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Sediment samples have been collected in the Guacanayabo gulf located in the southeast Cuba, to determinate the radioactivity levels of 210Pb, 234Th, 214Pb, 137Cs, 232Th and 40K using Low‐Background Gamma Spectrometry and to evaluate its impact in the habitat of important marine species for fishery industry. The obtained results show the lowest radioactivity levels determined in Cuban marine environments. The species capture declination in the last years is not originated by radioactive pollution of the zone.

Textos de comunicaciones defendidas en la X Reunión Científica de la Fundación Española de Historia Moderna, previa evaluación ciega por pares., En nuestra comunicación abordaremos la caída en desgracia de Henri Escoubleau de Sourdis, arzobispo de Lyon y almirante de las galeras de Francia en el Mediterráneo, a causa de su controvertida actitud durante la campaña militar francesa en Cataluña en 1641, cuyo objetivo principal fue la toma de Tarragona. Escoubleau de Sourdis, personaje de primer orden en la corte de Luis XIII, y uno de los más ilustres marinos de su reinado, fue relevado de sus cargos y exiliado a Carpentras tras retirar sus navíos situados frente a Tarragona y retirarse a Francia, según la versión del mismo, para salvar la flota real. Este episodio, que marcó la primera campaña francesa en el Principado tras la proclamación de Luis XIII como conde de Barcelona, nos permitirá observar en primer lugar la conflictividad entre mandos militares durante el ocaso del régimen de Richelieu, eco de las tensiones políticas dentro del entorno cardenalicio que se mostrarían claramente tras la muerte del ministro y que constituyen un fenómeno poco estudiado de la transición entre los reinados de Luis XIII y Luis XIV. Así mismo, quisiéramos poner de relieve la importancia del dominio del mar durante la guerra hispano-francesa, sensiblemente focalizada en Cataluña, durante los años 40 y principio de los 50 del seiscientos. La atención puesta en ese acontecimiento nos permitirá también redescubrir la figura de Escoubleau de Sourdis, cuya trayectoria brillante quedó ensombrecida por el asunto de Tarragona y una muerte temprana. Con Sourdis desaparece en cierto modo la figura del prelado-soldado (aquel mismo año moría el Cardenal-Infante Don Fernando de Austria, y un año después Richelieu), característica de la Europa renacentista y barroca (especialmente durante la guerra de los Treinta Años) . Nuestra comunicación se fundará en la documentación publicada e inédita en torno a este episodio. Respecto a la primera utilizaremos la correspondencia de Escoubleau de Sourdis por Eugène Sue a principios del siglo XIX.

To determine hygienists' knowledge of and attitudes to X-ray equipment and film processing, and to assess both after a 1-day course.One-hundred and four dental hygienists from the south-east of Spain attending a 1-day course in oral radiology.A questionnaire comprising different sections related with socio-demographic items, X-ray equipment and the processing of dental films was answered before and after a 1-day pilot course on radiation protection.The response rate was 89.42% (n = 93). Of the participants 94.6% were women, with a mean age of 29.52 (SD 6.861) and 7.20 years of professional experience (SD 5.089). The level of knowledge before the course was 48.28%, which increased to 85.62% after the course (P0.001).The prescribed standard was reached by23.65% of those attending the course at the beginning. Although attending the course led to a considerable improvement, it did not always result in a high level of knowledge of basic radiation equipment and processing.

Background Advance Care Planning (ACP) helps communicate patients’ preferences, particularly for older and chronic patients. Aim To determine what was most important to patients whit End-Stage Renal Disease (ESRD), if they wanted to participate in decision-making process and what degree of functional impairment they would consider intolerable. Methods Prospective qualitative study carried out on selected ESRD patients from a dialysis unit. Two semi-structured interviews with each patient were performed, including their relatives. Results From May to November 2013 fourteen patients (9 male and 5 female) with an average age of 66 years were interviewed. They believe that the information process is adecuate, but there is no information about the plan of care if a trasplant is not a real option. Patients would like to participate in decisions concerning their care and end-of-life. They would want to keep on with dialysis treatment while their quality of life continues to be acceptable for them. Respecting end-of-ife care, dying without pain and to be cared for at home are the most important points for them. Patients think that doctors don’t speak to them about end-of-life because they are focused on other aspects of care. Conclusion Although there are great opportunities to talk with ESRD patients about end-of-life care this is often not done. In cases with severe cognitive impairment they would prefer to withdraw dialysis. Then they wish to receive care at home to relieve suffering or pain. The best way to achieve this is by integrating palliative care into dialysis units.

