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1.
Radiología (Madr., Ed. impr.) ; 62(2): 139-147, mar.-abr. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET6-343

RESUMO

OBJETIVOS: Explorar si los niños y adolescentes con trastorno por déficit de atención e hiperactividad (TDAH) tienen alterada la conectividad funcional entre la red de control ejecutivo y la red neuronal por defecto. MATERIAL Y MÉTODOS: Estudio exploratorio de prueba diagnóstica, prospectivo, con diseño de casos y controles. Se reclutaron consecutivamente 56 participantes (29 con TDAH de tipo inatento o combinado y 27 controles) entre 7 y 16 años, de sexo masculino, dominancia derecha. Se aplicaron los criterios diagnósticos del DSM-5 como prueba de referencia y una batería de pruebas neuropsicológicas para confirmar el diagnóstico y evaluar comorbilidades. Se les realizó resonancia magnética funcional de reposo como prueba índice. La aplicación y evaluación de las pruebas fue ciega. Las regiones cerebrales se escogieron a priori y se usó técnica de región de interés. Se evaluó la conectividad funcional de la corteza del cíngulo anterior (CCA) con el precuneus (P), la corteza del cíngulo posterior (CCP) y la corteza prefrontal dorsomedial (CPDM). RESULTADOS: Las conectividades funcionales en cada una de las asociaciones evaluadas en los pacientes con TDAH comparado con los controles fueron: P_D=0,41 vs. 0,44; CCP_D=0,43 vs. 0,53; CPDM_D=0,75 vs. 0,79; P_I=0,40 vs. 0,41; CCP_I=0,48 vs. 0,53; CPDM_I=0,76 vs. 0,72). D: lado derecho I: lado izquierdo. Valor de p> 0,05. CONCLUSIÓN: La conectividad funcional cerebral en estado de reposo es menor en los pacientes con TDAH cuando se compara con controles sanos; sin embargo, la diferencia no fue estadísticamente significativa


OBJECTIVE: To explore whether children and adolescents with attention deficit/hyperactivity disorder (ADHD) have altered the functional connectivity between the executive control network and the default mode network. METHODS: Exploratory study of a diagnostic test, prospective, case and control design. A total of 56 participants were recruited consecutively (29 inattentive or combined ADHD subtype and 27 controls) between 7 and 16 years old, male, right dominance. DSM-5 was applied as reference test and a battery of neuropsychological tests to confirm the diagnosis and assess comorbidities. Resting state functional magnetic resonance imaging was performed as an index test. The application and evaluation of the tests was blind. The brain regions were chosen a priori and the region of interest technique was used. The functional connectivity of the anterior cingulate cortex (ACC) was evaluated with: the precuneus (P), the posterior cingulate cortex (PCC) and the dorsomedial prefrontal cortex (DMPC). RESULTS: The functional connectivity in each of the associations evaluated in the patients with ADHD compared with the controls were: P_D=0.41 vs 0.44; CCP_D=0.43 vs 0.53; CPDM_D=0.75 vs. 0.79; P_I=0.40 vs 0.41; CCP_I=0.48 vs 0.53; CPDM_I=0.76 vs. 0.72). D: right side I: left side. Value of p> 0.05. CONCLUSION: Cerebral functional connectivity at rest is lower in ADHD patients when compared with healthy controls, however, the difference was not statistically significant

2.
Rev. argent. dermatol ; 100(3): 106-116, set. 2019. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1057389

RESUMO

RESUMEN Las verrugas vulgares son proliferaciones benignas producidas por el HPV (virus del papiloma humano) que afectan al 7-10 % de la población en general. Cuando se localizan en la planta del pie generan intenso dolor, interfiriendo en la vida diaria del paciente, y su erradicación suele ser dificultosa. Existen múltiples tratamientos; ninguno es efectivo en su totalidad. La bleomicina es una opción terapéutica en aquellos casos rebeldes y recidivantes.


SUMMARY Common warts are benign proliferations caused by HPV (papilloma virus).When these are in foot generate an intense pain that interferes with daily life of the patient and are difficult to eradicate. There are multiple treatments, none is completely effective. Bleomycin is a therapeutic option for those rebels and recurrent cases.

