Epidemiologia de la fractura de fèmur a Espanya (1997-2010)

L'osteoporosi representa un problema de salut important, doncs, juntament amb les caigudes, és la principal causa de la majoria de fractures òssies. Entre elles destaca la fractura de fèmur per la seva alta mortalitat i morbiditat en una societat amb una tendència progressiva a l'envelliment. Les tendències temporals en la seva incidència han estat reportades en molts països desenvolupats. Aquestes dades a Espanya s'han realitzat de manera incompleta. Aquest estudi analitza la incidència de les fractures de fèmur en persones majors de 65 anys en un període de 14 anys (1997-2010). Els objectius principals dels estudis són establir les tendències de la fractura de fèmur que s'han produït en el període d'estudi i la seva variabilitat en el conjunt de l'Estat espanyol i en les diferents Comunitats Autònomes (CCAA). S'han realitzat dos estudis que es complementen i permeten obtenir una informació global sobre la tendència en la incidència de fractura de fèmur a l'Estat Espanyol i sobre les diferencies en les taxes d'incidència entre les seves CCAA. Es tracta d'estudis observacionals, retrospectius i analítics sobre les persones ≥ de 65 anys que han patit un fractura de fèmur a Espanya durant el període de 1997-2010. Aquests registres provenen del Conjunt Mínim Bàsic de Dades (CMBD) dels pacient atesos en el conjunt d'hospitals del país. S'analitzen 119.857 fractures de fèmur en homes i 415.421 en dones de ≥ 65 anys. Comparant períodes separats 10 anys (P1 enfront de P2), la taxa d'incidència bruta/100.000 hab/any va augmentar un mitjana de 2,3%/ any en els homes i un 1,4%/any en dones. Amb taxes ajustades per edat, la taxa va augmentar una mitjana del 0,4%/ any en homes (p 0,0001), però va disminuir un 0,2%/ any en dones (p 0,0001). En els homes menors de 85 anys, la disminució no va ser significativa excepte en el grup de 70-74 anys, augmentat significativament a partir dels 85 anys (p 0,0001). En les dones, es va observar en els grups de menys de 80 anys una disminució significativa de la taxa ajustada a l'edat, que augmenta de manera significativa a partir del 85 anys d'edat . Les taxes de mortalitat es van reduir un 22% en ambdós sexes i l'índex d' envelliment va pujar un 30,1% en homes i un 25,2% en dones. La taxa ajustada/100.000 hab/any va ser de 722,6 en dones i 248,8 en homes. Per sobre de la mitja en dones trobem 7 CCAA, entre les que destaquen Catalunya, C. Valenciana i Castella la Manxa. Per sota la mitjana n'hi ha 6 CCAA, entre les que destaquen Canàries i Galícia. La diferència entre les CCAA amb major i menor taxa de fractura ajustada per població és un 44% menor en dones (Canàries enfront de Castella la Manxa) i un 50% menor en homes (Galicia enfront de Catalunya). Podem concloure que hi ha un augment de la taxa bruta d'incidència de fractura de fèmur a Espanya en els darrers 14 anys, fet que reflexa un canvi en l'estructura de la població. En taxes ajustades s'observa una estabilització o lleugera disminució en els grups d'edat més joves, especialment en dones, que augmenta de nou, de manera important, en els grups d'edat majors de 85 anys. S'observa una important variabilitat entre CCAA i per tant, zones geogràfiques, que, excepte a Canàries, és difícil d'explicar només per factors com l'edat, l'exposició solar