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To investigate concerns surrounding the benefits of antiresorptive drugs in older adults, a systematic review was carried out to evaluate the efficacy of these treatments in the prevention of osteoporotic hip fractures in older adults.a systematic review and meta-analysis of randomized clinical trials.older adults ≥65 years with osteoporosis, with or without a previous fragility fracture. Studies with cancer-related and corticosteroid-induced osteoporosis, participants65 years and no reported hip fracture were not included.MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science and Scopus databases were searched. The primary outcome was hip fracture, and subgroup analysis (≥75 years, with different drug types and secondary prevention) and sensitivity analysis was carried out using a GRADE evaluation. Secondary outcomes were any type of fractures, vertebral fracture, bone markers and adverse events. The risk of bias was assessment with the Cochrane risk of bias tool.A total of 12 randomised controlled trials (RCTs) qualified for this meta-analysis, with 36,196 participants. Antiresorptive drugs have a statistically significant effect on the prevention of hip fracture (RR=0.70; 95%CI 0.60 to 0.81), but with a moderate GRADE quality of evidence and a high number needed to treat (NNT) of 186. For other outcomes, there is a statistically significant effect, but with a low to moderate quality of evidence. Antiresorptives showed no reduction in the risk of hip fracture in people ≥75 years. The results for different drug types, secondary prevention and sensitivity analysis are similar to the main analyses and have the same concerns.Antiresorptive drugs have a statistically significant effect on preventing hip fracture but with a moderate quality (unclear/high risk of bias) and high NNT (186). This small benefit disappears in those ≥75 years, but increases in secondary prevention. More RCTs in very old osteoporotic adults are needed.

SUMMARYOral anti-diabetic drugs (OADs) have been associated with community-acquired pneumonia (CAP). We aimed to validate the recording of CAP in the Spanish Database for Pharmacoepidemiological Research in Primary Care (BIFAP) for the future evaluation of OAD–CAP association. The incidence rate (IR/1000 person-years) of CAP in type 2 diabetes mellitus (T2DM) was also determined. In total, 2966 pneumonia records (2040 listed as diagnosis and 926 as identified from comments added by physicians) were identified from 76 009 patients with T2DM after the first OAD in 2002–2013. Data around the CAP date were reviewed: 1803 (60·9%) were classified as ‘probable CAP’ (confirmed by X-ray/laboratory, referral letters or CAP lung site); 589 (19·8%) as ‘no-case’ (486 had other illness, 78 previous CAP, 25 cancer); and 574 (19·4%) as ‘possible CAP’ (441 without confirmatory information, 133 with uncertain diagnosis or uncertain diagnosis date). In total, 74·2% and 31·4% of pneumonia records in the diagnosis and comments, respectively, were ‘probable cases’ (IR: 6·04), which increased to 90·5% and 42·9%, respectively, when the 441 ‘possible cases’ without confirmatory information were included (IR: 7·52). In summary, diagnosis had a high positive predictive value, and adding cases automatically detected from comments decreased that value significantly.

23 paginas.-- 10 figuras.-- 6 tablas.-- 88 referencias.-- Supporting information Additional Supporting Information may be found in the online version of this article at the publisher’s web-site: http://dx.doi.org/10.1111/1462-2920.13380

El libro contiene las comunicaciones y pósters presentados en el The third International congress of Science and Technology for the Conservation of Cultural Heritage, TechnoHeritage 2017, was held in Cadiz, from 21 to 24 May 2017, under the umbrella of the TechnoHerita, The first tomb of a Roman Necropolis in the area of Carmona (Seville, Spain) was accidentally discovered in 1830. Few more tombs were exhumed between 1868 and 1869. These tombs were plundered until the beginning of the archaeological excavations in 1882. This necropolis, located in the town of Carmona, represents one of the most significant Roman burial sites in Southern Spain, and was in use during the 1st and 2nd centuries AD. Initially, the necropolis was used as quarry from which stone blocks were extracted and used for building construction. The quarry was then abandoned and reused as necropolis due to the workability of the rock. The Necropolis has suffered numerous and extensive interventions since its discovery. The first one was the adaptation of the necropolis for visits in 1885, including the construction of a trail, design of gardens around the tombs and plantation of trees. Nowadays, the gardens are considered one of the most deteriorating factors affecting the conservation of the tombs due to irrigation and consequent percolation of water inside the tombs, in addition to the damage caused by roots. Taking into account the cultural, artistic and religious importance of the Necropolis of Carmona, its preservation and conservation are a major issue, both from cultural and economic points of view. This importance emphasizes the need to define accurate and sustainable intervention protocols based on a deep understanding of the environmental and/or anthropogenic-induced deterioration processes. The design of effective preservation and/or conservation strategies should be based on exhaustive in situ surveys and laboratory investigations. Here we review 10 years of research in the Necropolis and we focus on the Circular mausoleum, as a case study, including an assessment of its conservation state, and the identification of the main deteriorating agents. In addition, an intervention proposal for the preservation of the Circular Mausoleum was presented.

