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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-5, 01/jan./2022. tab
Article in English | LILACS | ID: biblio-1358203

ABSTRACT

Objectives: The present study was designed to examine the efficacy of Cissus quadrangularis paste on fracture healing in artificially induced fractured rabbits. Methods: Fifteen rabbits were separated into three groups namely A, B, and C. Veldt grape paste was applied in groups B and C (Treatment Group) by close reduction and open reduction methods of fracture management; respectively, while group A was kept as control. The blood parameter and fracture healing properties in all animals have been monitored and examined routinely during the study period. Results: Both treated groups revealed lower serum calcium levels (SCL) than the control group after 24 hours of fracture that became within the normal range on the 14th day. Fracture healing in the treated groups has been commenced more rapidly than the control group with complete bridging of discontinuity by a distinct osseous callus in the fracture line on day 7 and complete effacing of fracture line on day 14. Conclusion: We did not find any type of anomalousness, clinical deviations, and alteration of serum calcium level on the 14th day of the fracture in treated animals hence Veldt Grape paste could be readily applicable to the management of the fracture in animals.


Objetivos: avaliar a eficácia da pasta de Cissus quadrangularis na consolidação de fraturas em coelhos fraturados artificialmente. Metodos: quinze coelhos foram separados em três grupos (A, B e C). A pasta foi aplicada nos grupos B e C (Grupo de Tratamento) pelos métodos de redução fechada e redução aberta de gerenciamento de fraturas; respectivamente. O grupo A foi mantido como controle. O parâmetro sanguíneo e as propriedades de cicatrização de fraturas em todos os animais foram monitorados e examinados, rotineiramente, durante o período do estudo. Resultados: ambos os grupos tratados revelaram níveis séricos de cálcio (SCL) mais baixos do que o grupo controle, após 24 horas de fratura que se tornou normal no 14º dia. A cicatrização da fratura nos grupos tratados foi iniciada mais rapidamente do que o grupo controle, com ponte completa de descontinuidade por um calo ósseo distinto na linha de fratura no dia 7 e apagamento completo da linha de fratura no dia 14. Conclusao: não encontramos nenhum tipo de anomalia, desvios clínicos e alteração do nível sérico de cálcio no 14º dia da fratura nos animais tratados, portanto, a pasta Veldt Grape pode ser aplicável ao manejo da fratura em animais.


Subject(s)
Fracture Healing , Cissus , Ointments , Therapeutics , Bony Callus , Fractures, Bone , Goals , Animals, Laboratory , Methods
2.
J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022.
Article in English | LILACS | ID: biblio-1369172

ABSTRACT

Introduction: It is reported a case of a 57-year-old woman with multiple psychiatric hospitalizations, during which different diagnostic hypotheses and therapeutic procedures were proposed. Case report: After analyzing the patient's clinical records, the medical team proposed a diagnosis of Schizoaffective Disorder. This disorder presents a high risk of recurrent hospitalizations and high costs associated with therapeutic and follow-up withdrawal, yet there is limited data to assess the post-discharge critical periods. Final considerations: Further research in this area is required to adopt effective therapeutic strategies, reduce the probability of hospital admissions, improve prognosis, and lessen associated financial costs.


Introdução: é relatado o caso de uma mulher de 57 anos com múltiplas hospitalizações psiquiátricas, durante as quais diferentes hipóteses diagnósticas e terapêuticas associadas foram propostas. Relato do caso: Após análise dos registos clínicos, a equipa médica propôs o diagnóstico de Perturbação Esquizoafetiva. Esta Perturbação apresenta um elevado risco de re-internamento, para além do custo associado ao abandono do seguimento clínico e terapêutico. Porém, não existem dados suficientes que avaliem os períodos pós-alta. Consideracoes finais: Portanto, tornam-se necessárias pesquisas mais amplas na área para adotar estratégias terapêuticas eficazes, reduzir a probabilidade de re-internamento, melhorar o prognóstico e minimizar os custos financeiros associados.


Subject(s)
Psychotic Disorders , Patients , Prognosis , Therapeutics , Women
3.
Rev. SPAGESP ; 23(1): 117-130, jan.-jun. 2022.
Article in Portuguese | LILACS, Index Psychology - journals | ID: biblio-1356774

ABSTRACT

RESUMO Este estudo teve por objetivo realizar uma pesquisa teórica em psicanálise sobre a clínica da toxicomania. Trata-se pesquisa teórica em psicanálise, visando a novos encadeamentos conceituais a respeito do tema. O consumo, que se apresenta como toxicômano, é atribuído a um gozo mortífero, dinâmica que visa à satisfação total das pulsões do Sujeito. Concluímos ao longo desse escrito que as dinâmicas de gozo representadas pelo Suplemento e Suplência possuem uma análise diferencial para a compreensão do consumo de drogas. Sugerimos, como contraponto, que o movimento de Alienação e Separação, metaforizado pela dinâmica do Fort-Da, é de grande valia na condução do processo clínico para o tratamento desse Sujeito.


