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Background: The objective of this study was to assess long-term outcome in patients with spontaneous intracerebral hemorrhage admitted to the intensive care unit., Methods: Mortality and Glasgow Outcome Scale, Barthel Index, and 5-level EQ-5D version (EQ-5D-5L) scores were analyzed in a multicenter cohort study of three Spanish hospitals (336 patients). Mortality was also analyzed in the Medical Information Mart for Intensive Care III (MIMIC-III) database., Results: The median (25th percentile-75th percentile) age was 62 (50-70) years, the median Glasgow Coma Score was 7 (4-11) points, and the median Acute Physiology and Chronic Health disease Classification System II (APACHE-II) score was 21 (15-26) points. Hospital mortality was 54.17%, mortality at 90 days was 56%, mortality at 1 year was 59.2%, and mortality at 5 years was 66.4%. In the Glasgow Outcome Scale, a normal or disabled self-sufficient situation was recorded in 21.5% of patients at 6 months, in 25.5% of patients after 1 year, and in 22.1% of patients after 5 years of follow-up (4.5% missing). The Barthel Index score of survivors improved over time: 50 (25-80) points at 6 months, 70 (35-95) points at 1 year, and 90 (40-100) points at 5 years (p < 0.001). Quality of life evaluated with the EQ-5D-5L at 1 year and 5 years indicated that greater than 50% of patients had no problems or slight problems in all items (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). In the MIMIC-III study (N = 1354), hospital mortality was 31.83% and was 40.5% at 90 days and 56.2% after 5 years., Conclusions: In patients admitted to the intensive care unit with a diagnosis of nontraumatic intracerebral hemorrhage, hospital mortality up to 90 days after admission is very high. Between 90 days and 5 years after admission, mortality is not high. A large percentage of survivors presented a significant deficit in quality of life and functional status, although with progressive improvement over time. Five years after the hemorrhagic stroke, a survival of 30% was observed, with a good functional status seen in 20% of patients who had been admitted to the hospital., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.)

The Spanish Familial Pancreatic Cancer Registry (PANGENFAM) was established in 2009 and aims to characterize the genotype and phenotype of familial pancreatic cancer (FPC). Furthermore, an early detection screening program for pancreatic ductal adenocarcinoma (PDAC) is provided to healthy high-risk individuals from FPC and hereditary pancreatic cancer families (first-degree relatives). This article describes our experience over the last 10 years in high-risk screening. Hereditary and familial pancreatic cancer families were identified through the oncology and gastroenterology units. High-risk individuals underwent annual screening with endoscopic ultrasound (EUS) and magnetic resonance (MRI) from age 40 or 10 years younger than the youngest affected family member. Results: PANGENFAM has enrolled 290 individuals from 143 families, including 52 PDAC cases and 238 high-risk individuals. All high-risk individuals eligible for screening were offered to enter the surveillance program, with 143 currently participating. Pancreatic abnormalities were detected in 94 individuals (median age 53 years (29-83), with common findings including cystic lesions and inhomogeneous parenchyma. Imaging test concordance was 66%. Surgical intervention was performed in 4 high-risk individuals following highly suspicious lesions detected by imaging. PANGENFAM is a valuable resource for science innovation, such as biobanking, with clinical and imaging data available for analysis. For high-risk families, it may offer a potential for early diagnosis. Collaboration with other national and international registries is needed to increase our understanding of the disease biology and to standardize criteria for inclusion and follow-up, optimizing cost-effectiveness and efficacy., (© 2024. The Author(s).)

