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Introduction As a pretransplantation evaluation, renal function is determined by the glomerular filtration rate (GFR) with the use of renal scintigraphy (RS) and the estimated glomerular filtration rate (eGFR). To date, there are few studies that correlate renal cortex volume with eGFR determined with renal gammagram (GR) and eGFR by equations (Cockroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equation) in Latin American living donors. Aim This study sought to determine whether there is correlation of the volume of the renal cortex by Herts equation with the GFR determined with renal gammagram (GFR-GR). Patients and Methods This was an analytical, observational, and cross-sectional study. A review of the donor charts from January 1, 2014, to December 1, 2014, with a complete clinical file, kidney measurements, predonation tomography volume, and eGFR by different formulas and by renal scintigraphy. Results Thirty-three donors were included, 51.5% male and 48.5% female. The mean age was 38.58 ± 10 years, with an average volume of 127.83 ± 28.30 mL, with diethylenetriamine-pentaacetate (DTPA) of 54.80 ± 7.13 mL/min/1.73 m2 in the donated kidney. Spearman correlation showed the best association with the Herts equation (r = 0.346) reaching significance (P = .049) when comparing the different equations against the GFR with DTPA. Using the Bland-Altman method, the lowest variability and best significance was verified with the same equation compared to the other formulas (P = .0002). Conclusions There is no consensus regarding which is the best formula for calculating the GFR of both kidneys. Of the different formulas, the one that best correlated with the GFR was the Herts method, which uses the volume of the kidney.

Summary. Thrombosis is a rare complication in patients with congenital clotting factor deficiencies. In most cases, it is related to inherited procoagulant factors, use of central venous catheters or administration of coagulation factor concentrates. There are only a few case reports about thrombotic events during treatment with fresh frozen plasma (FFP). We report the case of a patient with homozygous inherited factor V deficiency, who developed a pulmonary embolism at a time of treatment with methylene blue treated FFP (MBFFP). The patient had only two other factors predisposing to thrombosis and both were acquired: obesity and bed rest. He started anticoagulant treatment with low molecular weight heparin (LMWH) while the deficient factors were replaced with MBFFP. After 8 days of treatment the patient developed a severe respiratory insufficiency. Pulmonary haemorrhage was considered among the differential diagnosis and LMWH was stopped. An inferior vena cava filter was placed without any further thrombotic complications. To our knowledge, there are no reports about patients with clotting factor deficiencies who developed a thrombotic event during treatment with MBFFP.

Objective The aim of this study was to investigate the impact of self-rated stigma and functioning in patients with bipolar disorder in Latin-America. Methods Two-hundred and forty-one participants with bipolar disorder were recruited from three Latin American countries (Argentina, Brazil, and Colombia). Functional impairment was assessed with the Functioning Assessment Short Test (FAST) and experiences with and impact of perceived stigma was evaluated using the Inventory of Stigmatizing Experiences (ISE). Results Higher scores of self-perceived stigma were correlated with lower scores of functioning. After multiple regression analysis, being on disability benefit, current mood symptoms and functioning were associated with self-perceived stigma. Conclusions This is the first study to demonstrate an association between stigma and poor functioning in bipolar disorder. Possible implications of such findings for practitioners are discussed. Limitations The main limitation of this study is that the Inventory of Stigmatizing Experiences has not yet been validated in a population of bipolar patients in our countries. The sample size and heterogeneous clinical subjects from different countries and cultures limit the generalization of the present findings.

Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events.A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed.A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked.Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure.

OBJECTIVES: 1. To study the factors predicting the giving-up of tobacco and to correlate the categories in the Smoker's Aid Programme (SAP) with levels of motivation and dependency, using brief questionnaires. 2. To find the annual percentage in the «winners» category, using the SAP methodology. DESIGN: Prospective, observational, intervention study without a control group of a random sample of smokers attending primary care clinics. SETTING: Four urban health centres in Zaragoza and Barcelona. INTERVENTIONS: Systematic intervention on smokers in the change phase (SAP category). Use of questionnaires on motivation/dependency and of biochemical checks that they had actually given up. Patients. 362 patients of whom 288 smokers (79.5%) took part. Average age was 40.85 (SD: 15.7). 60.8% were males. MEASUREMENTS AND MAIN RESULTS: 21.4% of the smokers had tobacco-related pathology. The number of previous attempts to give up smoking was 1.6 (SD: 2.9) Patients smoked an average of 13.4 cigarettes for 22.2 years (SD: 15.7). Average age at start of consumption was 17 (SD: 4.7). Initial motivation on the Richmond Test was 4.78 (SD: 3.2); and average dependency according to the modified Fagerström Test (TFm) was 0.6 (SD: 0.7). The number of SAP interventions was 1.9 (SD: 2.9). By the end 15.6% of the patients had achieved «winner» status, which was confirmed in 95.6% of them by the biochemical test. The logistic regression model confirmed that the factors predicting giving up tobacco were age, the initial levels of motivation and the initial number of cigarettes. CONCLUSIONS: The short tests of motivation (Richmond) and, to a lesser extent, dependency (TFm) were good predictors of giving up tobacco and can be recommended in primary care.