ABSTRACT This study aimed to conduct theoretical research in psychoanalysis on the clinical care for drug addiction. It is theoretical research in psychoanalysis, aiming at new conceptual chains on the theme. The consumption that presents itself as drug addiction is attributed to a deadly enjoyment, a dynamic that aims at the total satisfaction of the individual's drives. We concluded how the dynamics of jouissance represented by Replacement and Supplement play a differential role in comprehending drug consumption. We suggest, as a counterpoint, that the Alienation and Separation movement, which worked as a metaphor in the Fort-Da dynamic, is of great value in conducting the clinical process for the treatment of these individuals.


RESUMEN Este estudio tuvo como objetivo realizar una investigación teórica en psicoanálisis sobre una clínica de drogadicción. Se trata de una investigación teórica en psicoanálisis, apuntando a nuevas cadenas conceptuales sobre el tema. El consumo que se presenta como drogadicto se atribuye a un goce mortal, dinámica que apunta a la satisfacción total de los impulsos del Sujeto. Concluimos a lo largo de este artículo cómo la dinámica del goce representada por el Suplemento y el Reemplazo tiene un papel diferencial en la comprensión del consumo de drogas. Sugerimos, como contrapunto, que el movimiento de Alienación y Separación, metaforizado por la dinámica Fort-Da, es de gran valor en la conducción del proceso clínico para el tratamiento de estos sujetos.


Subject(s)
Personal Satisfaction , Psychoanalysis , Role , Therapeutics , Substance-Related Disorders , Drive , Pleasure
4.
Diagn. tratamento ; 27(2): 61-71, abr-jun. 2022. tab, tab
Article in Portuguese | LILACS | ID: biblio-1369116

ABSTRACT

Contextualização: A pandemia do novo coronavírus é uma das maiores preocupações da sociedade atualmente. O elevado número de mortes associadas ao vírus levou à busca urgente de estratégias terapêuticas eficazes na luta contra a doença. Objetivos: Avaliar a efetividade das intervenções terapêuticas para COVID-19, segundo as revisões sistemáticas da Colaboração Cochrane. Métodos: Trata-se de overview de revisões sistemáticas Cochrane. Procedeu-se à busca na Cochrane Library (2022), sendo utilizado o termo MeSH "COVID-19". Todos os estudos relacionados ao tratamento da COVID-19 foram incluídos. O desfecho primário de análise foi a melhora clínica. Resultados: Nove estudos foram incluídos, totalizando 75 ensaios clínicos randomizados (ECRs) (n = 72.859 participantes). Remdesivir, cloroquina/ hidroxicloroquina, ivermectina e colchicina não reduziram a mortalidade. Corticosteroide sistêmico reduziu discretamente a mortalidade de pacientes internados e diminuiu o número de dias de ventilação mecânica. Tocilizumabe reduziu discretamente a mortalidade até o 28o dia. Não há evidência de benefício de uso de vitamina D, azitromicina e anticorpos monoclonais. Discussão: Embora haja boa evidência para algumas intervenções, a maioria carece de estudos de melhor qualidade. No caso da cloroquina/hidroxicloroquina a evidência é fortemente desfavorável ao uso e suficiente para desencorajar novos estudos. Sugere-se a realização de novos ECRs de qualidade para intervenções cuja efetividade é ainda incerta, seguindo-se as recomendações do CONSORT (Consolidated Standards of Reporting Trials) Statement para melhor elucidação da questão. Conclusão: Não há suporte com bom nível de evidência atualmente para a maioria das intervenções para COVID-19, à luz das revisões sistemáticas da Cochrane.


