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Epicardial right ventricular outflow tract (RVOT) ablation has been described for the treatement of Brugada syndrome (BrS) high risk patients. Purpose Success evaluation of epicardial ablation for BrS. Methods Type 1 ECG was defined as spontaneous if recorded in absence of drugs and/or specific conditions. BrS patients were scheduled for ablation if presented at least one of: spontaneous type 1 ECG, syncope, ventricular arrhythmias (VA). Programmed electrical stimulation (PES) was performed (2 extrastimuli, 2 sites) in basal conditions and after ajmaline infusion. Epicardial subxifoid access and electroanatomical endo-epicardial maps were obtained during sinus rhythm. Delayed fragmented/low-frequency, low-voltage electrograms (EGM) were targeted: substrate area measured in basal conditions and after ajmaline. Epicardial ablation Radiofrequency (RF) was delivered (50 W power control mode) till complete elimination of targeted EGM and BrS-ECG pattern after ajmaline. Eventually PES repeated: if positive a repeated PES scheduled at follow-up (fu). Success was defined as absence of type 1 ECG either spontaneous or with ajmaline challenge at 3 month. Recurrences were scheduled to redo ablation. Results 55 patients were submitted to 58 ablation procedures. 38 spontaneous type 1 ECG: 18 symptomatic for syncope/polimorphic VT/VF or appropriate ICD shock; 13 had VA induction at PES. 4 patients with ajmaline-type 1 ECG had VA induction. 36% of the symptomatic patients and 26% of asymptomatic had PES-VA induction. In all patients abnormal EGM area (cm2) was detected in epicardial RVOT (table 1). Acute success: No patient had ECG type 1 with ajmaline. 5 patients had PES induction of VA. Complications: 1 cardiac tamponade, 16 mild pericarditis. At FU of 1,1±0,6 yrs no patient had spontaneous ECG type 1 nor arrhythmic events. 50 had negative ajmaline challenge (90% success rate after single procedure), 3 underwent redo: 2 had negative ajmaline challenge at FU, 1 had persistence type 1-ajmaline induction; 2 are scheduled for redo. No patient had VT induction at PES. Multivariate analysis: Single procedure success was not related either to history (symptoms, VA, type 1 ECG) or to procedural findings (PES results, substrate area). Conclusion Epicardial substrate ablation was safe end effective in BrS. No clinical or procedural findings were related to success Funding Acknowledgement Type of funding source: None

ResumenAntecedentesLa versiόn de 28 elementos del Cuestionario de Salud General (GHQ-28) desarrollada por Goldberg y Hillier en 1979 está construida a partir de un análisis de componentes principales del GHQ-60. Utilizada en una poblaciόn espanola, una traducciόn del GHQ-28 desarrollada para una poblaciόn inglesa puede llevar a valores predictivos peores.MetodosUsamos nuestra muestra espanola para replicar el proceso entero de construcciόn del GHQ-28 administrado en un entorno de atenciόn primaria.ResultadosSe proponen dos versiones más breves: una con seis escalas y 30 elementos, y la otra con cuatro escalas y 28 elementos.ConclusionesEl GHQ-28 resultante fue una adaptaciόn acertada para uso en la muestra espanola. Comparada con la versiόn original, sόlo 21 elementos eran los mismos. Además, a diferencia de la versiόn inglesa, que agrupa los problemas de sueno y la ansiedad en la misma escala, se encontrό una escala con elementos relacionados exclusivamente con “Perturbaciones del sueno”.

In this paper, the spectrum occupancy of the VHF and UHF bands are investigated. The primary objective is to identify the bands that have low utilization and could be accessed for future developments in TV broadcasting, especially in the analog to digital transition as well as other digital technological developments. Results could provide an avenue for emerging technologies such as cognitive radio. The study consists of data collection and analyses in the VHF and UHF TV bands. Average occupancy calculations based on measurements and results taken over a two-day period show an overall average occupancy of about 16% of the total spectrum surveyed. Specifically, average occupancies for the low band VHF, high band VHF and UHF band are about 57%, 60% and 7% of the respective bands. Since the study on white space is at its early stages, this paper serves as a preliminary study, thus further studies are needed to fully optimize the white spaces of the spectrum for future applications in the advancement of the technology.

