Facial disability index (FDI): adaptation to Spanish, reliability and validity

Objectives: To adapt to Spanish the facial disability index (FDI) described by VanSwearingen and Brach in 1995 and to assess its reliability and validity in patients with facial nerve paresis after parotidectomy. Study Design: The present study was conducted in two different stages: a) cross-cultural adaptation of the questionnaire and b) cross-sectional study of a control group of 79 Spanish-speaking patients who suffered facial paresis after superficial parotidectomy with facial nerve preservation. The cross-cultural adaptation process comprised the following stages: (I) initial translation, (II) synthesis of the translated document, (III) retro-translation, (IV) review by a board of experts, (V) pilot study of the pre-final draft and (VI) analysis of the pilot study and final draft. Results: The reliability and internal consistency of every one of the rating scales included in the FDI (Cronbach's alpha coefficient) was 0.83 for the complete scale and 0.77 and 0.82 for the physical and the social well-being subscales. The analysis of the factorial validity of the main components of the adapted FDI yielded similar results to the original questionnaire. Bivariate correlations between FDI and House-Brackmann scale were positive. The variance percentage was calculated for all FDI components. Conclusions: The FDI questionnaire is a specific instrument for assessing facial neuromuscular dysfunction which becomes a useful tool in order to determine quality of life in patients with facial nerve paralysis. Spanish adapted FDI is equivalent to the original questionnaire and shows similar reliability and validity. The proven reproducibi- lity, reliability and validity of this questionnaire make it a useful additional tool for evaluating the impact of facial nerve paralysis in Spanish-speaking patients

Multivariate explanatory model for sporadic carcinoma of the colon in Dukes’ stages I and IIa

We obtained before an explanatory model with six dependant variables: age of the patient, total cholesterol (TC), HDL cholesterol (HDL-C), VLDL cholesterol (VLDL-C), alkaline phosphatase (AP) and the CA 19.9 tumour marker. Our objective in this study was to validate the model by means of the acquisition of new records for an additional analysis.Ministerio de Educación y Cienci

Pre-hospital antibiotic treatment and mortality caused by invasive meningococcal disease, adjusting for indication bias

<p>Abstract</p> <p>Background</p> <p>Mortality from invasive meningococcal disease (IMD) has remained stable over the last thirty years and it is unclear whether pre-hospital antibiotherapy actually produces a decrease in this mortality. Our aim was to examine whether pre-hospital oral antibiotherapy reduces mortality from IMD, adjusting for indication bias.</p> <p>Methods</p> <p>A retrospective analysis was made of clinical reports of all patients (n = 848) diagnosed with IMD from 1995 to 2000 in Andalusia and the Canary Islands, Spain, and of the relationship between the use of pre-hospital oral antibiotherapy and mortality. Indication bias was controlled for by the propensity score technique, and a multivariate analysis was performed to determine the probability of each patient receiving antibiotics, according to the symptoms identified before admission. Data on in-hospital death, use of antibiotics and demographic variables were collected. A logistic regression analysis was then carried out, using death as the dependent variable, and pre-hospital antibiotic use, age, time from onset of symptoms to parenteral antibiotics and the propensity score as independent variables.</p> <p>Results</p> <p>Data were recorded on 848 patients, 49 (5.72%) of whom died. Of the total number of patients, 226 had received oral antibiotics before admission, mainly betalactams during the previous 48 hours. After adjusting the association between the use of antibiotics and death for age, time between onset of symptoms and in-hospital antibiotic treatment, pre-hospital oral antibiotherapy remained a significant protective factor (Odds Ratio for death 0.37, 95% confidence interval 0.15–0.93).</p> <p>Conclusion</p> <p>Pre-hospital oral antibiotherapy appears to reduce IMD mortality.</p

Forest biomass density across large climate gradients in northern South America is related to water availability but not with temperature