o el gradient nord-sud.Osteoporosis represents an important health problem as once it is associated with falls it becomes the main cause of bone fractures. Of those fractures, hip fractures stand out because of the higher morbidity and mortality rates in a society with a progressive ageing tendency. Temporal trends in hip fracture incidence have been documented thoroughly in several developed countries, but in Spain the data is incomplete. This study analyses the stratified incidence of hip fracture in the population older than 65 years of age in Spain during a period of 14 years. The main objective of these studies are to establish the trends in hip fracture that occurred during the study period and the variability observed in the whole of Spain and in the different Autonomous Communities of Spain (CCAA) These are retrospective observational and analytical studies conducted on people 65 years of age or older who have experienced hip fractures during the period 1997-2010. These data is drawn from the "Collected Minimum Basic Data" (CMBD) of patients attending Spain's nationwide system of Hospitals. The analysis compares two periods of four years: 1997-2000 (P1) and 2007-2010 (P2). There were 119,857 fractures in men and 415,421 in women. Comparing periods (P1 vs. P2) over 10 years, the crude incidence rate/100,000 inhabitant/year increased an average of 2.3 %/year in men and 1.4 % in women. After adjusting both rates by age, the rate increased an average of 0.4 %/year in men (p 0.0001), but decreased 0.2 %/year in women (p 0.0001). In men, younger than 85, the decrease was not significant except for those in the 70-74 years range, increasing significantly (p 0.0001) after 85 years of age. In women, the observation is made in those under 80 years of age, of a significant decrease in the adjusted rate; with no change in those in the 80-84 years range, and a significant adjusted rate increase for those of 85 years of age or older (p 0.0001). Mortality rates declined by 22 % in both sexes, and the index of over aging population rises 30.1% in men and 25.2 % in women. The adjusted rate/100.000 in habitant /year was of 722,6 in women and 248,8 in men. Overaverage rates in women were found in 7 Autonomous Communities of which Catalonia, C. Valencia and Castilla la Mancha stand out. Other six communities remained below average, of which Canarias and Galicia stands out. The difference between the highest and the lowest adjusted rate of hip fractures in the Autonomous Communities was 44% lower in women (Canarias in front of Castilla La Mancha) and 50% lower in Men ( Galicia in front of Catalunya) . We can conclude that there has been an increase in the crude incidence of hip fractures in Spain during these 14 years which reflects changes in the age composition of its population. These results are similar to the findings in other international studies. The incidence of hip fractures adjusted to age has a tendency to stabilize or even to diminish slightly in the younger age group population, especially in women. Rising again in a significant measure in those aged 85 years or older. There's a measureable variability between the different Autonomous Communities of Spain, that can't be easily explained by factors like age, sun exposure, or the north-south gradient except perhaps in "Canarias"

