[Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy]. / Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.

INTRODUCTION: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. AIM: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. PATIENTS AND METHODS: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. RESULTS: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. CONCLUSION: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.

TITLE: Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.Introducción. El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual son escasos. Objetivo. Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual. Pacientes y métodos. Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos. Resultados. Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global. Conclusión. La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.

[Myocardial revascularization surgery: short and long-term survival analysis].

BACKGROUND: This study sets out to describe the survival and clinical evolution of patients who undergo myocardial re-vascularisation surgery, and identifies the short- and long-term predictive factors for surgical outcomes. METHODS: Study of a cohort of 175 patients undergoing pure or mixed coronary myocardial revascularisation surgery at a heart surgery unit, recruited between 2008 and 2010 and monitored for ten years. Descriptive and logistic regression (OR and 95%CI) analysis were carried out, along with an analysis of survival by Kaplan Meier and Cox uni- and multivariate regression (HR and 95%CI) in the short- (one year) and long-term (ten years). RESULTS: Predominantly male cohort (85.1%), mean age of 67 years (45-84), and mean EuroSCORE of 5.3%. Mortality was 6.8 and 26.9% at 1 and 10 years, respectively. Mean survival of deceased individuals was 40 months (32.2-47.8). In the short-term, a better NYHA =III preoperative functional level was not significantly associated with lower mortality (OR: 0.11; 95%CI: 0.01-1.08; p=0.058), while being female (OR: 2.94; 95%CI: 1.01-8.57; p=0.048) and having a EuroSCORE of >4% (OR: 4.94; 95%CI: 1.52-16.10; p=0.008) showed an increased risk of presenting adverse cardiac events. In the long-term, greater age (HR: 1.06; 95%CI: 1.01-1.10; p=0.026) and lower rates of body mass index after the first postoperative year (HR: 0.90; 95%CI: 0.81-0.99; p=0.040) were independent predictors of mortality. CONCLUSION: Age was an independent predictor of long-term mortality, while being female and a EuroSCORE >4% were associated with a higher risk of suffering from short-term cardiovascular events.

Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente / Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy

Introducción: El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcia l de reciente diagnóstico en la práctica clínica habitual son escasos.Objetivo: Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual.Pacientes y métodos: Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos.Resultados: Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global.Conclusión: La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.(AU)

Introduction: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. Aim: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. Patients and methods: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. Results: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. Conclusion: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.(AU)

Cirugía de revascularización miocárdica: análisis de supervivencia a corto y largo plazo / Myocardial revascularization surgery: short and long-term survival analysis

FUNDAMENTO: Describir la supervivencia y evolución clínica de pacientes sometidos a cirugía de revascularización miocárdica, identificando los factores predictores del resultado quirúrgico a corto y largo plazo. MÉTODO: Estudio de una cohorte de 175 pacientes sometidos a cirugía de revascularización miocárdica coronaria pura o mixta en un servicio de Cirugía Cardiaca, reclutada entre 2008 y 2010 y seguida durante diez años. Se realizó análisis descriptivo, de regresión logística (OR e IC95%) y de supervivencia por (Kaplan Meier y regresión de Cox uni y multivariante (HR e IC95%) a corto (un año) y largo plazo (diez años). RESULTADOS: Cohorte con predominio masculino (85,1%), media de edad 67 años (45-84), y EuroSCORE medio de 5,3%. La mortalidad fue 6,8% al año y 26,9% a los 10 años La media de supervivencia de los fallecidos fue 40 meses (32,2-47,8). A corto plazo, un mejor grado funcional preoperatorio NYHA≤III se asoció no significativamente a menor mortalidad (OR :0,11; IC95%: 0,01-1,08; p = 0,058), mientras que el sexo femenino (OR: 2,94; IC95%: 1,01-8,57; p = 0,048) y un EuroSCORE >4% (OR: 4,94; IC95%: 1,52-16,1; p = 0,008) incrementaron el riesgo de presentar eventos cardiacos adversos. A largo plazo, mayor edad (HR: 1,06; IC95%: 1,01-1,10; p = 0,026) y menor índice de masa corporal tras el primer año postoperatorio (HR: 0,90; IC95%: 0,81-0,99; p = 0,040) fueron predictores independientes de mortalidad. CONCLUSIONES: La edad fue predictor independiente de mortalidad a largo plazo, mientras que el sexo femenino y un EuroSCORE >4% se asociaron con mayor riesgo de padecer eventos cardiovasculares a corto plazo

