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The aim of this pilot study was to assess whether neurofeedback (NFB) can be useful in the treatment of impulsive behavior in long-term abstinent cocaine and heroin addicts. A single-blind sham-controlled NFB protocol was carried out to assess the effects of NFB on impulsivity in 20 (10 + 10) cocaine and heroin long-term abstinent addicts ( Diagnostic and Statistical Manual of Mental Disorders [4th ed., text rev.; DSM-IV-TR]). Psychotic and neurologic diseases were excluded. Participants underwent 40 NFB sessions based on the very slow cortical potential range. Inhibitory deficits were specifically addressed through right and left prefrontal training. Clinical improvement was measured with Likert-type scales, the Hamilton Depression Rating Scale, and the State–Trait Anxiety Inventory, and impulsivity was assessed using the Barratt Impulsiveness Scale and the Continuous Performance Test. Although the results are preliminary due to the small sample size, the NFB-treated group showed a significant clinical improvement, including symptoms of anxiety and depression, with two differentiated time periods. No significant clinical improvement was found in the control group. A significant decrease in the post- versus pre-treatment measures of global impulsivity, nonplanning impulsivity, and error commission measures was found in the NFB-treated group; effect size ( dKorr) in the pre–post control design was moderate. No significant change was found in the control group. Despite the limitations of this study, the results suggest that NFB is better than placebo in improving impulsivity and clinical symptoms of anxiety and depression in long-term abstinent cocaine- and heroin-dependent individuals.

Rationale & Objective Clinical practice guidelines for dietary intake in hemodialysis focus on individual nutrients. Little is known about associations of dietary patterns with survival. We evaluated the associations of dietary patterns with cardiovascular and all-cause mortality among adults treated by hemodialysis. Study Design Prospective cohort study. Setting & Participants 8,110 of 9,757 consecutive adults on hemodialysis (January 2014 to June 2017) treated in a multinational private dialysis network and with analyzable dietary data. Exposures Data-driven dietary patterns based on the GA2LEN food frequency questionnaire. Participants received a score for each identified pattern, with higher scores indicating closer resemblance of their diet to the identified pattern. Quartiles of standardized pattern scores were used as primary exposures. Outcomes Cardiovascular and all-cause mortality. Analytical Approach Principal components analysis with varimax rotation to identify common dietary patterns. Adjusted proportional hazards regression analyses with country as a random effect to estimate the associations between dietary pattern scores and mortality. Associations were expressed as adjusted HRs with 95% CIs, using the lowest quartile score as reference. Results During a median follow-up of 2.7 years (18,666 person-years), there were 2,087 deaths (958 cardiovascular). 2 dietary patterns, “fruit and vegetable” and “Western,” were identified. For the fruit and vegetable dietary pattern score, adjusted HRs, in ascending quartiles, were 0.94 (95% CI, 0.76-1.15), 0.83 (95% CI, 0.66-1.06), and 0.91 (95% CI, 0.69-1.21) for cardiovascular mortality and 0.95 (95% CI, 0.83-1.09), 0.84 (95% CI, 0.71-0.99), and 0.87 (95% CI, 0.72-1.05) for all-cause mortality. For the Western dietary pattern score, the corresponding estimates were 1.10 (95% CI, 0.90-1.35), 1.11 (95% CI, 0.87-1.41), and 1.09 (95% CI, 0.80-1.49) for cardiovascular mortality and 1.01 (95% CI, 0.88-1.16), 1.00 (95% CI, 0.85-1.18), and 1.14 (95% CI, 0.93-1.41) for all-cause mortality. Limitations Self-reported food frequency questionnaire, data-driven approach. Conclusions These findings did not confirm an association between mortality among patients receiving long-term hemodialysis and the extent to which dietary patterns were either high in fruit and vegetables or consistent with a Western diet.

Objectives To validate in Spanish (Spain) a self-administered questionnaire on the quality of life (QoL) specific to nocturia in an older adult male population. Material and Methods We analysed the Spanish version of the ICIQ-Nqol questionnaire (provided by ICIQ who owns the copyright), which meets the translation criteria required by the validation protocol. The study included 69 male patients older than 60 years of age with 1 or more nocturia episodes. The participants completed the questionnaire on two occasions, along with other Spanish-validated questionnaires that measure the QoL related to urinary symptoms. We analysed the internal reliability and consistency, reproducibility, convergent validity and discriminant validity. Results The study included 69 men, with a mean age of 70.64 years (range, 60-87 years). Both the overall scale and the energy/sleep subscale met the minimum criteria for internal reliability and consistency. A good correlation has been demonstrated between the overall index of the ICIQ-Nqol questionnaire and the other questionnaires included in the study. The reproducibility (test-retest reliability) of both the overall scale and subscales of the ICIQ-Nqol and the other questionnaires was demonstrated. Conclusions The ICIQ-Nqol questionnaire has been shown to be an appropriate instrument for assessing the symptomatic intensity and impact on the QoL of patients with nocturia. This study confirms its validity for a Spanish-speaking male population. Neurourol. Urodynam. © 2015 Wiley Periodicals, Inc.

