Health-related quality of life in individuals with metabolic syndrome: a cross-sectional study / Calidad de vida relacionada con la salud en individuos con síndrome metabólico: un estudio descriptivo

INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is a combination of various cardiovascular risk factors with a major impact on morbidity and premature mortality. However, the impact of MetS on self-reported health-related quality of life (HRQoL) is unknown. This study evaluated the HRQoL in a Spanish adult population aged 55 years and older with MetS. METHOD: A cross-sectional analysis was performed with baseline data from the PREDIMED-Plus multicentre randomized trial. The participants were 6430 men and women aged 55-75 years with overweight/obesity (body mass index ≥27 and ≤40kg/m2) and MetS. The SF-36 questionnaire was used as a tool to measure HRQoL. Scores were calculated on each scale of the SF-36 by gender and age. RESULTS: Participants showed higher scores in the social function (mean 85.9, 95% CI; 85.4-86.4) and emotional role scales (mean 86.8, 95% CI; 86.0-87.5). By contrast, the worst scores were obtained in the aggregated physical dimensions. In addition, men obtained higher scores than women on all scales. Among men, the worst score was obtained in general health (mean 65.6, 95% CI; 65.0-66.2), and among women, in body pain (mean 54.3, 95%CI; 53.4-55.2). A significant decrease was found in the aggregated physical dimensions score among participants 70-75 years old, but an increased one in the aggregated mental dimensions, compared to younger participants. CONCLUSIONS: Our results reflect that the MetS may negatively affect HRQoL in the aggregated physical dimensions, body pain in women, and general health in men. However, this adverse association was absent for the psychological dimensions of HRQoL, which were less affected

INTRODUCCIÓN Y OBJETIVOS: El síndrome metabólico (SM) es la combinación de diversos factores de riesgo cardiovascular que pueden derivar en un mayor impacto en la morbimortalidad prematura. Sin embargo, el impacto del SM en la calidad de vida relacionada con la salud (CVRS) es desconocido. El objetivo de este estudio es evaluar la CVRS en la población adulta española de 55 años o más con SM. MÉTODOS: Se realizó un análisis transversal con los datos del ensayo PREDIMED-Plus. Seis mil cuatrocientos treinta varones y mujeres entre 55-75 años con sobrepeso/obesidad y SM. El instrumento de medida de la CVRS fue el cuestionario SF-36. Cada escala del SF-36 fue descrita y estratificada por sexo. RESULTADOS: Los participantes mostraron valores más altos en las escalas función social (media: 85,9; IC 95%: 85,4-86,4) y rol emocional (media: 86,8; IC 95%: 86,0-87,5). En los varones, la peor puntuación fue en la dimensión salud general (media: 65,6; IC 95%: 65,0-66,2) y en las mujeres el dolor corporal (media: 54,3; IC 95%: 53,4-55,2). Además, los varones obtuvieron puntuaciones más altas en todas las escalas. En la escala función física en varones se encontró una disminución significativa de la CVRS en los participantes entre 70 y 75 años en comparación con los más jóvenes. Las peores puntuaciones se obtuvieron en las dimensiones físicas agregadas. CONCLUSIONES: El SM afecta de manera negativa a la CVRS en las dimensiones agregadas físicas, haciendo especial hincapié en la esfera dolor corporal en mujeres y salud general en varones. Sin embargo, las esferas psicológicas se encuentran menos afectadas por el SM

Health-related quality of life in individuals with metabolic syndrome: A cross-sectional study.

INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is a combination of various cardiovascular risk factors with a major impact on morbidity and premature mortality. However, the impact of MetS on self-reported health-related quality of life (HRQoL) is unknown. This study evaluated the HRQoL in a Spanish adult population aged 55 years and older with MetS. METHOD: A cross-sectional analysis was performed with baseline data from the PREDIMED-Plus multicentre randomized trial. The participants were 6430 men and women aged 55-75 years with overweight/obesity (body mass index ≥27 and ≤40kg/m2) and MetS. The SF-36 questionnaire was used as a tool to measure HRQoL. Scores were calculated on each scale of the SF-36 by gender and age. RESULTS: Participants showed higher scores in the social function (mean 85.9, 95% CI; 85.4-86.4) and emotional role scales (mean 86.8, 95% CI; 86.0-87.5). By contrast, the worst scores were obtained in the aggregated physical dimensions. In addition, men obtained higher scores than women on all scales. Among men, the worst score was obtained in general health (mean 65.6, 95% CI; 65.0-66.2), and among women, in body pain (mean 54.3, 95%CI; 53.4-55.2). A significant decrease was found in the aggregated physical dimensions score among participants 70-75 years old, but an increased one in the aggregated mental dimensions, compared to younger participants. CONCLUSIONS: Our results reflect that the MetS may negatively affect HRQoL in the aggregated physical dimensions, body pain in women, and general health in men. However, this adverse association was absent for the psychological dimensions of HRQoL, which were less affected.

