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1.
Actas Dermosifiliogr ; 2024 Feb 19.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38382749

RESUMEN

INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea.

2.
Clin Exp Dermatol ; 47(1): 235-239, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34435383

RESUMEN

Schimmelpenning-Feuerstein-Mims (SFM) syndrome is a neurocutaneous disorder that can affect many body systems. The principal and most characteristic anomalies are craniofacial naevus sebaceous in association with neurological, ocular and skeletal findings. The presence of vascular malformations in this condition is unusual; nevertheless, vascular malformations have been suggested by many authors to be part of the spectrum of the same disease. Few cases have been published on the association of SFM with lymphatic malformations. This syndrome is categorized as a mosaic RASopathy due to postzygotic mutations in the HRAS, KRAS or NRAS genes. These genes are involved in the RAF-MEK-ERK signalling pathway, which is activated by mutant cells, increasing cellular proliferation. These mutations have been found only in naevus sebaceous cells, and may be also the explanation for many of the associated pathologies. We report a case of an 18-year-old boy diagnosed with SFM syndrome associated with lymphatic malformation in the legs and agenesia of the inguinal lymph nodes. The lymphatic alterations were diagnosed by gammography of the legs. The genetic diagnosis was confirmed by the presence of a KRAS postzygotic mutation in naevus sebaceous cells of a skin specimen. Genetically confirmed cases of mosaic RASopathies should be used to more accurately characterize phenotypic presentations of this syndrome and develop a future therapeutic strategy, such as molecular targeted therapy.


Asunto(s)
Ganglios Linfáticos/anomalías , Nevo Sebáceo de Jadassohn/genética , Nevo Sebáceo de Jadassohn/patología , Proteínas Proto-Oncogénicas p21(ras)/genética , Adolescente , Ingle , Humanos , Pierna , Imagen por Resonancia Magnética , Masculino , Mutación , Nevo Sebáceo de Jadassohn/diagnóstico por imagen
3.
Clin Exp Dermatol ; 43(8): 876-882, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29756221

RESUMEN

BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) represents the most common form of skin cancer after basal cell carcinoma, and can be both locally invasive and metastatic to distant sites. Growth rate (GR) has been poorly evaluated in cSCC, despite clinical evidence suggesting that GR is an important risk factor in cSCC. AIM: To analyse the influence of GR in cSCC prognosis. METHODS: We retrospectively evaluated GR in a series of 90 cSCCs and tried to correlate GR with prognosis in cSCC. RESULTS: We demonstrated that tumours with a GR of > 4 mm/month exhibit a higher risk of nodal progression and a shorter progression time to lymph node metastasis in cSCC than those with GR of < 4 mm/month. As expected, GR correlated with tumour proliferation, as determined by Ki-67 expression. CONCLUSIONS: We consider a GR of 4 mm/month as the cutoff point that distinguishes between rapid- and slow-progressing tumours and, more importantly, to identify a subset of high-risk cSCCs.


Asunto(s)
Carcinoma de Células Escamosas/patología , Progresión de la Enfermedad , Neoplasias Cutáneas/patología , Anciano , Anciano de 80 o más Años , Antígenos de Superficie/metabolismo , Femenino , Humanos , Modelos Logísticos , Metástasis Linfática , Masculino , Pronóstico , Estudios Retrospectivos , Factores de Riesgo
4.
Br J Dermatol ; 176(5): 1279-1287, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27510450

