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The Royal Artillery Factory of Seville in Spain originated from pre‐existing private bronze foundries dating from the 16th century. The paper analyses the stratigraphy of wall cladding in the areas traditionally known as the 'Old Foundry' and the 'New Foundry', through its characterization by optical microscopy, scanning electron microscopy with energy‐dispersive X‐ray spectrometry (SEM‐EDX), micro‐X‐ray fluorescence (μ‐XRF) and micro‐X‐ray diffraction (μ‐XRD), in order to analyse the metal deposits that have accumulated since the 17th century. The data obtained allowed the verification of the available historiographical information and the location of the original bronze smelting furnaces. The analysis of patinas deposited on the overlapping layers of lime also confirmed that neither the raw materials nor the composition of the alloys used presented any substantial changes. [ABSTRACT FROM AUTHOR]

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Introduction: Greater understanding of the prevalence and incidence of multiple sclerosis in Spain and their temporal trends is necessary to improve the allocation of healthcare resources and to study aetiological factors., Methods: We performed a systematic search of the MedLine database and reviewed the reference lists of the articles gathered. We collected studies reporting prevalence or incidence rates of multiple sclerosis in any geographical location in Spain, with no time limits. In 70% of cases, data were extracted by 2 researchers (FGL and EAC); any discrepancies were resolved by consensus., Results: We identified 51 prevalence and 33 incidence studies published between 1968 and 2018. In the adjusted analysis, the number of prevalent cases per 100 000 population increased by 26.6 (95% confidence interval [CI], 21.5-31.8) every 10 years. After adjusting for year and latitude, the number of incident cases per 100 000 population increased by 1.34 (95% CI, 0.98-1.69) every 10 years. We observed a trend toward higher prevalence and incidence rates at higher latitudes., Conclusions: The prevalence of multiple sclerosis in Spain has increased in recent decades, although case ascertainment appears to be incomplete in many studies. Incidence rates have also increased, but this may be due to recent improvements in the detection of new cases., (Copyright © 2022 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To determine the prevalence of chronic pelvic pain (CPP) symptoms and associated risk factors in Spanish women., Design: A cross-sectional study., Setting: in Malaga and its province in Spain., Population: women aged 18-65 years using non-probability sampling by quotas (n = 940), stratified by age and county., Materials and Methods: All the participants completed the CPPQ-Mohedo, a self-administered validated questionnaire able to discriminate between patients with and without CPP., Results: Taking a CPPQ-Mohedo score of > or = 6 as an indication of CPP symptoms, the prevalence of CPP symptoms was 26.8% in the general population in women aged 18-65 years. After adjustment for age, those women who exercised had a lower CPPQ-Mohedo score than those who did not exercise (mean difference -3.02 +/- 4.27). Higher (worse) scores were associated with the following factors: lifting and/or moving heavy loads during activities of daily living (3.57 +/- 4.51), laxatives and/or a high-fiber diet (4.71 +/- 5.07), history of recurrent urogenital infection (vulvovaginitis, cystitis; 4.40 +/- 5.22), pelvic trauma (4.77 +/- 4.55), irritable bowel (5.10 +/- 5.50), anal fissure (7.46 +/- 6.50) or uterine prolapse (13.66 +/- 2.36)., Conclusions: The prevalence of CPP symptoms in Spanish women is high and is associated with risk factors that should be addressed by multidisciplinary preventive, diagnostic, and therapeutic strategies. More prevalence studies are needed to determine the true situation concerning chronic pelvic pain in Spain.

Introduction: Minor Surgery is an ever-increasing programmed activity in Primary Health Care Centres. The aim of this paper is to determine the relationship between the clinical diagnosis prior to Minor Surgery and its concordance with the histological results., Material and Methods: We carried out a retrospective study using the registered activity log in a Primary Health Care Centre in the region of Valdejalón of Aragón., Subjects: A total of 1231 patients were included between April 1999 and June 2009. A total of 1391 diagnoses were given, together with the corresponding medical care., Measurements: Clinical diagnosis and histological results, and the level of correlation between both., Results: A total of 820 samples were submitted for histological study (59% of the total sample). Eleven of the main clinical and histological diagnoses were evaluated, and a contingency table was prepared. The result of the correlation gave a Kappa coefficient of 0.638., Conclusions: Once the results were analysed and compared to similar studies of Minor Surgery carried out in Primary Care, our results confirm that there is a high correlation between the clinical diagnosis and the histological results., (Copyright © 2011 Elsevier España, S.L. y SEMERGEN. All rights reserved.)

