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1.
World J Surg ; 47(9): 2197-2205, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37210692

RESUMO

BACKGROUND: Improvements in quality of life (QoL) after parathyroidectomy in patients with primary hyperparathyroidism (PHPT) is discussed. It has not been analyzed whether these improvements can be influenced by a specific socio-personal or clinical patient profile. OBJECTIVES: to analyze QoL differences after parathyroidectomy and to determine a socio-personal and clinical profile that influences improvement after parathyroidectomy. METHODS: A longitudinal prospective cohort study in patients with PHPT. SF-36 and PHPQOL questionnaires were completed by the patients. A comparative preoperatory analysis was carried out, at three and twelve months after surgery. Student's t test was used for the correlations. The size of the effect was assessed using G*Power software. A multivariate analysis was performed to evaluate the socio-personal and clinical variables affecting the improvement in QoL after surgery. RESULTS: Forty-eight patients were analyzed. Three months after surgery an improvement was found in physical function, general health, vitality, social function, emotional role, mental health and in the patient's declared health assessment. One year after the intervention a general improvement was observed, with a greater effect on mental health and declared health evolution. Patients with bone pain presented with a higher probability of improvement after surgery. Patients with prior psychological disease had a lower associated probability of an improvement and high levels of PTH related to a greater probability of improvement after surgery. CONCLUSIONS: There is an improvement in the QoL of PHPT patients after parathyroidectomy. Patients with bone pain and high PTH levels prior to the parathyroidectomy present with a greater probability of having a greater improvement in QoL after surgery.


Assuntos
Hiperparatireoidismo Primário , Qualidade de Vida , Humanos , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/cirurgia , Estudos Prospectivos , Paratireoidectomia , Dor , Hormônio Paratireóideo
2.
Health Commun ; : 1-8, 2023 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-37528761

RESUMO

The creation of audio-visual content and the increase in the use of social networks by society have provided new opportunities for promoting health and the benefits of organ donation. This study analyzes the influence of audiovisual content produced by adolescents in the context of an educational program related to the promotion of organ donation with diffusion through social media. The program was implemented in the fourth year (mainly 15 and 16 year olds) in ten high schools in Spain. In the first phase, students learn about donation and create audio-visual messages about its benefits for society; in the second phase, they share this content on social networks. The influence of the content was measured using YouTube Analytics. In addition, a questionnaire was administered after the program to measure the way in which they shared the content on social networks. A total of 391 students participated in program, submitting 63 short films that obtained 104,912 views. The short films focused on appealing to society about the need for organs and the benefits of the organ donation and transplantation process. The social network that was used most frequently to share the content was WhatsApp (81.8%). Educating teenagers and turning them into prescribers of the health benefits of the organ donation and transplantation process through the use of social networks could be a good tool that can be exported to other fields of health.

3.
Langenbecks Arch Surg ; 406(7): 2441-2448, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34101001

RESUMO

INTRODUCTION: Paragangliomas are infrequent neuroendocrine tumours whose only criterion for malignancy is presence of metastases; thus, all paragangliomas show malignant potential. Actually, different risk factors have been analyzed to predict metastases but they remain unclear. PURPOSE: To analyze clinical, histological, and genetic factors to predict the occurrence of metastasis. PATIENTS AND METHOD: A multicentre retrospective observational analysis was performed between January 1990 and July 2019. Patients diagnosed with paraganglioma were selected. Clinical, histological, and genetic features were analyzed for the prediction of malignancy. RESULTS: A total of 83 patients diagnosed with paraganglioma were included, of which nine (10.8%) had malignant paraganglioma. Tumour size was greater in malignant tumours than in benign (6 cm vs. 4 cm, respectively; p = 0.027). The most frequent location of malignancy was the thorax-abdomen-pelvis area observed in six cases (p = 0.024). No differences were observed in histological differentiation, age, symptoms, and catecholaminergic production. The most frequent genetic mutation was SDHD followed by SDHB but no differences were observed between benign and malignant tumours. In the univariate analysis for predictive factors for malignancy, location, tumour size, and histological differentiation showed statistical significance (p = 0.025, p = 0.014, and p = 0.046, respectively); however, they were not confirmed as predictive factors for malignancy in the multivariate analysis. CONCLUSION: In this study, no risk factors for malignancy have been established; therefore, we recommend follow-up of all patients diagnosed with paraganglioma.


