Search

Resumen Introduccion Analizar las caracteristicas clinico-patologicas de los pacientes operados por nodulo pulmonar solitario (NPS) y 18F-FDG PET-TC integrado tras su reseccion quirurgica. Material y metodos Estudio retrospectivo sobre una base de datos prospectiva de pacientes operados entre enero-2007 y octubre-2017 por NPS sin diagnostico preoperatorio. La variable dependiente fue el resultado anatomopatologico (benigno vs. maligno) del NPS. Las variables del estudio fueron: edad, sexo, captacion en PET-TC, SUVmax, tabaquismo, EPOC, antecedente de tumoracion maligna previa, localizacion del tumor y tamano en la TC. Resultados Un total de 305 pacientes fueron incluidos en el estudio, 225 (73,8%) varones, 80 (26,2%) mujeres, edad media = 63,9 (rango 29-86 anos), tamano medio NPS = 1,68 (d.t. 0,65 cm), benignos = 46 (15,1%), malignos = 258 (84,6%), tipo de reseccion: cuna = 151 (49,5%), lobectomia = 141 (46,2%), segmentectomia = 12 (3,9%), exploradora = 1 (0,3%). La mortalidad postoperatoria fue del 1,9%. EPOC = 50,8% casos, cancer previo = 172 casos (56,4%), tabaquismo = 250 casos (82%), PET positiva = 280 casos (91,8%), NPS en campos superiores = 204 casos (66,9%), SUVmax mediana = 3,4 (rango 0-20,7). El modelo de regresion logistica binaria por pasos hacia atras mostro que la edad, SUVmax, enfermedad maligna previa y sexo femenino fueron factores de riesgo independientes con significacion estadistica (p La sensibilidad, especificidad, el valor predictivo positivo, el valor predictivo negativo y la seguridad diagnostica fueron 94,6%, 23,4%, 87,1%, 44% y 83,6%, respectivamente. Hubo un total de 14 casos falsos negativos (4,6%) y 36 casos falsos positivos (11,8%). Conclusiones La edad, el SUVmax, antecedentes de enfermedad maligna previa y sexo femenino fueron factores de riesgo independientes en nuestro estudio. Cada caso debe ser evaluado de forma individual en un comite multidisciplinario y atender las inquietudes o preferencias de cada paciente. Hay que tener en cuenta que la opcion quirurgica no esta exenta de morbimortalidad, incluso en resecciones sublobares o en cuna.

Resumen: Se ha comprobado que los temas de actualidad y los puntos claves para el desarrollo de la neumología y cirugía torácica son comunes independientemente de la comunidad autónoma valorada, aunque con realidades bien distintas a la hora de afrontarlos. Esto hace que este tipo de foros, además de enriquecedores al poner de manifiesto las diferencias territoriales existentes, sean necesarios para diseñar estrategias de futuro comunes que puedan ser lideradas desde SEPAR a nivel nacional. Abstract: Current issues and key points in the development of pulmonology and thoracic surgery are the same among the different autonomous communities of Spain, although each community takes a very different approach in addressing these issues. As a result, forums that shed light on territorial differences are not only informative, but are also essential for designing common SEPAR-led strategies for the future at a countrywide level.

In a recent study we found that fathers’ but not mothers’ onset of overweight in puberty was associated with asthma in adult offspring. The potential impact on offspring’s adult lung function, a key marker of general and respiratory health, has not been studied. We investigated the potential causal effects of parents’ overweight on adult offspring’s lung function within the paternal and maternal lines. We included 929 offspring (aged 18–54, 54% daughters) of 308 fathers and 388 mothers (aged 40–66). Counterfactual-based multi-group mediation analyses by offspring’s sex (potential moderator) were used, with offspring’s prepubertal overweight and/or adult height as potential mediators. Unknown confounding was addressed by simulation analyses. Fathers’ overweight before puberty had a negative indirect effect, mediated through sons’ height, on sons’ forced expiratory volume in one second (FEV1) (beta (95% CI): −144 (−272, −23) mL) and forced vital capacity (FVC) (beta (95% CI): −210 (−380, −34) mL), and a negative direct effect on sons’ FVC (beta (95% CI): −262 (−501, −9) mL); statistically significant effects on FEV1/FVC were not observed. Mothers’ overweight before puberty had neither direct nor indirect effects on offspring’s lung function. Fathers’ overweight starting before puberty appears to cause lower FEV1 and FVC in their future sons. The effects were partly mediated through sons’ adult height but not through sons’ prepubertal overweight.

