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1.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(2): 143-148, mar. 2020. graf, ilus, tab
Artículo en Español | IBECS | ID: ibc-191504

RESUMEN

INTRODUCCIÓN: La determinación de la superficie corporal afectada, Body Surface Area (BSA), es una de las escalas de medida más empleadas en la evaluación de la gravedad de la psoriasis, pero no está exenta de inconvenientes. OBJETIVO: Validación de un nuevo sistema de medida del BSA. MATERIAL Y MÉTODO: Estudio multicéntrico, prospectivo, que incluyó 56 pacientes con psoriasis. Cada paciente fue evaluado en 2 visitas por 2 dermatólogos del mismo Centro que valoraron BSA mediante 2 procedimientos: método visual «tradicional» (MT), palma mano=1%; y el método «lápiz óptico» (LO), lápiz capacitivo puntero sobre pantalla táctil con medición de la superficie mediante software específico. RESULTADOS: Se observó una concordancia aceptable entre ambos métodos, con coeficiente de correlación intraclase (CCI) de 0,87, pero con unos límites de acuerdo excesivamente grandes y un sesgo sistemático consistente en mayores medidas de BSA con MT que con LO. La concordancia entre métodos fue superior en el tronco y las extremidades inferiores (CCI > 0,8). La fiabilidad intraobservador fue excelente con ambos métodos (CCI: MT, 0,97; LO, 0,98). La fiabilidad interobservador fue elevada (CCI: MT, 0,91; LO, 0,94), pero el BSA medio difirió significativamente entre observadores. Además, el CCI se redujo drásticamente cuando se consideró la cabeza exclusivamente. CONCLUSIONES: El presente estudio valida el método LO para la medición de la superficie corporal afectada en pacientes con psoriasis. Muestra una buena concordancia con el MT, presentando menos variabilidad y mayor fiabilidad interobservador


INTRODUCTION: Body surface area (BSA) affected by psoriasis is one of the most often used measures for assessing severity, but this method has shortcomings. OBJECTIVE: To validate a new way to estimate BSA. MATERIAL AND METHOD: Prospective, multicenter study in 56 patients with psoriasis. Each patient was evaluated by 2 dermatologists in 2 visits to the same hospital. Each dermatologist used 2 methods for estimating BSA: the traditional visual estimation in which the area of the palm equals 1% of the total body surface and an optical pencil (OP) method in which the affected area is drawn on a touch screen. Software in the application then calculates the BSA. RESULTS: Overall concordance between the 2 methods was acceptable according to an intraclass correlation coefficient (ICC) of 0.87. However, the limits of agreement were unacceptably large and there was systematic bias: traditional estimates were consistently greater than OP calculations. Concordance between the methods was better (ICC > 0.8) on the trunk and lower extremities. Intraobserver reliability was excellent with both methods (ICCs, 0.97 and 0.98 for the traditional and OP estimates, respectively). Interobserver reliability was also high (ICCs, 0.91 and 0.94 for the traditional and OP methods), although the mean BSA differed significantly between observers. The ICCs were much lower for BSA estimates on the head. CONCLUSIONS: This study to validate the OP method for estimating the affected BSA in patients with psoriasis shows good agreement between the OP and traditional approaches. The OP calculations also showed less variance and better interobserver reliability


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Psoriasis/diagnóstico , Superficie Corporal , Índice de Severidad de la Enfermedad , Estudios Prospectivos , Análisis de Varianza , Encuestas y Cuestionarios
2.
Actas Dermosifiliogr (Engl Ed) ; 111(2): 143-148, 2020 Mar.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31472926