BackgroundThe 28-item version of the General Health Questionnaire (GHQ-28) developed by Goldberg and Hillier in 1979 is constructed on the basis of a principal components analysis of the GHQ-60. When used on a Spanish population, a translation of the GHQ-28 developed for an English population may lead to worse predictive values.MethodsWe used our Spanish sample to replicate the entire process of construction of the GHQ-28 administered in a primary-care setting.ResultsTwo shorter versions were proposed: one with six scales and 30 items, and the other with four scales and 28 items.ConclusionsThe resulting GHQ-28 was a successful adaptation for use on the Spanish sample. When compared with the original version, only 21 items were the same. Moreover, contrary to the English version, which groups sleep problems and anxiety in the same scale, a scale with items related exclusively to ‘Sleep disturbances’ was found.

Background: Respiratory allergies are inversely related to early acquisition of food-borne and fecal-oral infections, consumption of unpasteurized milk, early exposure to stables and high endotoxin concentrations in a farming environment. We tested therefore if infection by Salmonella in early life can protect from development of respiratory allergies later in life. Methods: During 2003, we studied two groups of Sardinian children (age 6–18 years) who had been hospitalized before 4 years of age (during 1989–2001) with non-typhoid salmonellosis (n = 148) or acute enteritis of nonbacterial etiology (NB-enteritis) (n = 167). Allergic rhinoconjunctivitis (AR) and asthma were evaluated by telephonic interview with a ISAAC questionnaire; participants reporting AR and/or asthma were further examined through a complete diagnostic work-up to objectively confirm or exclude current disease. Kaplan–Meier curves and Cox proportional hazard models were used to analyze the role of different types of enteritis on the risk of developing allergic rhinoconjunctivitis or asthma over time. Results: Children who had been hospitalized with salmonellosis had a lower prevalence of allergic rhinoconjunctivitis (eight of 148, 5.4%vs 23 of 167, 13.8%; P = 0.019) or asthma (five of 148, 3.4%vs 21 of 167, 12.6%; P = 0.006) than those who had been hospitalized with NB-enteritis. The proportional hazard of salmonellosis for asthma was 0.23 (95% CI: 0.08–0.67; P

This study shows the relationship between BMI of 3000 adolescents and their perceived-weight status, and the strategies for weight loss. The finding indicate that substantial numbers of teenage females perceive themselves as overweight when BMI suggest they are not, while males have a reasonably accurate weight. Diet was the most frequently selected method for losing weight especially among females that wrongly perceive themselves overweight (O.R. = 5.54 I.C. 95% 4.28-7.19); while males were as likely to use diet as a strategy to lose weight only if they were really overweight (O.R. = 6.00; I.C. 95% 2.26-15.92). Exercise was selected as a method for losing weight by males independently to be overweight and by females only that perceive themselves overweight. The study shows that the young people of Sardinia need a health program to empower their knowledge the difference between health and aesthetic.

Present transfusional regimen protocols increase the life expectancy of patients with beta-thalassemia major, but cause a progressive iron overload that can be prevented or limited only by appropriate iron chelation. Siderosis is responsible for the clinical complications of the disease. Short stature and hypogonadism are extremely frequent in patients with thalassemia. Many factors are responsible for short stature in patients with thalassemia, the most important of which are dysfunction of the GH-IGF-I axis and desferoxamine (DFX)-induced bone dysplasia. Hypogonadism is the most frequent endocrine complication, mostly due to gonadotrophins deficiency secondary to iron overload. Sex steroid treatment for induction of puberty and/or maintenance of sexual characteristics is necessary. Both short stature and hypogonadism are present in a significant percentage of bone marrow transplanted patients with thalassemia. Factors responsible for short stature are previous iron overload, liver impairment, DFX treatment, and toxicity of chemotherapeutic agents. In some patients absence of pubertal development is due to gonadotropin insufficiency, probably secondary to previous iron overload; other patients exhibit hypergonadotrophic hypogonadism due to the toxic effect of chemotherapeutic agents on the gonads. Both groups need hormonal replacement therapy. These data support the need for vigilant follow-up of patients with thalassemia before and after transplantation, in order to treat endocrine dysfunctions at the appropriate age.