Background: There are increasing reports on the cognitive and emotional benefits of positive reminiscence therapy in older people. The objective of this study is to assess the differential improvement of the quality of life for older people in different vital situations (three different types of aging) and from different countries by implementing a positive reminiscence therapy program (REMPOS)., Methods: The participants were 144 older adults above the age of 65, 77 participants from Spain (45 experimental groups, 32 control groups) and 67 from Mexico (34 experimental groups, 33 control groups). The participants were recruited from nursing and retirement homes. A factorial randomized design with pre-post measurement with three independent variables: country (Mexico, Spain), condition (experimental, control), and types of aging (healthy aging, HA., mild cognitive impairment, MCI., Alzheimer's disease, AD). The experimental groups received REMPOS therapy and control groups received standard cognitive stimulation program. The quality of life was measured with the Life Satisfaction Inventory for adults (LSI-A) and autobiographical memory test (AMT) before and after REMPOS therapy., Results: The REMPOS intervention showed significantly higher positive effects than the control condition on the recall of specific positive memories across countries and types of aging, except for the Spanish MCI group. Life satisfaction in the Alzheimer's and MCI group only improved with REMPOS in the Mexican sample., Conclusions: The REMPOS effects showed generalizable effects across countries, but the cross-cultural differences shown highlight the necessity of running studies to test those differential effects., (© 2023. The Author(s).)

Water stored in open-pit lakes can be a water resource when the mine is closed. This study aimed to develop a reliable model to evaluate the water quality, based on the sulphate concentration, in the Reocín Mine area (Spain) by using geostatistical algorithms. To this end, water samples were taken from the beginning of the flooding period in November 2004 until August 2020. The model showed that the sulphate concentration was highest between February 2009 and February 2012 and decreased as the flooding process progressed. The area with the highest concentration (2000 mg L -1 ) was the central part of the study area, where the mine is located, while in the northeast and southwest, the values from the beginning of the flooding period were lower, below 500 mg L -1 . In the last obtained model, the values decreased considerably to 1300 mg L -1 in the central area and below 250 mg L -1 in the northeast and southwest areas. The modelling conducted to assess the water quality in the area of influence of the mine determined that the flooding process has little influence on the water in the rivers and streams in the area, since the sulphate concentration measured in the adjacent rivers and streams was less than 250 mg L -1 , indicating that anomalous concentrations were only found in the open-pit area. It was shown that geostatistical algorithms are useful tools that can be used to model the intensity and extension of water pollutants in space over time., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The medical staff who work in specialized healthcare are among the professionals with a greater risk of presenting negative indicators of mental health. These professionals are exposed to numerous sources of stress that can have a negative influence on their personal life. Currently, SARS-CoV-2 poses an additional and relevant source of stress. The aim of this study was to identify the interactions between the work and family environments, as well as to analyze self-perceived mental health and burnout in physicians who, during the COVID-19 pandemic, carried out their jobs in public health in Huelva (Spain), also considering a series of sociodemographic variables., Methods: This is a descriptive, cross-sectional study. Information from 128 participants was collected using the SWING, MBI-HSS and GHQ-12 questionnaires, along with sociodemographic data and possible situations of contact with SARS-CoV-2. The data were analyzed, and correlations were established., Results: Most of the sample obtained a positive interaction result of work over family. Those who had been in contact with SARS-CoV-2 represented higher percentages of a positive result in GHQ-12, negative work-family interaction, burnout, emotional exhaustion and depersonalization. In general, the men showed a worse mental health state than women., Conclusions: The medical staff of Huelva who had been in contact with situations of SARS-CoV-2 in their work environment presented worse indicators of mental health and greater negative interaction of work over family than those who had not been in contact with these situations.