Artrosi de genoll a l' Atenció Primària. Utilitat de l' ecografia en el seu maneig i seguiment

L' artrosi de genoll es una de les malalties reumatològiques mes freqüents a l'Atenció Primària Objectiu. Prevalença de sinovitis Material i mètodes. Estudi transversal descriptiu. Resultats. 19 pacients, promig d'edat de 59,8 anys . L'estudi ecogràfic es va trobar vessament articular en 17 pacients (89.4%) i hipertrofia sinovial en 10 (52,6%) . Entre pacients amb i sense vessament existeixen diferencies significatives en el temps d'evolució i el qüestionari Lequesne. Conclusions. L'ecografia articular és una eina eficaç. La malaltia artròsica no es un procés purament degeneratiu, sinó que existeixen signes inflamatoris

Cucumis metuliferus is resistant to root-knot nematode Mi1.2 gene (a)virulent populations and a promising melon rootstock

[EN] Pot experiments were carried out to characterize the response of two Cucumis metuliferus accessions against (a)virulent Meloidogyne arenaria, M. incognita or M. javanica populations, to Mi1.2 gene and to determine the compatibility and the effect on physicochemical properties of cantaloupe melon. In addition, histopathological studies were conducted. Plants were inoculated in 200 cm3 -pots with 1 J2 cm-3 24 of soil containing sterilized sand a week after transplanting and maintained in a growth chamber at 25 ºC for 40 days. The susceptible cucumber cv. Dasher II or melon cv. Paloma were included for comparison. The number of egg masses and number of eggs per plant were assessed, and the reproduction index (RI) was calculated as the percentage of eggs produced on the C. metuliferus accessions respect those produced on the susceptible cultivars. The compatibility and fruit quality was assessed grafting three scions (two of Charentais type) and one of type Piel de Sapo under commercial greenhouse conditions. The resistance level of both C. metuliferus accessions ranged from highly (RI < 1%) to resistant (1% ¿RI ¿ 10%) irrespective of Meloidogyne populations. Melon plants grafted onto C. metuliferus accession BGV11135 grew as selfgrafted plants and did not modify negatively fruit quality traits. Giant cells induced by RKN on C. metuliferus were mostly poor developed compared to those on cucumber. Furthermore, necrotic areas surrounding the nematode were observed. C. metuliferus accession BGV11135 could be a promising melon rootstock to manage Meloidogyne spp. irrespective of its (a)virulent Mi1.2 condition without melon fruit quality reduction.This work was supported by AGL2013-49040-C2-1-R, and AGL2014-53398-C2-2-R projects from the Spanish Ministry of Economy, Industry and Competitiveness, and cofounded with FEDER Funds. The authors would like to thank Semillas Fito for providing melon cv. Paloma, Dr Christine Vos (Scientia Terrae Research Institute) for her English revision and critical comments of the manuscript and Dr Nuria Escudero (Universitat Politecnica de Catalunya) for her support and critical comments on the manuscript.Expósito, A.; Munera, M.; Giné, A.; López Gómez, M.; Cáceres-Burbano, A.; Picó Sirvent, MB.; Gisbert Domenech, MC.... (2018). Cucumis metuliferus is resistant to root-knot nematode Mi1.2 gene (a)virulent populations and a promising melon rootstock. Plant Pathology. 