Background: Technical and medical advances over the past few years have produced an important increase in the functionality of renal allografts. The aim of this study was to identify the factors associated with allograft survival 15 years after transplantation in our series., Methods: A retrospective study of kidney transplantations was carried out at Reina Sofia Hospital in Cordoba from February 1979 to December 1997, with follow-up through June 2012. A subanalysis of the series was undertaken, and Kaplan-Meier analysis and Cox proportional hazards model regression used to achieve the main objective of the study., Results: A total of 487 renal allografts with a mean follow-up of 114 months were studied, of which 37% (n = 180) survived for >15 years. Of the 180 patients, the main causes of graft failure were chronic allograft nephropathy in 29 (66%) and patient death in 13 (29.5%). Multivariate analysis identified the number of HLA mismatches (hazard ratio [HR] 1.25, 95% CI 1.01-1.56), panel reactive antibodies (HR 2.61, 95% CI 1.28-5.26), and delayed graft function (HR 11.25, 95% CI 1.33-95.28) as being significantly associated with graft loss after 15 years., Conclusions: The high immunologic risk of the patients was independently associated with graft loss. Delayed graft function was the most important factor in the speed of graft failure beyond 15 years., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Non-compliance is a common cause of failed medical action, contributing to absence of regular check-ups. Our group has already published studies that analyse the level of non-compliance with appointments amongst patients attending our Allergology clinic, and we have made proposals for improvement., Objective: This article evaluates the results obtained three years after setting up and launching telephone reminders for patients' first appointments., Methods: All patients who were given appointments for first and subsequent visits during 2005 were included. A total of 18215 appointments were studied (3115 first appointments and 15100 subsequent ones). Of these, there were 2479 missed appointments (438 first appointments and 2041 subsequent ones), corresponding to 2215 patients (412 first visits and 1803 subsequent ones), with a mean of 1.12 appointments/patient/year., Results: The non-compliance rate was 13.61%. The most common non-compliers were men (14.11% missed appointments against 13.24% missed appointments in women) and in the age range 20-29 years and 30-39 years (16.46% and 15.28% non-compliance, respectively). The mean age of non-compliers was 34.55 +/- 14.73 years. We observed a significant number of patients who missed more than one appointment (5.12% of all non-compliers and 0.7% of all patients). Differences were found in the degree of non-compliance depending on the type of appointment (14.06% non-compliance with first visits and 13.52% with subsequent visits). We observed a significant increase in missed appointments during the Summer holidays; July and August showed the highest percentage of missed appointments for both the first visit (20.62% in July and 23.59% in August) and subsequent visits alike (16.14% in July and 14.23% in August)., Conclusions: A slight reduction in non-compliance was observed after implementing the proposals made in our previous study. In view of the high costs incurred from missed appointments, the government should finance studies to reduce this problem. The causes of non-compliance may be difficult to control, including present access to the public health service. We must be alert to and/or take preventive measures in young patients and cases of previous non-compliance. The degree of non-compliance is a quality indicator, because it reduces the yield of appointments, and it evidences a lack of cohesion of patients with Primary Health Care Units for first appointments, and with Specialist Care Units for subsequent appointments. Once certain levels of attendance have been attained, it is difficult to achieve an effect on this point in order to improve attendance rates.

The effect of restricted feeding schedule was investigated on the seasonal shifting of daily demand-feeding pattern and food anticipatory activity in European sea bass (Dicentrarchus labrax) held under natural environmental conditions in an outdoor laboratory. To that end, demand-feeding behavior was continuously monitored for approximately one year in four groups of 15 fish each exposed to natural fluctuations of water temperature (from 13.2 degrees C to 27.4 degrees C) and photophase (from 9.5 h to 14.5 h of light). When the animals were subjected to a time-restricted feeding schedule, the demand-feeding rhythm rapidly synchronized to the three periods of food availability: the first meal (FM) from 08:00 to 09:00 h, the second meal (SM) from 16:00 to 17:00 h, and the third meal (TM) from 00:00 to 01:00 h. The occurrence of demand-feeding activity into the three periods of food availability displayed a double seasonal shift: fish that self-fed mostly during the daytime periods of feeding availability (FM and SM) in summer and autumn changed to nocturnal feeding (TM) from December to April, returning to diurnal preferences in April. Food-demands appeared to be predominantly associated with feed availability, reaching its maximum levels during the hours of reward. In addition, feeding anticipatory activity (FAA) was observed. A relationship was detected between the duration of FAA and feeding-time, with shortest FAA (30-60 min) when mealtime occurred just after sunrise (FM) or sunset (TM). These findings demonstrate the ability of sea bass to self-feed under time-restricted schedules, and show a seasonal-phase inversion in demand-feeding activity in spite of the restrictions in their feeding availability. Sea bass can use external signals as reference to anticipate the time of feed availability. This information may be useful for designing new feeding strategies for European sea bass fish farming.

