Variabilidad de la estancia media en pacientes hospitalizados en un hospital de Traumatología durante el año 2010

Objetivos: El objetivo principal del estudio es conocer la estancia media hospitalaria y su variabilidad en relación con el motivo de ingreso, en una unidad de hospitalización de un hospital monográfico de Traumatología. (Unión de Mutuas. Castellón) Metodología: Estudio transversal, descriptivo, basado en datos administrativos, cuya población estuvo formada por todos los individuos que tuvieron algún episodio de hospitalización durante el año 2010, siendo este el criterio de inclusión, por orden cronológico de aparición. Resultados: Se identificaron un total de 736 episodios asistenciales y 133 códigos CIE-9CM. La edad media fue 44 (+/-10) años. El 83,25% de los pacientes fueron varones. El código 836.0 (Desgarro de cartílago o menisco interno de la rodilla-actual) fue el diagnóstico más habitual (12,25%) y la artroscopia la técnica quirúrgica mayoritaria. “Fractura de pelvis” (CIE-9CM 808) resultó el código diagnóstico que presentó mayor estancia media con 25 (+/-9.84) estancias y mayor variabilidad de la misma, seguido de los diagnósticos “Fractura de diáfisis de tibia-cerrada”, “Fractura de diáfisis de tibia/peronéabierta”, “Contusión de múltiples sitios, ncoc” y “Fractura de tibia y peroné”. Conclusiones: Se observa poca variabilidad en la estancia media excepto en los procesos diagnosticados como fractura de pelvis y en los relacionados con fracturas de los miembros inferiores.

Plant regeneration functional groups modulate the response to fire of soil enzyme activities in a Mediterranean shrubland

Soil enzymes are critical to soil nutrient cycling function but knowledge on the factors that control their response to major disturbances such as wildfires remains very limited. We evaluated the effect of fire-related plant functional traits (resprouting and seeding) on the resistance and resilience to fire of two soil enzyme activities involved in phosphorus and carbon cycling (acid phosphatase and β-glucosidase) in a Mediterranean shrublands in SE Spain. Using experimental fires, we compared four types of shrubland microsites: SS (vegetation patches dominated by seeder species), RR (patches dominated by resprouter species), SR (patches co-dominated by seeder and resprouter species), and IP (shrub interpatches). We assessed pre- and post-fire activities of the target soil enzymes, available P, soil organic C, and plant cover dynamics over three years after the fire. Post-fire regeneration functional groups (resprouter, seeder) modulated both pre- and post-fire activity of acid phosphatase and β-glucosidase, with higher activity in RR and SR patches than in SS patches and IP. However, we found no major differences in enzyme resistance and resilience between microsite types, except for a trend towards less resilience in SS patches. Fire similarly reduced the activity of both enzymes. However, acid phosphatase and β-glucosidase showed contrasting post-fire dynamics. While β-glucosidase proved to be rather resilient to fire, fully recovering three years after fire, acid phosphatase showed no signs of recovery in that period. Overall, the results indicate a positive influence of resprouter species on soil enzyme activity that is very resistant to fire. Long-lasting decrease in acid phosphatase activity probably resulted from the combined effect of P availability and post-fire drought. Our results provide insights on how plant functional traits modulate soil biochemical and microbiological response to fire in Mediterranean fire-prone shrublands.

Optic neuritis in pediatric population: A review in current tendencies of diagnosis and management

Optic neuritis is an inflammation of the optic nerve and may be related to different systemic conditions. The clinical presentation of this pathology usually includes sudden loss of visual acuity (VA) which may be unilateral or bilateral, visual field restriction, pain with eye movements, dyschromatopsia, a relative afferent pupillary defect and optic disk swelling. Optic neuritis in children has specific clinical features and a better prognosis than in adulthood. Although usually appears an underlying viral disease, the main concern for practitioners is the relationship of optic neuritis with multiple sclerosis. In addition to the classical techniques as magnetic resonance imaging (MRI), current tendencies of diagnosis for eye practitioners include new imaging devices as optical coherence tomography (OCT), useful to show a thinning of the retinal fibers layer (RFL) after the inflammatory episode. Regarding the management of these patients, short-term intravenous steroid dosages seem to be the best option to treat acute attacks characterized by a very poor bilateral VA.

Geological risk assessment of Amtoudi Agadir in southern Morocco: a key case for sustainable cultural heritage

Medieval fortified granaries known as “agadirs” are very common in southern Morocco, being catalogued as world cultural heritage by United Nations. These Berber buildings (made of stones and tree trunks) usually located on rocky promontories, constitute historical testimonials related to the origin of Morocco, and, as tourist attractions, have a positive impact on the local economy. The sustainability of these ancient monuments requires geological-risk evaluations of the massif stability under the agadir with the proposal of stabilization measures, and an architectonic analysis with appropriate maintenance of the structural elements. An interdisciplinary study including climate, seismicity, hydrology, geology, geomorphology, geotechnical surveys of the massif, and diagnosis of the degradation of structural elements have been performed on the Amtoudi Agadir, selected as a case study. The main findings from this study are that the prevalent rocks used for construction (coming from the underlying substratum) are good-quality arkosic sandstones; the SW cliffs under the agadir are unstable under water saturation; some masonry walls are too thin and lack interlocking stones and mortar; and failures in the beams (due to flexure, fracture, and exhaustion in the resistance due to insect attacks or plant roots) are common. The basic risk assessment of ancient buildings of cultural heritage and their geologic substratum are needed especially in undeveloped areas with limited capacity to implement durable conservation policies. Therefore, recommendations have been provided to ensure the stability and maintenance of this important archaeological site.

Health-related quality of life and determinant factors in celiac disease. A population-based analysis of adult patients in Spain

Background: Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population. Methods: An observational, transversal study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors. Results: We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores. Conclusions: The HRQL of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.