Assuntos
Neoplasias das Glândulas Suprarrenais , Paraganglioma , Feocromocitoma , Humanos , Paraganglioma/genética , Estudos Retrospectivos , Fatores de Risco , Succinato Desidrogenase
4.
Am J Transplant ; 20(1): 204-212, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31329359

RESUMO

Our main objective was to compare liver transplant (LT) results between donation after circulatory death (DCD) and donation after brainstem death (DBD) in our hospital and to analyze, within the DCD group, the influence of age on the results obtained with DCD donors aged >70 years and up to 80 years. All DCD-LTs performed were analyzed prospectively. The results of the DCD group were compared with those of a control group who received a DBD-LT immediately after each DCD-LT. Later, the results obtained within the DCD group were analyzed according to the age of the donors, considering 2 subgroups with a cut-off point at 70 years. Survival results for LT with DCD and super rapid recovery were not inferior to those obtained in a similar group of patients transplanted with DBD livers. However, the cost of DCD was a higher rate of biliary complications, including ischemic cholangiopathy. Donor age was not a negative factor.


Assuntos
Morte , Rejeição de Enxerto/diagnóstico , Sobrevivência de Enxerto , Transplante de Fígado/efeitos adversos , Doadores de Tecidos/provisão & distribuição , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Sistema Cardiovascular , Feminino , Seguimentos , Rejeição de Enxerto/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
8.
Clin Transplant ; 28(2): 259-66, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24476384

RESUMO

BACKGROUND: Teachers play a fundamental role in providing information to adolescents and could influence their attitudes. OBJECTIVES: To analyze the attitude of teachers toward organ donation and the concept of brain death (BD); the psychosocial variables related to attitude; and the information provided to pupils. METHODS: A multicenter study was carried out using a random sample of secondary school teaching staff from 10 schools (n = 327) in the southeast of Spain. Attitude toward organ donation was assessed using a validated questionnaire that was self-administered and completed anonymously. RESULTS: The questionnaire completion rate was 88% (n = 288), with 75% (n = 215) in favor of organ donation, 23% had doubts, and 2% were not in favor. Regarding the knowledge of BD, 62% (n = 179) accepted that this meant a person's death. The variables associated with a more favorable attitude included conversations with family and friends (p < 0.05); a partner's favorable opinion (OR 3.194); knowledge of the concept of BD (p = 0.006); being a blood donor (OR 8.264); and a favorable attitude toward autopsy (OR 4.716). Teachers provided information about organ donation to pupils in 16% of cases (n = 47). CONCLUSIONS: Seventy-five percent of teachers are in favor of organ donation. Their attitude is affected by psychosocial factors.


Assuntos
Atitude Frente a Saúde , Docentes , Conhecimentos, Atitudes e Prática em Saúde , Transplante de Órgãos/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos , Adolescente , Adulto , Idoso , Morte Encefálica , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Instituições Acadêmicas , Espanha , Inquéritos e Questionários , Adulto Jovem
9.
Surgery ; 175(5): 1291-1298, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38350761

RESUMO

BACKGROUND: Primary hyperparathyroidism can impact patient quality of life with psychopathological symptoms like mood and sleep disturbances. In the latest recommendations published according to the primary hyperparathyroidism surgical consensus, these neuropsychological symptoms continue to be excluded. This study aims to assess the negative effects of mood and sleep on patients with primary hyperparathyroidism compared to healthy controls and analyze their improvement after surgery. METHODS: Prospective case-control study of patients with primary hyperparathyroidism. The Beck questionnaire and Pittsburgh Sleep Quality Index were used. The control group consisted of healthy people matched by age and sex. Preoperative results were compared with results at 3 and 12 months after surgery and compared with the control group. Statistical analysis consisted of the Kolmogorov-Smirnov test and Student's t test for correlations. RESULTS: Forty-nine patients who underwent parathyroidectomy were analyzed. In relation to depression, differences were observed between the results of the preoperative period and 3 months after surgery, with a significant decrease in depression score (16.80 ± 9.98 vs 13.08 ± 10.76; P = .001). This improvement was maintained after 1 year (P < .001). Regarding the quality of sleep, there were no differences 3 months after the intervention, but there were differences at 12 months (9.48 ± 4.76 vs 8.27 ± 4.38; P = .032). The dimensions of the Pittsburgh Sleep Quality Index were analyzed, observing significant differences only in daytime dysfunction after 3 months and 12 months after surgery (1.02 ± 0.99 vs 0.69 ± 0.82; P = .01 and 1.04 ± 0.98 vs 0.60 ± 0.76; P = .004). CONCLUSION: Mood changes and sleep quality improve after primary hyperparathyroidism surgery, although at different postoperative times, with this improvement being more pronounced in mood. This assessment should be taken into account in the preoperative consultation of patients with primary hyperparathyroidism.


