RESUMO
Objetivo: En la lumbalgia mecánica por síndrome facetario lumbar están indicadas como opciones terapéuticas los bloqueos periarticulares e intrarticulares de las articulaciones facetarias lumbares, así como el bloqueo nervioso del ramo medial de la raíz o ramo posterior del nervio raquídeo. El bloqueo nervioso del ramo medial puede llevarse a cabo mediante control ecográfico o radioscópico. El objetivo de este estudio es valorar si existen diferencias en la eficacia analgésica del bloqueo en función de la técnica de imagen con la que se lleva a cabo (ecografía frente a radioscopia-fluoroscopia). Pacientes y método: Se ha realizado un estudio clínico transversal durante el mes de noviembre de 2020, analizando los bloqueos facetarios realizados en la Unidad del Dolor del Hospital Universitario Clínico de Salamanca entre mayo de 2018 y septiembre de 2020. La muestra analizada cuenta con 315 pacientes, de los cuales 212 fueron sometidos a bloqueo facetario ecoguiado en consulta y 103 se realizaron bajo control radioscópico en el quirófano. Se ha evaluado la medida del dolor inicial, previo al bloqueo, mediante la escala analógica visual (EVA inicial), así como la EVA final y el porcentaje de mejoría subjetiva recogido en los 15 días posteriores a la realización de la intervención, valorando sus diferencias en función de la técnica de imagen empleada para su realización. Resultados: Los valores de EVA final de los pacientes que se realizaron el bloqueo mediante radioscopia y la de aquellos que lo realizaron ecoguiado fue similar, con un resultado final de 3,5 (mediana), así como el porcentaje de mejoría subjetiva que también fue similar en ambos grupos, alcanzando esta el 50 %. Conclusiones: No existen diferencias en la eficacia analgésica del bloqueo facetario lumbar en función de la técnica de imagen empleada para su realización: radioscopia-fluoroscopia o ecografía.(AU)
Objective: In mechanical low back pain due to lumbar facet syndrome, periarticular and intra-articular blocks of the lumbar facet joints as well as nerve blocks of the medial branch of the spinal nerve root or posterior branch of the spinal nerve are indicated as therapeutic options. The nerve block of the medial branch can be performed by ultrasound or radioscopic monitoring. The aim of this study is to assess whether there are differences in the analgesic efficacy of the block depending on the imaging technique used (ultrasound versus fluoroscopic-radioscopy). Patients and method: A cross-sectional clinical study was conducted during the month of November 2020, analysing the facet blocks performed in the Pain Unit of the Hospital Universitario Clínico de Salamanca between May 2018 and September 2020. The sample analysed consisted of 315 patients, of whom 212 underwent an echo-guided facet block in consultation and 103 were performed under radioscopic control in the operating theatre. The initial pain measurement, prior to the block, was evaluated using the visual analogue scale (initial VAS), as well as the final VAS and the percentage of subjective improvement recorded 15 days after the intervention, assessing the differences according to the imaging technique used for its performance. Results: The final VAS values of the patients who underwent radioscopic block and those who underwent echo-guided block were similar, with a final result of 3.5 (median), as was the percentage of subjective improvement, which was also similar in both groups, reaching 50 %. Conclusions: There are no differences in the analgesic efficacy of the lumbar facet block depending on the imaging technique used for its performance: fluoroscopy-radioscopy or ultrasound.(AU)
Assuntos
Humanos , Fluoroscopia , Ultrassonografia , Dor Lombar , Bloqueio Nervoso , Medição da Dor/métodos , Estudos Transversais , Espanha , DorRESUMO
The behavior of the binary mixed Langmuir monolayers of bovine insulin (INS) and phosphatidylcholine (PC) spread at the air-water interface was investigated under various subphase conditions. Pure and mixed monolayers were spread on water, on NaOH and phosphate-buffered solutions of pH 7.4, and on Zn(2+)-containing solutions. Miscibility and interactions between the components were studied on the basis of the analysis of the surface pressure (π)-mean molecular area (A) isotherms, surface compression modulus (C(s)(-1))-π curves, and plots of A versus mole fraction of INS (X(INS)). Our results indicate that intermolecular interactions between INS and PC depend on both the monolayer state and the structural characteristics of INS at the interface, which are strongly influenced by the subphase pH and salt content. Brewster angle microscopy (BAM) was applied to investigate the peptide aggregation pattern at the air-water interface in the presence of the studied lipid under any experimental condition investigated. The influence of the lipid on the INS behavior at the interface strongly depends on the subphase conditions.
