Depósito funerario y recinto fortificado de la Edad del Bronce en el Castro del Chao Samartín: argumentos para su datación

The Chao Samartín hillfort, in western Asturias, was initially fortified at the end of the Bronze Age. A large building enclosed within several defensive lines was present at the settlement around the 8th century B.C., its excavation yielding important bronze artefacts. A small stone urn containing a human female cranium has been recently uncovered by the main gate of this fortress. The aim of this contribution is to present a set of new radiocarbon dates that allow us to ascertain the placement of this burial within the chrono-archaeological context of the Final Bronze Age settlement.El castro de Chao Samartín, en el occidente de Asturias, remonta su condición de asentamiento fortificado a finales de la Edad del Bronce. Durante el siglo VIII a.C. defensas monumentales delimitaban un recinto en el que se alzaba, en posición principal, una cabaña de grandes dimensiones de la que procede un interesante repertorio de materiales metálicos fabricados en bronce. Junto a la puerta de acceso al recinto, al pie de la fortificación, se instaló una pequeña cista que contenía el cráneo de una mujer joven. Este artículo presenta las nuevas dataciones que permiten establecer la antigüedad del depósito y su contextualización crono-arqueológica con el establecimiento del Bronce Final

Pregnancy rate in dairy cows treated with human chorionic gonadotropin five days after insemination

This study tested whether the administration of hCG five days after insemination increased progesterone concentration and pregnancy rate (PR) in dairy cows. A total of 989 lactating Holstein cows with different parity and number of prior services wereused. Cows were inseminated after overt estrus or at a fixed-time. Five days post-insemination, cows were randomly assigned to two treatment groups: hCG (n=482), which received 3500 IU of hCG by intramuscular injection; and the control group (n=507), which did not receive any treatment. Pregnancy was diagnosed by ultrasound on day 30 post-insemination, and gestation was confirmed on day 60 post-insemination by rectal palpation. In 15 cows from each treatment group, plasma progesterone concentration was determined on days 5, 11, and 15 post-insemination. Pregnancy rate was analysed using logistic regression. Variations in progesterone concentration between treatments were tested by ANOVA for repeated measurements. Progesterone concentration was higher on days 11 and 15 in cows treated with hCG, compared to the control group (P<0.05). Treatment with hCG increased pregnancy rate (47.5 vs. 37.4%. Odds ratio 1.3; P<0.05). No interaction was observed between treatment and body condition, prior services, milk production, parity, or insemination type (overt estrus or fixed time). Treatment with hCG did not reduce pregnancy losses between day 30 and 60 post-insemination (P>0.1). We conclude that injection of hCG five days after insemination increased progesterone concentration and pregnancy rate in dairy cows