The Reocín mine is located in Cantabrian region, in northern Spain. Its exploitation ended in 2003 due to the exhaustion of its reserves. In November 2004, the controlled flooding of the openpit began. During this process, both the qualities of stored water and piezometric levels have been monitored to control the possible water detraction from the Saja-Besaya hydrographic system. This paper deals with the water chemistry analysis of the pit lake surface, as well as the different conditions of the area. Geological and hydrogeological contexts play an important role in the lake water chemistry. The lake water quality continues improving. The sulphate content and zinc concentrations are already below the permitted pouring limits. Three factors are distinguished: the washing of the mine shafts is completed; the water supply from the aquifer contributes to the dissolution of the salt content and the bedrock, and dolomite, which neutralizes acid waters and improves the water quality during the flooding process with a pH value of 8. Owing to these conditions, the stored water meets the necessary conditions for discharge and provides the opportunities to use it., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Inequalities between men and women in the workplace are reflected in professional sports, specifically football refereeing. This phenomenon sometimes becomes sexual harassment since it is a stereotypically considered male profession in which women are a minority. To measure that behavior, it is necessary to count on valid and reliable tools. Therefore, the goal of this study was to determine the factorial structure and the discriminant and convergent validity of the 'sexual experiences questionnaire', version of the Department of Defence (SEQ-DoD). Eighty-nine male football referees and ninety-four female football referees, with a mean age of 23.30 ± 4.85 years, participated in this studio conducted questionnaire in Andalusia, Spain. A confirmatory factor analysis was performed using the robust maximum-likelihood estimation method. The goodness of fit was assessed, and the factorial invariance was calculated to determine the stability of the model. Subsequently, the validity was confirmed. The results corroborated the validity and reliability of the questionnaire adapted to the population studied. Therefore, it can be used as a research instrument.

Objective: Validation of the intracerebral haemorrhage (ICH) score in patients with a diagnosis of spontaneous ICH admitted to the intensive care unit (ICU)., Methods: A multicentre cohort study was conducted in all consecutive patients with ICH admitted to the ICUs of three hospitals with a neurosurgery department between 2009 and 2012 in Andalusia, Spain. Data collected included ICH, Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores. Demographic data, location and volume of haematoma and 30-day mortality rate were also collated., Results: A total of 336 patients were included. 105 of whom underwent surgery. Median (IQR) age: 62 (50-70) years., Apache-Ii: 21(15-26) points, GCS: 7 (4-11) points, ICH score: 2 (2-3) points. 11.1% presented with bilateral mydriasis on admission (mortality rate=100%). Intraventricular haemorrhage was observed in 58.9% of patients. In-hospital mortality was 54.17% while the APACHE-II predicted mortality was 57.22% with a standardised mortality ratio (SMR) of 0.95 (95% CI 0.81 to 1.09) and a Hosmer-Lemenshow test value (H) of 3.62 (no significant statistical difference, n.s.). 30-day mortality was 52.38% compared with the ICH score predicted mortality of 48.79%, SMR: 1.07 (95% CI 0.91 to 1.23), n.s. Mortality was higher than predicted at the lowest scores and lower than predicted in the more severe patients, (H=55.89, p<0.001), Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva calibration belt (p<0.001). The area under a receiver operating characteristic (ROC) curve was 0.74 (95% CI 0.69 to 0.79)., Conclusions: ICH score shows an acceptable discrimination as a tool to predict mortality rates in patients with spontaneous ICH admitted to the ICU, but its calibration is suboptimal., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Adherence to a Mediterranean diet seems to be inversely associated with C-reactive protein (CRP) concentration. A 14-point Mediterranean Diet Adherence Screener (MEDAS) has been developed to assess dietary compliance. Objective: The aim of this study was to assess whether each of the MEDAS questions as well as their final score were associated with the levels of CRP in general Spanish population., Methods: Cross-sectional analysis of 1411 subjects (mean age 61 years, 43.0% males) randomly selected from the general population. CRP levels were determined by a commercial ELISA kit. Adherence to the Mediterranean diet was measured by the 14-point MEDAS. Results: There was an inverse correlation between adherence to the Mediterranean diet and the CRP concentration, even after adjusting by age, gender, hypertension, metabolic syndrome, body mass index, statin treatment and hypertension treatment ( p = 0.041). Subjects who consume ≥2 servings of vegetables per day ( p = 0.003), ≥3 pieces of fruit per day ( p = 0.003), ≥1 serving of butter, margarine, or cream per day ( p = 0.041) or ≥3 servings of fish/seafood per week ( p = 0.058) had significantly lower levels of CRP. Conclusions : Adherence to a Mediterranean-type diet measured by a simple questionnaire is associated with lower CRP concentration. However, this association seems to be particularly related to a higher consumption of vegetables, fruits, dairy products, and fish., Competing Interests: The authors declare no conflict of interest.