RESUMEN

BACKGROUND: Cutaneous squamous cell carcinoma (CSCC) is the second most frequent cancer in humans after basal cell carcinoma, and its incidence is dramatically rising. CSCC is rarely problematic, but given its high frequency, the absolute number of complicated cases is also high. It is necessary to identify molecular markers in order to recognize those CSCCs with poor prognosis. There is controversy concerning the role of epidermal growth factor receptor (EGFR) as a marker of prognosis in CSCC. In addition, EGFR-targeted therapies have emerged in recent years and a better understanding of the role of EGFR in CSCC may be of help for some patients in predicting prognosis and guiding curative management. OBJECTIVES: To evaluate the role of EGFR as a prognostic factor in CSCC. METHODS: We evaluated clinical and histopathological features, including events of poor clinical evolution, in a series of 94 cases of CSCC. We also analysed EGFR expression by immunohistochemistry, fluorescent in situ hybridization and quantitative polymerase chain reaction. RESULTS: We detected EGFR in 85 cases (90%), with overexpression in 33 cases (35%), and aberrant EGFR expression in the cytoplasm in 50 cases (53%). EGFR overexpression in the primary tumours was associated with lymph node progression, tumour-nodes-metastasis stage progression and proliferation (Ki-67 staining) in CSCC. EGFR overexpression and poor grade of differentiation were the strongest independent variables defining lymph node metastasis and progression in CSCC in a logistic regression model. CONCLUSIONS: We demonstrate that EGFR overexpression has prognostic implications associated with lymph node metastasis and progression in CSCC.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/diagnóstico , Receptores ErbB/metabolismo , Neoplasias Cutáneas/diagnóstico , Anciano de 80 o más Años , Carcinoma de Células Escamosas/genética , Progresión de la Enfermedad , Receptores ErbB/genética , Femenino , Humanos , Inmunohistoquímica , Metástasis Linfática , Masculino , Pronóstico , Factores de Riesgo , Neoplasias Cutáneas/genética
5.
Br J Dermatol ; 177(1): 168-178, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27943259

RESUMEN

BACKGROUND: Cutaneous squamous cell carcinoma (CSCC) is the second most widespread cancer in humans and its incidence is rising. These tumours can evolve as diseases of poor prognosis, and therefore it is important to identify new markers to better predict its clinical evolution. OBJECTIVES: We aimed to identify the expression pattern of microRNAs (miRNAs or miRs) at different stages of skin cancer progression in a panel of murine skin cancer cell lines. Owing to the increasing importance of miRNAs in the pathogenesis of cancer, we considered the possibility that miRNAs could help to define the prognosis of CSCC and aimed to evaluate the potential use of miR-203 and miR-205 as biomarkers of prognosis in human tumours. METHODS: Seventy-nine human primary CSCCs were collected at the University Hospital of Salamanca in Spain. We identified differential miRNA expression patterns at different stages of CSCC progression in a well-established panel of murine skin cancer cell lines, and then selected miR-205 and miR-203 to evaluate their association with the clinical prognosis and evolution of human CSCC. RESULTS: miR-205 was expressed in tumours with pathological features recognized as indicators of poor prognosis such as desmoplasia, perineural invasion and infiltrative growth pattern. miR-205 was mainly expressed in undifferentiated areas and in the invasion front, and was associated with both local recurrence and the development of general clinical events of poor evolution. miR-205 expression was an independent variable selected to predict events of poor clinical evolution using the multinomial logistic regression model described in this study. In contrast, miR-203 was mainly expressed in tumours exhibiting the characteristics associated with a good prognosis, was mainly present in well-differentiated zones, and rarely expressed in the invasion front. Therefore, the expression and associations of miR-205 and miR-203 were mostly mutually exclusive. Finally, using a logistic biplot we identified three clusters of patients with differential prognosis based on miR-203 and miR-205 expression, and pathological tumour features. CONCLUSIONS: miR-205 and miR-203 tended to exhibit mutually exclusive expression patterns in human CSCC. This work highlights the utility of miR-205 and miR-203 as prognostic markers in CSCC.


Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , MicroARNs/metabolismo , Neoplasias Cutáneas/diagnóstico , Biomarcadores/metabolismo , Línea Celular Tumoral , Transformación Celular Neoplásica , Progresión de la Enfermedad , Humanos , Clasificación del Tumor , Pronóstico
8.
J Chem Phys ; 145(24): 244309, 2016 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-28049318

RESUMEN

We study the vibrational dynamics of a model for the HCN molecule in the presence of a monochromatic laser field. The variation of the structural behavior of the system as a function of the laser frequency is analyzed in detail using the smaller alignment index, frequency maps, and diffusion coefficients. It is observed that the ergodicity of the system depends on the frequency of the excitation field, especially in its transitions from and into chaos. This provides a roadmap for the possibility of bond excitation and dissociation in this molecule.

9.
Chaos ; 26(6): 065305, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27368795

RESUMEN

The communication and migration patterns of a country are shaped by its socioeconomic processes. The economy of Senegal is predominantly rural, as agriculture employs over 70% of the labor force. In this paper, we use mobile phone records to explore the impact of agricultural activity on the communication and mobility patterns of the inhabitants of Senegal. We find two peaks of phone calls activity emerging during the growing season. Moreover, during the harvest period, we detect an increase in the migration flows throughout the country. However, religious holidays also shape the mobility patterns of the Senegalese people. Hence, in the light of our results, agricultural activity and religious holidays are the primary drivers of mobility inside the country.


Asunto(s)
Agricultura , Comunicación , Emigración e Inmigración , Teléfono Celular , Humanos , Dinámica Poblacional , Población Rural , Imágenes Satelitales , Senegal
10.
Chaos ; 25(3): 033114, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25833436

RESUMEN

We say that a population is perfectly polarized when divided in two groups of the same size and opposite opinions. In this paper, we propose a methodology to study and measure the emergence of polarization from social interactions. We begin by proposing a model to estimate opinions in which a minority of influential individuals propagate their opinions through a social network. The result of the model is an opinion probability density function. Next, we propose an index to quantify the extent to which the resulting distribution is polarized. Finally, we apply the proposed methodology to a Twitter conversation about the late Venezuelan president, Hugo Chávez, finding a good agreement between our results and offline data. Hence, we show that our methodology can detect different degrees of polarization, depending on the structure of the network.

11.
Br J Dermatol ; 169(4): 830-7, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23662851

RESUMEN

BACKGROUND: Melanoma is responsible for almost 80% of the deaths attributed to skin cancer. Stem cells, defined by CD133 expression, have been implicated in melanoma tumour growth, but their specific role is still uncertain. OBJECTIVES: We hypothesized that the phenotypic heterogeneity of human cutaneous melanomas is related to their content of CD133+ cells. METHODS: We compared the percentages of CD133+ cells in 29 tumours from four classic types of melanoma: lentigo maligna melanoma (LMM), superficial spreading melanoma, nodular melanoma and acral lentiginous melanoma (ALM). Also, we compared the percentages of CD133+ cells in melanomas with different degrees of exposure to ultraviolet radiation: 16 melanomas from skin with chronic sun-induced damage and 13 melanomas from skin without such damage. RESULTS: We found a statistically significant increase of CD133+ cells in three different contexts: in melanomas arising on skin with signs of chronic sun-induced damage vs. nonexposed skin, in melanomas in situ vs. invasive melanomas, and in LMM vs. ALM. The proportions of CD133+ cells did not differ among samples of normal skin with different degrees of sun exposure. A distinct subpopulation of CD133+CXCR4+ cancer stem cells (CSCs) was identified and shown to be related to the invasive phenotype of the tumours. CONCLUSIONS: Here, we provide evidence showing, for the first time, that an increase in the CD133+ cell content is associated both with melanomas arising on skin with signs of chronic sun-induced damage and in melanomas in situ with better prognosis. Moreover, our study further confirms the existence of a subpopulation of CD133+CXCR4+ CSCs in cutaneous melanomas with invasive phenotype and poor prognosis.