BACKGROUND: This study sets out to describe the survival and clinical evolution of patients who undergo myocardial revascularisation surgery, and identifies the short- and long-term predictive factors for surgical outcomes. METHODS: Study of a cohort of 175 patients undergoing pure or mixed coronary myocardial revascularisation surgery at a heart surgery unit, recruited between 2008 and 2010 and monitored for ten years. Descriptive and logistic regression (OR and 95%CI) analysis were carried out, along with an analysis of survival by Kaplan Meier and Cox uni- and multivariate regression (HR and 95%CI) in the short- (one year) and long-term (ten years). RESULTS: Predominantly male cohort (85.1%), mean age of 67 years (45-84), and mean EuroSCORE of 5.3%. Mortality was 6.8 and 26.9% at 1 and 10 years, respectively. Mean survival of deceased individuals was 40 months (32.2-47.8). In the short-term, a better NYHA ≤III preoperative functional level was not significantly associated with lower mortality (OR: 0.11; 95%CI: 0.01-1.08; p = 0.058), while being female (OR: 2.94; 95%CI: 1.01-8.57; p = 0.048) and having a EuroSCORE of >4% (OR: 4.94; 95%CI: 1.52-16.10; p = 0.008) showed an increased risk of presenting adverse cardiac events. In the long-term, greater age (HR: 1.06; 95%CI: 1.01-1.10; p = 0.026) and lower rates of body mass index after the first postoperative year (HR: 0.90; 95%CI: 0.81-0.99; p = 0.040) were independent predictors of mortality. CONCLUSION: Age was an independent predictor of long-term mortality, while being female and a EuroSCORE >4% were associated with a higher risk of suffering from short-term cardiovascular events

Calidad de vida relacionada con la salud dos años después de cirugía de revascularización miocárdica / Health-related quality of life two years after myocardial revascularization surgery

FUNDAMENTO: Describir los niveles de calidad de vida relacionada con la salud (CVRS) alcanzados y la magnitud del efecto de la cirugía de revascularización miocárdica. MÉTODO: Estudio descriptivo prospectivo que, a través del cuestionario de salud SF-12v2 y diferentes variables sociodemográficas y clínicas, evaluó durante dos años de seguimiento la CVRS de pacientes sometidos a cirugía de revascularización miocárdica en el servicio de Cirugía Cardiaca. RESULTADOS: Se incluyeron 175 pacientes con edad media 67 años (rango 45-84), 85,1% hombres. El 72,5% fue sometido a cirugía de revascularización pura y al 80,8% se les practicó un bypass múltiple; el EuroSCORE medio fue 5,3%. Las puntuaciones preoperatorias de los componentes sumario del SF-12v2 reflejaban menor CVRS física (CSF 49,4; DE: 23,4) que mental (CSM 74,8; DE: 20,2), y todas las dimensiones incrementaron al año de la cirugía, especialmente las de salud física (CSF aumentó un 36,8%, p < 0,001). A los dos años todas las dimensiones disminuyeron respecto a las del primer año (excepto Dolor corporal) Se mantuvieron significativamente por encima de las preoperatorias en las dimensiones de salud física (CSF aumentó un 23,9%, p < 0,001) y disminuyeron significativamente las dimensiones Vitalidad y Rol emocional. Las mujeres refirieron niveles de CVRS significativamente peores que los hombres, no encontrando otros factores determinantes de CVRS postoperatoria. CONCLUSIONES: La CVRS durante los dos años de seguimiento tras la revascularización miocárdica mejoró significativamente pero sin llegar a alcanzar los niveles de la población general española. El sexo femenino presentó niveles de salud postoperatoria significativamente inferiores

BACKGROUND: To describe the levels of health-related quality of life (HRQoL) attained and the magnitude of the effect of myocardial revascularization surgery. METHOD: Prospective descriptive study that, using the SF-12v2 health questionnaire and different socio-demographic and clinical variables, evaluated during a two-year follow-up the HRQoL of patients who had received myocardial revascularization surgery in the Cardiac Surgery service. RESULTS: One hundred and seventy-five patients were included with an average age of 67 years (range 45-84), 85.1% men. Seventy-two point five percent received complete revascularization surgery and 80.8% received a multiple bypass; the average EuroSCORE was 5.3%. The preoperative scores of the summary components of the SF-12v2 reflected a lower physical HRQoL (MHQ 49.4; SD: 23.4) than mental HRQoL (PHQ 74.8; SD: 20.2), and all the dimensions increased one year after surgery, especially those for physical health (PHQ increased 36.8%, p < 0.001). Two years later all the dimensions decreased with respect to those of the first year (except Bodily Pain). Scores remained significantly above preoperative ones in the physical health dimensions (PHQ increased 23.9%, p < 0.001) and the dimensions of Vitality and Emotional Role decreased significantly. Women showed significantly worse levels of HRQoL than men; no other determinant factors of postoperative HRQoL were found. CONCLUSIONS: HRQoL during the two-year follow-up after myocardial revascularization improved significantly but without reaching the levels of the general Spanish population. The female sex showed significantly lower levels of postoperative health

