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2.
Rev. esp. investig. quir ; 23(2): 51-55, 2020. ilus, tab
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-FGT-4948

RESUMO

Los aneurismas de la arteria poplítea son una patología relativamente frecuente al constituir los de mayor incidencia y prevalencia dentro de los periféricos. Este tipo de patología, presenta una serie de peculiaridades de acuerdo a datos demográficos y también con respecto a formas y tipos de presentación. La clínica se centra especialmente en su perfil de bultoma que late y expande y en las complicaciones de frecuente presentación. Su tratamiento quirúrgico está basado en opciones terapéuticas de cirugía abierta y cirugía convencional. Se presenta la experiencia de un solo centro durante diez años en la atención de esta patología


Popliteal artery aneurysms are a relatively frequent pathology as they are those with the highest incidence and prevalence within the peripherals. This type of pathology presents a series of peculiarities according to demographic data and also with respect to forms and types of presentation. The clinic focuses especially on its profile of beating and expanding lump and on complications that frequently appear. His surgical treatment is based on therapeutic options of open surgery and conventional surgery. The experience of a single center for ten years in the care of this pathology is presented

3.
Rev. esp. investig. quir ; 23(2): 77-81, 2020. ilus
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-FGT-4953

RESUMO

La investigación quirúrgica y el adiestramiento en cirugía, se ha soportado durante muchas décadas en la existencia de laboratorios de cirugía experimental, que utilizando en mayor o menor grado los animales, y que han aportado una muy estimable ayuda a la investigación clínica y el desarrollo de la cirugía. El laboratorio de Cirugía Experimental de la Facultad de Medicina de Vallado-lid, ya con 5 décadas de existencia ha servido de soporte a la investigación, docencia y formación continua del área del entorno de la Universidad de Valladolid y sus hospitales vinculados. Ha sufrido una evolución a lo largo de los años que se comunica y analiza en el presente trabajo


Surgical research and training in surgery have been supported for many decades in the existence of experimental surgery laboratories, which use animals to a greater or lesser degree, and which have provided a very considerable aid to clinical research and the development of Surgery. The Laboratory of Experimental Surgery of the Faculty of Medicine of Valladolid, already with 5 decades of existence, has served as support for research, teaching and continuous training in the area around the University of Valladolid and its related hospitals. It has undergone an evolution over the years that is reported and analyzed in this work

4.
Rev. esp. investig. quir ; 23(1): 3-7, 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-191764

RESUMO

Los aneurismas viscerales son entidades raras, siendo el más frecuente de los aneurismas de este grupo el que afecta a la arteria esplénica. Su prevalencia es estimada desde un 0.9 a un 9.7% según los autores. No obstante la introducción de técnicas de imagen para valorar los procesos abdominales han incrementado los hallazgos casuales de estos casos. Una vez diagnosticados se considera su tratamiento cuando los mismos tienen un tamaño superior a 2 cm de diámetro. La cirugía convencional en la mayoría de los casos se plantea con la esplenectomía y resección de la arteria aneurismática. Mediante procedimientos endovasculares es posible realizar un tratamiento menos agresivo y eficaz. Se presenta la experiencia del grupo en el tratamiento de 37 casos de aneurismas esplénicos, analizando el perfil de los pacientes, el tratamiento realizado y los resultados obtenidos. Se valora este tipo de terapéutica con respecto a los datos recogidos en la bibliografía


Visceral aneurysms are rare entities, being the most frequent of the aneurysms of this group that affects the splenic artery. Its preva-lence is estimated from 0.9 to 9.7% according to the authors. However, the introduction of imaging techniques to assess abdominal processes have increased the casual findings of these cases. Once diagnosed, their treatment is considered when they are larger than 2 cm in diameter. Conventional surgery in most cases arises with splenectomy and aneurysmal artery resection. Endovascular procedures suggest a less aggressive and effective treatment. The experience of the group in the treatment of 37 cases of splenic aneurysm is presented, analyzing the profile of the patients, the treatment performed and the results obtained. This type of therapy is analyzed with respects included in the literatura