Subject(s)
Therapeutics , Coronavirus , Evidence-Based Practice , Systematic Review , COVID-19
5.
Washington; PAHO/WHO; 04 May 2022. 462 p.
Non-conventional in English | PIE, LILACS, PIE | ID: biblio-1368644

ABSTRACT

Background: The urgent need for evidence on measures to respond to the COVID-19 pandemic had led to a rapid escalation in numbers of studies testing potential therapeutic options. The vast amount of data generated by these studies must be interpreted quickly so that physicians have the information to make optimal treatment decisions and manufacturers can scale-up production and bolster supply chains. Moreover, obtaining a quick answer to the question of whether or not a particular intervention is effective can help investigators involved in the many ongoing clinical trials to change focus and pivot to more promising alternatives. It is crucial for healthcare workers to have access to the most up-to-date research evidence to inform their treatment decisions. To address this evidence gap, we compiled the following database of evidence on potential therapeutic options for COVID-19. We hope this information will help investigators, policy makers, and prescribers navigate the flood of relevant data to ensure that management of COVID19, at both individual and population levels, is based on the best available knowledge. We will endeavor to continually update this resource as more research is released into the public space. Summary of evidence: Tables 1 and 2, which divide the total group of identified studies into randomized (Table 1) and non-randomized (Table 2) designs, indicate the primary outcome measures used for each investigation and the level of certainty. Table 3 summarizes the status of evidence for the 193 potential therapeutic options for COVID-19 for which studies were identified through our systematic review.


Subject(s)
Coronavirus Infections/drug therapy , Coronavirus Infections/therapy , COVID-19/drug therapy , COVID-19/therapy , Therapeutics
6.
San Salvador; MINSAL; may. 11, 2022. 47 p. tab.
Non-conventional in Spanish | LILACS, BISSAL | ID: biblio-1372447

ABSTRACT

El presente Plan nacional contra la resistencia a los antimicrobianos, tiene como objetivo prevenir las enfermedades infecciosas, asegurando el uso adecuado de los tratamientos con medicamentos eficaces, seguros y de calidad garantizada, que se usen de modo responsable, tanto para el tratamiento de enfermedades infecciosas en humanos y animales, así como para garantizar la producción de alimentos. Este Plan se construye bajo la visión de «Una Salud¼ en el plano internacional, la OMS colabora estrechamente con la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO) y la Organización Mundial de Sanidad Animal (OIE) para proponer soluciones viables a los peligros y riesgos generados por el uso inadecuado de antibióticos en la producción de alimentos de origen animal. En este plan nacional se contempla la participación de diversas instituciones relacionadas con la prestación de servicios de salud, producción de alimentos e instituciones formadoras de recursos humanos en salud, coordinadas todas por la Comisión Nacional contra la Resistencia a Antimicrobianos


This National Plan against antimicrobial resistance aims to prevent infectious diseases, ensuring the proper use of treatments with effective, safe and quality-guaranteed medicines, which are used responsibly, both for the treatment of infectious diseases in humans and animals, as well as to guarantee food production. This Plan is built under the vision of "One Health" at the international level, the WHO collaborates closely with the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE) to propose solutions viable to the dangers and risks generated by the inappropriate use of antibiotics in the production of food of animal origin. This national plan contemplates the participation of various institutions related to the provision of health services, food production and training institutions for human resources in health, all coordinated by the National Commission against Antimicrobial Resistance


Subject(s)
Pharmaceutical Preparations , Programming , Anti-Infective Agents , Anti-Bacterial Agents , Solutions , Therapeutics , Health , El Salvador , Food
7.
Actas esp. psiquiatr ; 50(3): 144-159, Mayo - Junio 2022. graf, tab
Article in Spanish | IBECS | ID: ibc-203228

ABSTRACT

Introducción. La ketamina es un anestésico de efecto rápido con propiedades hipnóticas. Además, podría mejorar potencialmente los síntomas afectivos en pacientes con trastorno depresivo refractario. Objetivo. Explorar la literatura científica disponible hasta el 10 de diciembre de 2021 sobre la eficacia y seguridad de la ketamina en pacientes con trastorno depresivo mayor refractario al tratamiento. Material y métodos. Revisión exploratoria que incluyó PubMed y Scopus. Se incluyeron registros de ensayos clínicos y publicaciones con datos empíricos en inglés y español. Resultados. Se incluyeron 31 documentos y 12 registros de ensayos clínicos: estudios clínicos aleatorizados (n = 19), estudios clínicos no aleatorizados (n = 11) y estudios de cohortes retrospectivos (n = 1). La suma de participantes en registros de ensayos clínicos fue de 1,318. Un 58,3 % (7/12) de los registros de ensayos clínicos aún no están reclutando la población de estudio, el 25 % (3/12) son estudios de fase 2 y solo un estudio se encuentra actualmente en la fase cuatro. Conclusiones. La evidencia apoya el uso de ketamina para el tratamiento de la depresión refractaria. Los efectos adversos son generalmente leves y autolimitados, aunque los efectos adversos más complejos requieren vigilancia por parte de personal experimentado. Son necesarios estudios experimentales que comparen la eficacia y seguridad de la ketamina frente a la terapia electroconvulsiva como tratamiento de primera línea de esta entidad.(AU)