Assuntos
Hiperparatireoidismo Primário , Humanos , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/cirurgia , Hiperparatireoidismo Primário/psicologia , Qualidade do Sono , Qualidade de Vida , Estudos de Casos e Controles , Paratireoidectomia/métodos , Estudos Prospectivos
10.
Biomedicines ; 12(6)2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38927559

RESUMO

BACKGROUND: Pheochromocytoma (PHEO) is a rare neuroendocrine tumour with a strong genetic link, which therefore may modify its clinical behaviour and prognosis. The aim of the study is to evaluate the epidemiological and clinical differences between patients with sporadic and familial PHEO, as well as the specific differences in the index cases. METHODS: A retrospective analysis of 136 patients in a tertiary hospital (1984-2021). Epidemiological, clinical, and histological variables were analysed. STATISTICS: SPSS 28.0 software was used. Univariate and multivariate logistic regression analyses were performed. p < 0.05 was considered statistically significant. RESULTS: 64.71% of the cases (n = 88) presented a genetic mutation (familial cases). Additionally, 32.39% (n = 23) corresponded to index cases and the rest to screening cases. The main differences between patients with familial and sporadic PHEO were age (OR = 0.93 (0.89-0.97)), blood pressure-related symptoms (OR = 0.22 (0.06-0.89)), bilaterality (OR = 15.49 (3.76-63.84)), and size (OR = 0.70 (0.54-0.92)). Among patients with sporadic PHEO and index cases, only bilaterality was significant (OR = 13.53 (1.24-144.34)). CONCLUSIONS: Patients with familial PHEO diagnosed by screening differ from sporadic cases in terms of age, clinical features, and size. However, patients with sporadic PHEO only differ from index cases by a lower presence of bilaterality, which reaffirms the importance of genetic screening of patients with PHEO and their relatives.

11.
Head Neck ; 46(6): 1486-1499, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38380767

RESUMO

The tumor immune microenvironment of thyroid cancer is the heterogeneous histological space in which tumor cells coexist with host cells. Published data from this review were identified by search and selection database of Pubmed, Elsevier, and Science Direct. Searching was made in two steps using different keywords. In thyroid pathology, the inflammatory response is very important, and might have a key role finding new diagnostic and therapeutic methods, particularly in thyroid cancer. Different immune cells may be more or less present in different types of thyroid cancer and may even have different functions, hence the importance of knowing their presence in different thyroid tumor pathologies. Cancer-related inflammation could be a useful target for new diagnostic and therapeutic strategies by analyzing peritumoral and intratumoral immune cells in different types of thyroid tumors. Moreover, novel strategies for thyroid cancer treatments, such as monoclonal antibodies targeting checkpoint inhibitors, are emerging as promising alternatives.


Assuntos
Neoplasias da Glândula Tireoide , Microambiente Tumoral , Humanos , Microambiente Tumoral/imunologia , Neoplasias da Glândula Tireoide/terapia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/imunologia , Inibidores de Checkpoint Imunológico/uso terapêutico
12.
Prog Transplant ; 23(3): 217-9, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23996940

RESUMO

One of the complications that can occur in pancreas transplant is a massive intestinal hemorrhage, although such a hemorrhage is very rarely caused by ulcers due to cytomegalovirus infection. Treatment is fundamentally based on relaparatomy, although in some cases interventional radiology can be an efficient alternative because it allows the exact bleeding point to be located and therapeutic embolization to be performed. In this case, a man with diabetes type 1 who was given a simultaneous kidney-pancreas transplant had an ulcer due to cytomegalovirus infection develop in the duodenal graft (in the early postoperative period), causing a severe hemorrhage in the lower part of the gastrointestinal tract that was controlled via selective embolization of a branch of the pancreaticoduodenal artery.