Objective: To evaluate SAPS 3 performance in Spain, assessing discrimination and calibration in a multicenter study., Design: A prospective, multicenter study was carried out., Patients and Setting: A prospective cohort study was performed in Spanish hospitals between 2006 and 2011., Measurements and Results: A total of 2171 patients were included in the study. The mean age was 61.4±16.09 years, the ICU mortality was 11.6%, and hospital mortality 16.03%. The SAPS 3 score was 46.29±14.34 points, with a probability of death for our geographical area of 18.57%, and 17.97% for the general equation. The differences between observed-to-predicted mortality were analyzed with the Hosmer-Lemeshow test, which yielded H=31.71 (p<0.05) for our geographical area and H=20.05 (p<0.05) for the general equation. SAPS 3 discrimination with regard to hospital mortality, tested using the area under the ROC curve, was 0.845 (0.821-0.869)., Conclusion: Our study shows good discrimination of the SAPS 3 system in Spain, but also inadequate calibration, with differences between predicted and observed mortality. There are more similarities with regard to the general equation than with respect to our geographical area equation, and in both cases the SAPS 3 system overestimates mortality. According to our results, Spanish ICU mortality is lower than in other hospitals included in the multicenter study that developed the SAPS 3 system, in patients with similar characteristics and severity of illness., (Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.)

Coastal environments, such as marshes, dunes, or estuaries, are characterized by their high natural values that usually cause them to be subjected to high protection levels, affecting activities taking place within them. This is why the action in these spaces must be based on the use of proper techniques and approaches, which integrate ecology with practical engineering necessities. In this context, the Department of Sciences and Techniques of the Water and Environment of the University of Cantabria, through methods developed in the natural reserve of the Salt Marshes of Santoña and Noja, proposes the use of a working methodology based on the discipline of "ecosystem management" combined with the "adaptive management" methodologies; the application of mathematical, statistical, and specific predictive instruments; and the utilization of an "ecologic niche" as a union between the scientific knowledge of the littoral environments and the true actuation scale of the projects and activities carried out within them.

Remote sensing has been used since the 1980s to study parameters in relation with coastal zones. It was not until the beginning of the twenty-first century that it started to acquire imagery with good temporal and spectral resolution. This has encouraged the development of reliable imagery acquisition systems that consider remote sensing as a water management tool. Nevertheless, the spatial resolution that it provides is not adapted to carry out coastal studies. This article introduces a new methodology for estimating the most fundamental physical property of intertidal sediment, the grain size, in coastal zones. The study combines hyperspectral information (CASI-2 flight), robust statistic, and simultaneous field work (chemical and radiometric sampling), performed over Santander Bay, Spain. Field data acquisition was used to build a spectral library in order to study different atmospheric correction algorithms for CASI-2 data and to develop algorithms to estimate grain size in an estuary. Two robust estimation techniques (MVE and MCD multivariate M-estimators of location and scale) were applied to CASI-2 imagery, and the results showed that robust adjustments give acceptable and meaningful algorithms. These adjustments have given the following R(2) estimated results: 0.93 in the case of sandy loam contribution, 0.94 for the silty loam, and 0.67 for clay loam. The robust statistic is a powerful tool for large dataset.

Background: Marked hypertransaminasemia (HT) is not an infrequent situation within clinical practice, which is usually interpreted as primary acute liver damage. The objectives of this study were to determine the incidence, mortality rate and aetiology of marked HT among the general population, and the use therefore as an indicator of primary acute liver damage., Methods: A retrospective study was made of all patients with marked HT (ALT >400 IU/L) which were attended over a two-year period at the Healthcare Department n 11 in the Autonomous Community of Valencia. The computerized medical records and the results of the different supplementary examinations made were reviewed, and an analysis was made of different variables: clinical diagnosis and evolution, other liver function-related biochemical parameters and autoimmune and infection serology markers., Results: A total of 414 patients with marked HT were identified (incidence of 88 cases/100,000 inhab./year), 73 of whom died (mortality rate of 16 deaths/100,000 inhab./year). Of the twenty aetiologies found, the most frequent were extrahepatic cholestasis (28.3%), hypoxic hepatopathy (14.6%) and sepsis (11.9%). The positive predictive value of marked HT as an indicator of primary acute liver damage was 27.7%., Conclusions: Marked HT is a disorder having a remarkable incidence rate among the general population, entailing a high mortality rate. Its aetiology is widely varied, being however the extrahepatic origin predominant.