[Health-related quality of life two years after myocardial revascularization surgery].

BACKGROUND: To describe the levels of health-related quality of life (HRQoL) attained and the magnitude of the effect of myocardial revascularization surgery. METHOD: Prospective descriptive study that, using the SF-12v2 health questionnaire and different socio-demographic and clinical variables, evaluated during a two-year follow-up the HRQoL of patients who had received myocardial revascularization surgery in the Cardiac Surgery service. RESULTS: One hundred and seventy-five patients were included with an average age of 67 years (range 45-84), 85.1% men. Seventy-two point five percent received complete revascularization surgery and 80.8% received a multiple bypass; the average EuroSCORE was 5.3%. The preoperative scores of the summary components of the SF-12v2 reflected a lower physical HRQoL (MHQ 49.4; SD: 23.4) than mental HRQoL (PHQ 74.8; SD: 20.2), and all the dimensions increased one year after surgery, especially those for physical health (PHQ increased 36.8%, p<0.001). Two years later all the dimensions decreased with respect to those of the first year (except Bodily Pain). Scores remained significantly above preoperative ones in the physical health dimensions (PHQ increased 23.9%, p<0.001) and the dimensions of Vitality and Emotional Role decreased significantly. Women showed significantly worse levels of HRQoL than men; no other determinant factors of postoperative HRQoL were found. CONCLUSIONS: HRQoL during the two-year follow-up after myocardial revascularization improved significantly but without reaching the levels of the general Spanish population. The female sex showed significantly lower levels of postoperative health.

Calidad del sueño en pacientes sometidos a cirugía cardiaca durante el postoperatorio en cuidados intensivos / Quality of sleep in patients undergoing cardiac surgery during the postoperative period in intensive care

Objetivos: Describir la calidad del sueño de los pacientes sometidos a cirugía cardiaca durante las dos primeras noches de postoperatorio e identificar algunos de los factores condicionantes del descanso nocturno de estos pacientes en la Unidad de Cuidados Intensivos. Método: Estudio descriptivo observacional basado en la aplicación del Cuestionario del Sueño de Richards-Campbell mediante un muestreo consecutivo de pacientes sometidos a cirugía cardiaca con ingreso en Unidad de Cuidados Intensivos. Simultáneamente se aplicó un cuestionario que evaluaba diferentes factores ambientales existentes en la unidad como posibles condicionantes del descanso nocturno. Se estudió la asociación entre el consumo de opiáceos y la calidad del sueño. Resultados: Muestra de 66 pacientes con edad media de 65±11,57 años, de los cuales el 73% eran hombres (N=48). El Cuestionario del Sueño de Richards-Campbell obtuvo una puntuación media de 50,33mm (1.a noche) y 53,30mm (2.a noche). Los principales factores perturbadores del sueño fueron el malestar con los diferentes dispositivos 30,91mm y el dolor 30,18mm. Los problemas generados por el ruido ambiental 27,5mm o bien a través de las voces de los profesionales 26,53mm también resultaron elementos de molestia nocturna. No se encontró asociación estadística entre el sueño y la distancia del box del paciente respecto al control de enfermería ni en relación con el consumo de analgésicos opiáceos. Conclusiones: La calidad del sueño durante las dos primeras noches de ingreso en Unidad de Cuidados Intensivos fue ‘regular’. Los factores ambientales que más condicionaron el descanso nocturno de los pacientes fueron el malestar, el dolor y el ruido ambiental (AU)