Objective: We studied the epidemiological characteristic of tuberculosis in Lorca area, drug resistant and the effect of the immigration population (Ecuador) in this area., Patients and Methods: A retrospective study for six years ago (1999, January to 2004, December) was realized. Epidemiological data, initial diagnostic probability, mycobacteria stain and cultive, drug resistance, treatment response, and epidemiological differences between immigrants and spain population were compared., Results: Within 158 cases registered, 41.7 percent were immigrants with less than one year in Spain, the most part Ecuador population. We observed that extrapulmonar tuberculosis was lower initial diagnostic probability than pleural disease as well too haemoptisis, pleural pain and weight loss. It was identified positive micobacterial stain in 35.4 percent of respiratory samples. It was successfully results in 74 percent of cases and 13.9 percent of patients were lost, this result was frequently registered in immigrants, The isoniazide resistant in patients with not previous treatment was 5.3 percent and it was 9.5 percent in immigrants and 10.8 percent in Ecuador population., Conclusion: It is necessary improve: the diagnostic of extrapulmonar tuberculosis and avoid loss patient by programs of capture and then the successfully treatments raise. The isoniazide resistant in this area suggest that we must use initial four drug than tree and this manner not raise the drug resistant in the area.

A method has been developed for the simultaneous determination of paraquat (PQ), deiquat (DQ), chlormequat (CQ) and mepiquat (MQ) in water samples by liquid chromatography (LC) coupled with electrospray ionization mass spectrometry (MS). The LC separations of the target compounds, as well as their MS parameters, were optimized in order to improve selectivity and sensitivity. Separation was carried out in a Xterra C8 column, using as mobile phase methanol-heptafluorobutyric acid (HFBA) in isocratic mode. The molecular ion was selected for the quantitation in selected ion monitoring (SIM) mode. Off-line solid-phase extraction (SPE) was applied with silica cartridges in order to preconcentrate the compounds from waters. Detection limits were in the range 0.02-0.40 microg l(-1). Recovery range varied between 89 and 99.5% with precision values lower than 6%. The method has been applied successfully to the analysis of both surface and groundwater samples from agricultural areas of Andalusia (Spain), using well defined internal quality control (IQC) criteria. The results revealed the presence of deiquat and paraquat in some samples.

Water quality assessment in the Aznalcollar area was attempted using multivariate methods based on heavy metal concentrations in red swamp crayfish (Procamburus clarkii). Trace levels of four heavy metals, copper (Cu), zinc (Zn), cadmium (Cd) and lead (Pb), were detected in crayfish from eleven different stations. Principal component analysis (PCA) highlighted a gradient of contamination between the sampling stations. Cluster analysis (CA) distinguished three groups of stations. Discriminant analysis also differentiated three groups. The group centroids of the first discriminant function were used to devise an index that varies according to the source of the crayfish. These standardized values are proposed for use as a water quality index. The ability of this index to successfully predict environmental quality was proved with random samples.

Clinical practice is supposed to be evidence-based but it always conveys underlying values, judgements, moral principles or axioms. We explore the evidence-based nature of clinical practice in the fast-changing field of kidney transplantation and its relationship with values in five different interventions: those well supported on evidence, focussed on the use of immunosuppressant drugs like cyclosporine, mycophenolate mofetil and tacrolimus, and the elective withdrawal of cyclosporine or steroids; disputable interventions where evidence, focussed on anti-lymphocyte antibodies, is strong but not strong enough to be applied on the majority of occasions; interventions not supported by randomised controlled trials with focus on primary treatment of vascular graft rejection and rescue treatment for acute graft rejection; interventions not widely applied despite strong evidence from sources other than randomised controlled trials, with focus on HLA-matched kidney transplants in cadaver donor and living donor transplants; and finally, a variety of interventions when evidence is lacking. Being aware of the factors influencing every clinical decision we can make the strength of evidence and the nature of the values underlying them explicit and we will find it easier to improve the process of transferring evidence into practice and openly face and acknowledge the values involved.