Asunto(s)
Antígenos CD/metabolismo , Glicoproteínas/metabolismo , Melanoma/patología , Péptidos/metabolismo , Neoplasias Cutáneas/patología , Antígeno AC133 , Proliferación Celular , Enfermedad Crónica , Humanos , Melanoma/metabolismo , Traumatismos por Radiación/patología , Piel/metabolismo , Piel/efectos de la radiación , Neoplasias Cutáneas/metabolismo , Luz Solar/efectos adversos , Rayos Ultravioleta/efectos adversos
12.
J Endocrinol ; 256(3)2023 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-36622663

RESUMEN

Breast cancer (BC) is the most diagnosed cancer in women worldwide. In estrogen receptor (ER)-positive disease, anti-estrogens and aromatase inhibitors (AI) improve patient survival; however, many patients develop resistance. Dysregulation of apoptosis is a common resistance mechanism; thus, agents that can reinstate the activity of apoptotic pathways represent promising therapeutics for advanced drug-resistant disease. Emerging targets in this scenario include microRNAs (miRs). To identify miRs modulating apoptosis in drug-responsive and -resistant BC, a high-throughput miR inhibitor screen was performed, followed by high-content screening microscopy for apoptotic markers. Validation demonstrated that miR-361-3p inhibitor significantly increases early apoptosis and reduces proliferation of drug-responsive (MCF7), plus AI-/antiestrogen-resistant derivatives (LTED, TamR, FulvR), and ER- cells (MDA-MB-231). Importantly, proliferation-inhibitory effects were observed in vivo in a xenograft model, indicating the potential clinical application of miR-361-3p inhibition. RNA-seq of tumour xenografts identified FANCA as a direct miR-361-3p target, and validation suggested miR-361-3p inhibitor effects might be mediated in part through FANCA modulation. Moreover, miR-361-3p inhibition resulted in p53-mediated G1 cell cycle arrest through activation of p21 and reduced BC invasion. Analysis of publicly available datasets showed miR-361-3p expression is significantly higher in primary breast tumours vspaired normal tissue and is associated with decreased overall survival. In addition, miR-361-3p inhibitor treatment of BC patient explants decreased levels of miR-361-3p and proliferation marker, Ki67. Finally, miR-361-3p inhibitor showed synergistic effects on BC growth when combined with PARP inhibitor, Olaparib. Together, these studies identify miR-361-3p inhibitor as a potential new treatment for drug-responsive and -resistant advanced BC.


Asunto(s)
Neoplasias de la Mama , MicroARNs , Humanos , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Resistencia a Antineoplásicos/genética , MicroARNs/genética , MicroARNs/metabolismo , Antagonistas de Estrógenos/farmacología , Inhibidores de la Aromatasa/farmacología , Inhibidores de la Aromatasa/uso terapéutico , Apoptosis/genética , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Línea Celular Tumoral
13.
Chaos ; 22(2): 023138, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22757545

RESUMEN

Transmitting messages in the most efficient way as possible has always been one of politicians' main concerns during electoral processes. Due to the rapidly growing number of users, online social networks have become ideal platforms for politicians to interact with their potential voters. Exploiting the available potential of these tools to maximize their influence over voters is one of politicians' actual challenges. To step in this direction, we have analyzed the user activity in the online social network Twitter, during the 2011 Spanish Presidential electoral process, and found that such activity is correlated with the election results. We introduce a new measure to study political sentiment in Twitter, which we call the relative support. We have also characterized user behavior by analyzing the structural and dynamical patterns of the complex networks emergent from the mention and retweet networks. Our results suggest that the collective attention is driven by a very small fraction of users. Furthermore, we have analyzed the interactions taking place among politicians, observing a lack of debate. Finally, we develop a network growth model to reproduce the interactions taking place among politicians.