Understanding and predicting the likely response of ecosystems to climate change are crucial challenges for ecology and for conservation biology. Nowhere is this challenge greater than in the tropics as these forests store more than half the total atmospheric carbon stock in their biomass. Biomass is determined by the balance between biomass inputs (i.e., growth) and outputs (mortality). We can expect therefore that conditions that favor high growth rates, such as abundant water supply, warmth, and nutrient-rich soils will tend to correlate with high biomass stocks. Our main objective is to describe the patterns of above ground biomass (AGB) stocks across major tropical forests across climatic gradients in Northwestern South America. We gathered data from 200 plots across the region, at elevations ranging between 0 to 3400 m. We estimated AGB based on allometric equations and values for stem density, basal area, and wood density weighted by basal area at the plotlevel. We used two groups of climatic variables, namely mean annual temperature and actual evapotranspiration as surrogates of environmental energy, and annual precipitation, precipitation seasonality, and water availability as surrogates of water availability. We found that AGB is more closely related to water availability variables than to energy variables. In northwest South America, water availability influences carbon stocks principally by determining stand structure, i.e. basal area. When water deficits increase in tropical forests we can expect negative impact on biomass and hence carbon storage

Clinical Predictors of Hyperperfusion Syndrome Following Carotid Stenting: Results From a National Prospective Multicenter Study

[Objectives] The aim of the HISPANIAS (HyperperfusIon Syndrome Post-carotid ANgIoplasty And Stenting) study was to define CHS rates and develop a clinical predictive model for cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS).[Background] CHS is a severe complication following CAS. The presence of clinical manifestations is estimated on the basis of retrospective reviews and is still uncertain.[Methods] The HISPANIAS study was a national prospective multicenter study with 14 recruiting hospitals. CHS was classified as mild (headache only) and moderate-severe (seizure, impaired level of consciousness, or development of focal neurological signs).[Results] A total of 757 CAS procedures were performed. CHS occurred in 22 (2.9%) patients, in which 16 (2.1%) had moderate-severe CHS and 6 (0.8%) had mild CHS (only headache). The rate of hemorrhages was 0.7% and was associated with high mortality (20%). Pre-operative predictors of moderate-severe CHS in multivariate analysis were female sex (odds ratio [OR]: 3.24; 95% confidence interval [CI]: 1.11 to 9.47; p = 0.03), older patients (OR: 1.09; 95% CI: 1.01 to 1.17; p = 0.02), left carotid artery treated (OR: 4.13; 95% CI: 1.11 to 15.40; p = 0.03), and chronic renal failure (OR: 6.29; 95% CI: 1.75 to 22.57; p = 0.005). The area under the curve of this clinical and radiological model was 0.86 (95% CI: 0.81 to 0.92; p = 0.001).[Conclusions] The rate of CHS in the HISPANIAS study was 2.9%, with moderate-severe CHS of 2.1%. CHS was independently associated with female sex, older age, history of chronic kidney disease, and a treated left carotid artery. Although further investigations are needed, the authors propose a model to identify high-risk patients and develop strategies to decrease CHS morbidity and mortality in the future.This study was supported by a Spanish grant from the Instituto de Salud Carlos III (ISCIII-FIS IP14/00971, 2014–2017). The ITRIBIS project has the registration number REGPOT-2013-1. Cooperative Cerebrovascular Disease Research Network (INVICTUS+) (RD16/0019/0015). Dr. Mancha is supported by a Río Hortega contract (CM16/00015). Abbott and Grifols have partial financial supported the conduction of the HISPANIAS project but had no role in the design of the study, interpretation of the data, or manuscript approval.Peer reviewe

