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Dolor Abdominal/etiología , Hipertrigliceridemia/complicaciones , Pancreatitis/complicaciones , Pancreatitis/etiología , Complicaciones del Embarazo/terapia , Dolor Abdominal/diagnóstico por imagen , Dolor Abdominal/terapia , Enfermedad Aguda , Adulto , Femenino , Humanos , Hipertrigliceridemia/terapia , Necrosis , Pancreatitis/diagnóstico por imagen , Embarazo , Complicaciones del Embarazo/diagnóstico por imagenRESUMEN
BACKGROUND: The clinical and histological characteristics of salivary gland tumors vary widely, complicating their diagnosis and management, and major differences have been recorded in the distribution of histopathological diagnoses among different countries. MATERIAL AND METHODS: This retrospective study reviewed the demographic (age, sex) and clinicopathological (pathology diagnosis and localization) characteristics of cases diagnosed with primary SGC between June 1992 and May 2014 in the Pathology Department of the 12 de Octubre Hospital of Madrid. Diagnoses were recorded according to the 2005 WHO classification. RESULTS: The study included 149 SCG patients, aged between 11 and 94 yrs, with mean age at onset of 55.56 yrs and peak incidence in the eighth decade of life. The male:female ratio was 1.01. The parotid gland was the most frequently involved (75.2%). The most frequent carcinoma was mucoepidermoid carcinoma (24.2%), followed by acinic cell carcinoma (15.4%). CONCLUSIONS: The demographic and histopathological characteristics of patients with salivary gland carcinomas in Spain, reported here for the first time, are broadly similar to those found in other countries.
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Neoplasias de las Glándulas Salivales/epidemiología , Neoplasias de las Glándulas Salivales/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , España/epidemiología , Adulto JovenRESUMEN
AIM: Our aim was to validate a novel use of C-reactive protein (CRP) measurement to identify postoperative infectious complications in patients undergoing colorectal surgery, and to compare the predictive value in this setting against white blood cell (WBC) count and neutrophil-to-lymphocyte ratio (NLR). METHOD: This was a retrospective study of CRP, NLR and WBC measurements in patients undergoing colorectal surgery. CRP, NLR and WBC were recorded on the second postoperative day and on the day of infectious complication (patients who developed infectious complications) or within 3 days prior to discharge (subjects with no complications). The test for detecting infectious complications consisted of comparing the value of the inflammatory marker on the day on which a complication was suspected against the value recorded on the second postoperative day. The test was considered positive if a given value was higher than the registered peak at postoperative day 2. Factors influencing the postoperative peak CRP were also studied. RESULTS: A total of 254 patients were retrospectively studied. Patients whose CRP value was higher than on the second postoperative day had a diagnostic accuracy for infectious complications of up to 94.4% and sensitivity, specificity, positive predictive value and negative predictive value of up to 97.4%, 93.4%, 85.7% and 99.1%, respectively. Poorer results were observed when WBC count and NLR were used rather than CRP measurement. Multiple linear regression analysis showed that surgical procedure and approach, as well as additional resections, were independent factors for 48 h peak CRP. CONCLUSION: C-reactive protein is a better parameter than WBC count and NLR for detecting infectious complications. Our proposed methodology presents good diagnostic accuracy and performance and could potentially be used for any surgical procedure.
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Proteína C-Reactiva/análisis , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Infecciones/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Anciano , Biomarcadores/sangre , Femenino , Humanos , Infecciones/sangre , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Neutrófilos , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/etiología , Periodo Posoperatorio , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y EspecificidadAsunto(s)
Terapia de Resincronización Cardíaca , Anciano , Terapia de Resincronización Cardíaca/métodos , Protocolos Clínicos , Comorbilidad , Electrocardiografía , Femenino , Estudios de Seguimiento , Cardiopatías/diagnóstico por imagen , Cardiopatías/terapia , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Volumen Sistólico , Resultado del Tratamiento , UltrasonografíaRESUMEN
We use our latest dispersive analysis of ππ scattering data and the very recent K(â4) experimental results to obtain the mass, width, and couplings of the two lightest scalar-isoscalar resonances. These parameters are defined from their associated poles in the complex plane. The analytic continuation to the complex plane is made in a model-independent way by means of once- and twice-subtracted dispersion relations for the partial waves, without any other theoretical assumption. We find the f(0)(600) pole at (457(-13))+14))-i(279(-7)(+11)) MeV and that of the f(0)(980) at (996 ± 7)-i(25(-6)(+10)) MeV, whereas their respective couplings to two pions are 3.59(-0.13)(+0.11) and 2.3 ± 0.2 GeV.