Introduction. Ketamine is a fast-acting anesthetic with hypnotic properties. Moreover, could potentially improve affective symptoms in patients with refractory depressive disorder. Objective. explore the scientific literature available until December 10, 2021, about the efficacy and safety of ketamine in patients with treatment-refractory major depressive disorder. Material and methods. Scoping review that included PubMed and Scopus. Records of clinical trials and publications with empirical data in English and Spanish were included. Results. 31 documents and 12 clinical trial records were included: randomized clinical trials (n = 19), non-randomized clinical trials (n = 11) and retrospective cohort studies (n = 1). The sum of participants in clinical trial registries was 1,318. Some 58.3% (7/12) of the records of clinical trials are not yet recruiting the study population, 25% (3/12) are phase 2 studies and only one study is currently in phase four. Conclusions. The evidence supports the use of ketamine for the treatment of refractory depression. Adverse effects are generally mild and self-limited, although more complex adverse effects require monitoring by experienced personnel. Experimental studies are needed to compare the efficacy and safety of ketamine versus electroconvulsive therapy as the first-line treatment for this entity.(AU)


Subject(s)
Humans , Health Sciences , Depressive Disorder , Ketamine , Electroconvulsive Therapy , Therapeutics , Psychiatry
8.
Article in Spanish | IBECS | ID: ibc-203501

ABSTRACT

IntroducciónEl envejecimiento de la población infectada por VIH podría relacionarse con prescripciones de medicación potencialmente inadecuadas, interacciones medicamentosas y falta de adherencia terapéutica. Los criterios PIMDINAC buscan analizar conjuntamente estos problemas. El objetivo del estudio es determinar la prevalencia de los criterios PIMDINAC en una población VIH de edad avanzada.MétodosEstudio observacional, transversal y multicéntrico que incluyó pacientes mayores de 65 años en seguimiento farmacoterapéutico entre febrero-abril de 2020. La variable principal fue el porcentaje de cumplimiento de los criterios PIMDINAC.ResultadosSe incluyeron 47 pacientes, registrándose un PIMDINAC total en un 12,5%. De forma aislada, se detectó no adherencia al tratamiento concomitante en un 65,6% de los pacientes, medicación potencialmente inadecuada en un 48,9% e interacciones medicamentosas en un 25,2%. El número de fármacos y la polifarmacia se relacionaron con una mayor aparición de criterios PIMDINAC.ConclusiónLa prevalencia de criterios PIMDINAC en pacientes VIH de edad avanzada es elevada.


IntroductionAging of people living with HIV could be related to potentially inappropriate medication prescriptions, drugs interactions and lack of drugs adherence. PIMDINAC criteria seek to jointly analyze these problems. The objective of this study is to determine the prevalence of PIMDINAC criteria in an elderly HIV population.MethodsObservational, cross-sectional, multicenter study that included patients older than 65 years in pharmacotherapeutic follow-up between February-April 2020. The main endpoint was the percentage of PIMDINAC criteria identified in the study population.ResultsForty-seven patientes were included, identifying total PIMDINAC in 12.5%. Non-adherence to concomitant treatment was detected in 65.6% of patients, potentially inappropriate medication in 48.9% and drugs interactions in 25.2%. The number of concomitant drugs and polypharmacy were associated with a higher appearance of PIMDINAC criteria.ConclusionThe prevalence of PIMDINAC criteria in elderly HIV patients is high.


Subject(s)
Humans , Male , Adult , Health Sciences , HIV , HIV Infections , Aging , Patients , Therapeutics , Pharmaceutical Preparations , Polypharmacy , Microbiology , Communicable Diseases , Case-Control Studies
10.
Farm. hosp ; 46(3): 1-5, May-Jun, 2022. tab
Article in Spanish | IBECS | ID: ibc-VR-276