Introduction First described as a case series by Pryse-Phillips in 1971, Olfactory Reference Syndrome (ORS) has been increasingly reported in the scientific literature. Although current classifications do not consider ORS as a unique clinical entity, its existence is widely acknowledged. Different approaches to treatment have been described. Objectives 1) Portray the clinical features and treatment response of a patient with ORS. 2) Summarize knowledge on different treatment options for ORS. Aims We present the case of a teenager with major depressive disorder who developed the delusional belief of emitting a foul smell (without any other psychotic symptoms), and report his response to antidepressants and cognitive-behavioral therapy. Subsequently, we embark on a literature review on pharmacological and non-pharmacological options for patients with ORS. Methods We conducted a literature review in different databases using the keyword 'olfactory reference syndrome'. Papers published from 1971 to 2014 were selected on the basis of availability, relevant information in the title/abstract, and language (English, Spanish or Portuguese). Results A brief summary is presented on the treatment options found in selected papers. Conclusions Different treatment approaches have proven beneficial for patients with ORS. This may reflect, however, a diversity of mechanisms by which this ailment is generated. More research on the physiopathology of ORS might result in better treatment outcomes.

La trajectòria d’un dels primers virreis francesos de Catalunya, Philippe de La Mothe-Houdancourt (1605-1657), ens guiarà en la nostra aproximació a les entrecreuades relacions entre França, Catalunya i Espanya durant el primer període de dominació francesa del Principat. Militar brillant, virrei de Catalunya entre 1642 i 1644 i primat de la noblesa catalana en la seva qualitat de duc de Cardona, presoner d’estat, frondeur i novament virrei entre 1651 i 1652: aquestes són les diferents vessants del personatge. Al present article ressaltem l’univers de relacions dinàstiques i clientelars al centre del qual es situa el que fou el més important dels virreis francesos de Catalunya. Un virrei a caball de dos regnats i especialment durant el ministeri de dos cardenals, Richelieu i Mazarí. El nostre estudi es limita als anys del primer mandat del mariscal de La Mothe, aproximadament des de la seva designació com a general en cap de l’exèrcit francès a la província, al gener de 1641, fins a la seva destitució al desembre de 1644, a la que van seguir la seva detenció, empressonament i procès., The life story of one of the first French viceroys of Catalonia, Philippe de La Mothe-Houdancourt (1605-1657), will guide us in our study of the intertwined relations among France, Spain, and Catalonia during the first period of the French domination over the Principality A brilliant military man, the viceroy of Catalonia between 1642 and 1644, the head of the Catalan nobility as duke of Cardona, a state prisoner, frondeur and once again viceroy from 1651 to 1652: these are some of the traits of this figure. In this article we emphasize the dynastic relations and clientelism whose center laid on that most important of French viceroys of Catalonia. He was viceroy in the turn of one reign to another and, specially important, during the ministries of Richelieu and Mazarin. Our study covers the years of his first tenure, roughly from his appointment as general-in-chief of the French army in the province in January 1641 to his dismissal in December 1644, which was followed by his arrest, incarceration and trial.

Summary Background : Atherosclerotic ischaemic heart disease is the second leading cause of general mortality in Mexico due to the growing prevalence of atherosclerotic risk factors in our society. The data of the FRIMEX study (Factores de Riesgo en Mexico, Risk Factors in Mexico), considered together with those of other contemporary epidemiological surveys, will aid in our comprehension of the current state of cardiovascular epidemics in Mexico. Methods : Frequencies of obesity, hypertension and smoking, and total cholesterol and glucose in capillary blood were estimated in a non-probabilistic sample comprised of 140017 individuals (aged 44±13 years; 42% men and 58% women), from six Mexican cities (Mexico City, Guadalajara, Monterrey, Puebla, Leon and Tijuana). Results : Obesity or overweight status was found in 71.9% of participants. Hypertension was found in 26.5%, and the proportions of awareness, treatment and control for this disease were 49.3, 73 and 36%, respectively. Prevalence of hypertension increased with age; while it was higher in men under 60 years of age, in the more aged individuals it was higher in women. Hypercholesterolaemia was found in 40% of the individuals and cholesterolaemia ⩾240mg/dl was significantly higher in women. Thirty-five and a half percent of men and 18.1% of women were smokers. Type 2 diabetes mellitus was found in 10.4% of participants. There was significant Pearson's correlation between body mass index and blood pressure, between hypertension and glucose levels, and between hypertension and total cholesterol concentrations. Conclusions : We conclude that this population has a high cardiovascular risk profile and a high probability of the occurrence of metabolic syndrome.