Asunto(s)
Gobierno Federal , Internet , Modelos Teóricos , Política , Humanos , Relaciones Interpersonales , Apoyo Social , España , Factores de Tiempo
14.
Integr Comp Biol ; 59(3): 548-558, 2019 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-31141121

RESUMEN

Biologists often study morphological evolution through form and function relationships. But biological structures can perform multiple functional roles, complicating efforts to understand the evolutionary significance of any one relationship. Plant reproductive organs perform multiple roles in a sequence, however, which provides a unique opportunity to understand how structures evolve to meet multiple functional demands. Using conifers as a study group, we discuss how a shared developmental trajectory links the performance of sequential functional roles. Variation in development among lineages can underlie morphological diversity; pollination-stage seed cones in Pinaceae conifers function similarly but show diverse forms reflecting differences in developmental rate. As cones develop further, the morphologies that they use to perform later functional roles are influenced by the specific developmental patterns used to meet earlier demands, which may ultimately limit morphological diversity. However, we also show how selective pressures relating to the final functional stage (seed dispersal) may influence cone anatomy and morphology over all previous stages, highlighting the complex linkages among form, function, and development. We end by discussing the potential relationships between functional ontogeny and morphological disparity in plant reproductive structures more broadly, suggesting that the complex functional roles associated with seed plant reproduction probably underlie the high disparity in this group.


Asunto(s)
Evolución Biológica , Pinales/anatomía & histología , Pinales/fisiología , Polinización , Filogenia , Reproducción
15.
Life Sci Space Res (Amst) ; 21: 49-64, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31101155

RESUMEN

The pumice volcanic samples could have possible connections to the evolution of life and give us insight about their bio-geochemical processes related. In this regard, the samples from the volcanic eruption from La Restinga (El Hierro, Spain) in 2011 have been mainly studied by means of Raman spectroscopy. The research also includes analysis of XRD, Scanning Electron Microscopy and Optical Microscopy to support the Raman analysis. The results show that the Raman methods and mineral analyses are in strong agreement with the results obtained from other authors and techniques. The internal white foamy core (WFC) of the studied pumice samples shows amorphous silica, Fe-oxides, Ti-oxides, quartz, certain sulfates, carbonates, zeolites and organics. On the other hand, the external part (dark crust - DC) of these samples mainly presents primary-sequence mineralogy combined with some secondary alteration minerals such as olivine, feldspar, pyroxene, amorphous silica, and Fe-oxide. Raman spectroscopy detected other minerals not yet reported on these samples like barite, celestine and lepidocrocite. Also, the different chemometric and calibration methods for Raman spectroscopy in elemental composition, mineral classification and structural characterization has been successfully applied. From the astrobiological perspective, the research was also complemented with comparisons to other similar samples from terrestrial analogs. The main consideration was taking into account the proposed hypothesis regarding the potential behavior of the pumice as a substrate for the evolution of life. Furthermore, the detailed analysis from La Restinga eruption is coherent with the mineral phases and processes discussed from previous literature. The white internal part fulfills the conditions to work as an organic reservoir, confirmed by the detection of organic matter and selected minerals that could be used as energy sources for bacterial communities. The external layers of the samples work as a shielding layer to protect the organics from decay in extreme conditions. Finally, here we have demonstrated that the characteristics and advantages of Raman spectroscopy could help to assess and understand the possible biogenicity and alteration processes of any geological sample to be found on Mars.


Asunto(s)
Exobiología , Sedimentos Geológicos/análisis , Minerales/análisis , Espectrometría Raman/métodos , Difracción de Rayos X
16.
Actas Dermosifiliogr (Engl Ed) ; 110(7): 533-545, 2019 Sep.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30837074

RESUMEN

Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea.


