Objective: The Mediterranean diet is considered one of the healthiest dietary models. Recent changes in the actual Mediterranean diet include a reduction in energy intake and a higher consumption of foods with low nutrient density (e.g. soft drinks, candy, sweets, etc.). In Spain, in association with cultural and lifestyle changes, there has been a reduction in the intake of antioxidants and vitamins, an increase in the proportion of SFA and a decrease in the consumption of fibre, among other changes. Children and adolescents may be the age groups with the most deteriorated Mediterranean diet. The current paper presents the results of applying the Mediterranean Diet Quality Index for children and adolescents (KIDMED) to a large sample of Spanish schoolchildren. Design: Data from questionnaires were used to calculate the KIDMED index. Setting: Granada, Southern Spain. Subjects: Schoolchildren (n 3190) aged 8-16 years. Results: Among the 8-10-year-olds, the KIDMED index classification was 'good' in 48?6 % of the population, 'average' in 49?5 % and 'poor' in 1?6 %. Among the 10-16-year-olds, the KIDMED index classification was good in 46?9 % of the population, average in 51?1 % and poor in 2?0 %. Conclusions: The nutritional behaviour of the present population of schoolchildren is similar to that found in the earlier KIDMED study.

Thirty-five patients with severe mitral stenosis underwent percutaneous mitral valvotomy (PMV). There were 29 female and six male patients (mean age 49 3 years, range 13 to 87). After transseptal left heart catheterization, PMV was performed with either a single-(20 patients) or double-(14 patients) balloon dilating catheter. Hemodynamic and left ventriculographic findings were evaluated before and after PMV. There was one death. Mitral regurgitation developed or increased in severity in 15 patients (43%). One patient developed complete heart block requiring a permanent pacemaker. PMV resulted in a significant decrease in mitral gradient from 18 + 1 to 7 + 1 mm Hg (p < .0001) and a significant increase in both cardiac output from 3.9 0.2 to 4.6 + 0.2 liters/min (p < .001) and in mitral valve area from 0.8 + 0.1 to 1.7 0.2 cm2 (p < .0001) Effective balloon dilating diameter per square meter of body surface area correlated significantly with the decrease in mitral gradient but did not correlate with the degree of mitral regurgitation. There was no correlation of age, prior mitral commissurotomy or mitral calcification with hemodynamic results. PMV is an effective nonsurgical procedure for patients with mitral stenosis, including those with pliable valves, those with previous commissurotomy, and even those with Circulation 75, No. 4, 0-0, 1987. ALTHOUGH the prevalence of rheumatic mitral stenosis has markedly decreased in the United States,l rheumatic heart disease is still common in underdeveloped and developing countries, accounting for 25% to 40% of all cardiovascular diseases.2'3 Surgical mitral commissurotomy is a low-risk surgical technique that results in symptomatic and hemodynamic improvement in selected patients. Percutaneous mitral valvotomy (PMV) or valvotomy via femoral cutdown using a balloon dilating catheter has recently been used in a small number of patients`as an alternative to surgical mitral commissurotomy. This study reports the results to PMV in 35 patients with severe mitral stenosis. Materials and methodsPatients. The patient population included 35 patients who presented with severe, symptomatic mitral stenosis. There were

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