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Artéria Esplênica/patologia , Aneurisma/terapia , Procedimentos Endovasculares , Resultado do Tratamento , Estudos Retrospectivos
5.
Rev. esp. investig. quir ; 23(1): 8-12, 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-191765

RESUMO

El aneurisma de la arteria renal se puede considerar como una entidad poco frecuente, con una incidencia que se cifra en el 0,09% de la población general. En la mayoría de las ocasiones se considera esta patología cuando se presenta, como un hallazgo incidental, tras evaluaciones diagnósticas utilizando resonancia nuclear magnética, tomografía axial computarizada, y estudios arteriográficos, realizados para otros fines diagnósticos. Las características clínicas y el manejo de los aneurismas de la arteria renal en general, han sido aportados en la bibliografía a través de pequeñas series de casos, que presentan un pequeño número de pacientes. Hasta hace poco ha existido controversia sobre el tratamiento de tos aneurismas, específicamente, en lo que respecta al tamaño del que requiere un tratamiento quirúrgico, de cómo realizar la reparación y como hacer el seguimiento de aquellos que se consideran no quirúrgicos. También presenta controversia, la causa etiológica, su relación con la hipertensión y otros factores. Por otro lado, a medida que avanza la terapia endovascular y se aplica preferentemente en otras afecciones vasculares, el resultado a largo plazo y la durabilidad del tratamiento con cirugía abierta o endovascular de los aneurismas de la arteria renal, debe ser documentado para la comparación


Aneurysm of the renal artery can be considered as a rare entity, with an incidence that is estimated at 0.09% of the general population. In most cases this pathology is considered when it is presented, as an incidental finding, after diagnostic evaluations using magnetic nuclear resonance, computed tomography, and arteriographic studies performed for other diagnostic purposes. The clinical characteristics and the management of renal artery aneurysms in general have been contributed in the literature through small series of cases, which present a small number of patients. Until recently there has been controversy about the treatment of aneurysm coughs, specifically, regarding the size of the one that requires surgical treatment, how to perform the repair and how to follow up on those that are considered non-surgical. It also presents controversy, the etiological cause, its relationship with hypertension and other factors. On the other hand, as endovascular therapy progresses and is preferably applied in other vascular conditions, the long-term outcome and durability of treatment with open or endovascular surgery of renal artery aneurysms should be documented for comparison


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Artéria Renal/diagnóstico por imagem , Artéria Renal/patologia , Aneurisma/diagnóstico por imagem , Aneurisma/terapia , Procedimentos Endovasculares , Resultado do Tratamento , Estudos Retrospectivos , Angiografia por Tomografia Computadorizada
6.
Rev. esp. investig. quir ; 23(1): 35-38, 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-191771

RESUMO

Se le reconoce a Rudolf Nissen como uno de los cirujanos más relevantes del siglo XX. Su principal aportación se considera que fue la técnica denominada de fundoplicatura para el tratamiento de la hernia hiatal, aunque realizó otras que no han tenido tanta relevancia científica. También ha sido recordado como el cirujano que trató quirúrgicamente a Albert Einstein de su aneurisma de aorta abdominal, mediante una técnica que no fue efectiva de recubrimiento con película de celofán. Rudolf Nissen inicio su formación y trabajo en Alemania vinculándose como ayudante al prestigioso cirujano Sauerbruch, para posteriormente trasladarse a Turquía potenciando el desarrollo de la cirugía de este país, emigrar más tarde a Estados Unidos trabajando en inicialmente en Boston y más tarde en New York y retornar a Europa exactamente a Basilea para culminar su carrera profesional. Sus orígenes judíos condicionaron su vida, en especial el haber tenido que emigrar de Alemania y su posterior relación con hospitales relacionado con esta comunidad religiosa