Several modifications to the cryogenic protocols previously described for pineapple apices were performed using vitrification and encapsulation-vitrification. Pregrowth of apices in sucrose-proline before loading significantly reduced the exposure duration to PVS2 and PVS3 required for successful cryopreservation. Encapsulation and treatments with PVS3 at 0 degree C gave the highest survival before and after cooling. Optimal conditions involved the encapsulation of pineapple apices in calcium alginate (3 percent) followed by a 2-d preculture in liquid medium with 0.16 M sucrose + 0.3 M proline for 24 h and then transfer to 0.3 M sucrose + 0.3 M proline for an additional 24 h. After preculture, samples were loaded in 0.75 M sucrose + 1 M glycerol solution at room temperature (25 min) and dehydrated with PVS3 at 0 degree C for 60 min before immersion into liquid nitrogen. Following this procedure 54 percent and 83 percent of apices from MD-2 and Puerto Rico varieties respectively survived.

El objetivo de este estudio fue determinar las caracteristicas de la radiologia dental en la Comunidad Autonoma de Murcia, con el proposito de poder evaluar el grado de cumplimiento de las recomendaciones Oficiales de la Union Europea. Para ello se estudian 1822 informes oficiales de control de calidad en radiodiagnostico dental intraoral y 157 pertenecientes a examenes panoramicos durante cinco anos consecutivos. Los resultados obtenidos ponen de manifiesto que un tercio de los equipos dentales intraorales revisados presentan averias en su funcionamiento y un 6?24% en el caso de los panoramicos. Solamente un 63.54% de las instalaciones intraorales cumplirian con las recomendaciones oficiales al emplear equipos modernos que funcionan a 70 kVp, 8 mA, 20 cm. de distancia foco piel y 1.5 mm de Al. Se ha producido un descenso del 11.53% en las dosis medias administradas a lo largo del estudio, aumentando la empleada con aparatos panoramicos. La entrada en vigor de esta nueva legislacion ha supuesto un descenso en las dosis medias de radiacion administradas a los pacientes tras los cinco anos de evolucion analizados aunque se sigue incumpliendo las recomendaciones oficiales europeas sobre Proteccion Radiologica.

To assess the influence of new European Union (EU) legislation on dental radiology practices and the reduction in patient radiation exposure.A total of 7176 official reports from Spanish dental offices or clinics covering the period 1996 to 2001 were analyzed.Of the dental radiological installations inspected in 2001, 72.79% used the kilovoltage recommended by the EU (70 kVp) and 98.85% used at least 1.5 mm Al filtration. At least 90.11% of the installations had a focal film distance of 20 cm although there were no cases with a rectangular collimator as adapted to the size of film. Thirty percent of the installations showed a mechanical fault every year. In 17.62% of cases the radiological film was stored in the exposure room. Few clinics (10.24%) used high-speed films and only 11.95% of clinics employed digital systems. The mean dose received by patients fell during the 5 years studied by 18.75%. Radiological equipment fulfilling the EU specifications emitted significantly lower doses than other nonapproved equipment.The introduction of legislation has resulted in a gradual improvement in dental radiology practices.