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El tema central es el de establecer las bases de un programa de compatibilización del ruido en la vecindad de los aeropuertos argentinos acorde con los requerimientos del mundo actual. Se realiza un desarrollo didáctico que se origina en una encomienda dedicada a evaluar el impacto sonoro producido por aeronaves de 57 aeropuertos del Sistema Nacional. Los 7 capítulos abarcan desde el enunciado de los conceptos básicos y definiciones hasta la propuesta de un marco legal de referencia. Comprende normas, reglamentos y procedimientos actualizados para la mitigación y control del impacto ambiental en las cercanías de aeropuertos, y datos concretos y específicos obtenidos en grandes aeropuertos de países desarrollados. Se incluye, como muestra patrón, la información obtenida en el caso del aeroparque Jorge Newbery de la Ciudad de Buenos Aires
RESUMEN
El tema central es el de establecer las bases de un programa de compatibilización del ruido en la vecindad de los aeropuertos argentinos acorde con los requerimientos del mundo actual. Se realiza un desarrollo didáctico que se origina en una encomienda dedicada a evaluar el impacto sonoro producido por aeronaves de 57 aeropuertos del Sistema Nacional. Los 7 capítulos abarcan desde el enunciado de los conceptos básicos y definiciones hasta la propuesta de un marco legal de referencia. Comprende normas, reglamentos y procedimientos actualizados para la mitigación y control del impacto ambiental en las cercanías de aeropuertos, y datos concretos y específicos obtenidos en grandes aeropuertos de países desarrollados. Se incluye, como muestra patrón, la información obtenida en el caso del aeroparque Jorge Newbery de la Ciudad de Buenos Aires
RESUMEN
FUNDAMENTALS: The doctors don't have reliable instruments in order to detect the painful experience in a patient with intention of deceiving. The objective of this investigation is the development of an instrument that helps the doctors on that task. METHOD: The investigation is based on that the pain is not possible to evoke. A patient that doesn't feel pain, really, will introduce the modifications characteristic of all memory when requests you that he/she describe the pain that says feel. The will of deceit will also distort their description. A discriminant analysis will detect the difference between the description of a pain that is not present and another that yes it are, and between the sincere descriptions of the deceiving one. RESULTS: The descriptions of the pain carried out by two different samples of nursing students have been studied with a list of pair of antonym adjectives (Osgood's semantic differential). A subgroup of the first sample described a pain that they suffered in the same moment of description, and the other subgroup described a suffering pain some days before. In the other sample, a subgroup made a sincere description of their pain and other subgroup described the pain with will of deceiving the interviewer. The investigation has provided two discriminant models. A discriminant model differentiates between a present and another remembered pain (sensibility: 0.75; specificity: 0.85; kappa reliability: 0.60; p < 0.000000001; probability of success p: 89%). The other discriminant model differentiates between a description of a pain with will of deceiving and another pain described sincerely (sensibility: 0.94; specificity: 0.95; kappa reliability: 0.89; p < 0.000000001; probability of success p: 97%). CONCLUSIONS: The results of this investigation seem to demonstrate that it is possible to discriminate between the descriptions of real pains and the suspicious pains of not being real, and that also one is able to discriminate between pains described with will of deceit and pains described sincerely. These discriminant models allows to classify the description of the subjects in four groups: "liars", "sincere", "magnifiers", and "psychogenic". However, it is necessary still carry out more effort of investigation so that these results could be replied in patients that suffer pain.
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Simulación de Enfermedad/diagnóstico , Dimensión del Dolor/métodos , Dolor/diagnóstico , Adulto , Análisis Discriminante , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Fundamento: Los médicos carecen de instrumentos que les permitan detectar de un modo fiable y mensurable que la experiencia dolorosa que le comunica su paciente, no sólo carece de base objetiva, sino que está intentando engañarle. El objetivo de la presente investigación es encontrar un procedimiento mensurable que auxilie al médico en esa tarea. Métodos: La investigación se basa en el hecho de que el dolor no es evocable. Si se fuerza a un paciente que no siente dolor a describirlo, forzosamente tendrá que intentar recordar otro anterior para hacerlo; con ello, introducirá en su descripción las distorsiones propias de la memoria. Si hay voluntad de engaño, dicho interés forzará, igualmente, la descripción para hacerla más creíble. Un análisis discriminante múltiple escalonado (ADME) debe ser capaz de detectar los elementos diferenciadores entre las descripciones del dolor actual y evocado y las descripciones sinceras de las no sinceras. Resultados: Se han estudiado las descripciones de dolores reales realizadas por dos muestras de estudiantes de enfermería diferentes con una lista de pares de adjetivos antónimos utilizando la técnica del Diferencial Semántico de Osgood. Una muestra describía dolores actuales o evocados. Otra muestra describía un dolor, con el mismo procedimiento, sinceramente o con voluntad de engaño. La investigación ha proporcionado dos modelos discriminantes que diferencian las descripciones de dolores actuales y evocados (sensibilidad: 0,75; especificidad: 0,85; fiabilidad kappa de 0,60; p< 0,000000001; probabilidad de acierto de ¼: 89 por ciento) y entre las descripciones sinceras y engañosas (sensibilidad: 0,94; especificidad: 0,95; fiabilidad kappa de 0,89; p< 0,000000001; probabilidad de acierto de ¼: 97 por ciento).Conclusiones: Los resultados de esta investigación muestran que es posible encontrar modelos que discriminen entre los dolores reales y los sospechosos de no serlo. Dichos modelos permiten situar las descripciones que hacen los pacientes de sus dolores en un eje de coordenadas. Y así, pueden ser clasificados como 'mentirosos', 'sinceros', 'magnificadores' y 'psicógenos'. Sin embargo, aún se necesita un esfuerzo investigador mayor para ratificar que dichas clasificaciones pueden ser aplicables a enfermos con dolor (AU)