Background-The usefulness of cardiovascular disease (CVD) predictive equations in different populations is debatable. We assessed the efficacy of the Framingham-REGICOR scale, validated for the Spanish population, to identify future CVD in participants, who were predefined as being at high-risk in the PREvención con DIeta MEDiterránea (PREDIMED) study-a nutrition-intervention primary prevention trial-and the impact of adherence to the Mediterranean diet on CVD across risk categories. Methods and Results-In a post hoc analysis, we assessed the CVD predictive value of baseline estimated risk in 5966 PREDIMED participants (aged 55-74 years, 57% women; 48% with type 2 diabetes mellitus). Major CVD events, the primary PREDIMED end point, were an aggregate of myocardial infarction, stroke, and cardiovascular death. Multivariate-adjusted Cox regression was used to calculate hazard ratios for major CVD events and effect modification from the Mediterranean diet intervention across risk strata (low, moderate, high, very high). The Framingham-REGICOR classification of PREDIMED participants was 25.1% low risk, 44.5% moderate risk, and 30.4% high or very high risk. During 6-year follow-up, 188 major CVD events occurred. Hazard ratios for major CVD events increased in parallel with estimated risk (2.68, 4.24, and 6.60 for moderate, high, and very high risk), particularly in men (7.60, 13.16, and 15.85, respectively, versus 2.16, 2.28, and 3.51, respectively, in women). Yet among those with low or moderate risk, 32.2% and 74.3% of major CVD events occurred in men and women, respectively. Mediterranean diet adherence was associated with CVD risk reduction regardless of risk strata (P > 0.4 for interaction). Conclusions-Incident CVD increased in parallel with estimated risk in the PREDIMED cohort, but most events occurred in non- high-risk categories, particularly in women. Until predictive tools are improved, promotion of the Mediterranean diet might be useful to reduce CVD independent of baseline risk., This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission

El levante de la peninsula Iberica ha registrado una sequia extrema desde la primavera de 2013, dando lugar a un profundo deterioro del estado fitosanitario de los pinares valencianos. Esta situacion ha supuesto un aumento de la disponibilidad de material hospedante para insectos perforadores, entre ellos Tomicus destruens. El control de estos insectos se basa en dos herramientas de gestion: los puntos cebo y las trampas cebadas con atrayentes feromonales y cairomonales. Tradicionalmente los puntos cebo han sido utilizados como herramienta en la gestion de los focos de T. destruens, pero su elaboracion es costosa y su manejo complicado. En los ultimos anos se han comercializado atrayentes cairomonales para ser utilizados en trampas como alternativa eficaz a las pilas cebo. Durante el periodo 2014-2015 se comparo la eficacia en la extraccion de T. destruens entre puntos cebo y trampas (Crosstrap® y multiembudos) cebadas con atrayentes cairomonales (etanol y α- pineno) en tres zonas de la provincia de Valencia, con el objetivo de mejorar la gestion. Las trampas resultaron mas eficaces en la atraccion y captura de T. destruens que los puntos cebo.

Rising levels of atmospheric CO2 are responsible for a change in the carbonate chemistry of seawater with associated pH drops (acidification) pro-jectedtoreach 0.4 units from 1950 to 2100. We investigated possible indirect effects of seawater acidification on the feeding, fecundity, and hatching success of the calanoid copepod Acartia grani, mediated by potential CO2-induced changes in the nutritional characteristics of their prey. Weused as prey the autotrophic dinoflagellate Heterocapsa sp., cultured at three distinct pH levels (control: 8.17, medium: 7.96, and low: 7.75) by bubbling pure CO2 via a computer automated system. Acartia graniadults collected fromalaboratory culture were acclimatized for 3d at food suspensions of Heterocapsa from each pH treatment (ca. 500 cells ml-1; 300 μg C l-1). Feeding and egg production rates of the preconditioned females did not differ significantly among the three Heterocapsa diets. Egg hatching success, monitored once per day for the 72 h, did not reveal significant difference among treatments. These results areinagreement with the lack of difference in the cellular stoichiometry(C: N,C: P, and N: Pratios) and fatty acid concentration and composition encountered between the three tested Heterocapsa treatments. Our findings disagree with those of other studies using distinct types of prey, suggesting that this kind of indirect influence of acidification on copepods maybe largely associated with interspecific differences among prey items with regard to their sensitivity to elevated CO2 levels. © International Council for the Exploration of the Sea 2015. All rights reserved.