This study concerned the anaerobic treatment of five different industrial wastewaters with a diverse and complex chemical composition. The kinetics of biotransformation of this wastewater at different chemical oxygen demand (COD) were studied in a batch reactor. Wastewater from an amino acid producing industry (Fermex) and from a tank that received several types of wastewaters (collector) contained 0.83 g l(-1) and 0.085 g l(-1) sulfate, respectively. During the study period of 20 days, methane formation was observed in all types of wastewaters. Studies on COD biodegradation showed the reaction velocity was higher for Fermex wastewater and lower for collector wastewater, with values of 0.0022 h(-1) and 0.0011 h(-1), respectively. A lower methanogenic activity of 0.163 g CH4 day(-1) g(-1) volatile suspended solids (VSS) and 0.20 g CH4 day(-1) g(-1) VSS, respectively, was observed for paper producing and brewery wastewater. Adapted granular sludge showed the best biodegradation of COD during the 20-day period. The sulfate-reducing activity in pharmaceutical and collector wastewater was studied. A positive effect of sulfate-reducing activity on methanogenic activity was noted for both types of wastewaters, both of which contained sulfate ions. All reactions of methane generation for the tested industrial wastewaters were first-order. The results of this study suggest that the tested wastewaters are amenable to anaerobic treatment.

The ischemic stroke represents a very important cause of death in the hospitals. The clinic changes of this disease and the frequent morphological evidence in necropses motived the study of the clinicopathological concordance taking as reference two institutions of the secondary attention. The two medical centers were our study was conducted were: Dr. Gustavo Alderegu a Lima Hospital in Cienfuegos and Camilo Cienfuegos in Sancti Spiritus. These two Cuban hospital have showed necropses indicators higher than 80%.To determine the clinicopathological correlation of the ischemic stroke as evidence of the quality of the diagnoses. The influence of the age of the patient and kind of care received by the patient.A retrospective, descriptive, and correlational study where 1556 death with necropsy were evaluated. As main variables were studied the age and services where demise took place, as well as, the following indicators: observed concordance, kappa index, sensitivity, specificity, positive and negative predictive values, positive and negative similarity reasons.At ischemic cerebrovascular lesions the concordance was significant with kappa values which were not higher than 0.66 in both facilities; nevertheless, sensitivity and positive predictive value were higher in Sancti Spiritus (75.5% and 63.5%, respectively). Overall, being aged was not a motive for diagnostic discordance on cerebrovascular damages, significantly the Sancti Spiritus values in the ages group were substantial: kappa (0.70), sensitivity (80.4%), and positive predictive value (19.0). Among death from 15 thought 60 years old from Sancti Spiritus province the results of measurements of diagnostic quality were reduced comparative with Cienfuegos and overall for this age group: kappa (0.37), sensitivity (42.8%), positive predictive value (37.5%). Analysis of each services evidence reductions of sensibility up to (59.1%) at clinic services of Cienfuegos with respect to (73.6%) progressive care for ischemic cerebrovascular lesions, besides a positive predictive value of (49.4%) in progressive care, lower than the results obtained for Sancti Spiritus.The clinicopathological concordance and the rest of the quality indicators were higher in Camilo Cienfuegos Hospital in Sancti Spiritus. The age below 60 years old favoreced the diagnostic discordance in the above mentioned center. Nevertheless, patients with age over 60 years old didn t show important changes in the concordance. The quality indicators were higher in unit f intensive care respect to the clinical services. The quality in the results in the Sancti Spiritus Hospital are determined by the existence of a stroke unit

Se ofrecen algunos datos de la prevalencia del tabaquismo en el mundo, en Cuba y en la provincia, así como sus consecuencias para la salud. Se expone el vínculo directo del tabaquismo con algunas enfermedades crónicas como el cáncer de pulmón y la cardiopatía isquémica. Partiendo de que el estado cubano ha manifestado su voluntad política y jurídica orientada hacia la gradual erradicación de esta adicción, se insta a la comunidad en general a cumplir con lo legislado para su control.Some data are provided on the prevalence of smoking in the world, in Cuba and in the province as well as its consequences for health. We describe the direct link between smoking and some chronic diseases such as lung cancer and ischemic heart disease. Given that the Cuban government has expressed its political and legal will, gradually oriented to the eradication of this addiction, we urge the community to comply with legislations related to smoking control.

The study of 26 patients who required percutaneous endoscopic gastrostomy (PEG) at the Endoscopic Surgery Center of the Calixto Garc a Central University Hospital,La Habana, Cuba, is presented in this report. Sixty two percent (62%) underwent this exam due to cancerous tumors in the esophagus and the remaining to non-cancerous disorders that promoted dysphagia. The average duration of the exam was 10 minutes. Two patients reported complications after the gastrostomy: one due to the rupture of the catheter s balloon and the other due to an abscess in the puncture zone. No deaths were reported.