The Mannitol test is used for the diagnosis of bronchial hyperreactivity. It is in the asthma diagnostic algorithm Aims. Make a descriptive review of the tests we had done and their usefulness. Settings and Design: Retrospective descriptive study. Methods and Material. Patients who have performed the mannitol test in the laboratory of functional respiratory tests between May 29, 2017 and December 3, 2018. Statistical analysis used. Study of frequencies in qualitative variables and measures of central tendency in quantitative. The relationships were studied with nonparametric tests: F of Fisher for qualitative variables and U of Mann-Whitney for quantitative variables. The significance was set at p≤0.05. Results. There were 54 patients, 81.5% women of 49.06 years. The most frequent adverse effect was cough that occurred in 85.4% and with a dose of 5 mg. The result was positive at 14.8%. The positives are among those older than 40 years (p = 0.04), so those who cough (p = 0.018). There are significant differences in the dose received and the fall in FEV1. There was no relationship between coughing and the positivity or negativity of the test (p=0.56), nor was there any relationship between gender and cough or positivity. Conclusions. The mannitol test is a useful test to detect hyperreactivity. The most frequent adverse effect is cough.

Objective: this study analyses long-term results of sublobar resection in daily clinical activity versus the standard procedure (lobectomy). Method: From a prospective database, patients treated with sublobar resection for NSCLC were identified (2007-2017). None of them had malignant disease in the 5 previous years nor induction treatment. Log-rank test was used to compare overall survival and disease free survival. One-to-one propensity score matching was performed for age, sex, stage, and comorbities to reduce bias selection. Results: 1214 patients were surgically treated for lung cancer in that period of time. Finally, 52 patients were included in sublobar group with following resections: pulmonary wedge 37(71.2%) cases; anatomic segmentectomy 15(28.8%) cases. Women 4(7.7%); Men 48(92.3%). Mean age: 68.6 y.o. (range 42-86). Pulmonary function test (FEV1 64.9% vs 77.3% p=0.004) and tumoral size (1.9cm vs 3.0cm p

To analyse clinicopathological characteristics of patients operated for pulmonary solitary nodule (PSN) and 18F-FDG integrated PET-CT scan after surgical resection.Retrospective study on a prospective database of patients operated from January 2007 to October 2017 for PSN without preoperative diagnosis. Dependent variable was anatomopathological result (benign vs malignant) of PSN. Variables of the study were: age, sex, PET-CT uptake, SUVmax, smoking history, COPD, previous history of malignant disease, tumoral location, and tumour size on CT-scan.A total of 305 patients were included in this study, 225 (73.8%) men, 80 (26.2%) women, mean age = 63.9 (range 29-86 years), mean size PSN = 1.68 (s.d. .65 cm), benign = 46 (15.1%), malignant = 258 (84.6%), type of resection: pulmonary wedge = 151 (49.5%), lobectomy = 141 (46.2%), segmentectomy = 12 (3.9%), exploratory intervention = 1 (0.3%). Postoperative mortality was 1.9%. COPD = 50.8% cases, previous cancer disease = 172 cases (56.4%), smoking history = 250 cases (82.0%), positive PET = 280 cases (91.8%), PSN in upper pulmonary fields = 204 cases (66.9%), median SUVmax = 3.4 (range 0-20.7). Backward stepwise binary logistic regression model showed that age, SUVmax, previous malignant disease and female sex were independent risk factors with statistical significance (p.05). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 94.6%, 23.4%, 87.1%, 44.0%, and 83.6% respectively. There were 14 false negative cases (4.6%) and 36 false positive cases (11.8%).Age, SUVmax, previous malignant disease, and female sex were independent risk factors in our study. Each case should be individually evaluated in a multidisciplinary committee, and the patient's preferences or concerns should be kept in mind in decision-making. Surgical resection of PSN is not exempt from morbidity and mortality, even in sublobar or pulmonary wedge resection.