Assuntos
Infecções por Citomegalovirus/terapia , Diabetes Mellitus Tipo 1/cirurgia , Úlcera Duodenal/terapia , Úlcera Duodenal/virologia , Embolização Terapêutica/métodos , Hemorragia Gastrointestinal/terapia , Hemorragia Gastrointestinal/virologia , Transplante de Rim , Transplante de Pâncreas , Adulto , Angiografia , Humanos , Masculino
14.
Ann Endocrinol (Paris) ; 84(1): 1-7, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36202230

RESUMO

INTRODUCTION: Quality of life (QoL) in patients with primary hyperparathyroidism (PHPT) can be negatively affected by the disease, and it is important to identify risk factors. The objectives of the present study were to analyze QoL, mood and quality of sleep in patients with PHPT and to determine the impact of socio-personal and clinical variables. PATIENTS AND METHOD: The study group included patients diagnosed with PHPT, and the control group was taken from general population, paired by age and gender. QoL was analyzed using the SF-36 and the PHPQoL questionnaires. The Beck-II and Pittsburg questionnaires were used to assess depression and sleep quality. Socio-personal and clinical variables were analyzed. Statistical analysis on SPSS software v.28 used the Student t-test, ANOVA, Pearson's rank correlation, Mann-Whitney test, Kruskal-Wallis test and Spearman's rank correlation. A multiple linear regression model of the QoL was constructed. RESULTS: Sixty-five patients with PHPT were analyzed. A greater negative effect on QoL, mood and sleep quality were observed in patients with PHPT than in controls (P<0.05), with a good correlation between the various questionnaires. Several socio-personal variables had an effect on QoL and mood (P<0.05). QoL in patients with PHPT was affected by educational level, having offspring, and psychological symptoms (P<0.05). CONCLUSIONS: Patients with PHPT had poorer QoL and greater neurocognitive disorder than the general population. Socio-personal profile should be taken into account in the clinical assessment of these patients, together with psychological symptoms.


Assuntos
Hiperparatireoidismo Primário , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Qualidade do Sono , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/epidemiologia , Hiperparatireoidismo Primário/psicologia , Inquéritos e Questionários , Fatores de Risco
15.
Transplant Proc ; 55(10): 2250-2252, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37775403

RESUMO

INTRODUCTION: Studies about the knowledge of and attitude toward new lines of organ donation in a group of older people are important due to the increase in older organ donors. OBJECTIVES: To analyze the attitude of citizens over 65 years of age in southeastern Spain toward controlled asystole donation (CAD) and to determine the psycho-social profile that influences this attitude. METHODS: The study population consisted of citizens over 65 years of age. A representative sample was obtained in southeastern Spain (N = 420). A questionnaire about attitudes toward CAD was used, detailing in the questionnaire that this is a type of donation from people who have died of circulatory and respiratory criteria after the limitation of life support treatment. Several psychosocial variables were also taken into account. Statistical analysis included the χ2 test and multivariate analysis. RESULTS: The completion rate was 84% (n = 351). Favorable attitude toward organ donation and transplantation (ODT) was 98% (n = 344) overall, and CAD was viewed favorably by 45% (n = 158). The psychosocial variables that influenced attitude toward CAD were mainly having received a talk about ODT (odds ratio [OR] 5.6), knowing the opinion of one's partner (OR 7.95), acceptance of cremation (OR 1.09), and acceptance of autopsy (OR 3.002). CONCLUSIONS: The attitude of older people toward CAD is unfavorable despite a willingness to support ODT in general. This attitude is influenced by variables of social and family dialogue about ODT, attitude to body manipulation, and having received information about ODT.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Humanos , Idoso , Atitude , Transplante de Órgãos/psicologia , Doadores de Tecidos/psicologia , Inquéritos e Questionários , Espanha , Conhecimentos, Atitudes e Prática em Saúde
17.
J Healthc Qual Res ; 37(5): 299-302, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35764496

RESUMO

BACKGROUND: The coronavirus disease pandemic of 2019 (COVID-19) made necessary to remodel the hospital's clinical consultations. OBJECTIVE: To evaluate the telematic consultation in endocrine surgery, as well as to select the group of patients susceptible to perform a telematic consultation in the future according to this assessment. METHODS: The study population were patients who had a clinical consultation by telephone. The evaluation was made with the Net Promoter Score (NPS). STATISTICAL ANALYSIS: SPSS v.28, X2 test and a multivariate analysis. RESULTS: 55 patients were analyzed. The NPS was +16, 24 promoters (43.6%) and 15 detractors (27.2%). There were differences between those whose main reason for consultation was malignant pathology (OR 4.5; p = 0.033). The NPS between malignant vs. non-malignant pathology was -13 vs. +38 (p > 0.001). The evaluation of the telematic consultations for the future was: telephone (83% very well), video call (58%), videoconference (19%). CONCLUSIONS: The evaluation of the telephone consultation has been good, finding a better assessment among patients with non-malignant pathology. Its future implementation could be necessary, being the telephone the preferred way.