The adrenal steroid secretion was studied in 6 prepubertal obese boys and 6 obese boys at the first stage of sexual maturation according to Tanner. Twelve normal boys, closely matched for age and stage of sexual maturation, were also studied as controls. Pregnenolone and dehydroepiandrosterone plasma levels were found to be significantly (P less than 0.001) higher in both groups when compared with normal boys. All the values, apart from pregnenolone in the prepubertal group, returned to normal after weight loss. Progesterone was found significantly increased (P less than 0.001) in both groups and normal after weight loss. 17-OH-progesterone plasma levels showed no significant difference between the obese and control groups. Androstenedione was increased in the prepubertal group before and normal after weight loss; no significant difference was found in the other group. Testosterone and estradiol showed normal values in the two groups both before and after weight loss. Cortisol showed a similar pattern. It can be concluded that an increased cortico-adrenal activity is present in obese boys as already reported in obese girls. This finding could explain the precocious adrenarche which often occurs in these patients. The increased adrenal androgen secretion might be due to an increased cortico adrenal stimulating hormone secretion or to an enhanced adrenal sensitivity to this hypothetical hormone.

We have evaluated the effect of galanin (Gal), a newly identified hypothalamic peptide, on growth hormone (GH) secretion in 10 children with normal stature (NS), nine with constitutional growth delay (CGD), and five with isolated GH deficiency (IGHD). Gal was infused intravenously at a rate of 8 or 15 micrograms/kg/h. All children also underwent an acute oral clonidine test (0.15 mg/m2). In CGD children the mean plasma GH peak after 8 micrograms/kg/h of Gal infusion (13.3 +/- 1.7 ng/mL; mean +/- SEM) was higher (p less than 0.02) than in NS children (8.5 +/- 0.8 ng/mL). When the dose of Gal was increased to 15 micrograms/kg/h the mean plasma GH peak in CGD children (18.5 +/- 3.5 ng/mL) was still higher than in the NS group (13.2 +/- 2.9 ng/mL), although not significantly so. In IGHD children the mean plasma GH peak elicited by 8 or 15 micrograms/kg/h of Gal (3.8 +/- 0.7 and 3.9 +/- 0.5 ng/mL, respectively) was lower than that obtained in either CGD (p less than 0.0002) or NS children (p less than 0.001). In NS children the mean plasma GH peak after acute clonidine administration (22.3 +/- 3.0 ng/mL) was higher than that observed after either dose of Gal used (p less than 0.001 and p less than 0.05 with 8 and 15 micrograms/kg/h, respectively). In CGD or IGHD children mean plasma GH peak after acute clonidine (14.8 +/- 2.6 and 4.1 +/- 1.2 ng/mL, respectively) was not significantly different from that observed after either dose of Gal.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of adrenoleucodistrophy in a 9 year old boy is reported. At onset, strabismo, skin hyperpigmentation, difficulty in deambulation and retarded writing and language capability were seen. The child's condition rapidly worsened. Normal hemochrome, urine tests, azotemia, blood calcium levels, alkaline phosphate, aminoaciduria and lipidogram values were found. EEG showed diffused slow activity mainly bilaterally at the anterior deviations. TAC revealed hypodense grey matter, especially in the parietal zone, a typical finding in leucodystrophy (Cattarossi e coll., 1981). Cellular biopsy showed modifications of the fibrocells, considered indicative of this condition. The study of the hypothalamic hypophyseal - adrenal - gonadal axis showed a significant increase of LH and RH after stimulation, increased testosterone and androstenedione and reduced basal plasma cortisol, and after stimulation, levels. These findings suggest that hyposurrenalism may be secondary to 21 - hydroxylase deficiency.