A descriptive study of children and adolescents that got sick with dengue in the health area served by "José Martí" polyclinics in Santiago de Cuba from May to August 1997 was conducted to determine the incidence of this affection in these age groups. It was observed that dengue was more frequent in males aged 5-11 years. Bronchial asthma, epilepsy and congenital cardiopathy were the most common previous affections found. The incidence of the disease in the casuistry was low, with well-nourished males without histories of chronic processes and good clinical recovery prevailing. Only one case was classified as hemorrhagic dengue.

Fuente TESIUNAM

To compare the perception of psychosocial conditions (during pregnancy) between two groups of adolescents; one group was integrated by young women diagnosed with pregnancy induced-hypertension and the other group by clinically healthy women.A case-control study design where 39 cases and 88 controls were chosen from pregnant adolescents seeking care at the General Hospital of Durango City, México, from July 1996 to February 1997, and from September 1998 to January 1999. Participants agreed to answer a semi-structured questionnaire to collect data on psychosocial support; psychosocial source of stress; coping responses; intention, desire and acceptance of pregnancy; and attitude and quality of socialization during pregnancy. Data analysis consisted of descriptive statistics, chi 2 and odds ratios with 95% confidence intervals.The two groups' sociodemographic and gyneco-obstetric characteristics were similar. Perception of stressors was higher among cases; sources of support were greater among controls. Positive attitudes and satisfactory socialization during pregnancy were more frequently reported by controls, with statistically significant differences between groups.We found qualitative differences in the perception of psychosocial conditions among study participants, with statistically significant favorable perceptions among controls.

The aim of the present work was to know the incidence of HIV infection in the sanitary area of León, and its tendency, throughout the period 1983-1997.A register of cases with the patients attended in the area hospitals, those detected in the Penitentiary Centre of León and notifications of cases of AIDS at a national level have been used. Only the patients residing in a municipality belonging to the area at the time of detection of the infection have been included. Age, sex, risk group, year of detection of the infection, development to AIDS and mortality were analysed. The Spearman coefficient correlation range has been used for the study of tendency.509 cases of HIV infection (374 males and 134 females) were detected in the area from 1983 to 1997. The accumulated incidence throughout the period of study was 1,368/million inhabitants. The annual incidence shows and upward phase until 1990, followed by another of plateau (1990-1993). In 1994-1995 there was a decrease, interrupted in 1996-1997. The curve as a whole doesn't reveal a descending tendency (p0.05). The annual incidence in the IDU follow a similar pattern to that of the complete group while the group of heterosexual transmission shows a tendency to increase (p0.025). 223 patients (43.8%) developed AIDS, 195 of whom we know the evolution. Of these, 139 have died and 56 are still alive.There is no evidence that the incidence of HIV infection tends to decrease in the sanitary area of León at present. This is probably related to the behaviour of the two main risk groups: a tendency to stability in the case of IDU and to increase in heterosexual transmission. It is important to insist on the prevention campaigns, especially those directed towards avoiding heterosexual transmission.

Varon de 55 anos con insuficiencia mitral leve-moderada de origen reumatico y fibrilacion auricular en tratamiento con dicumarinicos. Consulta por disnea de minimos esfuerzos de aparicion progresiva en el ultimo mes, ortopnea y episodios de disnea paroxistica nocturna. Al ingreso se encontraba hemodinamicamente estable, afebril, taquipneico a 20 respiraciones por minuto y con una saturacion basal del 81%. Los tonos cardiacos eran arritmicos y presentaba un soplo sistolico II/IV en foco mitral. Se auscultaban crepitantes hasta campos medios pulmonares, al tacto se palpaba hepatomegalia y presentaba edemas maleolares en las extremidades inferiores. El hemograma y la bioquimica basica realizada al ingreso no demostraban alteraciones significativas. Estaba correctamente anticoagulado con un INR de 2,81. Se realizo una radiografia de torax (fig. 1) y un ecocardiograma que demostro una hipertension pulmonar severa (PAP estimada de 105 mmHg) que no existia previamente y que no se justificaba por su insuficiencia mitral. Ante la posibilidad de un cor pulmonale agudo secundario a un tromboembolismo pulmonar (TEP) se realiza una gammagrafia pulmonar de ventilacion/perfusion compatible con microembolismos perifericos. Se continuo el estudio con una angio-TC pulmonar (fig. 2).