Ebola Virus infection is at present times a growing worldwide concern, although its history goes back to 1967, with subsequent outbreaks in 1979, 1980 and 1987, all of them by contact in workers in affected areas. The concern of the scientific community about this issue is partially reflected in publications included in MEDLINE (PUBMED database) and in which, taking as a keyword in the search box “Ebola virus”, 2.151 publications are found, belonging 984 of them to the last 5 years (45.7%) and 527 of these publications (53.5%) to the years 2014-2015. The earliest publication dates back to 1977, attaching no listed authors either reference abstract, and the most recent to January of current year 2015. This means Ebola infection is a global problem and that concern the international scientific community. A review of some of the studies published in this matter, considered of interest and discussed by the authors, is performed in this work.

In Spanish, the concepts of discapacidad (disability leave) and incapacidad (sick leave) jointly refer to the impairment of a person due to injuries, diseases or deficiencies that limit their activity in a social, personal or occupational field. However, this common link does not imply that both concepts are the same. Statistical data from INE (Instituto Nacional de Estadística: Statistic National Institute) show that Spain had in 2015 3.85 million persons with a disability (59.8% were women). Statistical data from 2015 from INSS (Instituto Nacional de Seguridad Social: Social Security National Institute) show high levels in the number of processes and in workers affected by temporary sick leave, with social costs to the social security system. Both concepts have been updated: about disability leave, Law 39/2006 adjusted terminology by avoiding the use of concepts with discriminating or pejorative connotation. Regarding sick leave, the Ley General de Seguridad Social (General Social Security Law)has been amended and came into effect in January, 2016. It is necessary to know and distinguish these aspects for a better administrative management, and a more oriented information to the affected patient.Los conceptos de discapacidad e incapacidad hacen referencia conjuntamente al menoscabo de una persona por lesiones, enfermedades o deficiencias que limitan su actividad en el ámbito social, personal o laboral. Pero este nexo común no implica equiparación entre ambos. Datos estadísticos del 2015 del Instituto Nacional de Estadística (INE) muestran en España 3.85 millones de personas con alguna discapacidad, el 59.8% mujeres. Datos estadísticos del 2015 del Instituto Nacional de la Seguridad Social (INSS), tanto en número de procesos, como de trabajadores afectados por incapacidad muestran cifras elevadas, con costos sociales en prestaciones a cargo de la seguridad social. Ambos conceptos han sido objeto de actualización legislativa: en discapacidad, la Ley 39/2006 ajusta la terminología y evita el uso de conceptos con connotación peyorativa o discriminativa. En incapacidad, la Ley General de la Seguridad Social ha sido modificada y ha entrado en vigor en enero de 2016. Es necesario conocer y diferenciar estos aspectos para una mejor gestión administrativa, e información más orientada al paciente afectado.

Introduction: The principal objective was to determine the incidence rate of adverse drug events (ADEs) in hospitalised patients and evaluate the event prevention percentage. Methods: Multi-centre, prospective observational study lasting four months, performed in fi ve hospitals providing different levels of care. We included all adult patients who were admitted to one of the selected centres for longer than 48 hours and who required pharmacological treatment. ADEs were identifi ed by direct observation and the use of previously defi ned alarm signals. The Karch-Lasagna scale was used to determine the causality relationship, and the Schumock and Thornton questionnaire adapted by Otero was used to evaluate ADE preventability. Preventable drug-induced adverse events were classifi ed according to the taxonomy that the Ruiz-Jarabo 2000 group defi ned, and coordinated by ISMP-Spain. Results: We included 1,550 patients, 159 of whom experienced at least one ADE (10.3 %). The preventability percentage was 51.6 %, which represented 5.3 % of the total sample. The endocrine system (34.8 %) and the cardiovascular system (20.7 %) were the most affected by preventable ADEs. Antibiotics were responsible for 16.5 % of all ADEs. 9.3 % of all preventable ADEs were triggered by use of opiates. The vast majority of preventable ADEs (36.3 %) resulted from omitting a necessary medication. Only 4.4 % of preventable ADEs are considered to be serious. Conclusions: There is a high incidence rate of ADEs during patients’ hospital stay (10.3 %), and half of them (51.6 %) could have been prevented. Implementation of an automatic alarm system and certain best practices for problem spots along the care circuit will help detect and avoid preventable ADEs.