Resumen Fundamento y objetivo El presente trabajo de investigacion pretende relacionar los eventos adversos (EA) asociados a la asistencia sanitaria con otro indicador de calidad asistencial como es la mortalidad hospitalaria, determinando la proporcion de fallecidos en los que esta presente algun EA y que factores se asocian a una mayor proporcion de EA en personas fallecidas. Material y metodos Inicialmente se realizo un estudio descriptivo de mortalidad de base hospitalaria, seguido de un estudio de casos y controles en pacientes fallecidos. Se estudio la presencia de EA, la probabilidad con la que se hubieran podido prevenir y predecir y su asociacion con diversos factores. Resultados La proporcion de EA encontrada fue del 19,8% (82/414), siendo la proporcion de pacientes fallecidos que padecio algun EA del 15,5% (64/414). La razon de EA por persona era de 1,28. El EA mas frecuente fue la infeccion nosocomial. El 48,8% de los EA eran prevenibles. No se ha encontrado una diferencia en la presencia de EA por edad ni por sexo. Entre los factores que se asociaron a la presencia de EA destacan la intervencion quirurgica, la estancia y el tipo de servicio en el que estaban ingresados los pacientes. Discusion La proporcion de pacientes fallecidos con EA, el porcentaje de EA prevenibles, el tipo mas frecuente (la infeccion nosocomial) y la relacion de la estancia y la intervencion quirurgica con su presencia, nos hacen centrar la atencion en el desarrollo de medidas que reduzcan la estancia hospitalaria y en la difusion de las medidas de prevencion y control de la infeccion nosocomial.

La gastropatia por antiinflamatorios no esteroideos (AINE) es una patologia frecuente que debemos tener en cuenta ante todo paciente que nos consulte por problemas de dispepsia o astenia de larga evolucion. Actualmente se cifran en 16.500 las muertes anuales por complicaciones por el consumo de estos farmacos y en mas de cien mil, los ingresos hospitalarios anuales, datos que pueden darnos una idea de la verdadera importancia del problema. Los factores de riesgo implicados mas frecuentemente y que siempre debemos tener en cuenta son la edad (mayor de 65 anos), la toma conjunta de mas de un AINE, la toma de anticoagulantes o corticoides, ISRS o ISRNS, ulcus o gastropatia previos y la existencia de alguna enfermedad concomitante grave. Otro aspecto a tener en cuenta es la erradicacion del Helicobacter (H.) pylori, lo que parece que es coste efectivo y reduce el riesgo de complicaciones gastrointestinales (GI). Ante un paciente con factores de riesgo en el que vayamos a iniciar un tratamiento con AINE o ya lo siguiera por cualquier causa, que tuviera un evento GI, debemos, siempre que se pueda, suspender el AINE y testar el H. pylori para erradicarlo si sale positivo y posteriormente reiniciar el tratamiento con AINE mas conveniente (si se puede, siempre el menos gastrolesivo) teniendo en cuenta los factores de riesgo GI y cardiovasculares y asociando un protector gastrico. El papel actual de los COX-2, como AINE y con un riesgo de lesion GI menor que los AINE clasicos, debe tenerse tambien en cuenta, si bien debe barajarse el riesgo cardiovascular del paciente en la decision de dicha alternativa terapeutica.