67:1161-1167. https://doi.org/10.1111/ppa.12815S1161116767Cortada, L., Sorribas, F. J., Ornat, C., Kaloshian, I., & Verdejo-Lucas, S. (2008). Variability in infection and reproduction ofMeloidogyne javanicaon tomato rootstocks with theMiresistance gene. Plant Pathology, 57(6), 1125-1135. doi:10.1111/j.1365-3059.2008.01906.xDavis, A. R., Perkins-Veazie, P., Hassell, R., Levi, A., King, S. R., & Zhang, X. (2008). Grafting Effects on Vegetable Quality. HortScience, 43(6), 1670-1672. doi:10.21273/hortsci.43.6.1670Devran, Z., & Söğüt, M. A. (2010). Occurrence of virulent root-knot nematode populations on tomatoes bearing the Mi gene in protected vegetable-growing areas of Turkey. Phytoparasitica, 38(3), 245-251. doi:10.1007/s12600-010-0103-yDjian-Caporalino, C., Palloix, A., Fazari, A., Marteu, N., Barbary, A., Abad, P., … Castagnone-Sereno, P. (2014). Pyramiding, alternating or mixing: comparative performances of deployment strategies of nematode resistance genes to promote plant resistance efficiency and durability. BMC Plant Biology, 14(1), 53. doi:10.1186/1471-2229-14-53Giné, A., & Sorribas, F. J. (2016). Effect of plant resistance and BioAct WG (Purpureocillium lilacinumstrain 251) onMeloidogyne incognitain a tomato-cucumber rotation in a greenhouse. Pest Management Science, 73(5), 880-887. doi:10.1002/ps.4357Giné, A., & Sorribas, F. J. (2017). Quantitative approach for the early detection of selection for virulence of Meloidogyne incognita on resistant tomato in plastic greenhouses. Plant Pathology, 66(8), 1338-1344. doi:10.1111/ppa.12679Giné, A., López-Gómez, M., Vela, M. D., Ornat, C., Talavera, M., Verdejo-Lucas, S., & Sorribas, F. J. (2014). Thermal requirements and population dynamics of root-knot nematodes on cucumber and yield losses under protected cultivation. Plant Pathology, 63(6), 1446-1453. doi:10.1111/ppa.12217Giné, A., González, C., Serrano, L., & Sorribas, F. J. (2017). Population dynamics of Meloidogyne incognita on cucumber grafted onto the Cucurbita hybrid RS841 or ungrafted and yield losses under protected cultivation. European Journal of Plant Pathology, 148(4), 795-805. doi:10.1007/s10658-016-1135-zGisbert C Sorribas FJ Martínez EM Gammoudi N Bernat G Picó B 2014 Grafting melons onto potential Cucumis spp. rootstocks http://upcommons.upc.edu/bitstream/handle/2117/27982/Grafting%20melons.pdf?sequence=1Gisbert, C., Gammoudi, N., Munera, M., Giné, A., Pocurull, M., Sorribas, F. J., & Picó, M. B. (2017). Evaluation of two potentialCucumisspp. resources for grafting melons. Acta Horticulturae, (1151), 157-162. doi:10.17660/actahortic.2017.1151.25Guan, W., Zhao, X., Dickson, D. W., Mendes, M. L., & Thies, J. (2014). Root-knot Nematode Resistance, Yield, and Fruit Quality of Specialty Melons Grafted onto Cucumis metulifer. HortScience, 49(8), 1046-1051. doi:10.21273/hortsci.49.8.1046Hadisoeganda, W. W. (1982). Resistance of Tomato, Bean, Southern Pea, and Garden Pea Cultivars to Root-Knot Nematodes Based on Host Suitability. Plant Disease, 66(1), 145. doi:10.1094/pd-66-145Lee, J.-M., & Oda, M. (2010). Grafting of Herbaceous Vegetable and Ornamental Crops. Horticultural Reviews, 61-124. doi:10.1002/9780470650851.ch2Leonardi, C., Kyriacou, M. C., Gisbert, C., Oztekin, G. B., Mourão, I., & Rouphael, Y. (s. f.). Quality of grafted vegetables. Vegetable grafting: principles and practices, 216-244. doi:10.1079/9781780648972.0216Liu, B., Ren, J., Zhang, Y., An, J., Chen, M., Chen, H., … Ren, H. (2014). A new grafted rootstock against root-knot nematode for cucumber, melon, and watermelon. Agronomy for Sustainable Development, 35(1), 251-259. doi:10.1007/s13593-014-0234-5López-Gómez, M., Gine, A., Vela, M. D., Ornat, C., Sorribas, F. J., Talavera, M., & Verdejo-Lucas, S. (2014). Damage functions and thermal requirements ofMeloidogyne javanicaandMeloidogyne incognitaon watermelon. Annals of Applied Biology, 165(3), 466-473. doi:10.1111/aab.12154López-Gómez, M., Flor-Peregrín, E., Talavera, M., Sorribas, F. J., & Verdejo-Lucas, S. (2015). Population dynamics of Meloidogyne javanica and its relationship with the leaf chlorophyll content in zucchini. Crop Protection, 70, 8-14. doi:10.1016/j.cropro.2014.12.015López-Gómez, M., Talavera, M., & Verdejo-Lucas, S. (2015). Differential reproduction ofMeloidogyne incognitaandM. javanicain watermelon cultivars and cucurbit rootstocks. Plant Pathology, 65(1), 