The basic concern of a Communication System is to transfer information from its source to a destination some distance away. Textual documents also deal with the transmission of information. Particularly, from a text categorization system point of view, the information encoded by a document is the topic or category it belongs to. Following this initial intuition, a theoretical framework is developed where Automatic Text Categorization(ATC) is studied under a Communication System perspective. Under this approach, the problematic indexing feature space dimensionality reduction has been tackled by a two-level supervised scheme, implemented by a noisy terms filtering and a subsequent redundant terms compression. Gaussian probabilistic categorizers have been revisited and adapted to the concomitance of sparsity in ATC. Experimental results pertaining to 20 Newsgroups and Reuters-21578 collections validate the theoretical approaches. The noise filter and redundancy compressor allows an aggressive term vocabulary reduction (reduction factor greater than 0.99) with a minimum loss (lower than 3 percent) and, in some cases, gain (greater than 4 percent) of final classification accuracy. The adapted Gaussian Naive Bayes classifier reaches classification results similar to those obtained by state-of-the-art Multinomial Naive Bayes (MNB) and Support Vector Machines (SVMs).

Introduction The principal objective was to determine the incidence rate of adverse drug events (ADEs) in hospitalised patients and evaluate the event prevention percentage. Methods Multi-centre, prospective observational study lasting 4 months, performed in 5 hospitals providing different levels of care. We included all adult patients who were admitted to one of the selected centres for longer than 48 hours and who required pharmacological treatment. ADEs were identified by direct observation and the use of previously defined alarm signals. The Karch-Lasagna scale was used to determine the causality relationship, and the Schumock and Thornton questionnaire adapted by Otero was used to evaluate ADE preventability. Preventable drug-induced adverse events were classified according to the taxonomy that the Ruiz-Jarabo 2000 group defined, and coordinated by ISMP-Spain. Results We included 1550 patients, 159 of whom experienced at least one ADE (10.3%). The preventability percentage was 51.6%, which represented 5.3% of the total sample. The endocrine system (34.8%) and the cardiovascular system (20.7%) were the most affected by preventable ADEs. Antibiotics were responsible for 16.5% of all ADEs. Nine point three percent of all preventable ADEs were triggered by use of opiates. The vast majority of preventable ADEs (36.3%) resulted from omitting a necessary medication. Only 4.4% of preventable ADEs are considered to be serious. Conclusions There is a high incidence rate of ADEs during patients’ hospital stay (10.3%), and half of them (51.6%) could have been prevented. Implementation of an automatic alarm system and certain best practices for problem spots along the care circuit will help detect and avoid preventable ADEs.

The laryngeal tube (VBM Medizintechnic GmbH, Sulz, Germany) is a supraglottic device designed for airway management in spontaneous or positive-pressure ventilation during anesthesia or in cardiopulmonary resuscitation. Currently, the tube is available in 4 versions: the standard laryngeal tube, the disposable tube (LT-D), the dual-lumen tube (with a tube for suction) (LTS II), and the disposable LTS (LTS-D). The design of the tube has been modified several times. It is easy to insert and the airway seal is more effective than that of the laryngeal mask. The incidence of complications is similar for both devices, though use of the laryngeal tube requires more adjustments. The standard tube is somewhat less effective than the ProSeal laryngeal mask, though the new LTS II has been improved considerably. The laryngeal tube is effective as an aid to management of the difficult airway. We reviewed the literature indexed on MEDLINE through December 2006 using the search terms laryngeal tube, anesthesia, equipment, and airway.