Propuesta de una guía instructiva dirigida a la familia del paciente alcohólico

A retrospective and descriptive study with quanti and quality cross-sectional approach was conducted during the first quarter of 2015 with relatives of dependent alcoholic patients previously diagnosed on individual and group consultation belonging to “Capitán Roberto Fleites” Policlinic. The universe was composed by 579 families; the sample size was 25 families of alcoholic patients in the Group of mutual help of alcoholism. Two questionnaires were applied: one, created by the researcher and subject to an assessment according to the criteria of specialists, consisting of 16 closed questions; the second was the test to assess family functioning. Later it was made an instructive guide directed to family of alcoholic patient that contemplated, fundamentally, instructive aspects of orientation to report to what services to go in order to help these patients and their families. There was a predominance of family nuclearization and policy crisis like phase change between two stages and prevailed crisis by demoralization and the high incidence of family dysfunction and mechanism of family to face with drug dependency of touching the bottom or going to the root of the problem turned out to be predominant. The proposed of instructive guide was considered to be very adapted by a high per cent of consulted specialists.Se realizó un estudio descriptivo retrospectivo con enfoque cuanticualitativo de corte transversal durante el primer trimestre del año 2015 con familiares de pacientes alcohólicos dependientes previamente diagnosticados en consulta individual y grupal pertenecientes al Policlínico “Capitán Roberto Fleites”. El universo quedó constituido por 579 familias, el tamaño de la muestra fue de 25 familias de pacientes alcohólicos pertenecientes al Grupo de ayuda mutua de alcoholismo. Se aplicaron dos cuestionarios: el primero, creado por el investigador y sometido a una valoración según criterio de especialistas, constaba de 16 preguntas cerradas; el segundo fue la prueba para evaluar el funcionamiento familiar. Posteriormente se confeccionó una guía instructiva dirigida a la familia del paciente alcohólico que contempló, fundamentalmente, aspectos instructivos de orientación para informar a que servicios acudir para ayudar a estos enfermos y a sus familias. Hubo un predominio de la nuclearización familiar y de las crisis normativas como fase de cambio entre dos etapas y predominaron las crisis por desmoralización y la alta incidencia a la disfuncionalidad familiar y el mecanismo de afrontamiento familiar a la drogodependencia de tocar fondo o ir a la raíz del problema resultó ser predominante. La propuesta de guía instructiva fue considerada muy adecuada por un por ciento elevado de especialistas consultados. 

Exposure to paracetamol and asthma symptoms

Multicenter study[Abstract] Background: Paracetamol is one of the factors that have been associated with the observed increase in asthma prevalence in the last few years. The influence of environmental or genetic factors in this disease may be different in some countries than in others. The purpose of this study was to analyse the relationship between the paracetamol consumption and asthma prevalence in our community. Methods: A cross-sectional study was conducted on more than 20,000 children and adolescents in Galicia, Spain. The International Study of Asthma and Allergies in Childhood methodology was used to collect the information on asthma symptoms in children, paracetamol consumption, body mass index (BMI), pets in the home, education level of the mother and parental asthma and smoking habits. The influence of paracetamol consumption on the prevalence of asthma symptoms was calculated using logistic regression, adjusted for the other parameters included in the study. Results: After adjusting for gender, BMI, having a cat or dog, maternal education, parental asthma and smoking, in 6- to 7-year-old children, the consumption of paracetamol during the first year of life is associated with asthma [odds ratio (OR) 2.04 (1.79-2.31) for wheezing at some time]. Paracetamol consumption in the previous year leads to a significant increase in the probability of wheezing at some time [OR 3.32 (2.51-4.41)] in young children and adolescents [OR 2.12 (1.68-2.67)]. Conclusions: Paracetamol consumption is associated with a significant increase in asthma symptoms. The effect is greater the more often the drug is taken

Impact of parental smoking on childhood asthma

[Abstract] Objective: To evaluate the exposure to environmental tobacco smoke (ETS) of the childhood population in this community and its relationship with asthma symptoms. Methods: A cross-sectional study was conducted using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire on children and adolescents in this community. The symptoms "wheezing ever", "current asthma", "severe asthma", and "exercise-induced asthma" were defined by this questionnaire. Parental smoking was classified into four mutually exclusive categories: 1) no parent smokes; 2) only the mother smokes; 3) only the father smokes; and 4) both parents smoke. The odds ratio of the prevalence of asthma symptoms according to ETS exposure was calculated using logistic regression. Results: A total of 10,314 children and 10,453 adolescents were included. Over 51% of the children and adolescents were exposed to ETS at home. ETS is associated with a higher prevalence of asthma symptoms, particularly if the mother or both parents smoke. Conclusion: The prevalence of ETS is still high in this community, although there has been a decreasing tendency in the last 15 years. ETS is associated with higher prevalence of asthma

Retention of fetal membranes and uterine pathologies in dairy cows treated with PGF2α after parturition