Introduction: Of the patients who come to the consultation to stop smoking, many do not return to the second consultation, so they do not initiate the treatment. Objective: To assess the follow-up of a smoking cessation program and analyze the characteristics of this population. Patients and Methods: We analyzed 1484 patients who attended the Specialized Smoking Treatment Unit of the University Hospital Complex of Albacete from January 1, 2008 to December 31, 2012, assessing anthropometric and social characteristics. Statistical Analysis: Chi-square and Fisher's exact test were used for qualitative variables and Student's t for quantitative variables and a logistic regression was performed to avoid confounding variables. The level of significance was established with p

Resumen: Introducción: El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio. Pacientes y métodos: Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución. Resultados: Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad. Conclusiones: La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso. Abstract: Introduction: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Patients and methods: Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. Results: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Conclusions: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight.

Introduction: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Patients and methods: Retrospective descriptive study of sleep tests conducted on children up to 14 years old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. Results: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age was 5 years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, SatO2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Conclusions: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight. Resumen: Introducción: El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio. Pacientes y métodos: Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución. Resultados: Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad. Conclusiones: La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso.

Objective: To analyze the economic impact of vaccination of the 65-year-old cohort with the 13-valent conjugated pneumococcal vaccine (VNC13) in the Autonomous Community of Castilla-La Mancha. Methods: A dynamic transmission model based on differential equations was adapted to analyze the burden of pneumococcal disease (ND) in the 65+ year old population over 5 years, with 59% being vaccinated annually. An efficacy of VNC13 of 52.5% (CAPITA study), coverage of vaccine serotypes of 60.1% (CAPA study) and incidence of EN in the Community of 258.5 / 100,000 cases year (CMBD 2011-2015) was applied. The perspective was that of the SESCAM; costs of hospitalized EN cases according to the CBCA's CMBD (hospitalized pneumonia, € 4,675, invasive pneumonia, € 4,792, meningitis, € 11,9342, primary bacteremia, € 4,792) and cost of extra-hospital pneumonia of € 358. Results: Vaccination with VNC13 would reduce the incidence of EN by 75%, up to 324.7 cases / 100,000 accumulated in 5 years. As a c n sequence, it is expected to avoid 1,219 cases of EN; 715 hospitalized pneumonias, 437 extra-hospital pneumonias and 67 cases of invasive disease. The expected cost of vaccination in 5 years of 2.3 million euros would be fully compensated by avoiding 3.9 million euros of medical costs of illness, with a cumulative net saving of 1.4 million Euros (discount rate of 3 %). The sensitivity analysis with different scenarios was robust. Conclusion: The costs of complications from pneumococcal disease are greater than those of a VNC13 pneumococcal vaccination campaign in 65-year-old adults. Death increases in unvaccinated patients.

Background: There is a relationship between smoking and some psychiatric disorders, and there is doubt whether antismoking treatment will be more complex because of psychiatric disorder.Aim: To analyze the differences in treatment success rates among patients without psychiatric disorder and patients with psychiatric disorder who have received complete pharmacological treatment.Materials and Methods: A retrospective cohort study was conducted using the records of patients completely treated at Albacete University Hospital Complex during 2011. The sample comprised 293 patients seen in 2011. We treated only 73 patients and divided them into patients with or without psychiatric disorders. We analyzed the following variables: sex, age, age at smoking onset, previous quitting attempts, cigarettes per day, CO-oximetry, Fagerstrom test, Richmond test, alcoholism, treatment distribution, treatment failure, success, and relapse.Results: Of a total sample of 293 patients seen in 2011, 73 patients were treated: 43 were men and 30 were women. Overall, 37% had psychiatric disorder (five men and 22 women). Treatment was successful in 51 (70%) patients. There were no differences between the demographic characteristics of the two groups, except for sex (P