Poly(L-lactic acid) (PLLA) was immersed in a simulated body fluid (SBF) solution at 37.58C for distinct times. The variation of the surface mechanical properties of PLLA samples with immersion time was followed by microhardness. These measurements showed that PLLA microhardness decreased significantly (� 60%) after only 30 days of immersion. The results were explained in terms of hydrolytic degradation of the samples. The dependence of microhardness with the applied dwell time was also an- alyzed. The creep curves were successfully described by a power law. A decrease of the creep constant k as the immersion time increased was found. Differential scanning calorimetry was also used to analyze the changes in the physical properties of PLLA, namely in crystallinity degree (Xc) and glass transition temperature (Tg), as a function of the immersion time in SBF. A significant variation in the crystallinity degree of PLLA, initially nearly amorphous (Xc 5 9%), was detected after only 3 days of immersion (Xc 5 37%). The interpretation of this behavior was based on the hydrolysis process suffered by PLLA. 2007 Wiley

The behaviour of Rh/γ-AlO 3 –sepiolite monolithic systems in the N 2 O decomposition reaction using catalysts with rhodium contents between 0.2 and 0.8 wt.% were analysed. The observed increase of the catalytic activity with the metal loading was related to an enhancement in the number of active sites. The SEM–EDX results showed that rhodium was mainly located on the alumina particles. The variation of the reaction rate values with the inlet N 2 O and O 2 concentrations, suggested an apparent first order equation with respect to N 2 O and zero order for O 2 . The presence of NH 3 traces or water vapour in the feed decreased the catalytic activity, probably due to the competitive adsorption of NH x or OH species. The ammonia oxidation reaction took place, producing N 2 O as a secondary product. The monolithic catalysts developed operate with a low pressure drop achieving a N 2 O conversion higher than 90% at 773 K in the presence of oxygen, ammonia or water vapour in the stream.

Using a list of avoidable mortality (AM) causes as indicators of medical care (IMC) according to the Holland classification, a study on AM was conducted in the Valencia Community hospitals during 1994 and 1995. A total of 617 patients out of 106,540 discharges with IMC criteria died (mortality rate: 0.58%). The most common causes of AM included hypertension and cerebrovascular disease, with 46% of avoidable deaths; maternalperinatal disease, with 36%, and tuberculosis, 7%. According to the logistic regression analysis, men had a higher risk of AM than women, the age groups at highest risk were those over 50 years and less than 18 years, and the presence of a higher number of diagnoses was associated with increased risk.

Se han estudiado de forma longitudinal (1987-1995) los principales factores de riesgo ligados a la evolucion de la mortalidad por cardiopatia isquemica con el fin de obtener una valoracion del problema en Espana, asi como de sus medidas preventivas. Material y metodos la mayor parte de los factores de riesgo considerados se obtuvieron de las Encuestas Nacionales de Salud Espanolas de los anos 1987, 1993 y 1995, procediendo a su adaptacion correspondiente. Las defunciones por cardiopatia isquemica se consultaron de los Movimientos Naturales de la Poblacion Espanola, se calcularon las tasas de mortalidad por 105 personas-ano y se estandarizaron por el metodo directo. Asimismo se realizo un ajuste polinomial de segundo grado en la linea de tendencia y se comprobaron diferencias significativas en la prevalencia de los factores de riesgo entre cada dos encuestas consecutivas. Resultados observamos que la situacion no es satisfactoria en cuanto a niveles de salud percibida, siendo claramente decreciente en ambos sexos. El consumo de tabaco para ambos sexos solo es ligeramente decreciente en el periodo considerado, aunque con grandes diferencias por sexo. Lo mismo sucede con el alcohol, disminuyendo los bebedores excesivos. Los datos de obesidad permanecen constantes, con una tendencia practicamente horizontal, mientras que parece decrecer el sedentarismo para ambos sexos. Es estable para todo el periodo estudiado el conocimiento del padecimiento de diabetes, hipertension y colesterol.

Resumen Paciente de 71 anos de edad, sin antecedentes clinicos de interes, valorada por una masa en el hemimaxilar superior izquierdo de 6 meses de evolucion. La tomografia computerizada y la resonancia magnetica mostraron una lesion de 7,7×6,9×4,7 cm en el seno maxilar izquierdo. La biopsia escisional confirmo el diagnostico de hemangioma.

We report the case of 71-year-old woman with no prior history who had a left maxillary mass for 6 months. Axial Tomography and Nuclear Magnetic Resonance revealed a lesion of 7.7x6.9x4.7cm in the left maxillary sinus. Excisional biopsy confirmed the diagnosis of haemangioma.