Background Dental disease is more extensive in adults with chronic kidney disease, but whether dental health and behaviors are associated with survival in the setting of hemodialysis is unknown. Study Design Prospective multinational cohort. Setting & Participants 4,205 adults treated with long-term hemodialysis, 2010 to 2012 (Oral Diseases in Hemodialysis [ORAL-D] Study). Predictors Dental health as assessed by a standardized dental examination using World Health Organization guidelines and personal oral care, including edentulousness; decayed, missing, and filled teeth index; teeth brushing and flossing; and dental health consultation. Outcomes All-cause and cardiovascular mortality at 12 months after dental assessment. Measurements Multivariable-adjusted Cox proportional hazards regression models fitted with shared frailty to account for clustering of mortality risk within countries. Results During a mean follow-up of 22.1 months, 942 deaths occurred, including 477 cardiovascular deaths. Edentulousness (adjusted HR, 1.29; 95% CI, 1.10-1.51) and decayed, missing, or filled teeth score ≥ 14 (adjusted HR, 1.70; 95% CI, 1.33-2.17) were associated with early all-cause mortality, while dental flossing, using mouthwash, brushing teeth daily, spending at least 2 minutes on oral hygiene daily, changing a toothbrush at least every 3 months, and visiting a dentist within the past 6 months (adjusted HRs of 0.52 [95% CI, 0.32-0.85], 0.79 [95% CI, 0.64-0.97], 0.76 [95% CI, 0.58-0.99], 0.84 [95% CI, 0.71-0.99], 0.79 [95% CI, 0.65-0.95], and 0.79 [95% CI, 0.65-0.96], respectively) were associated with better survival. Results for cardiovascular mortality were similar. Limitations Convenience sample of clinics. Conclusions In adults treated with hemodialysis, poorer dental health was associated with early death, whereas preventive dental health practices were associated with longer survival.

Pain is a major cause of medical consultation. The complexity of managing it is due to its long duration and intensity, and it sometimes requires a combination of multiple drugs. The objective of this study is to assess the use of drugs for pain in workers, the clinical response obtained, its influence on estimating work productivity, its relationship to sociodemographic variables, and the type of drug used.A cross-sectional study on 1,080 workers, aged 18-65 years, during periodic surveys to monitor their health in companies in the service sector in Spain. Treatments used, clinical efficacy, influence on work productivity and sociodemographic variables (age, gender) are evaluated. The Brief Pain Inventory questionnaire, validated for Spain, was used to assess pain, and the SPSS(®) 20.0 package for the statistical analysis.NSAIDs and simple analgesics have higher percentages of improvement in pain (P=.032 and P.0001, respectively). Men respond better to NSAIDs, and women to simple analgesics. Improved productivity is higher in men than in women (P=.042). No significant differences were observed for age, pain improvement or productivity, except in those over 55 years.The analgesic prescription pain conditions must consider the age and gender of the patient, as well as the type of drug. The choice of drug should be based on the aetiology and aspects unrelated to the clinical variables, such as sociodemographic, work or psychosocial.

Resumen Objetivo Evaluar la actividad de una unidad de media estancia de psicogeriatria a los 10 meses de su implantacion. Metodo Estudio descriptivo prospectivo sobre 64 pacientes en el que se analizaron perfil clinico-social, objetivos al ingreso, tiempo de estancia, cambios en funcionalidad, trastornos de conducta o uso de farmacos, complicaciones, procedencia y destino final. Para el analisis de datos se utilizo el programa estadistico SPSSv10. Resultados Medias: edad 78,3 anos, estancia hospitalaria 42 dias, I. Charlson 2,1. Tenian GDS > 4 el 86%. Como sindromes geriatricos predominaron incontinencia e inmovilidad. El objetivo fue evaluador/terapeutico en el 73% de casos y contencion social en el resto. La media de I. Barthel al ingreso/alta fue 32/43, la presencia de agresividad o trastorno del sueno al ingreso/alta fueron 22%/12% y 34%/3%, la media de farmacos y psicofarmacos al ingreso/alta fue respectivamente 5,2/4,7 y 2,2/1,9. Los principales diagnosticos neuropsiquiatricos fueron demencia y depresion. La procedencia mayoritaria fue domicilio, seguida de hospital. El destino final fue domicilio en un 50% e institucionalizacion definitiva en un 36%. Conclusiones Hubo mejoria global de funcionalidad y de trastornos de agresividad y sueno, asi como reduccion del numero de farmacos. Se observo un importante porcentaje de institucionalizacion al alta.

