistent evidence indicate that response inhibition problems in psychopathic subjects are linked to structural or functional damage in the frontal cortex. Furthermore, the prefrontal cortex, along with the amygdala and the hippocampus forms the limbic system, which is an important neural substrate of emotion processing; therefore the psychopath's capacity of affective processing could also be impaired. The theoretical frameworks of the somatic marker and mirror neuron hypotheses, along with the empirical study of executive functions may contribute to explain the inability of the psychopathic subjects to feel empathy, which is one of the main inhibitors of violence and antisocial behavior., Conclusions: The relationship between frontal lobe dysfunction and antisocial behavior arises an important legal issue. In order to consider some type of minor liability in the case of psychopaths it is suggested to gather further research data about the relationship between frontal lobe dysfunction and the ability to inhibit antisocial behavior by making an adequate use of empathy and emotional ties.

Introduction and Aims: Dysexecutive syndrome has traditionally been related to alterations affecting the functioning of the frontal lobes of the brain. Different studies suggest that this syndrome is present in addicts to substances and, hence, the use of a brief questionnaire has been put forward as a way of carrying out an initial screening for the condition, prior to a thorough assessment of the executive functions by a neuropsychologist., Subjects and Methods: The Spanish version of the dysexecutive questionnaire (DEX-Sp) was administered to 176 addicts who were beginning treatment and to 213 non-clinical (control) participants. The DEX is a 20-item self report that evaluates a wide range of dysexecutive symptoms., Results: Statistically significant differences appeared between the scores of addicts and those obtained by the control group. Whereas males showed differences in the types of symptoms they reported, female addicts displayed more intense dysexecutive clinical features, which affected all the areas under frontal control. No significant differences were observed as regards the main drug of abuse., Conclusions: It can be established that a total score of 24 points or more on the complete DEX-Sp scale suggests the existence of dysexecutive symptoms that are clinically relevant. Likewise, scores of 33 points or more indicate a probable moderate or severe dysexecutive syndrome. The DEX seems to be an instrument that is sensitive, fast and easy to apply in the initial assessment of addicts who are seeking treatment.

Lymphoepithelioma-like carcinoma of the lung is a rare tumor that is considered a subtype of undifferentiated large cell carcinoma with abundant invasion by lymphocytes. Although initially described as a tumor occurring in the nasopharynx, this type of carcinoma has since been seen in many other organs. We report the case of a 59-year-old male smoker diagnosed with lymphoepithelioma-like carcinoma.

Purpose: To develop an objective calculation method that is able to provide a customized surgical correction that allows the patient to reach the emmetropia and the maximum visual acuity after the surgery., Methods: The study included 187 eyes with myopia or myopic astigmatism that underwent LASIK. The optical characterization of each eye was developed by a complete theoretical model based in Le Grand eye, in which the measured values of radii and thicknesses of the different surfaces have been substituted. By means of a geometric ray tracing, the surgery has been simulated by changing the anterior corneal radius and the corneal thickness within the optical zone to obtain its influence in the ocular image and the visual acuity. We considered the surgery to be <> when the residual equivalent refraction was between 0 and +0.5 D., Results: An interval for the final corneal radius is proposed for each eye in order to reach the best visual acuity (optimal interval). The position of the post-surgical radius in this interval has been related with the success of the surgical process., Conclusions: An objective method for LASIK has been proposed: i) it calculates a personalized surgical plan that allows the patient to reach the best visual quality, and ii) it can be used as a reference by the surgeon to design his nomogram and to decrease his learning curve.

Objective: A linear regression study is made of the parameters identifying the electrical activity of the small bowel, with the aim of determining those variables most closely related to the type I pressure waves., Patients and Methods: A computer system was used for the simultaneous and real time acquisition of the manometric activity (using microballoons implanted in the bowel mucosa) and electromyogram of the intestine (employing bipolar electrodes implanted in the intestinal serosa) in dogs., Results: Of the electromyogram intestinal parameters studied, those determining signal energy (root mean square voltage and energy) yielded the highest correlation coefficients (0.71 +/- 0.08 in the jejunum and 0.78 +/- 0.06 in the duodenum) to bowel pressure. Peak-to-peak voltage also shows good correlation, though to a lesser degree. The rest of the parameters studied, such as those that measure the duration of the action potential or its number of peaks, yielded poor correlations to pressure., Conclusions: It is concluded that the energy of the intestinal electromyogram represents the mechanical activity of the small bowel, reflecting intestinal motility, and that the recording of this parameter is not subjected to subjective cutoff values or threshold levels. On the other hand, and unlike in the case of manometric recordings, the signal obtained is free of background interference and noise.

The aim of the present paper is to present the initial phases of the development of the Spanish version of the "World Health Organization Disablement Assessment Schedule II" WHO-DAS-II and also to describe the quantitative and qualitative methodological strategies used in the elaboration process of an instrument: i) compatible with the new International Classification of Functioning and Disability -ICIDH-2- of the World Health Organisation; ii) with criteria of cross-cultural applicability and; iii) to allow us to assess the disability in all its dimensions.

Introduction: Psychiatric disorders occurs in at least 20% of patients attending Primary Care settings, however, only 50% of them are detected by primary care physicians. Therefore a tool is required which can help primary care physicians to detect and diagnose psychiatric disorders. PRIME-MD (Primary Care Evaluation of Mental Disorders) is a questionnaire designed with this aim. In this article the results of the validation study of the Spanish version of this questionnaire are presented., Materials and Methods: 312 patients were interviewed by primary care physicians using PRIME-MD and by psychiatrists using SCAN (Schedules for Clinical Assessment in Neuropsychiatry)., Results: The time most frequently spent in questionnaire application by the physician was 10 minutes. PRIME-MD detected the presence of at least one psychiatric disorder in 44.3% of patients. PRIME-MD diagnoses agree well with SCAN diagnoses for mood disorders (coefficient of agreement: 0.50) and for anxiety disorders (coefficient of agreement: 0.35), but not for somatoform disorders or alcohol-related disorders., Conclusions: The Spanish version of PRIME-MD questionnaire in a useful tool to identify and diagnose mood and anxiety disorders in Primary Care settings.

Introduction: Suicide behavior is an important health problem. Several works found have reported that the majority of completed suicides visited to the general practitioner in previous days., Method: 219 suicide attempts attended in a General Hospital were asked about their previous contact with health system., Results: The third part of the patients have visited the general practitioner in the previous month. 60% of the patients with personal antecedents of psychiatric diseases have visited to mental services in the previous month., Conclusions: It is necessary to find risk suicide markers that allow identifying these patients in primary attention. The increment of the consultation periodicity is proposed as efficient risk suicide marker.