145-153. doi:10.1111/ppa.12394Omwega, C. O. (1988). A Nondestructive Technique for Screening Bean Germ Plasm for Resistance to Meloidogyne incognita. Plant Disease, 72(11), 970. doi:10.1094/pd-72-0970Ornat, C., Verdejo-Lucas, S., & Sorribas, F. J. (2001). A Population of Meloidogyne javanica in Spain Virulent to the Mi Resistance Gene in Tomato. Plant Disease, 85(3), 271-276. doi:10.1094/pdis.2001.85.3.271Seinhorst, J. W. (1965). The Relation Between Nematode Density and Damage To Plants. Nematologica, 11(1), 137-154. doi:10.1163/187529265x00582Sikora, R. A., & Fernández, E. (s. f.). Nematode parasites of vegetables. Plant parasitic nematodes in subtropical and tropical agriculture, 319-392. doi:10.1079/9780851997278.0319Sorribas, F. J., Ornat, C., Verdejo-Lucas, S., Galeano, M., & Valero, J. (2005). Effectiveness and profitability of the Mi-resistant tomatoes to control root-knot nematodes. European Journal of Plant Pathology, 111(1), 29-38. doi:10.1007/s10658-004-1982-xSoteriou, G. A., Kyriacou, M. C., Siomos, A. S., & Gerasopoulos, D. (2014). Evolution of watermelon fruit physicochemical and phytochemical composition during ripening as affected by grafting. Food Chemistry, 165, 282-289. doi:10.1016/j.foodchem.2014.04.120Talavera, M., Verdejo-Lucas, S., Ornat, C., Torres, J., Vela, M. D., Macias, F. J., … Sorribas, F. J. (2009). Crop rotations with Mi gene resistant and susceptible tomato cultivars for management of root-knot nematodes in plastic houses. Crop Protection, 28(8), 662-667. doi:10.1016/j.cropro.2009.03.015Talavera, M., Sayadi, S., Chirosa-Ríos, M., Salmerón, T., Flor-Peregrín, E., & Verdejo-Lucas, S. (2012). Perception of the impact of root-knot nematode-induced diseases in horticultural protected crops of south-eastern Spain. Nematology, 14(5), 517-527. doi:10.1163/156854112x635850Thies, J. A., Ariss, J. J., Hassell, R. L., Olson, S., Kousik, C. S., & Levi, A. (2010). Grafting for Management of Southern Root-Knot Nematode, Meloidogyne incognita, in Watermelon. Plant Disease, 94(10), 1195-1199. doi:10.1094/pdis-09-09-0640Trionfetti Nisini, P., Colla, G., Granati, E., Temperini, O., Crinò, P., & Saccardo, F. (2002). Rootstock resistance to fusarium wilt and effect on fruit yield and quality of two muskmelon cultivars. Scientia Horticulturae, 93(3-4), 281-288. doi:10.1016/s0304-4238(01)00335-1Tzortzakakis, E. A., Adam, M. A. M., Blok, V. C., Paraskevopoulos, C., & Bourtzis, K. (2005). Occurrence of Resistance-breaking Populations of Root-knot Nematodes on Tomato in Greece. European Journal of Plant Pathology, 113(1), 101-105. doi:10.1007/s10658-005-1228-6Verdejo-Lucas, S., Cortada, L., Sorribas, F. J., & Ornat, C. (2009). Selection of virulent populations ofMeloidogyne javanicaby repeated cultivation ofMiresistance gene tomato rootstocks under field conditions. Plant Pathology, 58(5), 990-998. doi:10.1111/j.1365-3059.2009.02089.xVerdejo-Lucas, S., Talavera, M., & Andrés, M. F. (2012). Virulence response to the Mi.1 gene of Meloidogyne populations from tomato in greenhouses. Crop Protection, 39, 97-105. doi:10.1016/j.cropro.2012.03.025WHITEHEAD, A. G., & HEMMING, J. R. (1965). A comparison of some quantitative methods of extracting small vermiform nematodes from soil. Annals of Applied Biology, 55(1), 25-38. doi:10.1111/j.1744-7348.1965.tb07864.xYe, D.-Y., Qi, Y.-H., Cao, S.-F., Wei, B.-Q., & Zhang, H.-S. (2017). Histopathology combined with transcriptome analyses reveals the mechanism of resistance to Meloidogyne incognita in Cucumis metuliferus. Journal of Plant Physiology, 212, 115-124. doi:10.1016/j.jplph.2017.02.002Donkers-Venne, D. T. H. M., Fargette, M., & Zijlstra, C. (2000). Identification of Meloidogyne incognita, M. javanica and M. arenaria using sequence characterised amplified region (SCAR) based PCR assays. Nematology, 2(8), 847-853. doi:10.1163/15685410075011279