Objective: To know the present situation about the follow-up of the patients with oral anticoagulant therapy (OAT) in primary care centers, the difficulties felt in its implantation and the professionals attitudes., Design: Cross-sectional descriptive study., Setting: All Spanish primary care centers., Participants: The study subjects are the managers of all primary care centers. We selected a sample of 227 centers (the total number is 1854), for prevalence of 50%, confidence at 95%, precision 7% and 30% loss. The sample is stratified by regions., Measurements and Main Results: We sent a questionnaire by post to the managers of sample primary care centers. We sent a new mailing, after three months, to the "no answers". A rate of 72.7% answers were obtained. 23% of sample primary care centers do follow-up of OAT al less in a part of the patients. Reduced access to hospital is the only structural cause that it has influence significantly. The main problem to carry out this activity is coordination with Haematology reference service., Conclusions: One every four Spanish primary care centers make the follow-up of OAT, higher when primary care centers are far away from hospital. So, accessibility is the factor with more influence in the decision of carry out OAT follow-up. Coordination with haematology services is the main problem to solve.

Background: The objective of this study was to describe the profile and evolution of accidents involving risk of transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) reported in a large Spanish hospital, together with the preventive measures administered and the factors associated with high-risk accidents., Methods: Data used were the accidents recorded in the hospital during the period from January 1989 to December 1995. A logistic model, using age, gender, service, occupation, and year of accident as independent variables was constructed to study the factors associated with these accidents., Results: The study included 1,009 accidents. Accidents were more common among nurses, female doctors, younger workers, and persons who worked in surgical settings. Of the total sources of infection studied, 11.6% were positive for HBV, 28.2% for HCV, and 24.4% for HIV. No seroconversions were detected in the partial follow-ups conducted. The factors associated with high-risk accidents were gender (relative risk [RR], 2.01; 95% confidence interval [CI95], 1.24-3.60); occupation as physician (RR, 2.57; CI95, 1.54-4.29) or as nursing staff (RR, 1.80; CI95, 1.12-2.89); and working in a surgical service (RR, 2.01; CI95, 1.27-3.18). Younger workers had more accidents overall, but older workers were more likely to have high-risk exposure. In the multivariate analysis, the occupation (physician and nursing staff) was the most important variable when adjusted by the other factors., Conclusions: Our results suggest that a greater effort still is required in the application and evaluation of preventive measures. New safety systems, with clearly proven cost-effectiveness, should be developed and applied.

Objective: To adapt the telephone interview for cognitive status using the Mini Mental Status Examination as criterium validity, replicating the original development of the test., Design: A quasi-experimental study with independent groups, and a correlational study between both tests and test-retest. SITE. Granada City., Participants: 62 Older population in chronic attention programs of Health Center 15 of them with dementia diagnosis., Measurements and Main Results: Significant statistical differences were found in test scores for dementia patients group, a mild criterium validity (0.65), a high feasibility (0.83) and sensibility (0.77) and a mild specificity (0.60). A significant statistical difference was found between Spanish and USA control groups scores., Conclusions: The adaptation of the test was done and it seems an useful test in dementia studies but is necessary to replicate and more studies about the test.

Background: In Spain since 1982 laws require that clinical trials involving drugs be approved before implementation. We studied the impact of regulations on the quality of published trials., Methods: Four sets of trials were chosen: trials implemented after 1982 and registered as approved; trials implemented after 1982 but not registered; trials implemented before 1982; and trials conducted outside Spain. Trials were identified via MEDLINE, EMBASE, and Indice Médico Español. Sets were compared with regard to indicators of quality, as obtained from the information in the published reports. The comparison was based on a total of 273 Spanish trials published between 1988 and 1990, 85 approved and 188 unregistered; 97 old trials, published between 1980 and 1982; and 152 non-Spanish trials published between 1988 and 1990., Results: Approved trials, compared to their unregistered and old counterparts, were more often informed randomised, more of their published reports included lists of reasons for exclusions and information on consent and achieved higher scores of a quality index. Approved trials, compared to non-Spanish trials, had lower proportion of sample size justification, greater discrepancies between randomised and analyzed cases and a trend to lower quality scores. Multiple logistic regression analysis of quality scores showed that approved trials had higher scores than unregistered trials when single-centre trials (odds ratio for reaching scores in the upper quartile: 2.90; 95% confidence interval: 1.27 - 6.64) and similar when multicentre trials., Conclusions: Approved trials achieved better indicators of quality than unregistered trials but did not achieve the standards of quality prevailing in the international community.