RESUMEN

INTRODUCTION: Body surface area (BSA) affected by psoriasis is one of the most often used measures for assessing severity, but this method has shortcomings. OBJECTIVE: To validate a new way to estimate BSA. MATERIAL AND METHOD: Prospective, multicenter study in 56 patients with psoriasis. Each patient was evaluated by 2 dermatologists in 2 visits to the same hospital. Each dermatologist used 2 methods for estimating BSA: the traditional visual estimation in which the area of the palm equals 1% of the total body surface and an optical pencil (OP) method in which the affected area is drawn on a touch screen. Software in the application then calculates the BSA. RESULTS: Overall concordance between the 2 methods was acceptable according to an intraclass correlation coefficient (ICC) of 0.87. However, the limits of agreement were unacceptably large and there was systematic bias: traditional estimates were consistently greater than OP calculations. Concordance between the methods was better (ICC>0.8) on the trunk and lower extremities. Intraobserver reliability was excellent with both methods (ICCs, 0.97 and 0.98 for the traditional and OP estimates, respectively). Interobserver reliability was also high (ICCs, 0.91 and 0.94 for the traditional and OP methods), although the mean BSA differed significantly between observers. The ICCs were much lower for BSA estimates on the head. CONCLUSIONS: This study to validate the OP method for estimating the affected BSA in patients with psoriasis shows good agreement between the OP and traditional approaches. The OP calculations also showed less variance and better interobserver reliability.


Asunto(s)
Superficie Corporal , Diagnóstico por Computador/métodos , Psoriasis/patología , Índice de Severidad de la Enfermedad , Análisis de Varianza , Femenino , Mano/anatomía & histología , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Portugal , Estudios Prospectivos , Reproducibilidad de los Resultados , Programas Informáticos , España
6.
Clin Exp Dermatol ; 38(4): 383-5, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23551363

RESUMEN

The coexistence of non-Hodgkin lymphoma (NHL) and Hodgkin disease (HD) in the same patient, although previously reported, is very unusual. This situation is extremely rare when the first diagnosis is a cutaneous B NHL, and exceptional if there is no personal background of cytostatic treatment. We report a 44-year-old man who developed cutaneous nodules over a period of two years. A marginal zone cutaneous B-cell lymphoma was diagnosed. On staging investigation a mass in the lingual tonsil was found and excision biopsy showed a classical Hodgkin lymphoma.


Asunto(s)
Enfermedad de Hodgkin/patología , Linfoma de Células B de la Zona Marginal/patología , Neoplasias Primarias Múltiples/patología , Neoplasias Cutáneas/patología , Neoplasias Tonsilares/patología , Adulto , Humanos , Masculino
7.
Eur Addict Res ; 17(2): 64-71, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21150205

RESUMEN

Impulsivity can be defined as choosing a smaller, immediate reward over a larger, delayed reward. From this perspective, addictive behaviors such as substance abuse and pathological gambling reflect a series of impulsive choices. However, impulsivity is not a homogeneous construct. Laboratory measures of impulsivity reflect two types of processes. The first is related to behavioral inhibition and refers to an individual's ability to appropriately inhibit thoughts or actions. The second is the delay of reward dimension, namely the degree to which immediate (rewarding) consequences have more control over an individual's behavior than consequences that are delayed. In this review, we describe how alcohol is associated with significant impairments in these paradigms. We also suggest that they may have a role in the development of alcohol dependence. These results are in agreement with a model in which delay of gratification might be a marker for early use and/or abuse of alcohol, whereas impairment in behavioral inhibition might be a marker for maintained use in time and, therefore, for progression towards alcohol dependence.


Asunto(s)
Alcoholismo/psicología , Conducta Adictiva/psicología , Conducta Impulsiva/psicología , Desempeño Psicomotor , Humanos , Inhibición Psicológica , Proyectos de Investigación , Recompensa
9.
J Eur Acad Dermatol Venereol ; 23(12): 1398-404, 2009 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19522707