Objectives: To describe the quality of sleep of patients undergoing cardiac surgery during the first two nights following surgery and identify some of the factors conditioning the nightly rest of these patients in the Intensive Care Unit. Method: Observational descriptive study based on applying the Richards-Campbell Sleep Questionnaire through a consecutive sample of patients undergoing cardiac surgery with Intensive Care Unit admission. Simultaneously, a questionnaire assessing different environmental factors existing in the unit as possible conditioning of the night's rest was applied. The association between consumption of opioid and sleep quality was studied. Results: Sample of 66 patients with a mean age of 65±11.57 years, of which 73% were men (N=48). The Richards-Campbell sleep questionnaire garnered average scores of 50.33mm (1.st night) and 53.30mm (2.nd night). The main sleep disturbing factors were discomfort with the different devices, 30.91mm and pain, 30.18mm. The problems caused by environmental noise, 27.5mm or through the voices of the professionals, 26.53mm were also elements of nocturnal discomfort. No statistical association was found between sleep and the distance of the patient with respect to the nursing control area or related to opioid analgesics. Conclusions: The quality of sleep during the first two nights of Intensive Care Unit admission was ‘regular’. The environmental factors that conditioned the night-time rest of patients were discomfort, pain and ambient noise (AU)

[Lance-Adams syndrome after infective endocarditis]. / Sindrome de Lance-Adams tras endocarditis infecciosa.

TITLE: Sindrome de Lance-Adams tras endocarditis infecciosa.

Quality of sleep in patients undergoing cardiac surgery during the postoperative period in intensive care. / Calidad del sueño en pacientes sometidos a cirugía cardiaca durante el postoperatorio en cuidados intensivos.

OBJECTIVES: To describe the quality of sleep of patients undergoing cardiac surgery during the first two nights following surgery and identify some of the factors conditioning the nightly rest of these patients in the Intensive Care Unit. METHOD: Observational descriptive study based on applying the Richards-Campbell Sleep Questionnaire through a consecutive sample of patients undergoing cardiac surgery with Intensive Care Unit admission. Simultaneously, a questionnaire assessing different environmental factors existing in the unit as possible conditioning of the night's rest was applied. The association between consumption of opioid and sleep quality was studied. RESULTS: Sample of 66 patients with a mean age of 65±11.57 years, of which 73% were men (N=48). The Richards-Campbell sleep questionnaire garnered average scores of 50.33mm (1.st night) and 53.30mm (2.nd night). The main sleep disturbing factors were discomfort with the different devices, 30.91mm and pain, 30.18mm. The problems caused by environmental noise, 27.5mm or through the voices of the professionals, 26.53mm were also elements of nocturnal discomfort. No statistical association was found between sleep and the distance of the patient with respect to the nursing control area or related to opioid analgesics. CONCLUSIONS: The quality of sleep during the first two nights of Intensive Care Unit admission was "regular". The environmental factors that conditioned the night-time rest of patients were discomfort, pain and ambient noise.

Contenidos fundamentales de la Dermatología en el grado de medicina en España. Recomendaciones del grupo de profesores de la Academia Española de Dermatología y Venereología / Core Content for Undergraduate Medical Education in Spain: Recommendations of the Instructors’ Group of the Spanish Academy of Dermatology and Venereology (AEDV)

ANTECEDENTES: Los problemas dermatológicos constituyen uno de los motivos de consulta más frecuentes en atención primaria. En los últimos años, como consecuencia de la adaptación al espacio europeo de educación superior, en muchos planes de estudios se ha reducido el tiempo destinado al aprendizaje de la dermatología. MATERIAL Y MÉTODOS: Para consensuar los contenidos básicos del programa de dermatología en el pregrado, se remitió electrónicamente una encuesta a los 57 miembros de grupo de profesores de la Academia Española de Dermatología y Venereología para establecer cuáles deberían ser los objetivos de aprendizaje de la asignatura en España. Se incluyeron 131 objetivos previamente seleccionados, buscándose un consenso mediante el método Delphi sobre los objetivos importantes o muy importantes (puntuación ≥ 4). RESULTADOS: Se obtuvieron 19 respuestas (33%). Tras una segunda ronda de consenso 68 objetivos alcanzaron una puntuación≥4 de promedio en la escala de Likert. Destacan que los graduados conozcan la estructura y las funciones de la piel, las infecciones bacterianas, víricas, micóticas y de transmisión sexual frecuentes, las 4 principales dermatosis inflamatorias, algunos problemas comunes como el prurito y la alopecia en placas, el manejo de dermatosis urgentes, la púrpura y el eritema nudoso como signos de enfermedad interna y reconocer algunos tumores cutáneos benignos y el cáncer de piel, así como la prevención de las enfermedades de transmisión sexual y del cáncer cutáneo. Además, durante las prácticas clínicas, deberían adquirir las habilidades de comunicación necesarias para realizar una entrevista y redactar una historia clínica dermatológica y una hoja de derivación. Conclusiones; Se definen los contenidos considerados fundamentales para impartir en las facultades de medicina y recomendados por el grupo de profesores y docentes de la Academia Española de Dermatología y Venereología