Esta tesis se enmarca dentro de la Formación Profesional de Grado Medio, en concreto, en la asignatura Animación del Punto de Venta, en el bloque de animación visual que comprende el estudio del escaparatismo. Esta investigación trata de demostrar la siguiente hipótesis: las aplicaciones didácticas del lenguaje visual en la asignatura animación del punto de venta, mejoran el proceso de enseñanza-aprendizaje en el módulo de escaparatismo. El escaparate es uno de los elementos clave que distingue una tienda y la dotan de imagen de marca, es el mejor vendedor y oferente de los productos, y sin embargo existen pocos estudios que pongan de relieve su importancia. En nuestra sociedad moderna la cultura visual es cada vez más compleja, y el escaparatismo se sirve de estos códigos para atraer al transeúnte a entrar y comprar. El visual merchandising se ha convertido en el democratizador del arte moderno en las ciudades, con sus vitrinas artísticas y teatrales. No hace falta más que pasear por las grandes urbes como Nueva York, París, Londres o Tokio para darse cuenta del maravilloso espectáculo de sus calles comerciales. Los objetivos principales de la investigación son identificar el problema y los recursos para desarrollar un método didáctico para estudiar escaparatismo, basándose en el lenguaje visual; elegir el proceso didáctico más adecuado para elaborar unas prácticas apropiadas al módulo de escaparatismo; considerar la viabilidad de la implementación de las Tecnologías de la Información y la Comunicación (TIC) para la investigación educativa del alumnado, y por último estudiar los postulados de diferentes autores de didáctica artística para elegir posteriormente los que resulten más idóneos para ser desarrollados en nuestra aplicación práctica. La metodología empleada se basa en una estrategia de estudio cualitativa, cuantitativa y experimental, estructurada según algunos elementos de la Educación Comparada. La investigación se divide en dos partes, el marco teórico y el marco práctico. En el marco teórico se estudian los fundamentos teóricos del diseño aplicados al escaparatismo, las conexiones del escaparatismo y el arte contemporáneo, cómo las redes sociales facilitan el aprendizaje, los paradigmas educativos de la educación artística y la Formación Profesional en España. En el marco práctico se detallan los resultados de la encuesta que se realizó a los centros públicos y privados concertados de la Comunidad de Madrid de Formación Profesional de Grado Medio y Superior que imparten estudios de escaparatismo, para determinar el número de centros que poseen aula taller para realizar las prácticas (imprescindible para implementar las actividades), la adecuación de la misma, y el tipo de prácticas que se realizan. Con las conclusiones de ésta se determina que la 14 investigación se tiene que realizar en el Grado Medio de Técnico en Comercio ya que éste Ciclo Formativo posee un aula taller adecuada. Pondremos en práctica un método didáctico para la enseñanza del escaparatismo, que se divide en siete unidades didácticas que nos permiten implementar la práctica en el aula. Finalmente los datos obtenidos demuestran que todos los alumnos consiguieron interpretar el lenguaje visual y por lo tanto obtuvieron aprendizajes significativos utilizando recursos artísticos, y las redes sociales como parte del aprendizaje del escaparatismo. Después del desarrollo de nuestra investigación, como conclusiones se evidencia la viabilidad de la metodología, la necesidad de producir más investigaciones que aborden el escaparatismo en la enseñanza vinculada al ámbito del lenguaje visual y artístico, las enormes e interesantes implicaciones de enfocar el escaparatismo desde un punto de vista artístico y la importancia de incluir las redes sociales como parte del aprendizaje en el aula. Madrid ESP