Objectives: To evaluate the performance of the Simplified Therapeutic Intervention Scoring System (TISS 28) on an independent database and to determine its relation to the original Therapeutic Intervention Scoring System (TISS 76)., Design: Analysis of the database of the Spanish prospective multicenter study PAEEC (Project for the Epidemiological Analysis of Critical Care Patients)., Setting: 86 intensive care units (ICUs) in Spain., Patients: Data on 8838 patients admitted to the ICUs., Measurements and Results: Administrative data, main diagnostic category, severity score [Acute Physiology and Chronic Health Evaluation (APACHE) II and III] and data for the calculation of the TISS 76 and TISS 28 were collected during the first 24 h after the patient's ICU admission. TISS 76 and TISS 28 scores were calculated and analyzed on how they varied according to other variables (diagnostic group, severity level, hospital size and age). The association between TISS 76 and TISS 28 was studied. The TISS 76 score was 21 +/- 10.5 points and the TISS 28 score 23.3 +/- 8.8 points. There was a good correlation between TISS 76 and TISS 28 (r = 0.85). The regression equation was: TISS 28 = 8.35 + (0.712 x TISS 76). The TISS 28 score behaved similarly to the TISS 76 score in relation to the other variables, with a positive correlation between the therapeutic and the severity level (APACHE II and III) and a negative correlation between therapeutic activity and age, with very similar correlation coefficients. Both TISS 28 and TISS 76 scores were higher in larger hospitals., Conclusions: There is a strong correlation between TISS 28 and TISS 76 scores in the PAEEC database and TISS 28 works correctly in our setting.

Objective: To establish whether the age of patients admitted into the intensive care unit (ICU) influences the amount of therapy received., Design: Observational, prospective, multicenter study., Setting: Eighty-six multidisciplinary ICUs in Spain, including coronary patients., Patients: The patients (n = 8,838) were studied during a 6-month period between 1992 and 1993. Patients < 16 yrs of age and patients dying within the first 6 hrs were excluded from the study., Measurements and Main Results: We collected data on age, gender, type of diagnosis at the time of admission, severity level by Acute Physiology and Chronic Health Evaluation (APACHE) II and III, quality of life survey score, therapeutic activity during the first 24 hrs by Therapeutic Intervention Scoring System, and ICU and hospital mortality rates. In the sample of patients, 12.5% were > 75 yrs of age. Compared with younger patients, these patients had higher APACHE II (18.41 +/- 0.23 vs. 15.14 +/- 0.09 points, p < .001) and APACHE III (65.8 +/- 0.81 vs. 53.32 +/- 0.33 points, p < .001) scores, a higher quality of life survey score (i.e., worse quality of life, 7.19 +/- 0.19 vs. 3.86 +/- 0.05 points, p < .001), and a greater ICU mortality rate (21.9% vs. 15.3%, p < .00001) and hospital mortality rate (30.8% vs. 19.3%, p < .00001). However, patients > 75 yrs had a lower Therapeutic Intervention Scoring System score (19.83 +/- 0.28 vs. 21.17 +/- 0.12 points, p < .001). Multivariate analysis showed that once severity, need for mechanical ventilation, diagnostic group, and mortality rate were taken into account, there was less therapeutic activity in patients > 75 yrs of age., Conclusions: Patients > 75 yrs of age represent a large proportion of patients in Spanish ICUs. Although their mortality rate and severity scores were higher than those values in younger patients, patients > 75 yrs of age received less therapy.