Rudolf Nissen is recognized as one of the most relevant surgeons of the 20th century. His main contribution is considered to be the so-called fundoplication technique for the treatment of hiatal hernia, although he performed others that have not had such scientific relevance. He has also been remembered as the surgeon who surgically treated Albert Einstein of his abdominal aortic aneurysm, using a technique that was not effective in coating with cellophane film. Rudolf Nissen began his training and work in Germany by joining the prestigious surgeon Sauerbruch as an assistant, and later moved to Turkey, promoting the development of surgery in this country, emigrating later to the United States working initially in Boston and later in New York and return to Europe exactly to Basel to complete his professional career. His Jewish origins conditioned his life, especially having had to emigrate from Germany and his subsequent relationship with hospitals related to this religious community


Assuntos
Humanos , História do Século XVIII , História do Século XIX , Cirurgia Geral/história , Polônia
7.
Rev. esp. investig. quir ; 22(1): 3-6, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184269

RESUMO

Se realiza un estudio retrospectivo de las características de las pacientes de sexo femenino portadoras de aneurismas de aorta abdominal, distribuyendo las pacientes en tres grupos de tratamiento quirúrgico electivo, urgente y no tratadas. Se consideran factores de riesgo y otras características del aneurisma. Se analizan estos factores y se hacen consideraciones en relación con la información aportada en la bibliografía


A retrospective study of the characteristics of female patients with abdominal aortic aneurysms was carried out, distributing the patients in three groups of elective, urgent and untreated surgical treatment. They are considered risk factors and other features of the aneurysm. These factors are analysed, and considerations are made in relation to the information provided in the bibliography


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/mortalidade , Resultado do Tratamento , Seguimentos , Estudos Retrospectivos , Fatores de Risco
8.
Rev. esp. investig. quir ; 22(1): 15-19, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184272

RESUMO

Introducción. La apendicitis aguda (AA) tradicionalmente se ha considerado una patología de gente joven. Con el envejecimiento progresivo de la población, aparece más frecuentemente a partir de los 65 años. El diagnóstico precoz y el tratamiento mínimamente invasivo evitarían una elevada morbi-mortalidad en estos pacientes. Material y métodos. Se realizó un estudio retrospectivo de las apendicectomías realizadas en un Hospital de Nivel 1 durante 2010-2016. Se seleccionaron los pacientes con edad mayor o igual a 65 años. Se efectuó un análisis descriptivo de la cohorte y después un análisis univariante, comparando AA complicada (plastrón, gangrenosa, perforada) frente a AA no complicada. Con las variables estadísticamente significativas (p<0,050) de éste, se realizó un análisis multivariante (método de Wald), para hallar factores predictores independientes para AA complicada. Resultados. De los 458 pacientes, 51 tenían edad ≥65 años. El 47,06% (24) tuvieron AA complicada. La mediana de edad fue 77 años [70,8-79,0]. El 70,8% eran varones. Edad, sexo, cirugía laparoscópica, evolución del dolor en horas, PCR mayor a 18 mg/ml y leucocitos mayor a 10.000/mL, fueron factores estadísticamente significativos en el análisis univariante. En el análisis multivariante, resultaron estadísticamente significativas: PCR>18mg/ml [OR=14,35(1,49-141,52)] y Leucocitos>10.000/mL [OR=11,70(1,15-119,26)]. Conclusiones. La apendicitis aguda es una entidad cada vez más frecuente en ancianos. Las escalas de probabilidad diagnóstica no son buenos predictores en ancianos. La PCR>18 mg/ml y los Leucocitos>10.000/mL demostraron ser factores predictores independientes para AA complicada. La apendicetomía laparoscópica se consolida como un tratamiento idóneo, seguro y con buenos resultados también en ancianos


Introduction. Acute appendicitis (AA) has traditionally been considered a pathology of young people. With the progressive aging of the population, it appears more frequently after 65 years of age. Early diagnosis and minimally invasive treatment would avoid a high morbidity and mortality in these patients. Material and methods. A retrospective study of appendectomies performed in a Level 1 Hospital during 2010-2016 was conducted. Patients older than or equal to 65 years were selected. A descriptive analysis of the cohort was made and then a univariate analysis, comparing complicated AA (plastron, gangrenous, perforated) versus uncomplicated AA. With the statistically significant variables (p <0.050) of this, a multivariate analysis (Wald’s method) was performed to find independent predictors for complicated AA. Results. Of the 458 patients, 51 were aged to 65 years. 47.06% (24) had complicated AA. The median age was 77 years [70.8-79.0]. 70.8% were males. Age, sex, laparoscopic surgery, pain evolution in hours, CRP greater than 18 mg / ml and leukocytes greater than 10,000 / mL were statistically significant factors in the univariate analysis. In the multivariate analysis, they were statistically significant: CRP> 18mg / ml [OR = 14.35 (1.49-141.52)] and Leukocytes > 10,000 / (L [OR = 11.70 (1.15-119, 26)]. Conclusions. Acute appendicitis is an increasingly common entity in the elderly. Diagnostic probability scales are not good predictors in the elderly. CRP> 18 mg / ml and Leukocytes> 10,000 / μL proved to be independent predictors for complicated AA. Laparoscopic appendectomy is consolidated as a suitable, safe treatment with good results also in the elderly


Assuntos
Humanos , Masculino , Feminino , Idoso , Apendicite/complicações , Apendicite/diagnóstico , Apendicite/cirurgia , Fatores de Risco , Estudos Retrospectivos , Apendicectomia , Prognóstico
9.
Rev. esp. investig. quir ; 22(1): 37-41, 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-184277

RESUMO

Se realiza en el trabajo una descripción histórica del empleo de otras especies especial animales, como soporte de la experimentación en el desarrollo y puesta a punto de las diferentes trasplantes. La mayoría de las aportaciones referenciadas constituyen a hitos en relación a la realización de forma pionera de las técnicas. En otros casos el apunte histórico se refiere a experimentos realizados de forma rutinaria que sirvieron para lograr aportaciones en algún campo puntual y también en el adiestramiento técnico quirúrgico para realizar los trasplantes. Hay referencia también al empleo de animales para la obtención de las vísceras como injertos en su aplicación en el ser humano lo que constituyen los xenoinjertos


A historical description of the use of other animals species, is carried out in the work as a support for the experimentation in the development and implementation of the different transplants. The majority of the referenced contributions constitute milestones in relation to the realization of a pioneering technique. In other cases the historical record refers to routinely performed experiments that served to achieve contributions in a specific field and also in the surgical technical training to perform the transplants. There is also reference to the use of animals for obtaining the viscera as grafts in their application in the human being what constitute the xenografts


Assuntos
Humanos , Animais , Modelos Animais , Animais de Laboratório , Xenoenxertos , Transplantes/história
10.
Rev. esp. investig. quir ; 22(2): 85-88, 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-184391

RESUMO

A lo largo de la historia se puede considerar que no han sido muchas las mujeres que han podido ejercer como cirujanas en las diferentes civilizaciones y cuando esto ha sido posible en muchos casos han tenido que hacerlo disfrazadas de nombre. El caso de Elena de Céspedes se puede considerar peculiar en primer lugar por su situación biológica de posible hemafroditismo, a lo que se añade su vida venturera ejerciendo múltiples oficios incluido el de soldado hasta llegar a la de médico cirujana que ejerce como varón. El descubrimiento de esta situación la hace que sea acusada de diferentes delitos y al final juzgada por la Inquisición siendo condenada. Resalta en su personalidad su reconocida inteligencia que la hace progresar desde el punto de vista social desde su inicio como esclava hasta lograr acreditarse como cirujano y cirujano sangrador logrando ejercer el oficio con solvencia y maestría. Se la considera referencia como mujer cirujano en la historia de la medicina


Throughout history it can be considered that there have not been many women who have been able to practice as surgeons in diffe-rent civilizations and when this has been possible in many cases they have had to do it disguised as a name. The case of Elena de Céspedes can be considered peculiar in the first place due to her biological situation of possible hemaphroditism, to which is added her life as a trainee exercising multiple trades, including that of a soldier until she becomes a surgeon practicing as a male. The discovery of this situation causes her to be accused of different crimes and in the end judged by the Inquisition to be condemned. Her personality stands out in her well-known intelligence, which makes her progress from the social point of view from her beginning as a slave to becoming accredited as a bleeding surgeon and surgeon, achieving the job with solvency and mastery. It is considered a reference as a female surgeon in the history of medicine


Assuntos
Humanos , Feminino , História do Século XVI , História do Século XVII , Cirurgiões/história , Transtornos do Desenvolvimento Sexual/história , Espanha
11.
Rev. esp. investig. quir ; 22(4): 143-145, 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-188317

RESUMO

La enfermedad oclusiva aorto-iliaca, concretamente las lesiones TASC-II C y D continúan siendo subsidiaras de tratamiento quirúrgico abierto según la recomendación de las guías actuales. Sin embargo, mediante la técnica CERAB, estas lesiones podrían ser tratadas endovascularmente con buenos resultados, menores tasas de complicación y una estancia media hospitalaria más corta. Comparando los stents recubiertos empleados en CERAB con otras configuraciones como los kissing stent, se observa que los primeros aportan una reconstrucción más fisiológica de la bifurcación aórtica, ya que se adaptan mejor al vaso y obtienen mejores resultados en comparación con kissing stents


Aorto-iliac occlusive disease, especially the TASC-II C and D lesions are in literatura still recomended to be treated with open surgery. However, with CERAB technique, these lesions can be treated endovascularly with very good results, fewer complication rates and shorter mean hospitalary stay. Comparing covered endovascular stents with other endovascular configurations such as kissing stent, it is shown that CERAB is an improved and more physiological reconstruction of the aortic bifurcation, in terms of minimize radial mismatch and improve outcome, compared to kissing stents


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Procedimentos Endovasculares/métodos , Arteriopatias Oclusivas/terapia , Aorta/diagnóstico por imagem , Artéria Ilíaca/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Arteriopatias Oclusivas/diagnóstico por imagem , Resultado do Tratamento
12.
Rev. esp. investig. quir ; 22(4): 157-162, 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-188319

RESUMO

Se realiza en el trabajo, un análisis de la figura del anatómico y su relación con la del cirujano, siendo a lo largo de la historia un perfil coincidente al contribuir ambos en el conocimiento anatómico a la vez que permitía el desarrollo de la técnica quirúrgica. El conocimiento anatómico fue aportado en muchos casos por cirujanos y siempre el cirujano ha precisado de amplios y profundos conocimientos anatómicos. Se analiza el periodo más fértil en el desarrollo de la anatomía y de la cirugía como fue el Renacimiento y la posterior vinculación que se ha mantenido por la necesidad del cirujano que le ha permitido realizar una cirugía más precisa, segura y científica. Esta condición ha conllevado que la docencia anatómica se realizara por parte del cirujano como perfil profesional médico más capacitado para desarrollarla. No obstante en algunas áreas geográficas la docencia anatómica para la formación de futuros médicos se ha acaparado fundamentalmente en base a una base morfológica en profesionales muy apartados en formación y desarrollo profesional de la anatomía macroscópica


In the work, an analysis of the anatomical figure and its relationship with that of the surgeon is carried out, being a coincident profile throughout history as both contribute to anatomical knowledge while allowing the development of the surgical technique. Anatomical knowledge was provided in many cases by surgeons and the surgeon has always required extensive and deep anato-mical knowledge. The most fertile period in the development of anatomy and surgery, such as the Renaissance and the subsequent linkage that has been maintained due to the need of the surgeon that has allowed him to perform a more precise, safe and scientific surgery, is analyzed. This condition has led to the anatomical teaching being carried out by the surgeon as the most qualified me-dical professional profile to develop it. However, in some geographical areas, anatomical teaching for the training of future doctors has been mainly based on a morphological basis in professionals who are very remote in training and professional development of macroscopic anatomy


Assuntos
Humanos , História Antiga , História Medieval , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História da Medicina , Cirurgia Geral/história , Anatomia/história
13.
Rev. esp. investig. quir ; 22(3): 119-121, 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-186043

RESUMO

La participación de la mujer en determinadas profesiones y oficios a lo largo de la historia en muchas ocasiones le ha sido restringida y a veces prohibida. Una de las profesiones que en pasado presentaba múltiples dificultades para ser ejercida por la mujer, ha sido la medicina y muy especialmente la cirugía. Existe un caso insólito que tuvo lugar en el siglo XIX y fue el de una mujer Margaret Ann Bulkley, que ejerció la cirugía como varón con el nombre de James Barry, ostentando cargos de responsabilidad en el ejército británico y que su situación y sexo, no fue descubierto hasta después de su muerte. Su historia se puede considerar insólita y extraña, y más teniendo en consideración, el periodo de tiempo y el perfil de la sociedad en la que la toco vivir


The participation of women in certain professions and trades throughout history has often been restricted and sometimes prohibited. One of the professions that in the past presented multiple difficulties to be exercised by women, has been medicine and especially surgery. There is an unusual case that took place in the nineteenth century and was that of a woman Margaret Ann Bulkley, who performed surgery as a man by the name of James Barry, holding positions of responsibility in the British army and that her situation and sex, not He was discovered until after his death. Its history can be considered unusual and strange, and more taking into consideration, the period of time and the profile of the society in which I live it


Assuntos
Humanos , História do Século XVIII , História do Século XIX , Identidade de Gênero , Medicina Militar/história , Retratos como Assunto , Inglaterra
15.
Rev. esp. investig. quir ; 21(2): 67-70, 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-175985

RESUMO

A Ambrosio Paré se le considera por muchos el padre de la cirugía moderna. Sin estudios académicos y actuando como barberocirujano participó en numerosas guerras, lo que le permitió adquirir amplios conocimientos y experiencia en el tratamiento de las heridas. Por otro lado llego a ser el cirujano y medico de cámara de nobles y de cuatro Reyes de Francia. Realizó múltiples aportaciones en numerosos campos del conocimiento sobre diversos temas, destacando el tratamiento de las heridas y amputaciones, realizando aportaciones en el diseño de material quirúrgico y prótesis de extremidades. En el campo vascular se podría destacar la sugerencia de la etiología de los aneurismas por la sífilis, la hemostasia de los vasos sanguíneos, la ligadura de los vasos en las amputaciones y el diseño de pinzas para la prensión de los conductos vasculares. Su obra ha quedado plasmada en numerosos documentos, en especial libros que ha servido para la trasmisión de sus aportaciones durante décadas y más bien siglos


Ambroise Paré is considered by many the father of modern surgery. Without academic studies and acting as a barber-surgeon he participated in numerous wars, which allowed him to acquire extensive knowledge and experience in the treatment of wounds. On the other hand he became the surgeon and chamber doctor of nobles and four Kings of France. He made multiple contributions in numerous fields of knowledge on various topics, highlighting the treatment of wounds and amputations, made contributions with the design of surgical material and limb prostheses. In the vascular field, the suggestion of the etiology of aneurysms due to syphilis, the hemostasis of blood vessels, the ligation of vessels in amputations and the design of forceps for blood vessel grasping could be highlighted. His work has been reflected in numerous documents, especially books that have served to transmit their contributions for decades and centuries


Assuntos
Humanos , História do Século XVI , Cirurgia Geral/história , França
16.
Int J Otolaryngol ; 2017: 5185268, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28757873