La Cova de Dalt del Tossal de la Font (Vilafamés, Castellón): conclusiones preliminares de las intervenciones arqueológicas (1982-1987 / 2004-2012)

Las excavaciones llevadas a cabo en el yacimiento de la Cova de Dalt del Tossal de la Font en la década de 1980 pusieron al descubierto un importante relleno kárstico del Pleistoceno Superior. Entre el registro recuperado destacan, además de diversas especies de herbívoros y carnívoros, así como de un reducido conjunto litotécnico, tres fósiles humanos adscritos en términos generales al grupo de los neandertales. Entre 2004 y 2012, en el marco de un convenio entre la Universitat Jaume I de Castelló (UJI), el Servei d¿Investigacions Arqueològiques i Prehistòriques (SIAP) de la Diputació de Castelló y el Institut Català de Paleoecologia Humana i Evolució Social (IPHES), se ha desarrollado una segunda época de intervenciones en el yacimiento. En este artículo ofrecemos un estado de la cuestión de la información disponible hasta la fecha sobre el yacimiento, especialmente en lo que se refiere a los aspectos tafonómicos y a la formación del depósito

Paleografía humana durante el Tardiglaciar y Holoceno inicial en el ámbito mediterráneo del Ne ibérico

En el NE mediterráneo de la Península Ibérica, el perído comprendido entre el Tardiglaciar y el Holoceno muestra una dinámica demográfica y cultural en la que se alternan momentos de abundancia de registro y diversidad de evidencias con fases de escasez y casos aislados. Los tecno-complejos microlaminares, que se inician durante el GI-1, rompen con el vacío del Pleniglaciar y parecen perdurar en el tiempo de forma discontinua hasta los inicios del Holoceno. Este hecho genera un escenario de convergencia cronológica con las escasas evidencias sauveterrienses y el Mesolítico de muescas y denticulados. Ambos aparecen en el registro coincidiendo con el tránsito Pleistoceno-Holoceno. La perduración de los conjuntos atribuídos al Paleolítico superior final rompe con la homgeneidad cronológica del proceso observada en los territorios cercanos, mostrando las peculiaridades de la ocupación en un territorio concreto dentro de la evolución cultural de la Cuenca del Ebro y el Levante mediterráne

Prediction of absolute risk of fragility fracture at 10 years in a Spanish population: validation of the WHO FRAX ™ tool in Spain

Background: Age-related bone loss is asymptomatic, and the morbidity of osteoporosis is secondary to the fractures that occur. Common sites of fracture include the spine, hip, forearm and proximal humerus. Fractures at the hip incur the greatest morbidity and mortality and give rise to the highest direct costs for health services. Their incidence increases exponentially with age. Independently changes in population demography, the age - and sex- specific incidence of osteoporotic fractures appears to be increasing in developing and developed countries. This could mean more than double the expected burden of osteoporotic fractures in the next 50 years. Methods/Design: To assess the predictive power of the WHO FRAX (TM) tool to identify the subjects with the highest absolute risk of fragility fracture at 10 years in a Spanish population, a predictive validation study of the tool will be carried out. For this purpose, the participants recruited by 1999 will be assessed. These were referred to scan-DXA Department from primary healthcare centres, non hospital and hospital consultations. Study population: Patients attended in the national health services integrated into a FRIDEX cohort with at least one Dual-energy X-ray absorptiometry (DXA) measurement and one extensive questionnaire related to fracture risk factors. Measurements: At baseline bone mineral density measurement using DXA, clinical fracture risk factors questionnaire, dietary calcium intake assessment, history of previous fractures, and related drugs. Follow up by telephone interview to know fragility fractures in the 10 years with verification in electronic medical records and also to know the number of falls in the last year. The absolute risk of fracture will be estimated using the FRAX (TM) tool from the official web site. Discussion: Since more than 10 years ago numerous publications have recognised the importance of other risk factors for new osteoporotic fractures in addition to low BMD. The extension of a method for calculating the risk (probability) of fractures using the FRAX (TM) tool is foreseeable in Spain and this would justify a study such as this to allow the necessary adjustments in calibration of the parameters included in the logarithmic formula constituted by FRAX (TM