RESUMEN

BACKGROUND: The most severe form of cutaneous acute graft-versus-host disease (aGVHD), stage IV, is characterized by the appearance of vesicles and blisters. OBJECTIVE: To describe the clinicopathological characteristics and evolution of stage IV cutaneous aGVHD presented in our hospital. METHOD: Retrospective study. The following criteria for inclusion were applied: (i) patients subjected to allogeneic stem cell transplantation between 1st January 1984 and 31st of December 2006; (ii) development of vesicles and/or blisters; (iii) extracutaneous coincidental aGVHD manifestations; and (iv) presence of histopathological features consistent with aGVHD. RESULTS: Fifteen cases (10 females and 5 males) were studied. The mean age was 38.1 years. The lesions appeared after a median interval of 19 days, always following a milder stage of GVHD. Two patterns of clinical evolution were found. Mucosal involvement was observed in nine patients. Nikolsky's sign was positive in eight patients. Nine of the patients had biopsies of the vesiculobullous stage which showed a subepidermal blister with epidermal necrosis and basal vacuolar degeneration. Only two patients survived. CONCLUSION: Stage IV cutaneous aGVHD is a severe and unusual complication after haematopoietic stem cell transplantation. Prognosis is poor with a very high mortality rate, although the cause of death is varied and not strictly linked to the cutaneous disease.


Asunto(s)
Enfermedad Injerto contra Huésped/patología , Enfermedad Aguda , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
11.
Br J Psychiatry ; 193(2): 121-5, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18669994

RESUMEN

BACKGROUND: The TaqI-A polymorphism of the ANKK1 gene, adjacent to the DRD2 gene, has been associated with alcoholism and other psychiatric conditions, although other DRD2 gene variants, such as the C957T polymorphism, could be related to these phenotypic traits. AIMS: To investigate the contribution of the TaqI-A and the C957T polymorphisms to the presence of psychopathic traits in patients with alcoholism. METHOD: We performed association and interaction analyses of the polymorphisms in 150 controls and 176 male alcohol-dependent patients assessed for the presence of dissocial personal disorder, using the Psychopathy Checklist-Revised (PCL-R). RESULTS: There was a significant association of the TaqI-A and C957T polymorphisms when both genotypes were present, with PCL-R scores of F(1-171=0.13) (P=0.01) and a frequency of dissocial personal disorder OR=10.52, P<0.001. CONCLUSIONS: The TaqI-A of the ANKK1 gene and the C957T of the DRD2 gene are epistatically associated with psychopathic traits in alcohol-dependent patients.


Asunto(s)
Alcoholismo/genética , Trastorno de Personalidad Antisocial/genética , Polimorfismo Genético/genética , Proteínas Serina-Treonina Quinasas/genética , Receptores de Dopamina D2/genética , Adulto , Anciano , Alcoholismo/psicología , Trastorno de Personalidad Antisocial/psicología , Estudios de Casos y Controles , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , España , Estadística como Asunto
13.
Psychopathology ; 41(1): 58-64, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-17975329

RESUMEN

BACKGROUND: Different neuropsychological studies have shown schizophrenic patients to have executive function deficits, as illustrated by their performance in neuropsychological tasks such as the Wisconsin Card Sorting Test (WCST); certain studies have described a relationship between these deficits and negative symptoms. Schizophrenic patients also exhibit a high lifetime prevalence (40-50%) of comorbid substance use disorders (SUDs). However, little attention has been paid to this comorbidity (dual diagnosis) in studies associating executive functions and negative symptoms. SAMPLING AND METHODS: Our objective is to investigate the relationship between performance in the WCST and psychopathology as measured by the Positive and Negative Syndrome Scale (PANSS) in a sample of 65 male schizophrenic patients with a history of SUDs (Sch SUD+) and in a sample of 48 male schizophrenic patients without such history (Sch SUD-). RESULTS: In the Sch SUD- group, patients who completed 4 or more categories in the WCST ('good performers') obtained a mean score of 21.2 +/- 8.8 on the negative subscale of the PANSS, compared with a mean score of 27.8 +/- 8.6 in those who completed 3 or less ('poor performers'); these differences were statistically significant (p = 0.015). In the Sch SUD+ group, however, no association was found between WCST performance and the PANSS negative subscale score. CONCLUSIONS: The presence of a history of comorbid SUDs should be taken into consideration in studies investigating executive functions and negative symptoms in schizophrenia.