Assuntos
Ar , Insulina/química , Fosfatidilcolinas/química , Água/química , Animais , Bovinos , Cloretos/química , Concentração de Íons de Hidrogênio , Compostos de Zinco/químicaRESUMO
OBJECTIVE: To describe the prevalence of functional thyroid pathology (FTP) and pathologies associated with it in an elderly population. DESIGN: Descriptive, cross-sectional study. SETTING: Urban primary care centre. PATIENTS: Representative sample of the entire population attended that was 60 years old or over. MAIN MEASUREMENTS: Demographic variables, clinical history of thyroid pathology and pathology associated with it, Body Mass Index, small tests for diagnosing depression and anxiety, the mini-mental test, electrocardiogram, determination of total cholesterol and LDL cholesterol, and of free thyrotrophin and thyroxin if it is disturbed. RESULTS: 192 people were studied, 56% women, 53% between 60 and 69 and 12% over 79 years old. 10% had a history of previous FTP. Prevalence of active FTP was 13% (10.41% sub-clinical hypothyroidism, 0.52% clinical hypothyroidism, 1.56% sub-clinical hyperthyroidism, and 0.52% clinical hyperthyroidism). Prevalence of new diagnoses of FTP was 4.1% (7 with hypothyroidism and 1 with hyperthyroidism, all sub-clinical). During the study the following pathology was detected in hypothyroidism sufferers: 43% anxiety disorder, 38% depressive syndrome, 28.5% cognitive deterioration, 9.5% dementia, 26% electrocardiographic disturbances, 47.6% obesity, and 28.5% with total cholesterol > or =250 mg/dL. In hyperthyroidism, 50% with depressive syndrome, 25% with cognitive deterioration, 25% with electrocardiographic disturbances, and 50% with obesity were detected. CONCLUSIONS: FTP is more prevalent among the elderly than in the population as a whole, with predominance of hypothyroidism, subclinical pathology and among women. In terms of pathology traditionally linked to thyroid malfunction, few differences were found between the population affected with FTP and those not affected. Primary care doctors are important in reducing under-diagnosis.
Assuntos
Doenças da Glândula Tireoide/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Espanha/epidemiologia , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/terapia , Testes de Função Tireóidea , Glândula TireoideRESUMO
OBJECTIVE: Evaluation of social determinants which are characteristics of balanced (functional) and extreme (dysfunctional) families regarding cohesion and flexibility dimensions. DESIGN: Observational, randomised survey. SETTING: Dr. José Castro Villagrana Primary Care Centre, Health Ministry, Mexico. PATIENTS: 270 randomised families of Tlalpan, Mexico City, who answered FACES III. MEASUREMENTS AND RESULTS: Using discriminant analysis statistical technique, 15 independent variables (social, demographic and familiar determinants) and two dependent variables (balanced and extreme types of families) were analysed and related with cohesion and adaptability dimensions. CONCLUSION: There is accordance of these results with others which were obtained using different family assessment instruments like Family Apgar. However using FACES III and Circumplex Model the analysis of variable's interaction were possible.
Assuntos
Família , Adolescente , Adulto , Criança , Pré-Escolar , Análise Discriminante , Estudos de Avaliação como Assunto , Características da Família , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Fundamentos: la patología tiroidea es un motivo de consulta frecuente en Atención Primaria. El conocimiento de la situación de la misma en su en torno facilita su manejo. Objetivo: conocer prevalencia y tipo de patología funcional tiroidea en población adulta atendida en un Centro de Atención Primaria. Diseño: estudio descriptivo transversal. Material y métodos : población mayor de 14 años adscrita a dos Unidades Básicas Asistenciales. Muestra de 442 personas, analizándose edad, sexo, determinación de tirotropina y patología tiroidea previa. Resultados: personas incluidas: 375 [edad media 46ñ17 años; 61,3 por ciento (n=230) mujeres]. Patología tiroidea previa: 16 casos (4 por ciento). Patología funcional tiroidea activa: 14 casos (3,63 por ciento) distribuidos entre 11 pacientes con aumento de tirotropina (78,6 por ciento) y 3 pacientes con disminución de tirotropina (21,4 por ciento). Prevalencia de patología funcional tiroidea: global del 5,9 por ciento (22 casos, 12 de nuevo diagnóstico); 8,7 por ciento (n=20) en mujere s ; 1,3 por ciento (n=2) en hombres; 5,9 por ciento (n=11) en el grupo menor a 50 años y 5,5 por ciento (n=11) en el grupo de 50 o más años. Tipos patología: 0,8 por ciento (n=3) hipotiroi dismo clínico; 3,7 por ciento (n=14) hipotiroidismo subclínico; 0,3 por ciento (n=1) hipertiroidismo clínico; 1 por ciento (n=4) hipertiroidismo subclínico. Conclusiones: tanto la prevalencia global de patología funcional tiroidea como la distribución de la misma por tipo de patología y sexo, no difieren de las descritas en la literatura. Se observan diferencias respecto a la distribución por edades, con una menor prevalencia en edades avanzadas de la vida. El elevado porcentaje de nuevos diagnósticos, implica reflexionar sobre la necesidad de aumentar la sospecha clínica de la patología funcional tiroidea (AU)
Assuntos
Adolescente , Adulto , Feminino , Masculino , Pessoa de Meia-Idade , Humanos , Doenças da Glândula Tireoide/diagnóstico , Atenção Primária à Saúde , Prevalência , Estudos Transversais , Doenças da Glândula Tireoide/classificação , Fatores Etários , Fatores SexuaisRESUMO
Trastuzumab es un nuevo anticuerpo monoclonal utilizado en el cáncer de mama metastásico que sobreexprese el receptor HER2. La sobreexpresión de dicho receptor está presente entre el 20-30 por ciento de los tumores de mama y es un signo de mal pronóstico. Este tipo de tumores presenta como características comunes mayor velocidad de crecimiento, aumento de la capacidad invasiva e incremento del número de recaídas tras los tratamientos convencionales. Trastuzumab ha demostrado su eficacia en los ensayos clínicos para los tumores HER2+ administrado tanto en monoterapia como en terapia combinada. Dada la baja toxicidad del fármaco, se puede administrar en hospital de día. Los pacientes reciben dosis semanales hasta remisión de la enfermedad (AU)