Subjective symptoms related to GSM radiation from mobile phone base stations : a cross-sectional study

Objectives: We performed a reanalysis of the data from Navarro et al., 2003, in which health symptoms related to microwave exposure from mobile phone base stations (BS) were explored, including data obtained in a retrospective inquiry about fear of exposure from BS. Design: Cross-sectional study. Setting: La Ñora (Murcia), Spain. Participants: Participants with known illness in 2003 were subsequently disregarded: 88 participants instead of 101 (in 2003) were analysed. Since weather circumstances can influence exposure, we restricted data to measurements made under similar weather conditions. Outcomes and methods: A statistical method indifferent to the assumption of normality was employed: namely, binary logistic regression for modelling a binary response (e.g. suffering fatigue (1) or not (0)), and so exposure was introduced as a predictor variable. This analysis was carried out on a regular basis and bootstrapping [95% percentile method] was used to provide more accurate confidence intervals. Main outcome measures Results: The symptoms most related to exposure were: lack of appetite [odds ratio (OR)] = 1.58, 95% confidence interval (95%CI) = 1.23-2.03; lack of concentration [OR = 1.54, 95% CI = 1.25- 1.89]; irritability [OR = 1.51, 95% CI = 1.23-1.85]; and trouble sleeping [OR = 1.49, 95% CI = 1.20-1.84]. Changes in -2 log likelihood showed similar results. Concerns about the BS were strongly related with trouble sleeping [OR = 3.12, 95% CI = 1.10-8.86]. The exposure variable remained statistically significant in the multivariate analysis. The bootstrapped values were similar to the asymptotic confidence intervals. Conclusion: This study confirms our preliminary results. We observed that the incidence of most of the symptoms was related to exposure levels ¿ independently of the demographic variables and some possible risk factors. Concerns about adverse effects from exposure, despite being strongly related with sleep disturbances, do not influence the direct association between exposure and sleep

Effects of intensity, attention and medication on auditory-evoked potentials in patients with fibromyalgia

Fibromyalgia (FM) has been associated to an increased processing of somatosensory stimuli, but its generalization to other sensory modalities is under discussion. To clarify this, we studied auditory event-related potentials (AEPs) to stimuli of different intensity in patients with FM and healthy controls (HCs), considering the effects of attention mechanisms and medication. We performed two experiments: In study 1 (n = 50 FM, 60 HCs), the stimuli were presented randomly within the sequence; in study 2 (n = 28 FM, 30 HCs), they were presented in blocks of the same intensity. We analyzed intensity and group effects on N1-P2 amplitude and, only for the FM group, the effect of medication and the correlation between AEPs and clinical variables. Contrary to the expectation, the patients showed a trend of reduced AEPs to the loudest tones (study 1) or no significant differences with the HCs (study 2). Medication with central effects significantly reduced AEPs, while no significant relationships between the N1-P2 amplitude/intensity function and patients' symptoms were observed. The findings do not provide evidence of augmented auditory processing in FM. Nevertheless, given the observed effect of medication, the role of sensory amplification as an underlying pathophysiological mechanism in fibromyalgia cannot be discarded.Spanish Government (Ministerio de ciencia e Innovación; ref PSI2009-14555 and, Ministerio de Economía y Competitividad; ref PSI2013-45818-R) and from the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; axudas para a consolidación e Estruturación de unidades de investigación competitivas do Sistema universitario de Galicia; grant number GPC 2014/047). A.G.V. was supported by a grant from the Portuguese Foundation for Science and Technology within the scope of the Individual Call to Scientific Employment Stimulus 2017. N.S.V. was supported by a grant from Spanish Government (Ministerio de Economía y Competitividad; grant number BES-2017-082684

Patients with fibromyalgia show increased beta connectivity across distant networks and microstates alterations in resting-state electroencephalogram

Fibromyalgia (FM) is a chronic condition characterized by widespread pain of unknown etiology associated with alterations in the central nervous system. Although previous studies demonstrated altered patterns of brain activity during pain processing in patients with FM, alterations in spontaneous brain oscillations, in terms of functional connectivity or microstates, have been barely explored so far. Here we recorded the EEG from 43 patients with FM and 51 healthy controls during open-eyes resting-state. We analyzed the functional connectivity between different brain networks computing the phase lag index after group Independent Component Analysis, and also performed an EEG microstates analysis. Patients with FM showed increased beta band connectivity between different brain networks and alterations in some microstates parameters (specifically lower occurrence and coverage of microstate class C). We speculate that the observed alterations in spontaneous EEG may suggest the dominance of endogenous top-down influences; this could be related to limited processing of novel external events and the deterioration of flexible behavior and cognitive control frequently reported for FM. These findings provide the first evidence of alterations in long-distance phase connectivity and microstate indices at rest, and represent progress towards the understanding of the pathophysiology of fibromyalgia and the identification of novel biomarkers for its diagnosis.Spanish Government (Ministerio de Economía y Competitividad; grant number PSI2016-75313-R) and from the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; axudas para a consolidación e Estruturación de unidades de investigación competitivas do Sistema universitario de Galicia; grant number GRC GI-1807-USC; REF: ED431-2017/27). A.G.V. was partially supported by a grant from Xunta de Galicia (Axudas de apoio á etapa de formación posdoutoral 2018) and by the Portuguese Foundation for Science and Technology within the scope of the Individual Call to Scientific Employment Stimulus 201