The effects of radical stress in the biological environment is a very active field of research connecting varies discipline in life science. Thus, a comprehensive vision of all possible reactive species is necessary for contributing to the solution of puzzling questions on free radicals. In this contest, damages to Zn(II) and Cd(II) complexes of a metallothionein from a plant (Quercus suber -QsMT), due to radical stress exposure, were investigated. Metallothioneins (MTs) are low molecular weight, cysteine-rich proteins with high capacity for binding both essential (ZnII and CuI) and xenobiotic (CdII and HgII) metal ions. Metal-MT coordination is mainly achieved by formation of metal-thiolate bonds. Also the contribution of non-proteic ligands, such as chloride and/or sulfide anions, has been recently reported. As almost all the plant MTs, QsMT presents a peculiar amino acid sequence organization consisting of two Cys-rich domains (8 and 6 Cys each), linked by a cysteine-devoid spacer region which includes additional putative ligand (His). Although MTs do not appear to be essential for life, there is mounting evidences for a survival advantage of MT in situations of stress, including exposure to radicals and toxic metals. In support to a MT function in control of oxidative stress, many studies have showed that MT expression increases most dramatically in response to tissue injury, inflammation, tumour and it appears to reduce apoptosis. The reactions of reductive reactive species (H' atoms and eaq-), produced by gamma-irradiation of water, with Zn- and Cd-QsMT were carried out in both aqueous solutions and vesicle suspensions, and were characterized by different approaches. Using a biomimetic model based on unsaturated lipid vesicle suspensions the occurrence of tandem protein/lipid damage was shown The reactions of reductive reactive species with methionine residues and/or sulfur-containing ligands afford diffusible sulfur-centered radicals, which migrate from the aqueous phase to the lipid bilayer and transform the cis double bond of the oleate moiety to the trans isomer. Tailored experiments allowed the reaction mechanism to be defined in some details. The formation of sulfur-centered radicals is accompanied by the modification of the metal-QsMT complexes, which were monitored by various spectroscopic and spectrometric techniques (Raman and ESI-MS). The H' atoms and eaq- attacks on the metal-QsMT aggregates are able to induce significant structural changes such as partial deconstruction and/or rearrangement of the metal clusters, and breaking of the protein backbone. In particular, Cys is among the most sensitive residues towards radical attack, suggesting that the thiolate clusters of both metal-QsMTs act as efficient interceptors of reducing species. The radical-induced effects are dependent on the divalent metal bound.

Damages to Zn2+and Cd2+ complexes of a metallothionein (MT) from a plant (Quercus suber - Qs), due to radicai stress exposure, were investigated. QsMT, obtained by in vivo synthesis, is a low-molecular weight cysteine-rich protein with high capacity for binding metal ions. Although MTs do not appear to be essential for life, there is mounting evidences for a survival advantage of MT in situations of stress, including exposure to radicals and toxic metals. Gamma-irradiation was used to simulate the conditions of an endogenous radical stress. The degradation of the metal complexes was followed by Raman spectroscopy and the occurrence of tandem protein/lipid damage was shown by using a biomimetic model based on unsaturated lipid vesicle suspensions. The H1 and eaq- attacks on the metal-QsMT aggregates are able to induce significant structural changes such as partial deconstruction and/or rearrangement of the metal clusters, and breaking of the protein backbone. Sulfur-containing residues resulted to be selectively attacked; in particular, Cys resulted to be among the most sensitive residues towards radical attack, suggesting that the thiolate clusters of both metal-QsMTs act as efficient interceptors of reducing species. Under reductive stress Zn-QsMT undergoes a significant thiolate group oxidation. The participation of His to metal coordination became necessary for protein stabilization after radical stress. The radical-induced effects were dependent on the divalent metal bound. The reactions of reductive reactive species with Met residues and/or sulfur-containing ligands afford diffusible sulfur-centered radicals, which migrate from the aqueous phase to the lipid bilayer and transform the cis doublé bond of thè oleate moiety to the trans isomer.

The concern in all countries of occupational health has led to the study of occupational risk factors and their impact on health. But maintaining the health of workers is increasingly complex, especially in occupational allergic diseases, which have increased in parallel with the increased use in industries of potentially irritating chemicals or allergens, leading to skin or respiratory sensitization. Diseases arising from these immunological substances are classified by Spanish Legislation as occupational diseases, as set out in Royal Decree 1299/2006, of November 10, 2006 (Group 1, Group 4 and Group 5). The most important ones in occupational medicine are allergic respiratory diseases and dermatological allergic diseases, although there are other allergies of interest, such as those involving mucous membranes (allergic eye diseases). A joint collaboration between the different medical disciplines involved to improve prevention at work is highly desirable.