Asunto(s)
Algoritmos , Consenso , Rosácea/terapia , Antibacterianos/uso terapéutico , Tartrato de Brimonidina/uso terapéutico , Técnica Delphi , Doxiciclina/uso terapéutico , Humanos , Terapia por Láser , Metronidazol/uso terapéutico , Guías de Práctica Clínica como Asunto , Calidad de Vida , Rosácea/clasificación , Rosácea/tratamiento farmacológico
17.
J Chem Phys ; 129(16): 164316, 2008 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-19045275

RESUMEN

Relevant aspects of the phase space structure corresponding to the vibrational dynamics of a two-dimensional model of the HCP molecule are studied in detail using a frequency analysis method. By performing this analysis locally for reduced periods of time, the underlying chaotic structure and the main resonances have been determined.

18.
Actas Urol Esp ; 32(9): 934-6, 2008 Oct.
Artículo en Español | MEDLINE | ID: mdl-19044305

RESUMEN

Kaposi's sarcoma is an infrequent tumor of unknown cause, but with a higher impact in immune depressed individuals, particularly in HIV and transplant patients. It usually appears as a benign cutaneous lesions, while the invasive visceral form is uncommon with malignant evolution and wit rare remission. We present a patient with a Kaposi's sarcoma localised in a renal graft and bad response even when immuno suppression was discontinued.


Asunto(s)
Neoplasias Renales , Trasplante de Riñón , Complicaciones Posoperatorias , Sarcoma de Kaposi , Humanos , Neoplasias Renales/etiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Sarcoma de Kaposi/etiología
19.
Actas Urol Esp ; 32(10): 1035-6, 2008.
Artículo en Español | MEDLINE | ID: mdl-19143297

RESUMEN

Tarlov cysts or perineural cyst are lesions of the nerve roots located at the sacral level and uncertain aetiology. Most of these cysts remain asymptomatic with no clinical relevance. The symptomatic cysts are uncommon and the usual symptoms are pain or radiculopathy. We report the case of a 53-year-old woman witha symptomatic cyst (with a history of frequency and urgency syndrom), that disappears after surgery.


Asunto(s)
Quistes de Tarlov/complicaciones , Quistes de Tarlov/cirugía , Enfermedades de la Vejiga Urinaria/etiología , Enfermedades de la Vejiga Urinaria/cirugía , Trastornos Urinarios/etiología , Trastornos Urinarios/cirugía , Femenino , Humanos , Persona de Mediana Edad
20.
Rev Esp Anestesiol Reanim ; 55(6): 360-6, 2008.
Artículo en Español | MEDLINE | ID: mdl-18693662

RESUMEN

OBJECTIVES: We performed a systematic review of randomized controlled trials to compare combined general-epidural anesthesia, followed by postoperative epidural analgesia, and general anesthesia followed by postoperative parenteral analgesia without epidural analgesia in patients undergoing thoracoabdominal surgery. Outcome measures considered were mortality, length of stay in hospital and in the intensive care unit, analgesia, and morbidity. MATERIAL AND METHODS: We performed a systematic search of online databases (MEDLINE, EMBASE, the Cochrane Controlled Trials Registry and the metaRegister of clinical trials at http://www.controlled-trials.com/mrct/ mrct info es.asp). We also hand-searched the literature. Authors were contacted when deemed necessary. RESULTS: A total of 30 trials (4294 patients) were analyzed. Combined anesthesia showed significant advantages in relation to 2 variables: respiratory failure (odds ratio, 0.71; 95% confidence interval [CI], 0.58 to 0.87) and analgesia on the first day after surgery (weighted mean difference, -6.91 95% CI, -9.46 to -4.36). No significant differences were found in the other variables. CONCLUSIONS: Combined anesthesia provides better analgesia and is associated with fewer cases of postoperative respiratory failure. No significant differences were found in mortality, length of stay in hospital, or other morbidity variables.


Asunto(s)
Abdomen/cirugía , Analgesia , Anestesia Epidural/efectos adversos , Anestesia Epidural/mortalidad , Anestesia General/efectos adversos , Anestesia General/mortalidad , Procedimientos Quirúrgicos Torácicos/mortalidad , Anestesia Epidural/métodos , Anestesia General/métodos , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
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