Measuring health-related quality of life in men with osteoporosis or osteoporotic fracture

<p>Abstract</p> <p>Background</p> <p>Osteoporosis is a serious health problem that worsens the quality of life and the survival rate of individuals with this disease on account the osteoporotic fractures. Studies have long focused on women, and its presence in men has been underestimated. While many studies conducted in different countries mainly assess health-related quality of life and identify fracture risks factors in women, few data are available on a Spanish male population.</p> <p>Methods/Design</p> <p>Observational study.</p> <p>Study population</p> <p>Men ≥ 40 years of age with/without diagnosed osteoporosis and with/without osteoporotic fracture included by their family doctor.</p> <p>Measurements</p> <p>The relationship between customary clinical risk factors for osteoporotic fracture and health-related quality of life in a Spanish male population. A telephone questionnaire on health-related quality of life is made.</p> <p>Statistical analysis</p> <p>The association between qualitative variables will be assessed by the Chi-square test. The distribution of quantitative variables by Student's t-test. If the conditions for using this test are not met, the non-parametric Mann-Whitney's U test will be used.</p> <p>The validation of the results obtained by the FRAX™ tool will be performed by way of the Hosmer-Lemeshow test and by calculating the area under the Receiver Operating Characteristic (ROC) curve (AUC). All tests will be performed with a confidence intervals set at 95%.</p> <p>Discussion</p> <p>The applicability and usefulness of Health-related quality of life (HRQOL) studies are well documented in many countries. These studies allow implementing cost-effective measures in cases of a given disease and reducing the costly consequences derived therefrom. This study attempts to provide objective data on how quality of life is affected by the clinical aspects involved in osteoporosis in a Spanish male population and can be useful as well in cost utility analyses conducted by health authorities.</p> <p>The sample selected is not based on a high fracture risk group. Rather, it is composed of men in the general population, and accordingly comparisons should not lead to erroneous interpretations.</p> <p>A possible bias correction will be ensured by checking reported fractures against healthcare reports and X-rays, or by consulting health care centers as applicable.</p

Prediction of absolute risk of fragility fracture at 10 years in a Spanish population: validation of the WHO FRAX ™ tool in Spain

<p>Abstract</p> <p>Background</p> <p>Age-related bone loss is asymptomatic, and the morbidity of osteoporosis is secondary to the fractures that occur. Common sites of fracture include the spine, hip, forearm and proximal humerus. Fractures at the hip incur the greatest morbidity and mortality and give rise to the highest direct costs for health services. Their incidence increases exponentially with age.</p> <p>Independently changes in population demography, the age - and sex- specific incidence of osteoporotic fractures appears to be increasing in developing and developed countries. This could mean more than double the expected burden of osteoporotic fractures in the next 50 years.</p> <p>Methods/Design</p> <p>To assess the predictive power of the WHO FRAX™ tool to identify the subjects with the highest absolute risk of fragility fracture at 10 years in a Spanish population, a predictive validation study of the tool will be carried out. For this purpose, the participants recruited by 1999 will be assessed. These were referred to scan-DXA Department from primary healthcare centres, non hospital and hospital consultations. Study population: Patients attended in the national health services integrated into a FRIDEX cohort with at least one Dual-energy X-ray absorptiometry (DXA) measurement and one extensive questionnaire related to fracture risk factors. Measurements: At baseline bone mineral density measurement using DXA, clinical fracture risk factors questionnaire, dietary calcium intake assessment, history of previous fractures, and related drugs. Follow up by telephone interview to know fragility fractures in the 10 years with verification in electronic medical records and also to know the number of falls in the last year. The absolute risk of fracture will be estimated using the FRAX™ tool from the official web site.</p> <p>Discussion</p> <p>Since more than 10 years ago numerous publications have recognised the importance of other risk factors for new osteoporotic fractures in addition to low BMD. The extension of a method for calculating the risk (probability) of fractures using the FRAX™ tool is foreseeable in Spain and this would justify a study such as this to allow the necessary adjustments in calibration of the parameters included in the logarithmic formula constituted by FRAX™.</p