3.
Rev. esp. patol. torac ; 31(2): 124-131, jun. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183653

RESUMO

Objetivo: determinar si la lectura del software de equipos de ventilación no invasiva (VMNI) domiciliaria puede predecir una exacerbación mediante la evaluación de los siguientes parámetros: frecuencia respiratoria, número de respiraciones activadas por el paciente, fuga y cumplimiento. Metodología: estudio prospectivo observacional en el que se compararon variables del software del ventilador en pacientes ventilados en domicilio. Se detectaron las exacerbaciones que requirieron ingreso hospitalario por acidosis respiratoria y se compararon las variables recogidas en este grupo de pacientes en situación estable y en los 10 días previos al ingreso. Resultados: se analizaron 43 pacientes (18 con diagnóstico de enfermedad pulmonar obstructiva crónica (EPOC) y 25 con síndrome de obesidad-hipoventilación (SOH)). No se encontraron diferencias significativas en los parámetros estudiados en situación estable al comparar los pacientes que no ingresaron con los pacientes que precisaron un ingreso posteriormente. La tasa de exacerbación global fue de 32,55% (el 44% de los pacientes diagnosticados de EPOC y el 24% del total de los pacientes con SOH) Al comparar las variables del software en los pacientes exacerbados, en situación estable y previas al ingreso, encontramos diferencias significativas (p = 0,017) en la frecuencia respiratoria, que se mostró más elevada previo a la exacerbación, con una diferencia entre medianas de 2 (0,75 - 3,5). Respecto a las respiraciones activadas, no se encontró una significación estadística, aunque sí una tendencia a la significación (p = 0,055), de forma que existía un mayor porcentaje de respiraciones activadas por el paciente previo a la exacerbación, con una diferencia entre medianas de 8 (-1- 21). Conclusiones: el estudio de variables asociadas a la monitorización de la VMNI domiciliaria puede ser útil como predictor de exacerbaciones. En nuestro caso la frecuencia respiratoria fue la más sensible mostrando un aumento previo al ingreso hospitalario


Objective: to determine if the readings from the built-in software (BIS) used in non-invasive ventilation (NIV) at home can predict an exacerbation by evaluating of parameters like respiratory rate, percentage of respiratory cycles triggered by the patient, leaks and daily use. Method: an observational prospective study comparing the variables of the BIS obtained from patients using NIV at home. Exacerbations that required hospitalization for respiratory acidosis were detected, and the variables collected in this group of patients in a stable situation were compared with the variables collected 10 days prior to admission. Results: we analyzed 43 patients (18 with chronic obstructive pulmonary disease (COPD) and 25 with obesityhypoventilation syndrome (OHS)). There were no significant differences in the parameters studied in stable situation when we compared patients who did not need an admission with patients who required admission later. The overall exacerbation rate was 32.55% (44% of patients diagnosed with COPD and 24% of patients diagnosed with SOH). When comparing the software variables in the exacerbated patients, both in a stable situation and prior to admission, we found significant differences (p= 0.017) in the respiratory rate, which was higher prior to the exacerbation, presenting a difference between medians of 2 (0.75 - 3.5). Regarding respiratory cycles triggered by the patient no statistical significance was found, although a trend towards statistical significance was found (p = 0.055), so that there was a higher percentage of respirtory cycles triggered by the patient prior to exacerbation, presenting a difference between medians of 8 (-1 - 21). Conclusions: the study of variables associated with the monitoring of NIV at home may be useful as a predictor of exacerbations. In our case the respiratory rate was the most sensitive, showing an increment of their values prior to a hospital admission


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Respiração Artificial/métodos , Exacerbação dos Sintomas , Acidose Respiratória/terapia , Doença Pulmonar Obstrutiva Crônica/terapia , Síndrome de Hipoventilação por Obesidade/complicações , Respiração Artificial/instrumentação , Estudos Prospectivos , Síndrome de Hipoventilação por Obesidade/terapia , Estudos de Coortes
5.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 43(4): 150-153, sept.-dic. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-156936