ABSTRACT

Objetivo: La prolongación del intervalo QT puede aumentar la estanciahospitalaria y la tasa de mortalidad de los pacientes. Esta investigacióndetermina la incidencia de prolongación del intervalo QT debido al usode medicamentos y evalúa el método más apropiado para realizar elmonitoreo electrocardiográfico.Método: Se realizó un estudio observacional retrospectivo en pacienteshospitalizados en el Hospital Clínica Bíblica durante el año 2018. Serevisaron los expedientes de los pacientes con hospitalización superiora 48 horas cuya historia clínica incluyera al menos tratamiento con unmedicamento que prolongara el intervalo QT y que las medidas manualesdel intervalo QT fueran corregidas con la fórmula Fridericia y Rautaharju,y las medidas automáticas con la fórmula Bazett. La valoración del riesgose realizó con la escala RISQ-PATH.Resultados: De los 141 pacientes analizados, 23 tenían una arritmia previaen su historia clínica y 14 de ellos sufrieron complicaciones durante la hospitalización.Un total de 113 (80%) pacientes tenían un valor alto RISQ‑PATHy sólo a 64 se les realizó un electrocardiograma al ingreso. En promedio,los pacientes recibieron tres medicamentos que aumentaban el intervalo QT.La mayoría de los QT obtenidos automáticamente fueron más cortos queaquellos obtenidos en forma manual. De todas las correcciones, los valoresdel intervalo QT más largos se obtuvieron con la fórmula de Bazett, y los máscortos con la fórmula Rautaharju. No ocurrieron eventos como taquicardiaventricular compleja o torsade de pointes durante el estudio.Conclusiones: Es necesario implementar estrategias que permitan una mejor monitorización del intervalo QT con el fin de prevenir las complicacionesderivadas en los pacientes ospitalizados


Objective: QT interval prolongation can increase patients’ hospitalstay and mortality rate. This study aims to determine the incidence ofdrug-induced QT interval prolongation and establish which QT intervalmeasurement method is the most appropriate for electrocardiographicmonitoring.Method: A retrospective observational study was conducted of patientsadmitted to the Clínica Bíblica Hospital during 2018. The electronic medicalrecords of patients hospitalized for longer than 48 hours and whosedrug regimen included at least one drug potentially able to prolong the QTinterval were reviewed. Manually-measured QT intervals were correctedusing Fridericia’s and Rautaharju’s formulae, while automatically-measuredQT intervals were corrected with Bazett’s formula. Risk was assessed usingthe RISQ-PATH scale.Results: Of the 141 patients analyzed, 23 had arrhythmia as per theirclinical history and 14 suffered a complication during their stay in hospital.A total of 113 (80%) had a high RISQ-PATH score and only 64 were subjectedto an electrocardiogram on admission. Patients received a meanof three potentially QT interval prolonging drugs. Most of the QT ntervalsmeasured automatically were shorter than those obtained manually. Of allcorrections, the longest QTc interval values were obtained with Bazett’sformula, and the shortest with Rautaharju’s formula. None of the patientsdeveloped TdP or complex ventricular tachycardia.Conclusions: Every effort should be made to implement strategies conducive to more effective monitoring of the QT interval to prevent QT intervalprolongation related complications in hospitalized patients


Subject(s)
Humans , Inpatients , Therapeutics , Length of Stay , Medical Records , Pharmacy Service, Hospital , Tachycardia, Ventricular , Drug Therapy
11.
Internet resource in English, Spanish, Portuguese | LIS -Health Information Locator | ID: lis-48753

ABSTRACT

Devido à sua natureza silenciosa, menos de 10% das pessoas infectadas com a doença de Chagas recebem anualmente o diagnóstico oportuno e, consequentemente, um tratamento eficaz no México, América Central e América do Sul, onde a enfermidade afeta entre 6 e 8 milhões de pessoas que, em sua maioria, vivem em áreas com transmissão vetorial e em situação de pobreza.


Subject(s)
Chagas Disease , Diagnosis , Therapeutics
12.
Lima; Perú. Ministerio de Salud; Abr. 2022. 33 p.
Non-conventional in Spanish | MINSAPERÚ, MINSAPERÚ | ID: biblio-1363677

ABSTRACT

La norma contiene los criterios técnicos para el diagnóstico y tratamiento de los pacientes pediátricos (menores de 18 años de edad) con infección probable o confirmada por el SARS-CoV-2 causante de COVID-19 y del síndrome inflamatorio multisistémico pediátrico asociado a SARS-CoV-2


Subject(s)
Therapeutics , Severe Acute Respiratory Syndrome , Minors , Diagnosis , SARS-CoV-2 , COVID-19 , Infections
14.
Oncología (Ecuador) ; 32(1): 87-99, 30-04-2022.
Article in Spanish | LILACS | ID: biblio-1368952