Asunto(s)
Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/epidemiología , Pruebas Neuropsicológicas , Esquizofrenia/epidemiología , Psicología del Esquizofrénico , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Diagnóstico Dual (Psiquiatría) , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos , Masculino , Esquizofrenia/diagnóstico , Índice de Severidad de la Enfermedad , Trastornos Relacionados con Sustancias/diagnóstico
14.
Actas Dermosifiliogr ; 98 Suppl 1: 4-14, 2007 Sep.
Artículo en Español | MEDLINE | ID: mdl-18093494

RESUMEN

Pyodermitis constitutes a very important chapter in dermatological practice. Its pathogenesis, in special the one caused by S. aureus, has improved due to the knowledge of the role developed by the host defensins, quorum-sensing signaling and the Panton-Valentine leucocidin gene among others. As well, exfoliative toxins and enterotoxins responsible for the staphylococal scalded skin syndrome (SSSS) and toxic shock syndrome, respectively, have been cloned. Also, it has been seen that bullous impetigo, SSSS and pemphigus foliaceus share a common target: desmoglein-1. The Panton-Valentine leucocidin gene has been related to the appearance of abscesses, necrotic cutaneous lesions and furuncles in young persons caused by meticillin resistant S. aureus, with its epidemiological implications. Finally, some atypical forms of erysipelas suppose a diagnostic challenge for the dermatologist.


Asunto(s)
Enfermedades Cutáneas Bacterianas/microbiología , Infecciones Cutáneas Estafilocócicas/microbiología , Staphylococcus/fisiología , Infecciones Estreptocócicas/microbiología , Streptococcus/fisiología , Toxinas Bacterianas/efectos adversos , Toxinas Bacterianas/genética , Toxinas Bacterianas/aislamiento & purificación , Foliculitis/microbiología , Humanos , Linfangitis/microbiología , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/fisiología , Enfermedades de la Uña/microbiología , Percepción de Quorum , Choque Séptico/epidemiología , Choque Séptico/microbiología , Piel/microbiología , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedades Cutáneas Bacterianas/epidemiología , Enfermedades Cutáneas Bacterianas/inmunología , Infecciones Cutáneas Estafilocócicas/clasificación , Infecciones Cutáneas Estafilocócicas/diagnóstico , Infecciones Cutáneas Estafilocócicas/epidemiología , Infecciones Cutáneas Estafilocócicas/inmunología , Staphylococcus/efectos de los fármacos , Staphylococcus/genética , Staphylococcus/aislamiento & purificación , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/inmunología , Streptococcus/efectos de los fármacos , Streptococcus/genética , Streptococcus/aislamiento & purificación , Virulencia
15.
Actas dermo-sifiliogr. (Ed. impr.) ; 98(supl.1): 4-14, sept. 2007. ilus
Artículo en Español | IBECS | ID: ibc-135693

RESUMEN

Las piodermitis son un capítulo importante de la práctica dermatológica. La patogenia de las mismas, en especial la causada por Staphylococcus aureus, ha avanzado notablemente al conocerse el papel desempeñado por las defensinas del huésped, la señalización por densidad celular y el gen de la leucocidina Panton Valentine, entre otros. Asimismo se han clonado las exfoliatinas y enterotoxinas responsables del síndrome de las 4 S, y del síndrome del shock tóxico respectivamente. Se vio también que el impétigo ampolloso, el síndrome de las 4 S y el pénfigo foliáceo compartían una diana común, que era la desmogleína-1. El gen de la leucocidina Panton Valentine se ha relacionado con la aparición de abscesos, lesiones necróticas y forúnculos en personas jóvenes causados por S. aureus resistente a meticilina, con sus correspondientes implicaciones epidemiológicas. Finalmente, algunas formas atípicas de erisipela suponen un reto diagnóstico para el dermatólogo. Palabras clave: piodermitis, exfoliatinas, enterotoxinas, gen de la leucocidina Panton Valentine, SARM-AC, desmogleína-1, estafilococo y estreptococo (AU)