The aim of this study was to analyse and to verify the efficacy of systematic advice for alcoholism prevention, assessing the reduction of the number in risk drinkers.A multicenter randomized controlled clinical trial was designed, to perform in general practitioner setting, on a sample of risk drinkers (alcohol intake280 g weekly, without dependence) sent by random in intervention group (systematic brief advice with support material and a five visit program during a year) and control group (once brief advice and a control in 1 year). The procedure to incorporate in both groups included physical exam, a blood test and the MALT questionnaire. A descriptive and analytic study on included variables was realised, assessing the percentage of drinkers who reduced alcohol intake below risk limit at the end of a year follow up, as well as the reduction intake in each group.Of the 139 included males, 75 were in the intervention group and 64 in the control group. The percentage of patients not excluded by MALT10, and/or liver disease, that finished the 1 year follow up, was 46%, being the sample average age of 43 +/- 11.8. Patients included in both groups were initially comparable. At the end of a year follow up there were statistically significant differences in: percentage of risk drinkers who decreased alcohol intake below 280 g weekly (82% intervention group; 47% control group); percentage of reduction in GPT, GGT, triglycerides, systolic blood pressure and the MALT questionnaire.The efficacy of isolated advice of general practitioner was proved to achieve the alcohol intake reduction below the risk limit accepted in male risk drinkers without alcohol dependence. The systematic follow up during a year significantly improves the results achieved with the isolated advice.

To analyse the thematic content and the origin of the free papers presented at four Family Medicine conferences (two national and two international) during 1992 and 1993; and to check the possibility of differences between Spanish and international lines of research.Descriptive study.A total of 1,339 papers were classified. There were statistically significant differences (p0.001) in the thematic areas of Family Medicine (25.33% in international conferences, 7.77% national), Community Medicine (18.16% international, 28.20% national) and organisation of care (17.68% international, 30.16% national). The provinces with the highest number of contributions at national conferences were Barcelona, Madrid, Valencia and Zaragoza. At international conferences (WONCA) the greatest number of contributions came from the Scandinavian countries, Holland, the United Kingdom, Israel and Spain.Spanish investigators do not often tackle questions of under- and post-graduate training, professional attitude, clinical interviews or Bioethics. The papers at national conferences come mainly, in quantitative terms, from large provinces. The lower participation of liberal health systems like the German, French and North-American is noticeable.

We have shown the coverage of periodic health examinations made in children aged between 0 and 14 years old in Aragón during 1991, comparing with results obtained at national level and results obtained during 1990.A descriptive transversal study was developed by reviewing clinic records of 9 primary health centers selected by systematic sampling. Sampling consisted on 436 histories.Main results were: age of child in the first visit: 83.5% below 1 month; metabolic disease screening: no data on 31.8%; DTP-polio: no data on 20.9%; triple viric: no data on 24.3%.Obtained data showed better results than those at national level. We should improve the metabolic diseases screening and vaccinations recording system.

To find the prevalence and aetiology of chronic cardiac failure (CCF) among elderly people in a health area.Retrospective, crossover study.Delicias Sur Health Centre, Zaragoza.A representative sample of the population over 65 registered at the Health Centre. Systematic random sampling: n = 1,635.104 cases of cardiac failure were identified, which corresponded to a 6.3% (+/- 0.01) prevalence. By age groups, prevalence was 4.5% (+/- 0.01) for the 65-74 group and 8.5% (+/- 0.02) for those over 75. Regarding aetiology, 50.9% was due to arterial hypertension, 21.2% coronary failure, 22.1% valvulopathies and 17.3% reason unknown.CCF prevalence in the community increases with age and in our ambit exceeds that found in other countries. Almost half the cases are related to arterial hypertension.

To study the modifications in some biological parameters in patients who stop smoking.An analytic observational prospective study.Urban Health Centre.152 patients included in an intervention project against tobacco addiction.Arterial pressure (systolic and diastolic), weight and base cardiac frequency were determined, using standard procedures at the start and end of the study year on smokers who gave up the tobacco habit and on those who continued smoking. Cessation was validated for those who gave up smoking. A non-significant reduction in arterial pressure, an average reduction of 6 beats per minute (p0.05) and an average weight increase of 1.5 kg (p0.05) were observed in the ex-smokers.Giving up tobacco produces a benefit not comparable to the light increase in weight observed in the ex-smokers. It would be useful to study whether proper dietary advice could minimise weight gain in recent ex-smokers.