Iglesia, en Jávea, España

This church design is based on the idea of enclosed and concentrated thought. Its light source is zenithal, from skylights at the top of the structure. It is shaped like a sailing boat, without comers or sharp edges, and seeks to enclose a smoothly contoured space, as most suitable to establish a mental encounter with the Almighty. The whole project is in concrete; the formwork being of exceptional quality. Both its formal concept emd its external and internal aspects make this a notable design, that is outstanding in modem religious architecture.Esta original iglesia ha surgido de una idea de interioridad, con total iluminación interior cenital, desde los lucernarios superiores. Su forma es la de una barca, sin esquinas, suave, como espacio más adecuado para un encuentro con Dios. Toda la obra es de hormigón vertido en encofrados maravillosamente realizados y, tanto su concepción formal como el tratamiento dado a sus interiores y exteriores, la destacan, notablemente, en el campo de la Arquitectura religiosa contemporánea

Parathyroidectomy in chronic kidney disease patients in Argentina: pre surgical studies, types of surgery, recurrence and persistence

Introduction: Parathyroidectomy (PTx) is the selecte treatment for patients with severe secondary hyperparathyroidism, refractory to medical treatment. There is not enough information about this procedure in Argentina, that is the reason why we performed this study. Methods: 255 patients with PTx were included from the year 2003 to 2007 on a voluntary register. Studies of pre-surgical localization, phosphocalcic metabolism laboratories before and after surgery were evaluated, and the type of surgical technique used. The persistence and recurrence of post-surgical hyperparathyroidism was analyzed. Results: The PTx rate was 2,7/1000 patients year. 83% of the patients had neck echography and 59% Sestamibi scans with Tc 99. There was a positive correlation (p<0,001) between the number of detected glands by echography and Sestamibi. The parathyroidectomy performed was: subtotal in 77%, total with self-implant in 14% and total without self-implant in 9%. There were significant falls of Ca and P, Alkaline Phosphatase and PTH (1744±788 pg/ml to 247±450 pg/ml; p<0.0001) post-surgical. 2.4 ±2,5 months after the PTx, 72% of patients had PTH <2 50 pg/ml, 19,8% had persistence and 8,3% had recurrence. According to the type of surgery, the persistence and recurrence were for subtotal PTx 22% and 8,3%, total PTx with implant 11% and 11%, and total PTx without selfimplant 13% and 4% respectively. The performance of the Sestamibi scan did not affect the PTx results. No noticeable differences were observed among the centers for persistence and recurrence. Conclusions: The PTx rate was very low, echography was the preferred method of pre-surgical localization, and subtotal PTx was the most used surgical technique. PTx was successful in most of the patients, and persistence and recurrence were not related to the technique

Natural-orifice transluminal endoscopic surgery

Background: Natural-orifice transluminal endoscopic surgery (NOTES) represents one of the most significant innovations in surgery to emerge since the advent of laparoscopy. A decade of progress with this approach has now been catalogued, and yet its clinical application remains controversial. Methods: A PubMed search was carried out for articles describing NOTES in both the preclinical and the clinical setting. Public perceptions and expert opinion regarding NOTES in the published literature were analysed carefully. Results: Two hundred relevant articles on NOTES were studied and the outcomes reviewed. A division between direct- and indirect-target NOTES was established. The areas with the most promising clinical application included direct-target NOTES, such as transanal total mesorectal excision and peroral endoscopic myotomy. The clinical experience with distant-target NOTES, such as for appendicectomy and cholecystectomy, showed feasibility; however, NOTES-specific morbidity was introduced and this represents an important limitation. Conclusion: NOTES experimentation in the preclinical setting has increased substantially. There has also been a significant increase in the application of NOTES in humans in the past decade. Enthusiasm for NOTES should be tempered by the risk of incurring NOTES-specific morbidity. Surgeons should carefully consider patient preferences regarding this new minimally invasive option, as opinions are not unanimously supportive of NOTES. As technical limitations are overcome, the clinical application of NOTES is predicted to increase. It is paramount that, when this complex technique is performed on humans, it is applied judiciously by appropriately trained experts with outcomes recorded in a registry