BACKGROUND: Skin problems are among the most frequent reasons for seeking medical attention in primary care. In recent years, as a result of the process of adapting medical curricula to the requirements of the European Higher Education Area, the amount of time students spend learning the concepts of dermatology has been reduced in many universities. MATERIAL AND METHODS: In order to reach a consensus on core content for undergraduate education in dermatology, we sent a survey to the 57 members of the instructors' group of the Spanish Academy of Dermatology and Venereology (AEDV), asking their opinions on what objectives should be set for a dermatology course in Spain. A total of 131 previously selected objectives were listed. We then applied the Delphi method to achieve consensus on which ones the respondents considered important or very important (score ≥ 4 on a Likert scale). RESULTS: Nineteen responses (33%) were received. On the second round of the Delphi process, 68 objectives achieved average scores of at least 4. The respondents emphasized that graduates should understand the structure and functions of the skin and know about bacterial, viral, and fungal skin infections, the most common sexually transmitted diseases (STDs), and the 4 main inflammatory dermatoses. Students should also learn about common complaints, such as itching and bald patches; the management of dermatologic emergencies; purpura and erythema nodosum as signs of internal disease; and the prevention of STDs and skin cancer. During clinical clerkships students should acquire the communication skills they will need to interview patients, write up a patient's medical history, and refer the patient to a specialist. CONCLUSIONS: The AEDV's group of instructors have defined their recommendations on the core content that medical faculties should adopt for the undergraduate subject of dermatology in Spain

Core Content for Undergraduate Medical Education in Spain: Recommendations of the Instructors' Group of the Spanish Academy of Dermatology and Venereology (AEDV).

BACKGROUND: Skin problems are among the most frequent reasons for seeking medical attention in primary care. In recent years, as a result of the process of adapting medical curricula to the requirements of the European Higher Education Area, the amount of time students spend learning the concepts of dermatology has been reduced in many universities. MATERIAL AND METHODS: In order to reach a consensus on core content for undergraduate education in dermatology, we sent a survey to the 57 members of the instructors' group of the Spanish Academy of Dermatology and Venereology (AEDV), asking their opinions on what objectives should be set for a dermatology course in Spain. A total of 131 previously selected objectives were listed. We then applied the Delphi method to achieve consensus on which ones the respondents considered important or very important (score≥4 on a Likert scale). RESULTS: Nineteen responses (33%) were received. On the second round of the Delphi process, 68 objectives achieved average scores of at least 4. The respondents emphasized that graduates should understand the structure and functions of the skin and know about bacterial, viral, and fungal skin infections, the most common sexually transmitted diseases (STDs), and the 4 main inflammatory dermatoses. Students should also learn about common complaints, such as itching and bald patches; the management of dermatologic emergencies; purpura and erythema nodosum as signs of internal disease; and the prevention of STDs and skin cancer. During clinical clerkships students should acquire the communication skills they will need to interview patients, write up a patient's medical history, and refer the patient to a specialist. CONCLUSIONS: The AEDV's group of instructors have defined their recommendations on the core content that medical faculties should adopt for the undergraduate subject of dermatology in Spain.

Adverse reaction to silicone simulating orofacial granulomatosis.

BACKGROUND: Granulomatous reactions to silicone facial fillers are well described in the literature. Clinically, these reactions present as nodules or pseudotumors that are frequently described as silicone granulomas or siliconomas. OBJECTIVE: We want to report a peculiar form of granulomatous reaction to injected silicone characterized by recurrent episodes of facial edema. METHODS: We collected silicone infiltrated patients with a similar clinical picture consisting of asymptomatic episodes of unilateral facial edema that had been recurring for months or years. RESULTS: We found four women with recurrent episodes of facial edema. They had been infiltrated with silicone in the face. Histology showed silicone deposits and a granulomatous infiltrate in all 4 cases. CONCLUSION: We describe and illustrate a new type of adverse reaction to injected silicone simulating orofacial granulomatosis. The reaction presents as recurrent, unilateral, asymmetric facial edema of the cheek in patients who have been injected with silicone in the face. Familiarity with this adverse reaction will help to prevent erroneous diagnoses such as idiopathic angioedema, Melkersson Rosenthal syndrome, and orofacial granulomatosis.