Restrospective analysis from a prospective database:January-2007 to September-2018, 1076 anatomical pulmonary resections were performed, of them 60(5.6%) were bronchial reconstruction for malignant disease. We analysed type of bronchial reconstruction, suture, postoperative complications, and follow-up. Results: male/female=50/10(83.3%/16.7%), mean age=60.5(range:26-79). -Sleeve lobectomy:39(65% two of them with pulmonary artery reconstruction and one with superior vena cava reconstruction), -Wedge-sleeve lobectomy:11(18.3% one of them with arterial reconstruction) -Sleeve bilobectomy:4(6.7%) -Sleeve segmentectomy:3(5%) -Lung-sparing sleeve bronchial resection:2(3.3%) -Bronchial reconstruction with autologous pericardium:1(1.7%) Right upper lobectomy: the most frequent 29(48.3%). Histology: adenocarcinoma=5 (.3%), squamous=40(66.7%) carcinoid=8(13.3%), others: 7(11.6%) Mean hospital stay:8.9days (s.d. 6.5). Induction treatment:5(8.3%), adjuvant Ch=19(31.7%), Rt=3(5.0%), Ch+Rt=7(11.7%). Non-absorbable suture=42(70.0%), absorbable=18(30.0%). Postoperative mortality:3(5.0%) Postoperative morbidity: - none:16(26.7%) - related to anastomosis:7(11.6%, two dehiscences with conservative treatment, two dehiscences with reoperation, one with diffuse mucus plugs and reintervention, two stenoses with dilatation) There were no statistically significant differences in anastomosis complications according to type of suture (p=0.14) or type of bronchial resection(p=0.47). Overal survival was lower in lymph nodes metastases(p=0.04) and squamous/adenocarcinoma vs other histology(p=0.03). Conclusions: We did not observe differences in types of surgical bronchial reconstruction.

Objectives: To assess the success of smoking cessation treatment, according to sex, comorbidities and treatments used. Method: Retrospective, descriptive study of the results obtained after analyzing the sample of all patients who attended the “Specialized Smoking Treatment” Unit in the University Hospital of Albacete from the 1st of January 2008 until the 31st of December 2009 and the subsequent posterior year follow-up. Results: 838 patients sent from Primary Care and Pneumology Service were included. 53.7% were men. The average age of the sample was 46.18 years. The average daily cigarette consumption was over a pack daily with 27.30 cigarettes per day. Most of the patients had comorbidities; among which was psychiatric comorbidity (37.7%), cardiovascular risk factors (CVRFs); among which the most common factor was dyslipidemia followed by hypertension and diabetes, and respiratory comorbidity (COPD, obstructive sleep apnea, asthma and chronic carriers of Domiciliary Oxygen Therapy). The global success in patients who attended the first consultation was (13.8%), while the success in patients who did not abandon the study without starting the treatment was 27.6%). With the variable “Respiratory Diseases / Cardiovascular Diseases” (RD/CVD) it was observed that having a respiratory or a cardiovascular disease does not influence the success of smoking cessation. There are hardly any differences in the success probability according to whether the patient is suffering or not hypertension, diabetes, dyslipidemia, psychiatric disorder, alcoholism or neoplasias. However statistical difference between success and the possibility of being diagnosed or not with SAHS was observed (p

The genetic variations responsible for tumorigenesis are called driver mutations. In breast cancer (BC), two studies have demonstrated that germline mutations in driver genes linked to sporadic tumors may also influence BC risk. The present study evaluates the association between SNPs and SNP-SNP interaction in driver genes TTN (rs10497520), TBX3 (rs2242442), KMT2D (rs11168827), and MAP3K1 (rs702688 and rs702689) with BC risk in BRCA1/2-negative Chilean families. The SNPs were genotyped in 489 BC cases and 1078 controls by TaqMan Assay. Our data do not support an association between rs702688: A&gt, G or rs702689: G&gt, A and BC risk. The rs10497520-T allele was associated with a decreased risk in patients with family history of BC or early-onset BC (OR = 0.6, p &lt, 0.0001 and OR = 0.7, p = 0.05, respectively). rs2242442-G was associated with a protective effect and rs11168827-C was associated with increased BC risk in families with a strong history of BC (OR = 0.6, p = 0.02 and OR = 1.4, p = 0.05, respectively). As rs10497520-T and rs2242442-G seemed to protect against BC risk, we then evaluated their combined effect. Familial BC risk decreased in a dose-dependent manner with the protective allele count, reflecting an additive effect (p-trend &lt, 10&minus, 4). To our knowledge, this is the first association study of BC driver gene germline variations in a Chilean population.