Se probó si la administración de dos inyecciones de PGF2α en las primeras 48 h posparto disminuye la incidencia de retención de las membranas fetales (RMF) y de patologías uterinas en vacas lecheras. Se utilizaron 800 vacas de diferente número de partos, las cuales se asignaron aleatoriamente a dos tratamientos; PGF2α (n= 400) recibieron una inyección de PGF2α (500 μg de cloprostenol sódico) en las primeras 12 h posparto y una segunda inyección 48 h después; testigo (n= 400) no recibió PGF2α. Se registró la incidencia de RMF (vacas que no eliminaron la placenta de las siguientes 24 h posparto) y de patologías uterinas (metritis y endometritis), tasa de gestación en el primer servicio y porcentaje de vacas gestantes en el día 150 posparto. Las vacas testigo tuvieron mayor probabilidad de RMF (Odds ratio 1.69; P= 0.01) que las vacas tratadas con PGF2α. La proporción de vacas con patologías uterinas en el día 28 posparto fue menor (P= 0.01) en las vacas tratadas con PGF2α (29.8 %) que en las testigo (36.7 %). La tasa de gestación en el día 150 posparto fue mayor en las vacas con involución normal que en las vacas con patologías uterinas (Odds ratio 1.4, P=0.03). Se concluye que dos inyecciones de PGF2α en las primeras 48 h posparto (primeras 12 y 48 h posparto) disminuyen la incidencia de RMF y de patologías uterinas en vacas lecheras.In order to determine its effect on incidence of retained fetal membranes (RFM) and postpartum uterine pathologies in dairy cows, the administration of two injections of PGF2α in the first 48 h after parturition was tested. In this study, 800 cows with different parities were randomly assigned to two treatment groups: PGF2α (n= 400), receiving two postpartum PGF2α injections (500 μg of cloprostenol sodium), one during the first 12 h and one at 48 h; and control (n= 400), not receiving PGF2α. The incidence of RFM (cows that had not expelled the placenta at 24 h postpartum), and of postpartum uterine pathologies (metritis and endometritis), was registered, as well as pregnancy rate at first service and percentage of pregnant cows at d 150 postpartum. Control cows had a higher probability of presenting RFM (Odds ratio 1.69; P= 0.01) than cows treated with PGF2α. Likewise, the proportion of cows with uterine pathologies at d 28 postpartum was lower (P= 0.01) in cows treated with PGF2α (29.8 %) than in control cows (36.7 %). The accumulated pregnancy rate at d 150 postpartum was higher in cows with normal involution than in cows with uterine pathologies (Odds ratio 1.4, P= 0.03). It is concluded that two injections of PGF2α in the first 48 h postpartum (at 12 and 48 h) lowers the incidence of RFM and of uterine pathologies in dairy cows.Facultad de Ciencias Veterinaria

Obesity and asthma: an association modified by age

[Abstract] Background. Some studies indicate some causal relationship between obesity and asthma, while others show inconsistent results. Our objective was to evaluate the prevalence of asthma according to obesity in children. Methods. A cross-sectional study, following the ISAAC study methodology, was conducted on two randomly selected groups consisting of 6–7 year-old children (n = 7485) and 13–14 year-old adolescents (n = 8496). The asthma symptoms and potential risk factors were determined from the questionnaire. Overweight and obesity were defined based on the body mass index. Multiple logistic regression was used to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals. Results. Obesity was associated with an increase in wheezing ever (OR: 1.35) and exercise-induced asthma (OR: 1.62) in the 6–7 year-old group. No significant relationship was observed in the adolescent population. Conclusion. Obesity was associated with a higher prevalence of asthma in young children, but not in adolescents

Cross‐sectional study about impact of parental smoking on rhinitis symptoms in children

