Both treatment approaches were equally effective but the intraoperative ERCP group had less morbidity, a shorter hospital stay, and reduced costs. The lower morbidity in the intraoperative ERCP group resulted from the lower rate of papillotomy and lower rates of post-ERCP pancreatitis and cholecystitis. Total morbidity was principally related to the type of treatment approach used.

Intraoperative ERCP is an option to prevent performing ERCP unnecessarily on patients with moderate risk of CLD not confirmed using appropriate radiological studies. It can resolve the biliary disease in a single step with a similar success rate to standard ERCP, but with low morbidity, especially of acute pancreatitis. The residual CLD rate is also very low.

El programa pretende fomentar el desarrollo psicolingüístico y priorizar el lenguaje escrito en el curriculum desde edades tempranas. La muestra está formada por un total de 106 alumnos pertenecientes a zonas socioculturales medio-bajas, con inteligencia normal y sin handicaps físicos, psíquicos y/o sensoriales. Los alumnos están distribuidos en dos grupos, el grupo experimental, al que se le aplica el programa desde los cuatro años hasta los seis años, y el grupo control, que sigue el curriculum escolar oficial. El diseño es longitudinal de medidas repetidas, con cuatro fases de evaluación y tres de intervención. Los resultados encontrados muestran como el grupo experimental alcanza mejor rendimiento académico en cada año de aplicación del programa que el grupo control. Se propone, por tanto, un cambio en los objetivos curriculares que implique la enseñanza-aprendizaje de la lectoescritura desde edades tempranas (4 a 6 años).

The excellent management of patients in the different Intensive Care Units has decreased mortality but, as a side effect, we have to treat an increasing number of patients with airway problems secondary to prolonged intubation. The clinical records of patients diagnosed of acquired or congenital subglottic stenosis (SE) between 1990 and 1995 were retrospectively reviewed. Types of treatment included conservative, endoscopic, and open surgery: anterior cricoid split (ACS), anterior laryngotracheoplasty (ALTP) and anteroposterior laryngotracheoplasty (APLTP). 46 patients had SE: 7 congenital and 39 acquired. According to Cotton's classification 13 had grade I, 16 grade II, 12 grade III and none grade IV. Eleven of twelve cases treated conservatively did well (92%); one out of six patients managed endoscopically required further surgery (7%); good results were obtained in 5 of 7 cases treated by ACS (71 %); 8 out of 9 patients treated by ALTP did well (89%) and 7 out of 8 managed by APLTP had good results (87.5%). One iatrogenic suture dehiscence required further surgery. There is no statistical difference in the complication rate between patients treated conservatively and those treated by open surgery, while the mean hospital stay was higher in the latter (p < 0.05). An appropriate surgical technique should be offered to those patients with SE who do not do well with conservative management, since these techniques have yielded good results with a low rate of complications. Long-term follow-up shows the absence of recurrence.

Extracorporeal Shock wave Lithotripsy (ESWL) has proved to be effective safe and nowadays is the preferred method of treatment of over 90% of upper urinary tract stones [1,2]. Nevertheless, ESWL is not devoid of complications. Although the majorities are trivial and transient, serious complications could occur but are extremely rare and only very few have been reported in the literature [3]. We report a case of small intestinal perforation following ESWL. The case is striking because we decided to carry out a non-operative management, which in this case turned out to be successful. We are not aware of another such case in the English-language literature.

The aim of this study is to analyze if accuracy reading is modified by quotidian stressors variables, in students who start Elementary Education. In this transversal study, accuracy reading processes and daily stress, were studied in a group of 111 students of Elementary Education from two different schools, a private/state-subsidised school and a state one. The design is transversal. Accuracy and daily stress are assemented. After variance analysis, results indicated significant differences in accuracy reading with respect to school stress. The importance of daily stress was highlighted in first course of obligatory education.Keywords: Quotidian stress. Accuracy reading. Primary Education. RESUMENEl objetivo de este estudio es analizar la influencia del stress cotidiano en la precisión lectora en, en el inicio de la Educación Primaria. La muestra esta formada por 111 alumnos de Educación Primaria, pertenecientes a dos centros escolares, uno privado/concertado y otro público. El diseño de este trabajo es transversal, evaluándose la precisión lectora y el estrés cotidiano de manera individual. Los resultados obtenidos con el análisis de varianza muestran diferencias significativas en la precisión lectora con respecto al estrés escolar. Se resalta la importancia del estrés cotidiano en la precisión lectora en el primer año de la enseñanza obligatoria.Palabras claves: Estres cotidiano. Precisión lectora. Educación Primaria. INTRODUCCIÓNActualmente es notable la importancia social que ha adquirido y cada vez más va adquiriendo el estrés como mediador social importante en las funciones de vida cotidiana. Ha sido y sigue siendo

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The aim of this study is to analyze if reading efficiency is modified by initial reading level, type of school and sex, in students who start Elementary Education. In this transversal study, accuracy reading processes and initial reading level were studied in a group of 111 students of Elementary Education from two different schools, a private/state-subsidized school and a state one. After compared average and variance analysis, results indicated significant differences in accuracy reading with respect to initial reading level, but not differences in accuracy reading with respect type of school and sex. The importance of initial reading level in Primary Education was highlighted as well as the effects of initial reading level in Preschool in school and home education.Keywords: accuracy reading, initial reading level RESUMEN El objetivo de este estudio es analizar si existen diferencias en precisión lectora en cuanto al nivel de lectura inicial, sexo y tipo de colegio, en el inicio de la Educación Primaria. La muestra esta formada por 111 alumnos de Educación primaria, pertenecientes a dos centros escolares, uno privado/concertado y otro público. El diseño de este trabajo es transversal, evaluándose el rendimiento lector (precisión lectora) y el nivel de lectura inicial en Educación Infantil, de manera individual. Los resultados obtenidos con el análisis de comparación de medias muestran diferencias significativas en la precisión lectora con respecto al nivel de lectura inicial, pero no en cuanto al tipo de cole-