Little is known about how Drosophila adults behave in the wild, including mating, allocation of food and space, and escape from predators. This lack of information has negative implications for our ability to understand the capabilities of the nervous system to integrate sensory cues necessary for the adaptation of organisms in natural conditions. We characterized a set of behavioral routines of D. melanogaster and D. simulans adults in three ecologically different orchards: grape, apple and prickly pear. We also investigated how the flies identify conspecifics and aliens in the wild to better understand relationships between group formation and adaptation of Drosophila to breeding sites. We characterized the locations by recording in each orchard humidity, temperature, illumination conditions, pH of fruits, the presence/absence of other Drosophila species and the predator ant Linepithema humile. Our findings suggest that the home range of these species of Drosophila includes decaying fruits and, principally, a variety of microhabitats that surround the fruits. The ecological heterogeneity of the orchards and odors emitted by adult D. melanogaster and D. simulans influence perch preferences, cluster formation, court and mating, egg-laying site selection, and use of space. This is one of the first large examinations of the association between changing, complex environments and a set of adult behaviors of Drosophila. Therefore, our results have implications for understanding the genetic differentiation and evolution of populations of species in the genus Drosophila.

Introduction Understanding the natural history of dysferlinopathy is essential to design and quantify novel therapeutic protocols. Our aim in this study was to assess, clinically and functionally, a cohort of patients with dysferlinopathy, using validated scales. Methods Thirty-one patients with genetically confirmed dysferlinopathy were assessed using the motor function measure (MFM), Modified Rankin Scale (MRS), Muscle Research Council (MRC) scale, serum creatine kinase (CK) assessment, baseline spirometry data, and echocardiographic and electrophysiologic studies. Results MFM and MRC scores showed a significant negative correlation with disease duration and inverse correlation with MRS, but not with onset age, clinical phenotype, or CK levels. Percent forced vital capacity (%FVC) correlated negatively with disease duration and onset age. Eight known pathogenic mutations were identified recurrently, 4 of which accounted for 79% of the total. Conclusions The results suggest that MFM is a reliable outcome measure that may be useful for longitudinal follow-up in dysferlinopathy. Recurrent mutations suggest a founder effect in the Chilean population. Muscle Nerve, 2015

Introduction Smoking is the cause of multiple diseases. Effective treatment is critical, and when there is, and fails, to detect posible contributing factors. Objectives Analyze the characteristics of people who fail in anti-smoking treatment. Material and methods Retrospective study of the patients evaluated in smoking unit between 2009-2011. Patients who had treatment failure were detected and were compared with those who had any time of abstinence. Chi square, Fisher statistic and student t was used. We defined failure as that one who has not been able to leave smoking even 24 hours. Results N=901 patients. 83 failed. Conclusions 1. Male gender influences in therapeutic failure. 2. Age, number of cigarettes, ECM and SBP are also associated. 3. Among respiratory diseases, suffering COPD and SAHS is more likely to fail. 4. Arrythmias, dyslipidemia, IBD and neoplasias also have a higher frecuency of treatment failure. 5. Neither psychiatric illness nor the use of other drugs or alcohol were associated with a higher frecuency of failure.

Introduction Smoking is a systemic disease. It is the the most important isolated cause of premature morbidity and mortality preventable and avoidable in developed countries. Multiple diseases and pathological conditions are directly caused or have been related to snuff exposure. Objectives We decided to see if with the experience the success rate, defined as a year of continuous abstinence, of our patients had improved. Material and methods Retrospective study using the database of our unit over years 2008 and 2012. Chi-square test was used to compare the success and relapse in one year and another, and student t test and chi-square were used to compare if the main characteristic of the samples were comparable.The study was made with all the patients who attended to the consultation. Results Conclusions: 1- More patients in 2012 than in 2008, but there were no differences in success. 2- Patients in 2008 smoked more and had more dependence. 3- There were fewer relapses in 2012. 4- We got more abstinence days in 2008.