[Abstract] Objective. Assess the prevalence of rhinitis and exposure to environmental tobacco smoke (ETS) of children in our community and its relationship with symptoms of rhinitis Methods (design, setting, participants, main outcome measures). Cross‐sectional study using questionnaire on rhinitis of the International Study of Asthma and Allergies in Childhood, in children (6‐7 years) and adolescents (13‐14 years). Categories: “rhinitis ever”, “recent rhinitis”, “recent rhinoconjunctivitis”, “severe rhinoconjunctivitis”. Parental smoking: (i) neither parent smokes; (ii) only the mother smokes; (iii) only the father smokes; and (iv) both parents smoke. Odds ratio of the prevalence of symptoms of rhinitis according to ETS exposure was calculated using logistic regression. Results. 10 690 children and 10 730 adolescents. The prevalence of “rhinitis ever” in children: 29.4%, “recent rhinitis” 24%, “recent rhinoconjunctivitis” 11.5% and “severe rhinoconjunctivitis” 0.1%. In adolescents: 46.2%, 34.5%, 16.2% and 0.2%, respectively. Environmental tobacco smoke exposure in the home occurred in 51% of cases. Parental smoking was associated with a higher prevalence of forms of rhinitis in adolescents when only the mother was a smoker. In children when both parents were smokers. Conclusion. Rhinitis is highly prevalent in our community. Environmental tobacco smoke exposure is still very common. The relationship between ETS and rhinitis symptoms in children of this community is not as robust as that found for asthma

Meningitis por criptococo y trombosis venosa cerebral en paciente sicklémica

A 47-year-old woman diagnosed with sickle cell anemia and a vaso-occlusive crisis in the brain was admitted with fever, general malaise and headache, with transient episodes of disorientation. In her evolution, there was a motor defect in the right side, dysarthria and convulsive seizures refractory to therapy. The cranial tomographic study revealed a hypodense image in the left parietal lobe in relation with an infarction, and evidence of contrast enhancement in the turns in the affected area due to cortical vein thrombosis. The patient had a torpid evolution, and died with neurological impairment and septic respiratory symptoms. At necropsy, it was concluded the presence of Cryptococcus neoformans meningitis and cerebral venous thrombosis in a sickle cell anemia patient, associated with severe bilateral bacterial bronchopneumonia that lead to her death. Infections in immunocompromised patients, and especially fungal infections, may not be suspected and may not be treated, as occurred with this patient. This fact, and the association with cerebral venous thrombosis, motivated a discussion in the clinicopathological session of the institution. The study of the autopsy is reported, as well as a review of the condition as a way of focusing attention on opportunistic fungal infections. This is another tough battleground for the diagnosis and treatment of patients, in which the main weapon is the proper use of the epidemiological-clinical method in all medical specialties – efforts must be directed that way.Mujer de 47 años de edad con diagnóstico de sicklemia y crisis vaso-oclusiva cerebral que fue ingresada por fiebre, toma del estado general y cefalea, con episodios de desorientación transitoria; en su evolución aparecieron un defecto motor derecho, disartria y episodios convulsivos refractarios a la terapéutica. El estudio tomográfico de cráneo reveló una imagen hipodensa en el lóbulo parietal izquierdo en relación con infarto, así como evidencias de realce de contraste en los giros en el área afectada debido a trombosis de venas corticales. Evolucionó tórpidamente y falleció con deterioro neurológico y cuadro respiratorio séptico. En la necropsia se concluyó: meningitis por Cryptococcus neoformans y trombosis venosa cerebral, asociadas a bronconeumonía bacteriana bilateral severa en paciente sicklémica, todo lo que la conduce a la muerte. Las infecciones en el paciente inmunodeprimido, y en especial las infecciones por hongos, pueden no ser sospechadas ni tratadas, como sucedió en este caso; este hecho, y la asociación con trombosis venosa cerebral, motivaron a discusión en Sesión Clínico-Patológica Institucional. Se presenta el estudio de la autopsia y la revisión de la enfermedad como forma de enfocar la atención en las infecciones micóticas oportunistas, otro duro campo de batalla para el diagnóstico y el tratamiento de los enfermos, cuya arma fundamental es el empleo adecuado del método clínico en todas las especialidades médicas, hacia lo que se deben dirigir los esfuerzos

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe