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Nutr Hosp ; 24(5): 596-606, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19893871


OBJECTIVE: To quantify by means of the so-called "Healthy lifestyle pyramid" and after two educational interventions, the changes in food intake, daily activities, and hygiene and health habits in the short and long terms in a cohort of healthy children. MATERIALS AND METHOD: prospective longitudinal study with baseline assessment of dietary and lifestyle habits, and two assessments after two educational interventions. RESULTS: 52 children participated, mean age 7.9 years, 15.4% of them being obese. There was a statistically significant reduction in whole milk intake in both the short and long term. There was a significant decrease in the short term in the intake of processed cold meat and an increase in fruit intake. There was a significant reduction in sweets intake in the short term. There was a statistically significant change in hand washing in the short and long terms, as well as in beach bathing after eating. There also was a significant change in achieving an appropriate posture and not bathing too far away, both in the long run. Finally, there was a significant change in the short term in not using inappropriate sports playing fields. The frequency at which they practise sports in the long term was significantly increased as well as the number of weekly sports, in the short term. CONCLUSIONS: After two educational interventions, the children did significant modifications of their health habits in the short term or the long term, which contributes to modify the risk factors for disease in the adulthood.

Ingestão de Alimentos , Comportamento Alimentar , Educação em Saúde , Higiene , Atividade Motora , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , Inquéritos e Questionários
An. med. interna (Madr., 1983) ; 24(7): 331-334, jul. 2007. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-057079


Un varón de 37 años ingresó en nuestro hospital por un cuadro de 8 semanas de evolución de malestar general, fiebre, artralgias, molestias faríngeas y nasales, cefalalgia holocraneal, fotofobia y náuseas. Con la ducha notó lesiones maculares en palmas de manos y plantas de pies. Un año antes había notado erosiones indoloras en el prepucio. Tenía factores de riesgo para enfermedades de transmisión sexual. La analítica mostró criterios de colestasis disociada, síndrome nefrótico, presencia de anticoagulante circulante, y positividad para la serología reagínica y específica de lúes. En una ecografía abdominal se objetivaron múltiples lesiones pequeñas, centimétricas, ocupantes de espacio. Con 2 semanas de tratamiento con penicilina revirtieron todas las manifestaciones clínicas, analíticas y de imagen. Se comenta la rica expresión semiológica y las peculiaridades de presentar lesiones ocupantes de espacio hepáticas y anticoagulante circulante en un caso de sífilis secundaria

A 37-year-old male was admitted at our hospital for evaluation of clinical presentation of 8 weeks evolution of malaise, fever, sore throat and nose, arthralgias, holocraneal headache, photophobia and nausea. With the shower he noticed spots in palms of hands and plants of feet. A year before had noticed painless erosions in foreskin. He had risk factors for sexual transmission diseases. The analytical showed criteria of dissociated colestasis, nephrotic syndrome, presence of circulating anticoagulant, and positivity for the reaginic and specific serological syphilis. In an abdominal ultrasonic multiple, focal and small liver lesions were watched. With two weeks of treatment with penicillin the clinical manifestations reverted, and the analytical and of image was watched bettering, which dissapeared at the three montnths of treatment. We comment the rich clinical expression and the peculiarities of presenting focal liver lesions and circulating anticoagulant, in a case of secondary syphilis

Masculino , Adulto , Humanos , Anticoagulantes/uso terapêutico , Fatores de Risco , Sífilis/complicações , Sífilis/diagnóstico , Síndrome Nefrótica/complicações , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/terapia , Colestase/complicações , Colestase/diagnóstico , Abdome/cirurgia , Abdome , Síndrome Nefrótica/fisiopatologia , Cálculos da Bexiga Urinária/complicações
Nefrologia ; 26(6): 666-72, 2006.
Artigo em Espanhol | MEDLINE | ID: mdl-17227243


Adult dominant polycystic kidney disease is an hereditary condition responsible for 6% of end-stage renal failure in Spain. Two genes were located in chromosomes 16 and 4 as related to this age-dependent disease in the 90s (PKD1 and PKD2). The diagnosis can be easily achieved by sonographic study, but molecular analysis by means of linkage analysis has the advantage of an early diagnosis in asymptomatic genetic carriers, with a view to the preventive follow-up of these subjects and genetic counselling. In this paper we present the results of molecular analysis of 30 families with Adult Dominant Polycystic Kidney Disease (from the province of Las Palmas Spain), carried out linkage analysis with two series of microsatellite markers located within or in the vicinity ofPKD1 (D16S521, KG8, AC2.5, CW2, SM7) and PKD2 (D4S1538, D4S1534, D4S423,D4S414) genes. The objectives of the study were: first, to verify the informativeness, and therefore, the usefulness of these markers for family studies in our population; and second,to assess the sensitivity and specificity of the genetic analysis in our population. Most of the markers showed a high heterozygosity, comparable to data in other studies. Considering the alleles of the different markers together in a chromosome as an haplotype increased the informativeness of the markers, and allowed the unequivocal identification of genetic data in 97.7% of patients and 88.7% of healthy subjects. The sensitivity and specificity of the genetic analysis were 90.7% (CI 95%: 85.7-95.7) and 86.8% (CI 95%: 80.6-93.0), respectively.

Cromossomos Humanos Par 14/genética , Cromossomos Humanos Par 16/genética , Rim Policístico Autossômico Dominante/diagnóstico , Canais de Cátion TRPP/análise , Ilhas Atlânticas/epidemiologia , Diagnóstico Precoce , Triagem de Portadores Genéticos , Marcadores Genéticos , Haplótipos/genética , Humanos , Hipertensão Renal/epidemiologia , Hipertensão Renal/etiologia , Escore Lod , Repetições de Microssatélites , Rim Policístico Autossômico Dominante/epidemiologia , Rim Policístico Autossômico Dominante/genética , Rim Policístico Autossômico Dominante/terapia , Diálise Renal , Sensibilidade e Especificidade
Scand J Rheumatol ; 31(1): 17-21, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-11922195


OBJECTIVE: To assess the diagnostic value of ultrasonography (US) in the evaluation of arthritic shoulder joints, especially in painless shoulders. METHODS: US examinations were performed in 57 consecutive patients with rheumatoid arthritis (114 shoulders) and in 32 controls (32 shoulders), using a 7.5 MHz linear probe and a standardized study protocol. US findings were compared with clinical, laboratory, and radiological data to find any relationship. RESULTS: Abnormal sonographic findings were found in 80 shoulders (70%); the most common were lesions in the supraspinatus tendon (38%), subacromial-subdeltoid bursitis (29%), bone erosions of the humeral head (20%), glenohumeral joint ellusion (19%), and biceps tendinitis (13%). Although US abnormalities were most frequent in patients with painful shoulders or abnormal findings on physical examination or radiography, a high rate of alterations was found in asymptomatic shoulders (51%), in normal shoulders on physical examination (44%) and in normal shoulders on radiographic assessment (61%). Differences of US findings in relation to time of evolution of rheumatoid arthritis, patient's age, and radiographic stage in hand and/or wrist joints were not found. CONCLUSION: US abnormalities in the shoulder joint are frequent in rheumatoid arthritis, both in patients with and without shoulder complaints as well as in patients with normal findings on physical examination.

Artrite Reumatoide/diagnóstico por imagem , Articulação do Ombro/diagnóstico por imagem , Adulto , Idoso , Artrite Reumatoide/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Reprodutibilidade dos Testes , Fator Reumatoide/análise , Nódulo Reumatoide , Articulação do Ombro/fisiopatologia , Ultrassonografia
Crit Care Med ; 24(10): 1690-4, 1996 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8874307


OBJECTIVE: To compare a blind manual bedside method for placing feeding tubes into the small bowel vs. a sonographic bedside technique in critically ill patients. DESIGN: Prospective study with a random sample. SETTING: Multidisciplinary intensive care unit in a tertiary care university hospital. PATIENTS: Thirty-five adult patients. All patients were hemodynamically stable, mechanically ventilated, and required a nasoenteric tube placement for short-term enteral feeding due to impaired gastric emptying. INTERVENTIONS: A well-known, blind, manual, bedside method for postpyloric tube placement was always attempted first in all cases. The technique was considered successful when a postpyloric location of the tip of the tube was achieved as shown by abdominal roentgenogram. However, if after 30 mins we failed to enter the small bowel, a radiologist attempted a sonographic bedside technique for postpyloric tube insertion. Finally, when the feeding tube was in place, before starting enteral nutrition, a nasogastric tube was inserted into the stomach. MEASUREMENTS AND MAIN RESULTS: The blind manual method was successful in nine (25.7%) of the 35 patients and the final location of these feeding tubes was the proximal jejunum. The average time for placement of the feeding tubes with this manual technique was 13.9 +/- 7.4 mins (range 5 to 30). The sonographic technique was successful in 22 (84.6%) of the remaining patients and the final location of the feeding tubes was three (11%) tubes in the second portion of the duodenum, eight (31%) tubes in the third portion of the duodenum, and 11 (42%) tubes in the proximal jejunum. The average time for placement with the sonographic technique was 18.3 +/- 8.2 mins (range 5 to 35). The pyloric outlet was sonographically akinetic or severely hypokinetic in 13 patients, and in four of them, we were unable to achieve postpyloric tube placement. In these four patients, the tubes were subsequently placed by endoscopy. CONCLUSIONS: The sonographic bedside technique for placing feeding tubes into the small bowel in critically III patients has a success rate of 84.6% (confidence interval 71% to 98%) after the failure of the blind bedside manual method, proving that the former is significantly more successful. This sonographic technique facilitates the insertion of the tubes in patients who cannot be moved and in those patients with severe impairment of the peristaltic activity of the stomach.

Estado Terminal , Nutrição Enteral/instrumentação , Intubação Gastrointestinal/métodos , Ultrassonografia de Intervenção , Sistema Digestório/diagnóstico por imagem , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Respiração Artificial
Surgery ; 117(6): 609-15, 1995 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7778024


BACKGROUND: The aim of this study was to determine the sensitivity, specificity, and predictive value of hydrocolonic sonography (HS) in the detection and preoperative staging of colonic carcinomas. METHODS: One hundred four patients referred to our department for colorectal disease were examined in a prospective study with conventional transabdominal sonography followed by HS and other well-established means for detection of colorectal cancer. In all diagnosed colorectal carcinomas, surgical resection and histologic examination were carried out, and the histologically confirmed tumor stage was then compared with the stage predicted by HS. RESULTS: HS staged and made a correct diagnosis of carcinoma in 39 of 40 patients, with a sensitivity of 97.5% and a specificity of 98%. Positive predictability was 97.5% and negative predictability 98%. In the evaluation of cancer depth invasion, HS staging was correct in all but one case, in which a T3 tumor was incorrectly judged to be T2. In the assessment of the presence or absence of peritumor metastatic lymph nodes, HS had a sensitivity of 50% and a specificity of 100%. CONCLUSIONS: HS allows the diagnosis and preoperative staging of colorectal carcinomas with high sensitivity, specificity, and predictive value. We highly recommend its preoperative use because of its definitive influence on surgical approach.

Carcinoma/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Neoplasias Retais/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Carcinoma/secundário , Carcinoma/cirurgia , Colo/diagnóstico por imagem , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Técnicas de Diagnóstico por Cirurgia , Feminino , Humanos , Mucosa Intestinal/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Estudos Prospectivos , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Reto/diagnóstico por imagem , Sensibilidade e Especificidade , Ultrassonografia