ResumenSe estudia la evolución de la mortalidad global por cáncer en España (1970–1987), y especialmente por cáncer de pulmón, por sexos y grupos de edad, estableciendo comparaciones con otros países (EEUU, Inglaterra y Gales).En cuanto a la evolución de la mortalidad global por cáncer se observa que únicamente en las edades más juveniles se detectan descensos notables de la mortalidad, en tanto que, en los otros países con los que se compara, se observa también una disminución en edades más avanzadas. Asimismo, aunque las tasas de mortalidad por cáncer de pulmón en España tienen unos valores inferiores a los de los países mencionados, se observa un incremento de la mortalidad de ambos sexos, especialmente entre los hombres. Se discute la evolución de los factores de riesgo ligados al cáncer, y más concretamente al cáncer de pulmón.Más que una situación desfavorable, parece que se observa la misma situación pero con retraso, sobre todo, en el caso de la mortalidad por cáncer de pulmón en los hombres. España estaría ahora en la fase de crecimiento, mientras que EEUU e Inglaterra y Gales habrían estabilizado sus tasas y comenzado incluso a disminuir.SummaryIn this paper we study the general mortality trends by cancer in Spain (1951–1987), and also by sex and age groups. We focus on lung cancer, establishing comparisons with USA, England and Wales.We appreciate on the general mortality trend that only young age groups show a higher decrease, while in other countries this decrease was also in old age groups. We observed a lower mortality trend in Spain by lung cancer than in the other countries, however increasing the rates in both sexes and more in males. That evolution could be related with the evolucion of cancer risk factors and especially lung cancer.On concluded that the general mortality trend in Spain is the same than other developed countries but with some delay in the evolution, when comparing lung cancer. Spain is now in an increasing phase and USA, England and Wales have stabilized their rates and begin to decrease their trends.

In the last few years, geomicrobiologists have focused their researches on the nature and origin of enigmatic reticulated filaments reported in modern and fossil samples from limestone caves and basalt lava tubes. Researchers have posed questions on these filaments concerning their nature, origin, chemistry, morphology, mode of formation and growth. A tentative microbial origin has been elusive since these filaments are found as hollow tubular sheaths and could not be affiliated to any known microorganism. We describe the presence of similar structures in a 16th century granite tunnel in Porto, Northwest Portugal. The reticulated filaments we identify exhibit fine geometry surface ornamentation formed by cross-linked Mn-rich nanofibres, surrounded by a large amount of extracellular polymeric substances. Within these Mn-rich filaments we report for the first time the occurrence of microbial cells.

To determine the percentage of new Specialist Healthcare prescriptions received and modified by Primary Healthcare physicians.Descriptive, cross-sectional and multi-centre study with the participation of Primary Healthcare physicians from one Madrid Health Area during 2 months. A method was established for registering the origin of the new prescriptions in the Computerised Medical Record System. In order to register new prescriptions without any change from Specialist Healthcare, the «second level» option was marked when the prescription was issued. A protocol was prepared and was available on the Computerized Medical Record System, so for those cases where there was a new Specialist Healthcare prescription, the Primary Healthcare physician would not issue any prescription or issue a prescription with changes as regards the original one.A total of 69 Primary Healthcare physicians from 15 Primary Healthcare centres registered 46,512 new prescriptions, 3,893 (8.4%) from Specialist Healthcare. From this number, 3,544 prescriptions (91.0% 95% CI: 90.1-91.9) were issued without changes, and 298 prescriptions were modified (7.7% 95% CI: 7.0-8.7). In 46 cases (1.2% 95% CI: 0.8-1.5) no prescription was issued. Some prescriptions were changed by 51% of Primary Healthcare physicians, and the median of prescriptions changed or not issued was 3. The main reason for the modification was replacement with generics.A high percentage of new Specialist Healthcare prescriptions are issued without any changes being made by Primary Healthcare physicians. Modifications are concentrated in half of the participating physicians. Therefore, these data suggest that this practice is not generally adopted by the professionals.

This study aims to associate adverse events related to health care with another indicator of quality of care such as hospital mortality, and determining the proportion of adverse events (AEs) and associated factors in deceased patients.First a descriptive study of hospital-based mortality was performed, followed by a case-control study in deceased patients. We studied the presence of AEs, the probability which they could be predicted and prevented, and their association with several factors.The proportion of AEs found was 19.8% (82/414), and the proportion of deceased patients who suffered an AE was 15.5% (64/414). The AE ratio per person was 1.28. The most common AE was nosocomial infection, and 48.8% of all AEs were preventable. No difference was found with the presence of an AE by age or sex. Factors associated with the presence of AEs were surgery, length of stay and hospital unit to which patients were admitted.The proportion of AEs found between patients who died, the percentage of preventable AEs, the most common AE (nosocomial infection) and the association of their presence with stay and the surgery should make us focus on the development of measures to reduce hospital stay and the dissemination of information on prevention and control of nosocomial infection.