Metallothioneins (MTs) are low molecular weight, cysteine-rich proteins with an exceptional heavy metal coordination capacity. Because of their ability to bind metals and to scavenge oxidant radicals, MTs are considered to play a role in metal homeostasis, metal detoxificalion and control of the oxidative stress. Although their high heterogeneity on the expression patterns, metal binding abilities and primary structure suggest very diverse functional specializations, the structural and functional studies have been mainly devoted to vertebrate and fungal MTs. Participation of metal ligands other than the cysteines and the presence of secondary structure elements in metal-MT complexes are fairly unknown, especially in non-vertebrate MTs. Recently, it has been shown that ligands other than Cys can participate in the coordination sphere of metals in MTs. Two main types have been identified: endogenous ligands such as imidazole moiety of His residues and /or exogenous ligands such as inorganic ions (i.e. sulfide or chloride ions).

Metallothioneins (MTs) are low molecular weight, cysteine-rich proteins with an exceptional heavy metal coordination capacity. Because of their ability to bind metals and to scavenge oxidant radicals, MTs are considered to play a role in metal homeostasis, metal detoxification and control of the oxidative stress. Their high heterogeneity, metal binding abilities and primary structure suggest very diverse functional specializations. Structural and functional studies have been mainly devoted to vertebrate MTs. Participation of metal ligands other than Cys and the presence of secondary structure elements in metal-MT complexes are fairly unknown, especially in non-vertebrate MTs. Recently, it has been shown that other ligands can participate in metal coordination; two main ligand types have been identified: endogenous, as His residues and exogenous, as inorganic ions (i.e. S2- or Cl-). In vivo-synthesized Zn-MTs, representative of different families (mollusc, insect, nematode, echinoderm, vertebrate and plant, enclosing the mammalian MT1 isoform), were heterologously synthesized in E.coli and studied by analytic and spectroscopic techniques. The examined MTs (CeMT2, MeMT, SpMTA, MtnB, QsMT and MT1) contain 43-73 a.a., among which at least a 30% are Cys. To evaluate the influence of the metal on the MT structure, also the Cd-QsMT was synthesised and analysed in comparison with Zn-QsMT. Almost all the MTs considered are devoid of aromatic residues (only Phe in SpMTA and QsMT, Tyr in CeMT2, and His in CeMT2 and QsMT) and contain variable amounts of metal and S2- ions, quantitatively evaluated by acid ICP-AES and GC-FPD measurements. The formation of more than one species (S2--containing and S2--devoid complexes), revealed by ESI-MS spectra, was evident for all the MTs. The Raman spectra gave information about the structure of the metal-MT aggregates. In particular, the presence of secondary structure elements was determined: for the examined MTs isoforms, a relevant contribution of p-sheet and p-turns was shown, whereas the a-helix content resulted almost negligible. As regards Cys sulfurs, almost all Cys were involved in the metal coordination, as indicated by several bands attributable to metal-S stretching modes at low wavenumbers (

Metallothioneins (MTs) are low molecular weight cysteine-rich proteins able to coordinate metal ions. Metal-MT chelation is mainly achieved by formation of metal-thiolate clusters but also by non-proteic ligands, such as chloride and sulfìde ions. Plant Quercus suber metallothionein (QsMT) differs from animal MTs in sequence organisation consisting of two Cys-rich regions separated by a Cys-devoid spacer domain containing one His residue. In contrast with the current knowledge on the 3D structure of animal MTs, there is an appalling lack of structural data on plant MTs. Zn+2 and Cd+2 complexes of QsMT were obtained by in vivo synthesis, in order to obtain physiological representative aggregates, and characterized by spectrometric and spectroscopic methods. The composition of the metallic aggregates were determined by ICP-AES, GC-FPD and ESI-MS. The results indicated that Cd-QsMT contains significantly higher amounts of metal and sulfìde ions that Zn-QsMT. Raman andir measurements revealed that, oppositely to what is known for other MTs, metal-QsMT contains significant amounts of secondary structures, predominantly B-sheet and B-turns elements, whereas it lacks a-helices. Interestingly, the properties of the metallic clusters formed are strongly dependent on the metal bound, Zn+2 or Cd+2. According to analytical results, the Raman spectra showed that Cd-QsMT is able to inglobe an the higher content of sulfide ions than Zn-QsMT, and suggested different structures of the complexes depending on the metal bound . Raman spectra also evidenced the participation of His in metal chelation in Cd-QsMT but not in Zn-QsMT. The differences observed between Zn+2 and Cd+2 metallic clusters suggest for QsMT a hybrid homeostatic/detoxificating role which would be developed through the acquisition of novel properties and metal-binding abilities depending on the metal coordinated.