RESUMO

BACKGROUND: Many drugs used for cancer chemotherapy produce reactive oxygen species, thus leading to various complications including nephrotoxicity, cardiotoxicity, and ototoxicity. OBJECTIVE: We have provided a haplogroup analysis of a cohort of cancer patients treated with chemotherapy and compared factors associated with associated hearing loss. STUDY DESIGN AND METHODS: This observational cohort study includes a pure-tone audiometry of the patients who underwent chemotherapeutic treatment. Medical history, presence of risk factors for hearing loss, toxic habits, and association with haplogroups have been determined. RESULTS: 40% of patients developed hearing loss after administration of cisplatin, which was bilateral and symmetrical and of high frequencies. The most frequent haplogroup was H with a slight overexpression of groups V and K and a low frequency of groups J and T. No association of the haplogroup types with the hearing loss has been found; however age was revealed as an important determining factor. CONCLUSIONS: Ototoxicity caused by cisplatin is manifested as bilateral, symmetrical, and predominantly high frequency hearing loss. Although we did not find a strong correlation of haplogroups with ototoxicity, our results revealed the existence of a risk group of elderly patients over 60, which are more susceptible to hearing loss induced by cisplatin, than young adults, regardless of preexisting hearing loss.

17.
Osteoporos Int ; 28(8): 2457-2464, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28466136

RESUMO

Determination of different forms of 25-OHD (total, free and bioavailable) in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency. INTRODUCTION: Determination of 25-OH vitamin D serum levels (25-OHD) constitutes the method of choice for evaluating vitamin D deficiency. However, vitamin D-binding protein (DBP) may modulate its bioavailability thereby affecting correct evaluation of 25-OHD status. We analysed the impact of the determination of 25-OHD (total, free and bioavailable) on the evaluation its biologic activity (estimated by serum PTH determination) in healthy young women. METHODS: 173 premenopausal women (aged 35-45 yrs.) were included. We analysed serum values of total 25-OHD (25-OHDT), DBP, albumin, PTH and bone formation (PINP,OC) and resorption (NTx,CTx) markers. Free(25-OHDF) and bioavailable (25-OHDB) serum 25-OHD levels were estimated by DBP and albumin determinations and also directly by ELISA (25-OHDF-2). We analysed threshold PTH values for the different forms of 25-OHD and the correlations and differences according to 25-OHDT levels <20 ng/ml. RESULTS: 62% of subjects had 25-OHD values <20 ng/ml and also had significantly lower 25-OHDF and 25-OHDB values, with no significant differences in bone markers and PTH values. The PTH threshold value was similar for all forms of 25-OHD (∼70 pg/ml). Women with PTH values >70 had lower 25-OHDT (15.4 ± 1.4 vs. 18.3 ± 2.7, p < 0.05) and 25OHDB values (1.7 ± 0.2 vs. 2.2 ± 0.09, p < 0.05). The different forms of 25OHD were significantly intercorrelated, with marginal correlations between PTH and 25-OHDT (r = -0.136, p = 0.082). CONCLUSIONS: Determination of different forms of 25-OHD in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency.


Assuntos
Deficiência de Vitamina D/diagnóstico , Vitamina D/análogos & derivados , Adulto , Disponibilidade Biológica , Biomarcadores/sangue , Feminino , Humanos , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Pré-Menopausa/sangue , Vitamina D/sangue
18.
Phys Med ; 37: 37-42, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28535913

RESUMO

PURPOSE: This study aimed to characterize the radiation exposure to patients and workers in a new vascular hybrid operating room during X-ray-guided procedures. METHODS: During one year, data from 260 interventions performed in a hybrid operating room equipped with a Siemens Artis Zeego angiography system were monitored. The patient doses were analysed using the following parameters: radiation time, kerma-area product, patient entrance reference point dose and peak skin dose. Staff radiation exposure and ambient dose equivalent were also measured using direct reading dosimeters and thermoluminescent dosimeters. RESULTS: The radiation time, kerma-area product, patient entrance reference point dose and peak skin dose were, on average, 19:15min, 67Gy·cm2, 0.41Gy and 0.23Gy, respectively. Although the contribution of the acquisition mode was smaller than 5% in terms of the radiation time, this mode accounted for more than 60% of the effective dose per patient. All of the worker dose measurements remained below the limits established by law. CONCLUSIONS: The working conditions in the hybrid operating room HOR are safe in terms of patient and staff radiation protection. Nevertheless, doses are highly dependent on the workload; thus, further research is necessary to evaluate any possible radiological deviation of the daily working conditions in the HOR.