SUMMARY The natural variation of sex-specific characters between populations can favor their behavioral isolation, eventually leading to the formation of new species. Marked variations for male courtship, mating and the production of sex pheromones – three complex characters potentially inducing sexual isolation – were found between Drosophila melanogaster populations of various origins acclimated for many generations in research laboratories. However, the natural variation of these three characters between natural populations and their evolution after long-term acclimation in the laboratory remains unknown. We measured many traits involved in these characters in six stocks initiated with distinct populations sampled in a restricted geographic area. Several sex-specific traits varied between stocks freshly brought back to the laboratory. After 100 generations spent in the laboratory without any experimental selection, traits varied in a strain-dependent manner. This variation was not related to a reduction of their variance except for copulation duration. This indicates that reproduction-related characters can diverge between neighboring D. melanogaster populations, and differently adapt to stable laboratory conditions.

We investigated pupa distributions of D. simulans, D. buzzatii, D. melanogaster, D. immigrans and D. hydei on a number of natural breeding sites. Pupae of all five species showed aggregated distributions, which prompted us to examine these aggregations in a more detail for two species that commonly co-occur in breeding sites, D. simulans and D. buzzatii. We found that pupae of both species tend to be aggregated in conspecific clusters. Subsequent experiments revealed that both species are attracted to the odors of other larvae, though only D. buzzatii differentiated between conspecifics and heterospecifics (they preferred conspecific). Furthermore, third instar larvae of both species preferred more alkaline substrates. Altogether, our results demonstrate that Drosophila species form conspecific pupa aggregations in natural breeding sites, and that pupation site selection depends on interactions among conspecific and heterospecific larvae and on chemical characteristics of the breeding sites.

We investigated the role of Drosophila larva olfactory system in identification of congeners and aliens. We discuss the importance of these activities in larva navigation across substrates, and the implications for allocation of space and food among species of similar ecologies. Wild type larvae of cosmopolitan D. melanogaster and endemic D. pavani, which cohabit the same breeding sites, used species-specific volatiles to identify conspecifics and aliens moving toward larvae of their species. D. gaucha larvae, a sibling species of D. pavani that is ecologically isolated from D. melanogaster, did not respond to melanogaster odor cues. Similar to D. pavani larvae, the navigation of pavani female x gaucha male hybrids was influenced by conspecific and alien odors, whereas gaucha female x pavani male hybrid larvae exhibited behavior similar to the D. gaucha parent. The two sibling species exhibited substantial evolutionary divergence in processing the odor inputs necessary to identify conspecifics. Orco (Or83b) mutant larvae of D. melanogaster, which exhibit a loss of sense of smell, did not distinguish conspecific from alien larvae, instead moving across the substrate. Syn 97CS and rut larvae of D. melanogaster, which are unable to learn but can smell, moved across the substrate as well. The Orco (Or83b), Syn 97CS and rut loci are necessary to orient navigation by D. melanogaster larvae. Individuals of the Trana strain of D. melanogaster did not respond to conspecific and alien larval volatiles and therefore navigated randomly across the substrate. By contrast, larvae of the Til-Til strain used larval volatiles to orient their movement. Natural populations of D. melanogaster may exhibit differences in identification of conspecific and alien larvae. Larval locomotion was not affected by the volatiles.

Understanding the natural history of dysferlinopathy is essential to design and quantify novel therapeutic protocols. Our aim in this study was to assess, clinically and functionally, a cohort of patients with dysferlinopathy, using validated scales.Thirty-one patients with genetically confirmed dysferlinopathy were assessed using the motor function measure (MFM), Modified Rankin Scale (MRS), Muscle Research Council (MRC) scale, serum creatine kinase (CK) assessment, baseline spirometry data, and echocardiographic and electrophysiologic studies.MFM and MRC scores showed a significant negative correlation with disease duration and inverse correlation with MRS, but not with onset age, clinical phenotype, or CK levels. Percent forced vital capacity (%FVC) correlated negatively with disease duration and onset age. Eight known pathogenic mutations were identified recurrently, 4 of which accounted for 79% of the total.The results suggest that MFM is a reliable outcome measure that may be useful for longitudinal follow-up in dysferlinopathy. Recurrent mutations suggest a founder effect in the Chilean population.