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Resumen Introduccion Guia para la practica clinica en neurorrehabilitacion de personas adultas con dano cerebral adquirido de la Sociedad Espanola de Neurorrehabilitacion. Documento basado en la revision de guias de practica clinica internacionales publicadas entre 2013-2020. Desarrollo Se establecen recomendaciones segun el nivel de evidencia que ofrecen los estudios revisados referentes a aspectos consensuados entre expertos dirigidos a definir la poblacion, caracteristicas especificas de la intervencion o la exposicion bajo investigacion. Conclusiones Deben recibir neurorrehabilitacion todos aquellos pacientes que, tras un dano cerebral adquirido, hayan alcanzado una minima estabilidad clinica. La neurorrehabilitacion debe ofrecer tanto tratamiento como sea posible en terminos de frecuencia, duracion e intensidad (al menos 45-60 minutos de cada modalidad de terapia especifica que el paciente precise). La neurorrehabilitacion requiere un equipo transdisciplinar coordinado, con el conocimiento, la experiencia y las habilidades para trabajar en equipo tanto con pacientes como con sus familias. En la fase aguda, y para los casos mas graves, se recomiendan programas de rehabilitacion en unidades hospitalarias, procediendose a tratamiento ambulatorio tan pronto como la situacion clinica lo permita y se puedan mantener los criterios de intensidad. La duracion del tratamiento debe basarse en la respuesta terapeutica y en las posibilidades de mejoria, en funcion del mayor grado de evidencia disponible. Al alta deben ofrecerse servicios de promocion de la salud, actividad fisica, apoyo y seguimiento para garantizar que se mantengan los beneficios alcanzados, detectar posibles complicaciones o valorar posibles cambios en la funcionalidad que hagan necesario el acceso a nuevos programas de tratamiento.

The experimental acquisition of data for monitoring cereal grain storage in silos for long periods is not practical in most cases; in such situations, mathematical modeling is an excellent alternative to predict temperature and mass transfer behavior. The model was developed in two dimensions using the equations of heat, mass, and momentum transport. The governing equations were solved using discretization of the spatial coordinates by orthogonal collocation with Jacobi polynomials and the resulting algebraic system was solved by employing nonlinear relaxation method that uses less computational resources. For the ambient boundary conditions, it was used as a more accurate equation to represent the diurnal–nocturnal temperature dynamic. This study analyzes the effects of moisture migration and temperature interactions between the interstitial air and the sorghum cereal grain bed defined as a porous medium in a cylindrical cavity, including the variations affected by meteorological conditions over 1 year. The mass–thermal gradients were predicted, and the effects of environmental temperature were analyzed for flow patterns, isotherms and moisture distribution changes, indicating how the environmental fluctuations influence the heat and moisture of the ambient spots in the grain storage. The maximum temperature inside the silo was 42 °C, considering the respiration heat of the grain, and the maximum temperature of the grain without the climatic boundary conditions was reported to be approximately 35 °C in previous studies. The proposed model can be easily extrapolated to be used for other cereal grains or to incorporate additional effects such as solar radiation, shadow sunlight path, wind velocity, equations to predict more precise ambient temperatures, etc. as boundary conditions.

Environmental forecasting temperature models have high application value for building design, environmental impact assessment, and human wellness, as they apply to the development of human comfort devices. The current models used in this field are complex and involve many parameters, resulting in a considerable amount of data and a complicated modeling process. This research proposes two models: First, a type-Gaussian model with four parameters calculated to fit the environmental temperature. The proposed model employs the maximum and minimum temperatures ( T M a x , T M i n ) registered in a year for previously selected city or town and the relative time (day number of the year, 1–365). Second: A cosenoidal model to predict the continuous temperature in the day-night cycle of the selected day. This model requires T M a x and T M i n previously estimated via the Gaussian model and the hour in the day-night cycle at which the lowest temperature occurs. The Gaussian model is validated with data from different cities, achieving a high degree of confidence with a CV(RMSE) less than 2.0% in the cases analyzed. This model was compared to Artificial Neural Networks and other mathematical models previously published to confirm its functionality. The proposed models can be used in agriculture, civil engineering, food industry, power plants, biology, heat transfer, transportation, etc.

