. Products which are non-essential from the point of view of health, such as sugar-rich products, processed meats, and alcoholic beverages, dominated the advertising mail delivered door-to-door by supermarkets in the Principality of Asturias. On a positive note, the prices of essential products, such as fresh fruit and vegetables, were, on average, significantly lower than the prices of non-essential products.Products which are non-essential from the point of view of health, such as sugar-rich products, processed meats, and alcoholic beverages, dominated the advertising mail delivered door-to-door by supermarkets in the Principality of Asturias. On a positive note, the prices of essential products, such as fresh fruit and vegetables, were, on average, significantly lower than the prices of non-essential products. To explore the extent to which the shift-workers of emergency ambulances maintain an adequate sleep quality and adaptation to shift-work, and its relationship to personal, circadian rhythm, and work-related factors. A cross-sectional study was performed on a sample of 180 technicians and nurses from the Emergency Medical Service of the Basque Country (18-60 years old) who were surveyed. The Pittsburgh Sleep Quality Index (PSQI), the Adaptation to Shift-Work Scale (ASW), the Circadian Type Questionnaire (CTQ) and the Composite Scale of Morningness (CSM) for evaluating chronotype, were administered. Fifty-two percent of the staff presented an intermediate adaptation and 30% reported a good adaptation. A progressive deterioration of sleep quality across the shifts (52% were bad sleepers during days-off, 63% after day-shifts and 90% after night-shifts) was related to a poorer level of adaptation to shift-work. A predictive model of adaptability was obtained based on the baseline level of sleep quality during the days-off and the V factor. The R factor moderated this interaction positively or negatively depending on sleep quality. There is a high presence of sleep disorders among the technicians and nurses of emergency ambulances as the main symptom of maladjustment to shift-work. Sleeping habits can cushion the impact of difficulties in resting and favor a better adaptation to shifts, introducing key-factors at the level of formation, prevention and intervention.There is a high presence of sleep disorders among the technicians and nurses of emergency ambulances as the main symptom of maladjustment to shift-work. Sleeping habits can cushion the impact of difficulties in resting and favor a better adaptation to shifts, introducing key-factors at the level of formation, prevention and intervention. Evaluate whether the implementation of an adnexal masses protocol, based on the GI-RADS system, allows a correct management of these masses, avoiding unnecessary clinical activity produced by overdiagnosis and overtreatment, as well as cost savings. Retrospective cohort study (July 2015 - June 2017) including women treated at the Gynaecology clinic of the Hospital Universitario Rey Juan Carlos (Móstoles, Madrid), with detection of an adnexal mass in high resolution echography. Adnexal masses were classified by the GI-RADS system, and together with the echographic image and menopausal status, surgery or follow-up was decided. A total of 154 women were studied, 24?% with images suggesting malignancy (G4 and G5). Surgery was performed on 33.1?% of adnexal masses; 33.3?% of them were ovarian carcinoma, mainly (88.2?%) in postmenopausal women with echographic images suggesting malignancy. Three point two percent of patients rejected the recommended surgery. During follow-up 21.4?% of the masses disappeared, 61 patients were only monitored due to a stable mass and two (1.3?%) due to surgical risk. Eventually, 96 (62.3?%) surgeries were avoided, achieving a 57,683 Euro saving. The application of a protocol based on the GI-RADS classification system avoided unnecessary surgeries, as well as the consequences and economical cost produced by them. Thus, this protocol is a useful and practical tool for the monitoring and treatment of adnexal masses.The application of a protocol based on the GI-RADS classification system avoided unnecessary surgeries, as well as the consequences and economical cost produced by them. Thus, this protocol is a useful and practical tool for the monitoring and treatment of adnexal masses.Randomized simulation trial to analyze dispatcher-assisted cardiopulmonary resuscitation instructions provided from the emergency call center in an out-of-hospital heart arrest assisted by lay persons. An analysis of the telephone instructions was performed using a 14-item checklist by two external researchers. Simulations lasted nine minutes. Twenty-one volunteers were enrolled. All of them started resuscitation maneuvers. Telephone instructions were verbalized in very heterogeneous ways. see more Half of the indicators exceeded 90% compliance. Frequently the recommendation of push hard and fast on the patient's chest was omitted and the dispatcher tended to mark a slower compression rate. The average time from the call to the start of the resuscitation was 3 min 33 s (SD 1 min 7 s). The telephone instructions were verbalized in a very heterogeneous way. It is necessary to standardize and provide training in how to guide a dispatcher-assisted resuscitation.Abiotrophia defectiva is a rare cause of endocarditis with a high embolization rate compared to other streptococcal endocarditis. Neurological complications may occur in 20-40% of cases, and include intracranial aneurysms and sub-arachnoid hemorrhage. Its isolation in the central nervous system (CNS) is extremely rare and is associated with previous neurosurgical procedures. We present the case of a 51-year-old patient who suffered an ischemic stroke as a complication of A. defectiva endocarditis, and the cases of CNS infections caused by this microorganism are reviewed. The relevance of the case lies in its singular character, due to the absence of previous valve disease in the patient without a recent history of invasive procedures or surgical interventions.An amendment to this paper has been published and can be accessed via a link at the top of the paper.