Introducción de Neurología en un hospital comarcal / Introducing a neurology department at a local hospital

No disponible

Dermatofibromas faciales: estudio clínico-patológico de 20 casos / Dermatofibroma of the Face: A Clinicopathologic Study of 20 Cases

INTRODUCCIÓN: El dermatofibroma es uno de los tumores cutáneos benignos más frecuentes. Suele aparecer en las extremidades inferiores entre la tercera y la quinta década de la vida, siendo más frecuente en mujeres. El diagnóstico clínico frecuentemente es sencillo. Se asocia a una tasa muy baja de recidivas locales tras la extirpación. OBJETIVOS: Presentar nuestra experiencia en dermatofibromas de localización facial con el fin de discutir las características clínicas e histopatológicas en esta localización. MATERIAL Y MÉTODOS: Estudio retrospectivo descriptivo de las características clínico-patológicas de los dermatofibromas de localización facial diagnosticados en el Departamento de Dermatología del Hospital General Universitario de Valencia entre los años 1990 y 2012. RESULTADOS: Se incluyeron 20 casos de dermatofibromas de localización facial (1,11% de los diagnosticados en todas las localizaciones). Estas lesiones mostraron un amplio rango de edad de aparición, que osciló de 28 a 84 años, con una media de 57,15 años y una mediana de 54 años. La distribución por sexo fue de 11 mujeres y 9 hombres. El promedio de seguimiento fue de 83 meses, con ninguna recurrencia local. Todos los casos estaban confinados en la dermis papilar y reticular, y el patrón de crecimiento predominante fue el estoriforme. CONCLUSIONES: El estudio de los dermatofibromas de localización facial observados en nuestro centro en un período de 22 años sugiere que esta es una localización infrecuente, pero que en la mayoría de los casos tiene un comportamiento similar al de otras localizaciones

INTRODUCTION: Dermatofibroma is one of the most common benign skin tumors. It typically develops on the lower limbs between the third and fifth decade of life and is more common in women. Clinical diagnosis is often straightforward. Dermatofibromas are associated with a very low rate of local recurrence following excision. OBJECTIVES: To describe the clinical and histologic features of dermatofibroma of the face based on our experience. MATERIALS AND METHODS: Descriptive retrospective study of the clinicopathologic features of dermatofibromas of the face diagnosed at the dermatology department of Hospital General Universitario de Valencia between 1990 and 2012. RESULTS: Twenty cases of dermatofibroma of the face (1.11% of all dermatofibromas diagnosed) were studied. The age at onset varied widely, from 28 to 84 years. The mean age at onset was 57.15 years and the median was 54 years. There were 11 women and 9 men. Mean follow-up was 83 months and there were no local recurrences. All the tumors were confined to the papillary and reticular dermis and the storiform pattern was the most common growth pattern observed. CONCLUSIONS: This study of facial dermatofibromas diagnosed at our hospital over a period of 22 years suggests that the face is an uncommon site but that dermatofibromas in this location behave similarly to those occurring elsewhere on the body

Pilomatrixoma gigante: un tumor benigno con una presentación poco frecuente / Giant pilomatrixoma: A benign tumour with a rare presentation

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Dermatofibroma of the face: a clinicopathologic study of 20 cases.

INTRODUCTION: Dermatofibroma is one of the most common benign skin tumors. It typically develops on the lower limbs between the third and fifth decade of life and is more common in women. Clinical diagnosis is often straightforward. Dermatofibromas are associated with a very low rate of local recurrence following excision. OBJECTIVES: To describe the clinical and histologic features of dermatofibroma of the face based on our experience. MATERIALS AND METHODS: Descriptive retrospective study of the clinicopathologic features of dermatofibromas of the face diagnosed at the dermatology department of Hospital General Universitario de Valencia between 1990 and 2012. RESULTS: Twenty cases of dermatofibroma of the face (1.11% of all dermatofibromas diagnosed) were studied. The age at onset varied widely, from 28 to 84 years. The mean age at onset was 57.15 years and the median was 54 years. There were 11 women and 9 men. Mean follow-up was 83 months and there were no local recurrences. All the tumors were confined to the papillary and reticular dermis and the storiform pattern was the most common growth pattern observed. CONCLUSIONS: This study of facial dermatofibromas diagnosed at our hospital over a period of 22 years suggests that the face is an uncommon site but that dermatofibromas in this location behave similarly to those occurring elsewhere on the body.