Atlas de mortalidad por cáncer. España 1980-1984

Se ha realizado un estudio ecológico descriptivo en el que se describen y comparan las tasas de mortalidad para las diferentes localizaciones tumorales de que disponíamos de datos en España (a nivel provincial) durante el quinquenio 1980-1984. Además, se han obtenido imágenes resumen del patrón de mortalidad por tumores malignos. La fuente de datos que hemos utilizado han sido las ediciones del movimiento natural de la población española de los años 1980 a 1984 que recogen a partir de los boletines estadísticos de defunción los datos de mortalidad por causa, edad, sexo y lugar de residencia. Los datos de población correspondientes al periodo de estudio, por grupos de edad y sexo, necesarios como denominadores para el cálculo de los diferentes indicadores, se obtuvieron mediante interpolación del censo de población de 1981 y del padrón municipal de 1986. En los resultados se aprecia como, en España, el patrón geográfico de mortalidad global por tumores malignos es para ambos sexos de tipo predominantemente periférico. En los hombres, las provincias con exceso de mortalidad están situadas en la cornisa cantábrica y en Andalucía Occidental. En las mujeres el patrón es semejante, aunque con una penetración más acusada hacia el interior, a expensas fundamentalmente de las provincias de la parte norte de la Comunidad de Castilla-León. Las causas de este patrón geográfico hemos de buscarlas en los hipotéticos factores de riesgo implicados en aquellas localizaciones tumorales que aportan el mayor numero de defunciones (tumores malignos de la tráquea, de los bronquios y el pulmón, tumores malignos del estómago, tumores malignos de la mama y tumores malignos de la próstata

Regional differences in colorectal cancer mortality trends, Spain (1980-2018).

the aim of this study was to describe the trends of colorectal cancer (CRC) mortality by autonomous communities (ACs) and gender in Spain (1980-2018). the age-standardized mortality rates (ASMRs) for CRC (per 100,000) were calculated by direct standardization, using the world standard population. Mortality trends were described by ACs using a joinpoint regression model in both sexes. The annual percent changes and average annual percentage of change were computed for trends using the joinpoint regression analysis. during the most recent five-year period (2014-2018), the rates decreased among both males and females and were more pronounced in males (-2.3 %) than in females (-1.1 %), although with differences by ACs. ASMRs decrease in both sexes in the Basque Country, Canary Islands, Catalonia, Castile and Leon, Andalusia, Balearic Islands, Madrid, Murcia and Valencia. Whereas in other ACs, it only increases in males (Navarre, Castile-La Mancha, Extremadura and La Rioja) or females (Aragon, Asturias and Galicia). this updated analysis of temporal patterns of CRC mortality in Spain from 1980-2018, divided by ACs and sex, shows gender differences in CRC mortality trends. Despite the favorable trends in both sexes, the gender gap is widening

Regresión logística no condicionada y tamaño de muestra: una revisión bibliográfica

La regresión logística no condicionada es un método de predicción de riesgo muy útil en epidemiología. En este artículo revisamos las diferentes soluciones que han dado diversos autores sobre la interfase entre el cálculo del tamaño muestral y la utilización de la regresión logística. A partir del conocimiento de las primeras aportaciones, se revisan los fenómenos de regresión a la media y de la constricción predictiva, el diseño de una exposición ordinal con una salida binaria, el concepto de evento de interés por variable, las variables indicadoras, la fórmula clásica de Freeman, etc. Recogemos también algunas ideas escépticas sobre este tema

REGRESIÓN LOGÍSTICA NO CONDICIONADA Y TAMAÑO DE MUESTRA: UNA REVISIÓN BIBLIOGRÁFICA

La regresión logística no condicionada es un método de predicción de riesgo muy útil en epidemiología. En este artículo revisamos las diferentes soluciones que han dado diversos autores sobre la interfase entre el cálculo del tamaño muestral y la utilización de la regresión logística. A partir del conocimiento de las primeras aportaciones, se revisan los fenómenos de regresión a la media y de la constricción predictiva, el diseño de una exposición ordinal con una salida binaria, el concepto de evento de interés por variable, las variables indicadoras, la fórmula clásica de Freeman, etc. Recogemos también algunas ideas escépticas sobre este tema

Regresión logística no condicionada y tamaño de muestra: una revisión bibliográfica

La regresión logística no condicionada es un método de predicción de riesgo muy útil en epidemiología. En este artículo revisamos las diferentes soluciones que han dado diversos autores sobre la interfase entre el cálculo del tamaño muestral y la utilización de la regresión logística. A partir del conocimiento de las primeras aportaciones, se revisan los fenómenos de regresión a la media y de la constricción predictiva, el diseño de una exposición ordinal con una salida binaria, el concepto de evento de interés por variable, las variables indicadoras, la fórmula clásica de Freeman, etc. Recogemos también algunas ideas escépticas sobre este tema