ABSTRACT

Introducción: El síndrome de vena cava superior (SVCS) es una patología poco frecuente, asociado en la mayoría de los casos a neoplasias de origen maligno; la cual en estadios avanzados representa una urgencia médico-oncológica que compromete la vida del paciente. Propósito de la revisión: El objetivo de la revisión es delinear el rol de las diferentes alternativas quirúrgicas y percutáneas para el tratamiento del SVCS. Buscamos reportes en donde se incluye los resultados de mejor supervivencia para los distintos tratamientos actuales. Recientes hallazgos: La literatura médica describe tratamientos como la radioterapia, la quimioterapia, el bypass, la terapia endovascular y la reconstrucción vascular para el manejo del SVCS, sin embargo, no todos responden con la misma eficacia al momento de presentarse una urgencia vital por SVCS; esto producto de los factores intrínsecos y extrínsecos del paciente. Dentro de los factores extrínsecos destaca la condición social la cual, se convierte en un reto al momento de realizar un manejo integral del paciente en ciudades fronterizas, donde los datos que conoce el médico sobre el paciente son limitados o el paciente no tiene un diagnóstico previo que permita orientar el manejo. Conclusiones: El punto de partida del tratamiento del paciente con SVCS consiste en diferenciar la emergencia y la estabilidad mediante la tabla de clasificación de gravedad. En casos emergentes se tiene 2 alternativas: la terapia endovascular y la radioterapia. El abordaje quirúrgico con Baypass está contraindicado y el tratamiento definitivo con reconstrucción vascular con prótesis tiene ventajas y desventajas que deben definirse en forma individual considerando la etiología del cáncer asociado.


Introduction: Superior vena cava syndrome (SVCS) is a rare pathology, associated in most cases with neoplasms of malignant origin; which in advanced stages represents a medical-oncological emergency that compromises the patient's life. Purpose of the review: The objective of the review is to outline the role of the different surgi-cal and percutaneous alternatives for the treatment of SVCS. We look for reports that include the best survival results for the different current treatments. Recent findings: The medical literature describes treatments such as radiotherapy, chemo-therapy, bypass, endovascular therapy and vascular reconstruction for the management of SVCS, however, not all respond with the same efficacy at the time of a vital emergency. by SVCS; this product of the intrinsic and extrinsic factors of the patient. Among the extrinsic fac-tors, the social condition stands out, which becomes a challenge when carrying out an integral management of the patient in border cities, where the data that the doctor knows about the patient is limited or the patient does not have a previous diagnosis. to guide management. Conclusions: The starting point of the treatment of the patient with SVCS consists in differentiating the emergency and the stability by means of the severity classification table. In emergent cases there are 2 alternatives: endovascular therapy and radiotherapy. The surgical approach with Baypass is contraindicated and the definitive treatment with vascular reconstruc-tion with a prosthesis has advantages and disadvantages that must be defined individually considering the etiology of the associated cancer.


Subject(s)
Humans , Adult , Middle Aged , Aged , Therapeutics , Venae Cavae , Superior Vena Cava Syndrome , Vena Cava, Superior , Neoplasms
15.
ABCS health sci ; 47: e022301, 06 abr. 2022. tab
Article in English | LILACS | ID: biblio-1363562

ABSTRACT

INTRODUCTION: Tinnitus is a sound perception not related to stimulation. It can significantly impair the quality of life and its treatment is considered one significant challenge of Medicine. OBJECTIVE: To evaluate systematic reviews developed by Cochrane regarding therapeutic interventions for subjective tinnitus. METHODS: It is an overview of Cochrane systematic reviews. We searched systematic reviews on Cochrane Library. The MeSH term "tinnitus" was used for searches. Inclusion criteria involved therapeutic interventions for patients with subjective tinnitus. RESULTS: The search strategy recovered 577 citations with 14 Cochrane systematic reviews. 13 were included because they were focusing on primary tinnitus interventions. One review had no scope of analysis for tinnitus and it was excluded. 7,998 tinnitus patients were evaluated. CONCLUSION: There is a lack of evidence of the effectiveness of any intervention for tinnitus treatment, considering the studies performed so far and compiled in Cochrane systematic reviews.


INTRODUÇÃO: O zumbido é a sensação do som sem que haja estimulação ambiental. Pode prejudicar significativamente a qualidade de vida e seu tratamento é considerado um grande desafio da Medicina. OBJETIVO: Avaliar as revisões sistemáticas desenvolvidas pela Cochrane, no que concerne às intervenções terapêuticas para o zumbido subjetivo. MÉTODOS: Trata-se de overview de revisões sistemáticas Cochrane. Procedeu-se à busca por revisões sistemáticas na Cochrane Library. Foi utilizado o termo DeCS "zumbido". Os critérios de inclusão envolveram intervenções terapêuticas para pacientes com zumbido subjetivo. RESULTADOS: A estratégia de busca recuperou 577 citações e, destas, 14 revisões sistemáticas Cochrane, sendo que 13 enfocavam intervenções primárias para zumbido, sendo estas incluídas neste estudo. Uma revisão não tinha escopo de análise para zumbido e foi excluída. Foram avaliados 7.998 portadores de zumbido. CONCLUSÃO: Há carência de evidência de efetividade de qualquer intervenção, medicamentosa ou não, para tratamento do zumbido, considerando os estudos realizados até o momento e compilados em revisões sistemáticas Cochrane.