RESUMO

El cribado combinado temprano es el método actual de cribado más efectivo en la detección del síndrome de Down. Un aspecto esencial e imprescindible es su control de calidad. En este estudio hemos pretendido evaluar de forma retrospectiva el rendimiento del screening en nuestro hospital entre abril de 2010 y abril de 2013. Hemos obtenido una tasa de detección para síndrome de Down de un 84,21% para una tasa de falsos positivos del 2,66%. Seguidamente hemos evaluado la calidad de nuestras mediciones de la TN utilizando las medianas de los MoM, con una clara tendencia a la infraestimación. Tan solo el 30,4% de los ecografistas presentaban medianas de los MoM de la TN entre 0,9 y 1,1. Nuestra tasa de detección y tasa de falsos positivos se encuentran por debajo de los estándares marcados por la Fetal Medicine Foundation, y la causa se encuentra en la infraestimación de la TN. Sin embargo, sí se observa una tendencia a la mejora en la calidad a lo largo de los años y nuestros resultados son acordes con los de otras publicaciones. La conclusión que podemos extraer es la importancia de que cada centro lleve a cabo controles de calidad de forma periódica. Es esencial la formación y evaluación individual de los ecografistas para poder intervenir en caso de desviaciones importantes


Effective screening for Down syndrome can be provided in the first trimester of pregnancy. Quality assurance is an essential aspect of this first-trimester screening. The objective of this study was to evaluate the performance of first-trimester screening in our hospital from April 2010 through April 2013. We obtained an 84.21% detection rate for Down syndrome for a false positive rate of 2.66%. Subsequently, we evaluated the quality of our NT measurements by using the median nuchal translucency multiples of the median (MoM) and found systematic underestimation of NT. Only 30.4% of the sonographers reported median nuchal translucency MoM between 0.9 and 1.1. Our detection rate and false-positive rate were below the standards described by the Fetal Medicine Foundation. The cause was NT underestimation. Nevertheless, we observed a trend toward an improvement in the quality of NT measurements during the 3-year period. Our results are similar to those of other publications. The results of our study show the importance of quality assurance. Training and continual monitoring of data from individual sonographers are needed to ensure that measurements do not deviate


Assuntos
Humanos , Feminino , Gravidez , Aneuploidia , Medição da Translucência Nucal/métodos , Síndrome de Down/diagnóstico , Aberrações Cromossômicas , Triagem Neonatal/métodos , Testes para Triagem do Soro Materno/métodos , Reações Falso-Positivas , Sensibilidade e Especificidade , Diagnóstico Pré-Natal/métodos
6.
Med Mal Infect ; 44(9): 423-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25234379

RESUMO

OBJECTIVE: We had for objective to study HIV management (hospital, ambulatory, and mixed) and assess compliance with health insurance database. METHOD: We conducted a retrospective study using the French Social Security (CPAM) database. The inclusion criteria were: age>18years of age, at least 2 prescriptions of antiretroviral therapy. RESULTS: Five hundred and seventy-five patients were included: extra-hospital (12), hospital (162), mixed (401). The prescriptions were exclusively hospital issued for 76.2% of the patients. Among the mixed group patients, 91% of treatments were delivered at least once in the community, and 45.6% of biological tests were performed in private laboratories at least once. The sex ratio (2.1 vs. 1.3), the number of patients having switched antiretroviral therapy (36.7% vs. 27.8%), and the frequency of biological tests (3.1 vs. 2.6) were significantly higher in the mixed group compared to the hospital group. The mean compliance was 90% in the hospital group and 91.8% in the mixed group. The compliance was<80% for 104 patients (21.8%). Patients with≥80% compliance were older (46.1years of age vs. 42.7years of age), with more frequent biological tests (3 per year vs. 2.5 per year), and more frequent switches in treatment (35.4% vs. 26.0%). CONCLUSION: Prescriptions of ARV were almost exclusively hospital issued. Their dispensation and biological tests were split between hospital and extra-hospital settings. Most patients demonstrated an optimal compliance. The CPAM database allows describing HIV management and assessing compliance.


Assuntos
Assistência Ambulatorial , Infecções por HIV/tratamento farmacológico , HIV , Hospitalização , Seguro Saúde/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , Adulto , Fármacos Anti-HIV/uso terapêutico , Gerenciamento Clínico , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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