BACKGROUND: The goal of the present work is to carry out a descriptive study about the impact of invasive cervical cancer in the area of Girona, Spain. METHODS:Using data from the population based cancer registry of Girona for the period 1980-89, several incidence rates were calculated. Incidence trends, demographical distribution and survival according of different variables were analyzed. RESULTS: The average age in which the disease appears was 57"14 years; the most frequent histological type was the squamous cell carcinoma; 51% of the cases were women born in Cataluna and the remaining percentage corresponds to women from others regions and foreigners. At the moment of diagnosis, el 36% of the cases were local, 34% were regional and 23% disseminated. Crude, standardized and truncated (35-64 years) incidence rates, during 1980 to 1989 were de 8.2, 6.2 and 13.7 cases x105 women respectively. According to the cumulative rate, 1 in 150 women will have this cancer by age 74. No increase of the trend has been found, however, a significative subincidence has been observed in rural areas. 5-years survival rates is 48.5% and was significantly associated with stage at diagnosis, but age was not. CONCLUSION: From an international viewpoint, Girona is a low incident area for this tumour and no rising trend has been found. The subincidence in rural areas may suggest a different exposition to risk factors, although certain aspects such as accessibility to health care services, the defining of rural and urban areas and the existence of migrations should be considered. Finally, the lower survival rate with regard to other countries could be attributed to the presence of more advanced stages, which emphasizes the importance that the early diagnosis of this tumour has.

The psychopathological basis of delusions in schizophrenia is poorly understood. The most enduring of several early theories has suggested a causal link with formal thought disorder, whereas recent approaches have proposed relationships with a variety of cognitive abnormalities. The correlations of delusions with other schizophrenic symptoms and with cognitive functions including semantic memory, executive function, and also probabilistic reasoning bias, were examined in a series of (overlapping) groups of 43-79 schizophrenic patients. Delusions were found to be significantly correlated with formal thought disorder, with evidence for a particular link between bizarreness and fragmentariness of delusions and "loosening of association". Delusions were not significantly correlated with overall intellectual function or memory, although there was some suggestion of a complex interaction between delusions, formal thought disorder, and semantic memory impairment. No association between delusions, formal thought disorder, and any measure of executive function was found. Although, as a group, schizophrenic patients showed evidence of probabilistic reasoning bias, this was unrelated to presence and severity of delusions.

The historical review of "psychiatric personality disorders" reveals the lack of convergence of those disorders with the organic personality disorder (OPD). Only the psychopathy concept has been used as a psychopathological phenotype for one of the groups of OPD, the so-called "pseudopsychopaths". These patients have been described from the beginning of the XXth century under the heading of "frontal lobe syndrome". It was only with the development of the psychiatric nosologies, towards the middle of the XXth century, that the term "organic personality disorder" started to be used. The accumulation of knowledge about the different prefrontal areas and the development of neuropsychological models that try to explain social behavior have opened new ways of understanding this syndrome. The orbitofrontal cortex has been identified as one of the key structures in behavioral and emotional regulation. Recognition of emotions in voices and faces, empathy, appreciation of humor, tasks that show "theory of mind" are some of the dimensions included in the examination of the non-cognitive functions of the prefrontal cortex

Medico-legal assessment of people who have suffered injuries in road traffic accidents must use Law 30/95 as a reference frame. Psychiatric and neuropsychological syndromes secondary to traumatic brain injury (TBI) are no exception and pose demanding challenges to physicians and psychologists. This paper analyzes descriptive and nosological difficulties face by psychiatrists and psychologists; their expert contribution includes translation of official diagnostic entities into categories published in the annex of Law 30/95. Our psychopathological repertoire was created in the 19th century and has hardly been revised since. The wide and varied types of neuropsychological impairments encountered in TBI have to be diagnosed within a very narrow range of DSM-IV and ICD-10 categories. The most common conflicts encountered in the medicolegal arena are revised: the differential diagnosis between dementia and combinations of organic personality disorder with cognitive impairment; differential diagnosis between spontaneous psychiatric illness (bipolar disorder, schizophrenia) and psychiatric syndromes secondary to brain injury (posttraumatic psychosis, organic bipolar disorder); differential diagnosis between concussional syndrome and organic personality disorder, cognitive impairment or organic affective disorder. Specific diagnostic guidelines are suggested for each of these clinical situations. Actas Esp Psiquiatr 2003;31(6):353-360FONT face="Courier New" size=2/FONT