Dipeptidyl peptidase-IV inhibitors induced bullous pemphigoid: a case report and analysis of cases reported in the European pharmacovigilance database.

WHAT IS KNOWN AND OBJECTIVE: Bullous pemphigoid has been reported in association with gliptins. We describe a case, review the literature and analyse all cases of bullous pemphigoid recorded in the European pharmacovigilance database, EudraVigilance. CASE SUMMARY: A 74-year-old woman, treated with vildagliptin/metformin for 12 months, developed bullous pemphigoid, confirmed by skin biopsy. The symptoms resolved within 7 months after vildagliptin/metformin withdrawal. WHAT IS NEW AND CONCLUSION: A search in EudraVigilance showed a disproportionality for bullous pemphigoid and gliptins, except alogliptin. These findings extend the evidence associating gliptins with this potentially serious disease.

Probable interaction between acenocoumarol and levofloxacin: a case series.

WHAT IS KNOWN AND OBJECTIVE: To report five cases with a probable interaction between acenocoumarol and levofloxacin. CASE DESCRIPTION: In five patients on long-term acenocoumarol treatment who had had stable international normalized ratios for at least 6 months, sudden erratic changes in the values of these ratios were observed after 1.5-8 days of concomitant levofloxacin treatment with no other apparent cause. WHAT IS NEW AND CONCLUSIONS: Closer monitoring should be considered in patients with concomitant use of acenocoumarol and levofloxacin, especially elderly patients and those with renal dysfunction who seemed to suffer the interaction more severely.

Papel del aprepitant en el manejo del prurito en un paciente con linfoma cutáneo de células T / Role of aprepitant in the management of pruritus in a patient with cutaneous T-cell lymphoma

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[Role of aprepitant in the management of pruritus in a patient with cutaneous T-cell lymphoma]. / Papel del aprepitant en el manejo del prurito en un paciente con linfoma cutáneo de células T.

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Estudio comparativo de eficacia y seguridad de dos protocolos antieméticos en quimioterapia ginecológica / No disponible

Objetivo: Evaluar la eficacia y seguridad de una actualización de un protocolo antiemético de quimioterapia en tumores ginecológicos. Método Estudio prospectivo, observacional, realizado durante 12 meses en un hospital general de 400 camas. Se evaluó la eficacia del protocolo antiemético antiguo, se implantó el protocolo nuevo, y se midió su eficacia. Se incluyeron pacientes con tumores ginecológicos que acudían al hospital de día. Tras cada ciclo de quimioterapia, en una encuesta, registraban el número y severidad de náuseas/vómitos y otros efectos adversos. Se midió la eficacia como respuesta completa (sin náuseas y sin vómitos) en la fase aguda (primeras 24h posquimioterapia) y en retardada (día 2-5 posquimioterapia). Se evaluó si la edad, el tipo de protocolo y el poder emetógeno de los esquemas podían influir en la respuesta. Resultados Se analizaron 102 ciclos de quimioterapia con el protocolo antiguo (52 pacientes) y 293 ciclos (98 pacientes) con el protocolo nuevo. Se encontraron diferencias significativas en la respuesta completa en la fase retardada con el protocolo nuevo (67,38 vs 36,27%), p < 0,0001. La probabilidad de obtener respuesta completa con el protocolo nuevo era dos veces mayor que con el antiguo en emesis aguda (OR=1,85; IC 95% = 1,05-3,24; p=0,03) y cuatro veces mayor en emesis retardada (OR=4,27; IC 95% = 2,59-7,02; p<0,0001). Conclusiones Con el nuevo protocolo se consiguió un mayor porcentaje de respuesta completa en la emesis retardada. La edad y el bajo poder emetógeno de los esquemas fueron factores predictivos de respuesta completa en la emesis aguda (AU)

Objectives: To evaluate the efficacy and safety of an update to an anti-emetic protocol in chemotherapy for gynecological tumours. Method: Prospective observational study performed over 12 months in a general hospital with400 beds. We evaluated the efficacy of the old anti-emetic protocol, a new protocol was implemented, and its efficacy was determined. We included patients with gynaecological tumours that sought treatment at the Day Hospital. After each chemotherapy cycle, patients filled out a survey that registered the number and severity of episodes of nausea/vomiting and other adverse effects. The efficacy of treatment was measured as complete response (no nausea orvomit) in the acute phase (first 24 h after chemotherapy) and late phase (2-5 days after chemotherapy). We also evaluated whether age, the type of protocol, and the emetogenous power of the different treatment schemes could influence patient response. Results: We analysed 102 chemotherapy cycles under the old protocol (52 patients) and293 cycles under the new protocol (98 patients). We observed significant differences in completeresponse rates in the late phase between old and new protocols (36.27% vs 67.38%, P<.0001).The probability of obtaining a complete response using the new protocol was twice as high as with the old protocol in acute emesis (OR = 1.85, 95% CI: 1.05-3.24, P=.03) and four times higherin late emesis (OR = 4.27, 95% CI: 2.59-7.02, P<.0001).Conclusions: A greater percentage of complete responses to late emesis was obtained using the new protocol. Age and the low emetogenous power of the treatment schemes were predictive factors for complete response in acute emesis (AU)

[Comparative study of the efficacy and safety of two anti-emetic protocols in gynecological chemotherapy]. / Estudio comparativo de eficacia y seguridad de dos protocolos antieméticos en quimioterapia ginecológica.