We attempted here the delineation of the natural history of the disease and corresponding prevention levels (NHD and PL) of the Wiedemann-Beckwith syndrome according to the classical model of Leavell and Clark for infectious-contagious diseases. This proposal was based on our own series of 39 patients and our previous reports on the didactics of the NHD and PL model, as well as on the relevant literature; with this approach we obtained an useful model which includes the health-disease status, the analysis of risk factors and the integration of the clinical practice with socio-epidemiological medicine. Furthermore, the NHD and PL model allow the selection of the preventive management depending on the clinical stage, namely health or disease. This approach to a Mendelian condition emphasizes that the Leavell and Clark concepts can be advantageously applied to any genetic disease.

In an article in this journal in which we reviewed the role of forced expiratory volume tests before lung resection, we stated that decisions on operability should include consideration of postoperative quality of life, especially for patients with few chances of survival. 1 In other words, is it worth performing lung resection to treat cancer, even at the risk of poor quality of life, in patients for whom expected survival time is not long? Although no study has dealt with the question as such, the literature does offer information that points toward some conclusions. Before approaching the problem it should first be emphasized that quality of life is a subjective assessment by the patient and that, based on our experience, it is a mistake to suppose what another person will think is worthwhile. For example, in patients surgically treated for lung cancer, the quality of life ratings by a psychiatrist treating the patients correlated very poorly (r=0.41) with the patients’ own ratings. 2 Before proceeding further it seems important to mention that, when consulted, many patients of the age when lung cancer is most frequent are willing to accept aggressive or toxic treatment if it prolongs survival; they usually opt to live longer even if presented with situations in which quality of life is poor due to dyspnea, immobility, or total dependence on others. That, at least, was the conclusion of a study of 388 older adult patients who chose hypothetical treatment options based on the reading of 17 situations of earlystage and advanced-stage cases. 3 One factor that seems to influence willingness to accept aggressive treatment is social well being, as subjects who considered they had a high level of social well being have been found to be more willing to undergo such treatment. 4 More to the point of the present editorial, Dales et al 5 measured quality of life before and after surgery at 1, 3, 6, and 9 months in a cohort of 117 consecutive subjects undergoing thoracotomy. Prior to surgery 14% complained of moderate or intense dyspnea; after surgery the percentage rose to 34% in the third month but dropped to 10% at 6 and 9 months. Likewise, an 11% reduction in ability to perform activities of daily living before surgery became a greater reduction of over 21% but returned to baseline at 6 and 9 months. Zieren et al 2 used the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (EORTC QLQ-C30) to evaluate quality of life in 20 patients who underwent lung resection with intention to cure. Quality of life was evaluated before surgery and every 3 months after surgery for 1 year. At discharge from the hospital the patients indicated that quality of life was several points lower than before the operation, but at 6 months they had regained baseline levels. In contrast, Handy et al 6 found that 131 patients had a poorer quality of life 6 months after lung resection than before, especially on the subscales for social functioning and pain. The authors used the Quality of Life Index and the Short-Form 36 Health Survey (SF36) before and 6 months after surgery. An interesting observation of the study was that intrahospital operative mortality was 5.8% and an additional 12.2% died in the first 6 months. Preoperative carbon monoxide diffusing capacity—but not spirometry or walk test results—was closely related to postoperative quality of life. The same study mentioned that patients were more concerned about how surgery would change their lives than about postoperative mortality. A more recent study 7 compared the quality of life results of 132 survivors of at least 1 year (23 months on the average) of surgical treatment for bronchogenic carcinoma with those of 121 patients undergoing aortocoronary surgery. The SF-36 scores of both groups were lower than the healthy population but there were no differences between them (including scores for anxiety and depression) except in the subgroup of physical function. Once again, the lowest quality of life level was at 3 months, but preoperative level was recovered by 12 months. The results of this study are somewhat surprising since one would expect higher levels of anxiety and depression associated with the pain of a lateral thoracotomy compared to a median sternotomy. 8 Nevertheless, the literature reports that surgically treated lung cancer patients rate their quality of life lower than those undergoing surgery for colon and prostate cancers. 9