The aims were to examine the prevalence of respiratory symptoms associated with rhinitis and asthma in Spanish workers and its variations by age, sex, work sector, location in the workplace, smoking habits and the relationship between symptoms in the upper and lower respiratory tract.The sample was of 2603 workers in different sectors and regions throughout the country. They agreed and answered the questions regarding respiratory symptoms, with the supervision of the company's physician.Chronic nasal symptoms were present in 438 workers (16.9 %); 193 (7.5 %) had pulmonary symptoms. With nasal and pulmonary symptoms were 124 patients (28.3 %). Likewise, of the 190 workers with pulmonary symptoms, 124 (64.2 %) had also nasal manifestations. We observed variations in nasal symptoms by sex, professional sector, work area and smoking habits, and variations in pulmonary symptoms by work sector. A higher prevalence was noted in the healthcare, postal, and transport sector as opposed to the construction, furniture or metal sector.The prevalence of nasal symptoms was higher than that of pulmonary symptoms in the working population. The workers affected by these pathologies were not treated adequately, despite they were presenting symptoms. We observed a relationship between pulmonary and nasal symptoms.INTRODUCCIÓN: en salud laboral interesa conocer la prevalencia de los síntomas respiratorios relacionados con la rinitis y el asma en trabajadores españoles y sus variaciones por factores demográficos y laborales. El objetivo de esta investigación fue interrelacionar los síntomas respiratorios de vías altas y bajas. MÉTODOS: se solicitó a 2603 trabajadores de distintos sectores y provincias españolas contestar una encuesta que fue supervisada por un médico del trabajo.438 trabajadores presentaron síntomas nasales crónicos (16.9 %) y 193 (7.5 %), síntomas pulmonares. De los 438 con síntomas nasales, 124 (28.3 %) presentaron síntomas pulmonares. Se observaron variaciones en los síntomas nasales por sexo, sector profesional, área de trabajo, tabaquismo y variaciones en los síntomas pulmonares por sector laboral, con mayor prevalencia en el sanitario, postal y transporte, en comparación con los sectores de la construcción, mueble o el metal.la prevalencia de los síntomas nasales en la población trabajadora fue más elevada que la de los síntomas pulmonares. Los trabajadores afectados estaban infratratados, a pesar de padecer síntomas. Se observó interrelación entre los síntomas pulmonares y nasales de los trabajadores afectados.

Objective: We analyze the knowledge of different medical specialists in relation to knowledge of the sexual dimension of their patients, as well as the attitudes and skills to listen and treat it. Design and Method: We used a validated FSP questionnaire: F= frequency with which the subject is confronted with the problem. S = given seriousness for the professional exercises. P = problems of skills to bring a response in terms of theoretical knowledge’s. Survey done with 62 different medical specialists: 19 gynecologists, 15 general practitioners, 13 urologists, 11 general surgeons and 4 medical oncologists. Comparisons of means were performed with Student t test. Results: (number = mean) (A) Frequency: a) personal awareness: higher in urologists (1.77), medical oncologists (1.5) and gynecologists (1.33) than in general surgeons (0.64)(p=0.001); b)professional confrontation with the sexual complaint: usual for urologists and general practitioners, less in medical oncologists and gynecologists and rarely in general surgeons (p=0.00); Urologists have a more proactive attitude (1.54) than gynecologists (1.05) and general surgeons (0.64) (p=0.03). (B) Seriousness: to be listening and reactive to sexual demand is more important for urologists than the remaining specialists. (C) Problems: theoretical knowledge: good in urologists (1.54) than the other specialists (gynecologists 1.0) (p=0.026). Conclusions: Urologists believe to have greater proactive and good knowledge to treat sexual problems of their patients compared to other physicians. It should encourage and conduct continuing education specific to different medical specialists, in order to have a proactive and sufficient knowledge about the sexual quality of life of the patients.

To ascertain the socioeconomic impact of diabetes, it is essential to estimate overall costs, including both direct and indirect costs (premature retirements, working hours lost, or sick leaves). This study analyzed indirect costs for temporary disability (TD) due to diabetes and its complications in Spain in 2011 by assessing the related ICD-9 MC codes.For this purpose, the number of TD processes and their mean duration were recorded. The indirect costs associated to loss of working days were also estimated.In 2011, diabetes and its complications were related to 2.567 TD processes, which resulted in the loss of 154.214 days. In terms of costs, this disease represented for Spanish public health administrations an expense of 3,297.095.3 €, with an estimated cost per patient and year of 141 €.These data suggest an urgent need to devise plans for prevention and early diagnosis of diabetes and its complications, as well as programs to optimize the available health care resources by creating multidisciplinary teams where occupational medical services assume an important role. A decrease in absenteeism would result in benefits for diabetic patients, society overall, and companies or public institutions.