Pyodermitis constitutes a very important chapter in dermatological practice. Its pathogenesis, in special the one caused by S. aureus, has improved due to the knowledge of the role developed by the host defensins, quorum-sensing signaling and the Panton-Valentine leucocidin gene among others. As well, exfoliative toxins and enterotoxins responsible for the staphylococal scalded skin syndrome (SSSS) and toxic shock syndrome, respectively, have been cloned. Also, it has been seen that bullous impetigo, SSSS and pemphigus foliaceus share a common target: desmoglein-1. The Panton-Valentine leucocidin gene has been related to the appearance of abscesses, necrotic cutaneous lesions and furuncles in young persons caused by meticillin resistant S. aureus, with its epidemiological implications. Finally, some atypical forms of erysipela suppose a diagnostic challenge for the dermatologist (AU)


Asunto(s)
Humanos , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedades Cutáneas Bacterianas/epidemiología , Enfermedades Cutáneas Bacterianas/inmunología , Enfermedades Cutáneas Bacterianas/microbiología , Infecciones Estafilocócicas/microbiología , Streptococcus/fisiología , Staphylococcus/aislamiento & purificación , Staphylococcus/fisiología , Choque Séptico/epidemiología , Choque Séptico/microbiología , Foliculitis/microbiología , Linfangitis/microbiología , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/inmunología , Streptococcus , Streptococcus/genética , Streptococcus/aislamiento & purificación , Staphylococcus , Staphylococcus/genética , Toxinas Bacterianas/efectos adversos , Toxinas Bacterianas/genética , Toxinas Bacterianas/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/fisiología
16.
Int J Dermatol ; 46(5): 503-4, 2007 May.
Artículo en Inglés | MEDLINE | ID: mdl-17472683

RESUMEN

We report a patient with multiple myeloma associated with primary systemic amyloidosis who had a rapid evolution and a very unusual form of presentation. The association of amyloidosis in patients with multiple myeloma is 15%, and clinically evident mucocutaneous involvement occurs in up to 40% of patients.


Asunto(s)
Amiloidosis/complicaciones , Conducto Auditivo Externo/anomalías , Ronquera/etiología , Enfermedades de la Piel/etiología , Amiloidosis/diagnóstico , Constricción Patológica/etiología , Diagnóstico Diferencial , Deformidades Adquiridas del Oído/etiología , Femenino , Humanos , Persona de Mediana Edad , Mieloma Múltiple/complicaciones , Mieloma Múltiple/diagnóstico
19.
Acta Psychiatr Scand ; 114(6): 435-8, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17087792

RESUMEN

OBJECTIVE: The objective was to confirm whether a homozygous genotype for the C957 allele of the C957T DRD2 gene single nucleotide polymorphism (SNP) is associated with schizophrenia in an independent study population. METHOD: We examined the genotypic distribution of this SNP in a set of clinically ascertained schizophrenic patients (n = 131) and age-matched control subjects (n = 364). Individuals were genotyped using automated analysis of fluorescently labeled PCR products. RESULTS: The distribution of grouped genotypes for the C957T DRD2 SNP (CC vs. CT, TT) showed that C homozygote genotype was over-represented in our patient sample when compared with control subjects. This difference reaches the statistical significance (chi(2) = 7.0; df = 1; P = 0.008; OR = 2.05; % CI 1.2-3.4). CONCLUSION: The findings of this study provide additional evidence that genetic variation at the DRD2 gene plays an important role in the vulnerability to schizophrenia.


Asunto(s)
Alelos , Genotipo , Polimorfismo de Nucleótido Simple/genética , Receptores de Dopamina D2/genética , Esquizofrenia/genética , Adulto , Femenino , Frecuencia de los Genes/genética , Predisposición Genética a la Enfermedad/genética , Variación Genética/genética , Homocigoto , Humanos , Masculino , Factores de Riesgo , Esquizofrenia/diagnóstico , España
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