To design a simple method to calculate overall cardiovascular risk (CVR), which could be used in Primary Care (PC).A descriptive study to correlate and validate our method (called CVR-PC) using the Framingham, the British Regional Heart study and the Spanish Society to fight against Arterial Hypertension methods.Urban health centre.670 patients of both sexes chosen at random in clinics, to apply a programme of preventive measures.The age, gender, blood pressure, tobacco consumption, Cholesterolaemia and Glycaemia were determined for each patient. A multiplicative memory method was designed to obtain the index of cardiovascular risk without recourse to electronic support. Figures obtained were correlated with those from the equation of the Framingham study. The Pearson r values were: 0.85 for the series total (0.85 for men and 0.83 for women). The cut-off point for high/low-moderate risk was identified. From this 76.3% sensitivity and 95.7% specificity were obtained.The method studied shows adequate correlation as well as high sensitivity and specificity when compared with the Framingham method. It can be useful in Primary Care clinic for identifying individuals at high cardiovascular risk.

To study the reliability and precision of the arterial pressure digital monitor, Palm Monitor-2 FS-40, model 1083 (DM). The mercury sphygmomanometer (MSM) was used as the reference.Comparative crossover study.Primary Care Centre.81 patients of both sexes between 26 and 65 found at random in a consultation during November and December, 1991. 24 of them had systolic arterial pressure (SAP) above 140 mmHg and/or diastolic arterial pressure (DAP) above 90 mmHg.Four measurements of AP for each patient were carried out at one minute intervals: the first and the fourth with the MSM and the second and third with the DM. The SAP averages with the DM were 130.27 mmHg in the first take and 129.36 in the second. The DAP averages were 82.53 and 81.88, respectively. The Pearson correlation r between the averages for both devices and the difference of averages, both absolute and in so much per cent, were obtained. The values obtained were 0.887 for SAP and 0.810 for DAP. The difference between averages was -3.83 mmHg (-2.86%) for SAP and -2.55 mmHg (-3.04%) for DAP.The measurements obtained with this DM are quite reliable, although a tendency to underestimate the AP values in relation to the MSM was noted. Overall it can provide useful information on certain aspects of the diagnosis and follow-up of AHT.

We determined the prevalence of tobacco consumption among the general population and established its distribution considering socioeconomical variables. We performed a cross-sectional study with 2781 subjects from 93 rural and urban areas, selected by randomized, census-based, multi-staged and stratified sampling. 40.9% of the population from Aragon are regular smokers (58.6 of men and 23% of women). Heavy smokers comprise 17.2% of the total (30.1% of men and 3.8% of women). The higher proportion of smokers in observed among single men over 40 and single women under 40. The percentage of smokers is lower among 20 to 29-years-old young people from high socio-economical than from low levels. In general, the mean percentage of smokers among men and, specially, among women from rural areas is higher than in the rural areas. In Aragon, tobacco is a risk factor affecting 41% of the adult population and, specially, young people, men, single persons from both sexes and living in urban areas. It seems that young people with a high socio-economical level are becoming smokers at a lower frequency.

Two patients who developed pain and tenderness in their calf muscles, without other organ system involvement, are described. A gastrocnemius biopsy disclosed necrotizing muscular arteritis. Five other reported cases are reviewed and we conclude that there is a limited form of polyarteritis nodosa localized to calf muscles, with a differentiated and more benign clinical course, a differential diagnosis restricted to local pathological processes and prompt response to treatment with corticosteroids alone.

We report the results of an intervention trial comparing the counseling (group A) of the general practitioner to encourage to quit smoking in dissonant smokers and an intervention based on counseling and offer of follow up at 2 and 3 weeks and at 3 and 6 months (group B). Both interventions were globally evaluated to assess the influence of the smoking habits of health professionals on the results. In the 93 group B patients there was a higher quitting rate than in group A. The rates of success after one year follow up were 26.9% and 11.9% (p less than 0.05). Forty-seven of the 152 patients were counseled by smoking physicians and 105 by non-smoking physicians; at one-year follow-up, the verified quitting rates were 10.6% and 25.7%, although the difference was not significant. It was concluded that the reinforcement of counseling by follow-up may increase the rate of quitting smoking in dissonant smokers in a primary care setting, and that the influence of the habit of the health professional can be limited through more systematic interventions.

Hasta ahora, gran parte de los estudios que argumentabanestos efectos beneficiosos habian sido realizados en pobla-ciones con importantes factores de riesgo cardiovascular ydemostraron una reduccion del riesgo de mortalidad portodas las causas, que era producido basicamente por unaimportante disminucion de las muertes de origen corona-rio