Probably the commonest neuropsychiatric sequela in persons who have had some type of cerebral lesion (of whatever origin) are the complaints of changes in the personality of the patient prior to the lesion which cause problems with the family, socially and at work. These problems have been grouped together under the same diagnosis in current psychiatric nosology called 'organic personality disorder'.In this article we wish to point out the disadvantages due to this diagnosis which have a double origin. Firstly, it is based on the concept of personality, which has been shown to be inconsistent throughout the history of science. Secondly, because this group contains heterogeneous phenomena and conducts which are probably based on different neurobiological processes.The development of strategies of investigation, and of effective therapeutic techniques for these patients make it necessary to separate the different phenomena which, in the author's opinion, are erroneously included in this nosological group.

Brain damaged patients have cognitive deficits, behaviour disorders and personality changes which affect socio-familial behaviour. Frequently, these changes generate considerable disturbance between family members and make it very difficult to return to work.We describe a pilot study which led to the development and application of a focal rehabilitation programme aimed at retraining this group in social skills.The programme was intensive (3 months) and included 6 outpatients (5 men and 1 woman) who took part in programmes of neuropsychological rehabilitation after traumatic or vascular cerebral lesions (X = 19.2 months after the lesion occurred). The average age of the patients was 27.2 years and their average IQ 109.2. Individual and group interventions were combined (role-playing, 'make-believe' work, video filming) emphasizing particularly the processes of learning without making mistakes and the extension of achievements to the natural setting (controlled trials).We state and describe the relationship between the nature of neuropsychological and psychopathological deficits, and the characteristics of the limitations in social behaviour. The patients showed a significant reduction in the level of anxiety and aggressive behaviour and improvement in consciousness of their defects. Some improvement was seen in expressing opinions and emotions, and in ability to adapt social conduct to different situations (flexible behaviour). Finally we describe the conclusions drawn as to this treatment for future review and improvement of the programme.

Fundamentos: la incidencia y factores de riesgo de cáncer tienen grandes variaciones en diferentes áreas geográficas incluso dentro de un mismo país. Es de máximo interés conocer y analizar los datos obtenidos en registros de cáncer como sistema de información sanitaria. Material y métodos: a partir de los datos obtenidos por el registro de cáncer de Girona se analiza la incidencia de cáncer ginecológico en el área santitaria de Girona para el período 1985-1989. Resultados: se registraron 469 casos de cancer ginecológico en sus distintas localizaciones. Las tasas brutas y ajustadas para los tumores más frecuentes fueron, respectivamente, para el cáncer de cuerpo de útero 16,2 y 10,6; para el cáncer de ovario 11,7 y 8,0, y para el cáncer de cérvix 8,9 y 6,9. Al comparar la incidencia por comarcas se encontró una menor incidencia de cáncer de ovario en el Gironès comparada con la incidencia del área sanitaria. A pesar de que las tendencias cronológicas de las tasas de incidencia para el período 1985-1989 para cada uno de los tumores estudiados fueron positivas ninguna de éstas fue estadísticamente significativa. Tampoco se encontraron diferencias en cuanto a incidencia de estos tumores al comparar entre zona rural y urbana. Conclusiones: con los datos obtenidos, observamos que nuestra área sigue la tendencia de los países industrializados, siendo los tumores ginecológicos más frecuentes el cáncer de útero y el de ovario, seguidos de los de cérvix, otros genitales y útero mal especificado.