Assuntos
COVID-19 , Consulta Remota , COVID-19/epidemiologia , Humanos , Pandemias , Telefone
18.
Transplant Proc ; 54(1): 7-10, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34844739

RESUMO

BACKGROUND: Audiovisual creation allows teachers and students to become consumers and producers of information, creating collaborative environments. In the field of organ donation and transplantation (ODT), most of the educational proposals analyzed to date consist of presentations. The teacher does not usually have a decisive role in this type of methodologies, in addition to not having the appropriate training to be able to participate actively. OBJECTIVES: To analyze the change in teachers' attitudes towards ODT after participating in an educational proposal based on the creation of short films. METHODS: Teachers of secondary education in ten schools in southeastern Spain. The proposal consisted in the creation of short films based on topics related to ODT by the students. A validated ODT attitude form was administered to teachers at the beginning of the proposal and at the end of the proposal. A descriptive analysis was carried out together with McNemar test was used to compare the pre and post test results of the teacher. P < .05 was considered statiscally significant. RESULTS: The favorable attitude towards organ donation at death increased after the proposal (64% vs 88%; P = .008). Favorable attitude towards organ donation from a relative also improved (52% vs 76%; P = .008), as did favorable attitude towards living kidney donation (52% vs 88%; P < .001), living liver donation (36% vs 85%; P = .008) and xenotransplantation (45% vs 82%; P < .001). CONCLUSIONS: The teachers improves after an educational proposal based on the creation of short films related to ODT.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Atitude , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Instituições Acadêmicas , Espanha , Inquéritos e Questionários
19.
Transplant Proc ; 54(1): 11-14, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34876269

RESUMO

BACKGROUND: In education, we can use cinema to create methodologies that develop the critical thinking to acquire knowledge in a collaborative way. Favorable attitudes toward organ donation and transplantation (ODT) is low in adolescents. Working on topics related to ODT, such as religion, immigration, and the law, can help to improve students' knowledge and endear them toward ODT with innovative educational methodologies. OBJECTIVES: This study aims to analyze the change in knowledge about religion, immigration, and legislation on ODT after an educational proposal based on film creation. METHODS: In this study, 16-year-old students participated in an educational proposal based on ODT education through filmmaking. A total of 543 students participated in the experimental group, and 320 participated in the control group. A validated ODT knowledge form was administered to both groups. Statistical analysis was carried out with SPSS version 21.0 package (SPSS, Inc, Chicago, IL, USA). A descriptive analysis and χ2 test were performed to analyze the differences between the experimental group and control group. P < .05 was considered statistically significant. RESULTS: The study had a 72% participation rate in the experimental group. After receiving the educational proposal, the students presented a greater knowledge with respect to the control group in all aspects: the position of the different religions in relation to organ donation, knowledge of the rights and obligations of immigrants in relation to the ODT, and knowledge of the law of presumed consent in ODT CONCLUSIONS: Working in the classroom on psychosocial aspects such as religion, immigration, and legislation through filmmaking can favorably influence the adolescent's awareness of organ donation.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Adolescente , Emigração e Imigração , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Filmes Cinematográficos , Religião , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-35886383

RESUMO

Currently, more than half of all donors are aged over 65 years, and previous studies have shown that this group is less willing to support organ donation. Objective: to analyse the attitude of people aged over 65 years toward organ donation and transplantation (ODT) and to determine how their psychosocial profile affects their attitude. Study population: citizens residing in southeastern Spain older than 65 years of age. A representative sample was obtained, which was stratified by gender and geographical location (n = 420). A validated questionnaire about ODT was used. Statistical analysis: a bivariate analysis was performed using the X2 test and a multivariate analysis. The favourable attitude toward the donation of one's own organs was 53%. The psychosocial variables affecting attitude were mainly: having discussed ODT with one's family (p < 0.001) or friends (OR 2.223), acceptance of cremation (OR 2.508), and acceptance of an autopsy (OR 2.578). Citizens aged over 65 tend to have an unfavourable attitude toward the donation of their own organs. The lack of dialogue about ODT in social and family settings, and the attitude to the manipulation of one's own body after death, are aspects of a respondent's psychosocial profile, which influence this attitude.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Idoso , Atitude , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Espanha , Inquéritos e Questionários
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