OBJECTIVES: To evaluate the efficacy and safety of an update to an anti-emetic protocol in chemotherapy for gynecological tumours. METHOD: Prospective observational study performed over 12 months in a general hospital with 400 beds. We evaluated the efficacy of the old anti-emetic protocol, a new protocol was implemented, and its efficacy was determined. We included patients with gynaecological tumours that sought treatment at the Day Hospital. After each chemotherapy cycle, patients filled out a survey that registered the number and severity of episodes of nausea/vomiting and other adverse effects. The efficacy of treatment was measured as complete response (no nausea or vomit) in the acute phase (first 24h after chemotherapy) and late phase (2-5 days after chemotherapy). We also evaluated whether age, the type of protocol, and the emetogenous power of the different treatment schemes could influence patient response. RESULTS: We analysed 102 chemotherapy cycles under the old protocol (52 patients) and 293 cycles under the new protocol (98 patients). We observed significant differences in complete response rates in the late phase between old and new protocols (36.27% vs 67.38%, P<.0001). The probability of obtaining a complete response using the new protocol was twice as high as with the old protocol in acute emesis (OR=1.85, 95% CI: 1.05-3.24, P=.03) and four times higher in late emesis (OR=4.27, 95% CI: 2.59-7.02, P<.0001). CONCLUSIONS: A greater percentage of complete responses to late emesis was obtained using the new protocol. Age and the low emetogenous power of the treatment schemes were predictive factors for complete response in acute emesis.

Acantoma de células claras eruptivo / Eruptive Clear Cell Acanthoma

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No disponible

Nódulo azulado en mano / Bluish nodule in the hand

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Evaluación del manejo multidisciplinario en el diagnóstico de fibroadenoma mamario / Evaluation of multidisciplinary management in the diagnosis of fibroadenoma of the breast

Objetivo. Demostrar que la punción aspirativa con aguja fina es un método fiable para el manejo de lesiones sólidas que clínica y/o radiológicamente son probablemente benignas y señalar las características de la valoración diagnóstica multidisciplinaria. Material y métodos. Se estudian 160 fibroadenomas comprobados histológicamente. Se valoran los hallazgos clínicos, radiológicos y de la punción aspirativa con aguja fina, así como los valores predictivos positivos para benignidad de los diferentes métodos diagnósticos, por separado y de forma combinada. Resultados. En lesión palpable, el mayor valor predictivo positivo corresponde a la punción aspirativa con aguja fina (99,12 por ciento) y el menor a la ecografía (78,84 por ciento). La concordancia de benignidad más observada corresponde a palpación asociada con punción aspirativa con aguja fina (94,64 por ciento) y el menor ha sido la combinación de palpación, mamografía, ecografía y punción aspirativa con aguja fina (67,34 por ciento). En lesión no palpable la punción aspirativa con aguja fina obtiene el valor predictivo positivo más alto (94,87 por ciento) y la mamografía el más bajo (44,44 por ciento). Combinando las diferentes técnicas diagnósticas, la concordancia de ecografía y punción aspirativa con aguja fina es la más observada (50 por ciento) y la mamografía asociada con punción aspirativa con aguja fina la de menor observación (11,11 por ciento).Conclusiones: a) La punción aspirativa con aguja fina ha resultado ser el test más fiable para el diagnóstico de fibroadenoma. b) La concordancia plena de benignidad se observa con frecuencia variable. c) La concordancia plena de benignidad en los diversos test realizados no es frecuente en este tipo de patología (AU)

Infectious meningitis with atypical cerebrospinal fluid cells.

Cytologic evaluation of the CSF is often difficult when trying to distinguish between truly neoplastic and reactive cells. Several non-neoplastic conditions may be associated with atypical cells in the CSF, a fact the clinician has to consider to avoid inadequate aggressive theraphies. We report here three patients with infectious meningitis (due to Herpes zoster virus in two, and neuroborreliosis in one) and cytologically atypical cerebrospinal fluid lymphocytes. Further characterization showed that the pleocyrosis in these patients was of reactive origin. Cytomorphology is frequently insufficient and histochemical, immuncytochemical and cellular genome analysis techniques may help differentiate atypical reactive cells from neoplastic cells.