Asunto(s)
Adulto , Masculino , Femenino , Humanos , Sensibilidad y Especificidad , Reproducibilidad de los Resultados , Análisis Discriminante , Dimensión del Dolor , Dolor , Simulación de EnfermedadRESUMEN
The keratin cytoskeleton is formed in different epidermal compartments by distinct polypeptides. Basal, proliferative keratinocytes express keratin (K) 5 and K14, whereas, suprabasal, post-mitotic keratinocytes express K1 and K10. Changes in this keratin pattern have been found to occur in hyperproliferative skin disorders and, in particular, throughout mouse epidermal carcinogenesis. Whereas some keratins not found in normal epidermis (K6, K16, K13, and K8) are induced at different stages of tumor development, K1 and K10 expression is lost. To determine whether K1 and K10 loss is just a consequence of the altered differentiation program or an event required for tumor progression, we generated transgenic mice carrying the human keratin 10 gene (hK10) under the control of a bovine keratin 6 gene regulatory region, which is silent in normal skin but is induced and drives transgene expression in hyperproliferative skin keratinocytes and, therefore, in skin tumors. Transgenic animals subjected to a complete carcinogenesis protocol developed tumors that contained various amounts of transgenic hK10. Although no significant difference was found in tumor number or malignancy, tumor onset was significantly delayed in transgenic mice, indicating that the presence of K10 actually impairs tumor development.
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Carcinoma de Células Escamosas/etiología , Cocarcinogénesis , Queratinas/biosíntesis , Neoplasias Cutáneas/etiología , Piel/metabolismo , 9,10-Dimetil-1,2-benzantraceno , Animales , Carcinógenos , Carcinoma de Células Escamosas/inducido químicamente , Carcinoma de Células Escamosas/metabolismo , Bovinos , División Celular/efectos de los fármacos , División Celular/fisiología , Expresión Génica , Humanos , Queratina-10 , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Transgénicos , Piel/efectos de los fármacos , Neoplasias Cutáneas/inducido químicamente , Neoplasias Cutáneas/metabolismo , Fenómenos Fisiológicos de la Piel , TransgenesRESUMEN
The sequential hypothesis about depression tells: "neurotic" and "endogenous" depression are not different diseases, but two different moments in the evolution of a unique disorder (initial and terminal, respectively). The authors use Kiloh and Garside's (1963) and Carney et al's (1965) data to support this hypothesis. The bibliographic data are analyzed in that way to show that biological correlates of endogeneity are the final pathway of an ontogenic evolution of biological modifications in depression less obvious in initial episodes ("neurotiforms") and more evident in subsequent episodes ("endogeniforms").
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Trastorno Depresivo/psicología , Trastorno Depresivo/diagnóstico , Humanos , Escalas de Valoración PsiquiátricaRESUMEN
The authors study the Kiloh and Garside's (1963) and Carney's et al. (1965) data. They apply a Factorial Analysis without and with Varimax rotation. Only account a bipolar factor (endogenous/neurotic) the unrotated solutions, but not in rotated solutions. They discuss the validity of the classification endogenous/neurotic depression supported by a erroneus application of the Factorial Analysis method.
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Trastorno Depresivo/clasificación , Trastorno Depresivo/psicología , Análisis Factorial , HumanosRESUMEN
The authors analyse the Kiloh and Garside's (1963) and Carney's et al. (1965) data. They studied the influence of item distinct quality on core depressive symptoms. Deleting influence of this item the depressive syndrome lose its original cohesion. It suggests that the distinct quality could be the agglutinative component of the core depressive symptomatology.
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Afecto , Trastorno Depresivo/psicología , Modelos Psicológicos , Adolescente , Adulto , Trastorno Depresivo/clasificación , Trastorno Depresivo/diagnóstico , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Equinococosis/patología , Adulto , Equinococosis Hepática/patología , Femenino , Humanos , Pierna , RecurrenciaRESUMEN
The factors found in the approach taken towards the disturbances caused by anxiety on the part of the doctors working outside the hospital environment are analyzed. After studying a sample of 45 patients seen consecutively in the outpatient clinica of a general hospital and evaluating their clinical, evolutive, social-demographical characteristics and the type of medical care received previously, we found an important tendency towards diagnostic error which does not seem to be related to the degree of specialization by the medical practitioner who treated the patient. A profile of a patient having a higher risk of receiving and incorrect diagnosis is elaborated.