Age and date for early arrival of the Acheulian in Europe (Barranc de la Boella, la Canonja, Spain)

The first arrivals of hominin populations into Eurasia during the Early Pleistocene are currently considered to have occurred as short and poorly dated biological dispersions. Questions as to the tempo and mode of these early prehistoric settlements have given rise to debates concerning the taxonomic significance of the lithic assemblages, as trace fossils, and the geographical distribution of the technological traditions found in the Lower Palaeolithic record. Here, we report on the Barranc de la Boella site which has yielded a lithic assemblage dating to ,1 million years ago that includes large cutting tools (LCT). We argue that distinct technological traditions coexisted in the Iberian archaeological repertoires of the late Early Pleistocene age in a similar way to the earliest sub-Saharan African artefact assemblages. These differences between stone tool assemblages may be attributed to the different chronologies of hominin dispersal events. The archaeological record of Barranc de la Boella completes the geographical distribution of LCT assemblages across southern Eurasia during the EMPT (Early-Middle Pleistocene Transition, circa 942 to 641 kyr). Up to now, chronology of the earliest European LCT assemblages is based on the abundant Palaeolithic record found in terrace river sequences which have been dated to the end of the EMPT and later. However, the findings at Barranc de la Boella suggest that early LCT lithic assemblages appeared in the SW of Europe during earlier hominin dispersal episodes before the definitive colonization of temperate Eurasia took place.The research at Barranc de la Boella has been carried out with the financial support of the Spanish Ministerio de Economı´a y Competitividad (CGL2012- 36682; CGL2012-38358, CGL2012-38434-C03-03 and CGL2010-15326; MICINN project HAR2009-7223/HIST), Generalitat de Catalunya, AGAUR agence (projects 2014SGR-901; 2014SGR-899; 2009SGR-324, 2009PBR-0033 and 2009SGR-188) and Junta de Castilla y Leo´n BU1004A09. Financial support for Barranc de la Boella field work and archaeological excavations is provided by the Ajuntament de la Canonja and Departament de Cultura (Servei d’Arqueologia i Paleontologia) de la Generalitat de Catalunya. A. Carrancho’s research was funded by the International Excellence Programme, Reinforcement subprogramme of the Spanish Ministry of Education. I. Lozano-Ferna´ndez acknowledges the pre-doctoral grant from the Fundacio´n Atapuerca. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Aula de innovación educativa

El artículo forma parte de un monográfico dedicado a recursos de atención a la diversidad específicos como motor de cambio en secundaria.Los equipos de asesoramiento y orientación son un servicio del Departamento de la Generalitat de Catalunya con asentamiento en el territorio de estructura sectorial y composición multiprofesional. Las funciones han ido cambiando a lo largo de los años, manteniendo la característica de ser estructuras de apoyo permanente a la tarea docente del profesorado y de los centros..CataluñaConsejería de Educación, Ciencia e Investigación. Biblioteca; Av. de la Fama, 15; 30006 Murcia; Tel. +34968279685; Fax +34968279835; [email protected]