Assuntos
Exposição Ocupacional , Salas Cirúrgicas , Doses de Radiação , Angiografia/instrumentação , Feminino , Pessoal de Saúde , Humanos , Masculino , Monitoramento de Radiação , Proteção Radiológica , Radiografia Intervencionista , Raios X
19.
Rev. esp. investig. quir ; 20(1): 19-25, 2017. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-161614

RESUMO

Las políticas de salud en gran parte del mundo desarrollado se ocupan de evaluar y mejorar la calidad de la atención de la salud. Las estrategias para mejorar la prestación de atención a nivel nacional e internacional incluyen la práctica basada en la evidencia, la eficacia clínica, las directrices clínicas basadas en evidencia y la auditoría, y se está haciendo una inversión considerable en una nueva infraestructura para apoyar estas iniciativas. La comunicación eficaz y el trabajo en equipo, son esenciales para la entrega segura de alta calidad y atención al paciente. El objetivo de este trabajo es intentar afianzar el pensamiento sobre la naturaleza de las culturas organizacionales en la atención de la salud como un medio de apoyar los debates sobre ella misma y cómo tales culturas deben o, de hecho, pueden, ser transformadas. En nuestra opinión, las estrategias destinadas a revolucionar la calidad de los servicios de salud a través de la transformación cultural deben ser más articuladas sobre los destinos culturales buscados, y los mecanismos que llevarán a las organizaciones hacia estos destinos


Health policy in much of the developed world is concerned with assessing and improving the quality of health care. Strategies for improving the delivery of healthcare at a national and international level include evidence based practice, clinical effectiveness, evidence based clinical guidelines, and audit, and considerable investment is being made in a new infrastructure to support these initiatives. Effective communication and teamwork is essential for the delivery of high quality, safe patient care. The aim of this paper is attempted to sharpen thinking on the nature of organisational cultures in health care as a means of underpinning debates on whether and how such cultures should or, indeed, can be transformed. It is our view that strategies aimed at revolutionising the quality of health services through cultural transformation need to be more articulate on the cultural destinations sought, and the mechanisms that will carry organisations towards these destinations


Assuntos
Humanos , Masculino , Feminino , Inovação Organizacional , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/tendências , Qualidade da Assistência à Saúde/organização & administração , Qualidade da Assistência à Saúde/normas , Liderança , Política de Saúde/tendências , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/organização & administração
20.
Rev. esp. investig. quir ; 20(1): 31-34, 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-161616

RESUMO

Alejandro San Martín Satrustegui, es uno de los mas prestigiosos cirujanos españoles del siglo XIX y XX. Catedrático de Cirugía, ha sido considerado uno de los pioneros de la cirugía vascular en España. Su perfil profesional asistencial le caracteriza por una visión fisiopatológica de la cirugía, campo en las que realiza interesantes y novedosas aportaciones. Realiza numerosas publicaciones informando de nuevas técnicas, novedosos tratamientos y diseño de instrumental quirúrgico. Su perfil personal se complementa con el politico y tambien el humanistico con interesantes contribuciones no solo para la epoca que le tocó vivir, sino tambien para el momento actual


Alejandro San Martín Satrustegui, is one of the most prestigious Spanish surgeons of the nineteenth and twentieth centuries. Professor of Surgery, has been considered one of the pioneers of vascular surgery in Spain. His professional profile is characterized by a physiopathological vision of surgery, field in which he makes interesting and innovative contributions. He makes numerous publications informing about new techniques, novel treatments and surgical instrument design. His personal profile is complemented by the political and also the humanist with interesting contributions not only for the time he had to live, but also for the present moment


Assuntos
História do Século XIX , História do Século XX , Cirurgia Geral/história , Cirurgia Torácica/história , Procedimentos Cirúrgicos Operatórios/educação , Procedimentos Cirúrgicos Operatórios/métodos , Cirurgia Geral/educação , Cirurgia Torácica/educação , Gânglio Trigeminal/cirurgia
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