Colorectal cancer is one of the most frequent cancers in both sexes and the most frequent in the developed countries, if men and women are considered together as a group. It has an important associated morbidity and mortality in all countries and constitutes a public health problem with a high direct and indirect economic cost. The number of workdays lost due to temporary disability (TD) is one of the quantifiable references of these indirect costs.To determine the indirect cost associated with TD due to colorectal cancer in Spain during the year 2011, a cost that aids in the prevention cost/benefit estimation.The number of TD processes, the number of workdays lost due to TD, and the mean duration of those processes, based on the CIE 9-MC codes related to this pathology, as well as the calculated cost, using the Spanish minimum wage as a reference, during the period of January to December 2011, were all reviewed.Colorectal cancer in Spain during 2011 represented 1,046 TD processes, 202,784 workdays lost, and a mean process duration of 194 days/year. The resulting cost of the pathology due to TD was 4,335,521.92 euros.These results are beneficial for evaluating the usefulness of implementing public health support strategies for a greater reduction in colorectal cancer prevalence and mortality, and an improvement in quality of life of the affected individuals and their families, together with an economic savings resulting from a reduction in TD as a consequence of this disease.

Chronic migraine is a clinically difficult to manage primary headache which affects the quality of life of the patients. This impact is important in the occupational world, where along with the clinical aspects of the disease, the therapies used for the control of the symptoms or preventive aspects, must be assessed. The side effects of the drugs and the limitations associated with their symptoms are aspects to highlight in occupational health, especially in individual workplaces, where there is a high risk of work-related injuries. The medical officer must assess the occupational risks of particular importance in the progression of this disease, as well as preventive actions, within the ambit of the current Spanish legislation, that may be favorable for both the company and the worker. The coordinated medical intervention and knowledge of these occupational aspects can provide clinically relevant tools, andoccupational and social optimization in the use of available resources.

Psychiatric and mood disorders may hamper the efficiency of workers and cause absenteeism.Revision of sick leaves related to schizophrenia, bipolar diseases, anxiety, depression and adaptive disorders that were granted in Spain in the period January- December 2011. The mean number of days off work for each disease and the costs per each labor day lost were calculated.The total number of labor days lost for schizophrenia, bipolar diseases and mood disorders were 72,831; 899,107 and 3,666,055 days, respectively. The mean duration of sick leaves for the same diagnoses were 84; 100 and 64 days/year respectively. The total indirect costs of sick leaves for psychiatric diseases during 2011 were € 100 million approximately, corresponding to 4% of costs for all diseases.The high costs of absenteeism derived from psychiatric diseases should prompt measures to promote a better adaptation to work environments of people suffering these ailments.

Breast cancer is one of the most frequent neoplasia in women, with an increasing prevalence in Europe and also in Spain. Although the predominance over the male sex is clear, we should not forget the cases where men are affected, even more so when in this case the risks attached to the type of job become more important. The importance of the indirect costs of this illness arises from: the high prevalence in people of working age, long periods of work disability, and permanent disability when the limitations are incompatible with the work activity once all the options of job readjustment and return to work have been exhausted. We will review the current criteria in order to establish some orientating guidelines that can be useful in the daily practice for Occupational Medicine professionals, General Practitioners and other specialists, always in collaboration with the medical teams from the National Health Service in charge of the evaluation of disabilities.

Fibromyalgia is a pain disorder listed in the International Classification of Diseases (ICD) of the World Health Organization under the code 729.1. It is a controversial disease that affects young people in many cases during their working years, posing a social and labour problem, in addition to the complexity of its diagnosis, which is based almost exclusively on clinical criteria as few objective data can be obtained from physical examination or additional tests. Nowadays, the criteria for clinical diagnosis of fibromyalgia are established and periodically revised by an Expert Consensus Panel; the most recent document is dated May, 2010. The occupational status of these patients attains an important significance due to the labour costs resulting from this disease and the difficulty in establishing clear and concise parameters for assessing the personal disability of the patients by the legally authorized organizations.