Subject(s)
Humans , Therapeutics , Tinnitus/therapy , Evidence-Based Medicine , Systematic Reviews as Topic
16.
An. sist. sanit. Navar ; 45(1): e0978, enero-abril 2022. tab, ilus
Article in Spanish | IBECS | ID: ibc-202913

ABSTRACT

La aparición de la COVID-19 ha supuesto un problema de salud pública mundial, provocando una elevada presión en los sistemas sanitarios. Las secuelas de esta enfermedad han puesto de manifiesto la importancia de la rehabilitación en pacientes COVID persistente, implicando en el proceso a diferentes profesionales. El tratamiento de las secuelas respiratorias en fase ambulatoria de esta reciente enfermedad es un campo especializado y parece oportuno ofrecer una serie de recomendaciones prácticas de rehabilitación cardio-respiratoria que ayuden a todos los profesionales implicados en la tarea de tratar este tipo de secuelas una vez superada la fase hospitalaria. Esta revisión de la literatura ofrece diez aspectos clave de fisioterapia respiratoria que incluyen la valoración, los parámetros que se deben monitorizar y los signos de alerta, así como las técnicas respiratorias específicas y otros ejercicios prácticos que se deben realizar en esta población.(AU)


The appearance of COVID-19 has been a problem for public health on a global scale, putting pressure on health care systems. The after-effects of this illness have highlighted the importance of rehabilitation in long COVID patients involving different health professionals. The treatment of the respiratory after-effects of this disease in an outpatient setting is a specialized field. It is appropriate to offer a series of practical recommendations of cardio-respiratory rehabilitation that are helpful to the professionals involved in the after-effects when ending hospitalisation. This review of the literature includes ten key aspects of respiratory physiotherapy that range from assessment, parameters to monitor, signs of alarm and respiratory rehabilitation techniques and other exercises for this population.(AU)


Subject(s)
Humans , Health Sciences , Coronavirus , Rehabilitation , Physical Therapy Specialty , Lung Diseases , Therapeutics
17.
An. R. Acad. Nac. Farm. (Internet) ; 88(1): 7-18, abr 2022. ilus, tab
Article in Spanish | IBECS | ID: ibc-202920

ABSTRACT

Los microARNs juegan un papel fundamental en el establecimiento de la identidad celular. Componentes de la maquinaria de síntesis de microARNs o microARNs per se, han sido asociados con patologías humanas. Se ha descubierto que los microARNs juegan un papel importante en muchos procesos celulares que están alterados en cáncer como: diferenciación, proliferación y apoptosis. Así, genes que codifican para los microARNs se han encontrado en regiones cromosómicas frecuentemente ganadas o perdidas en cáncer. Algunos microARNs presentan niveles de expresión alterados en cáncer y han demostrado su capacidad para afectar la transformación celular, carcinogénesis y metástasis actuando como oncogenes o tumores supresores. Estos microARNs que está implicados en el desarrollo tumoral se han denominado onco-microARNs, y su nombre da título a este trabajo. Estamos sólo al principio de comprender las repercusiones funcionales de la ganancia o pérdida de un microARN particular en cáncer, y aun se están ensayando las primeras aplicaciones farmacológicas para el tratamiento del cáncer. A pesar de todo, este campo está aportando una serie de prometedoras aplicaciones médicas en el diagnóstico, pronóstico y tratamiento del cáncer que podrían aportar nuevas herramientas a la medicina del futuro.(AU)


MicroRNAs play a fundamental role in establishing cell identity. Components of the microRNA synthesis machinery, or microRNAs per se, have been associated with human pathologies. MicroRNAs have been found to play an important role in many cellular processes that are altered in cancer, such as differentiation, proliferation, and apoptosis. Thus, genes that code for microRNAs have been found in chromosomal regions frequently gained or lost in cancer. Some microRNAs have altered expression levels in cancer and have demonstrated their ability to affect cell transformation, carcinogenesis, and metastasis by acting as oncogenes or tumor suppressors. These microRNAs that are involved in tumor development have been called onco-microRNAs, and their name gives the title to this work. We are only at the beginning of understanding the functional implications of the gain or loss of a particular microRNA in cancer, and early pharmacological applications for cancer treatment are still being tested. Despite everything, this field is providing a series of promising medical applications in the diagnosis, prognosis and treatment of cancer that could provide new tools for the medicine of the future.(AU)


Subject(s)
Humans , Health Sciences , MicroRNAs , Pharmacology , Neoplasms , Therapeutics , Drug Therapy
18.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 49(2): 1-11, Abril - Junio, 2022. tab, graf
Article in Spanish | IBECS | ID: ibc-203185

ABSTRACT

IntroducciónEl objetivo del estudio fue analizar el tratamiento quirúrgico recibido en pacientes octogenarias con cáncer de mama en un centro hospitalario de tercer nivel, analizar la calidad de vida de estas pacientes, así como la influencia del tratamiento en la supervivencia global.Material y métodosSe ha diseñado un estudio de cohorte retrospectivo. Se han analizado los resultados del tratamiento recibido, calidad de vida y supervivencia desde 2011 hasta 2015, con seguimiento prospectivo.ResultadosLa primera opción de tratamiento fue la cirugía en el 97% de los casos, a pesar de presentar elevadas comorbilidades según el índice de Charlson ajustado por edad. Más de la mitad de las pacientes respondieron a la pregunta sobre autopercepción de su salud como excelente, muy buena o buena (53%), observándose una tendencia a mayor supervivencia en estas pacientes. La mortalidad a los siete años fue del 46%. Sin embargo, la causa de la muerte estaba relacionada con el cáncer de mama solo en el 31% de los casos.ConclusionesLa mayoría de las pacientes octogenarias de nuestra cohorte se sometieron a cirugía como tratamiento de primera línea y se mostraron satisfechas con los resultados. La calidad de vida y la buena autopercepción del envejecimiento son un objetivo clave en las pacientes de edad avanzada y deben tenerse en cuenta.Es preciso realizar estudios analizando los resultados de la cirugía en pacientes de edad avanzada con cáncer de mama para mejorar la medicina basada en la evidencia y optimizar su tratamiento.


BackgroundThe study objective was to analyse the results of surgical treatment of breast cancer in octogenarian women and to analyse these patients’ quality of life and factors related to treatment and its influence on overall survival over a 7-year follow-up.MethodsA cohort cross-sectional observational study was designed. We analysed the results of treatment of octogenarian women with breast cancer in the Hospital Germans Trias i Pujol from 2011 to 2015 with follow-up until February 2018.ResultsThe first treatment option was surgery in 97% of cases, despite their having a high comorbidity burden according to the age-adjusted Charlson Index. More than half the patients responded to the question on self-perceived health that their health was excellent, very good or good (53%) and survival was higher in patients reporting good self-perceived health. Mortality at 7 years was 46%. However, the cause of death was related to cancer in only 31% of cases.ConclusionsMost of the octogenarian patients in our cohort underwent surgery as the first-line treatment and were satisfied with it. Quality of life and good self-perception of aging are a key aim in older adult patients and should be considered.Additional studies analysing results of surgery for breast cancer in older adult patients are warranted to improve evidence-based medicine and optimize treatment, thus enhancing their quality of life and increasing their survival.


Subject(s)
Female , Aged, 80 and over , Health Sciences , Breast Neoplasms , Patients , Therapeutics , General Surgery
19.
Clin. transl. oncol. (Print) ; 24(4): 659-669, abril 2022.
Article in English | IBECS | ID: ibc-203770

ABSTRACT

Esophageal cancer is an aggressive tumor, and is the sixth-leading cause of death from cancer. Incidence is rising in Spain, particularly among men. Two main pathological different subtypes have been described: squamous cell carcinoma and adenocarcinoma. Growing evidence of their epidemiology and molecular differences explains their different response to novel treatments, and they are therefore likely to be treated as two separate entities in the near future. The best results are obtained with a multidisciplinary therapeutic strategy, and the introduction of immunotherapy is a promising new approach that will improve prognosis. In these guidelines, we review the evidence for the different methods of diagnosis and therapeutic strategies that form the basis of our standard of care.


Subject(s)
Humans , Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/therapy , Carcinoma, Squamous Cell/pathology , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/therapy , Immunotherapy/adverse effects , Diagnosis , Therapeutics
20.
Clin. transl. oncol. (Print) ; 24(4): 670-680, abril 2022. ilus, tab
Article in English | IBECS | ID: ibc-203771

ABSTRACT

Nasopharyngeal carcinoma (NPC) is distinct from other cancers of the head and neck in biology, epidemiology, histology, natural history, and response to treatment. Radiotherapy (RT) is the cornerstone of locoregional treatment of non-disseminated disease and the association of chemotherapy improves the rates of survival. In the case of metastatic disease stages, treatment requires platinum/gemcitabine-based chemotherapy and patients may achieve a long survival time.


Subject(s)
Nasopharyngeal Carcinoma/therapy , Nasopharyngeal Neoplasms/pathology , Diagnosis , Therapeutics , Practice Guidelines as Topic
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