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1.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 50(4): [100901], Oct-Dic, 2023. tab
Article in Spanish | IBECS | ID: ibc-226527

ABSTRACT

Objetivo: Analizar el nivel de conocimiento entre profesionales sanitarios de atención primaria sobre endometriosis e identificar sus necesidades formativas en esta materia. Diseño: Estudio descriptivo realizado en atención primaria del Área de Salud de Gran Canaria, mediante cuestionario online anónimo. Resultados: Ciento diecinueve especialistas en medicina de familia y comunitaria y 37 matronas respondieron el cuestionario. El 54,6% de profesionales médicos y el 67,6% de matronas consideran escaso su conocimiento sobre endometriosis. Menos del 50% de profesionales conoce la guía de atención a las mujeres con endometriosis en el Sistema Nacional de Salud. Los síntomas más frecuentes relacionados con endometriosis son: dismenorrea moderada/severa, dolor pélvico crónico, esterilidad. Los menos relacionados son los digestivos y las alteraciones urinarias catameniales. Un 80% de profesionales médicos señalan como menor de 10 el número anual de pacientes en las que piensan que puedan tener endometriosis y menos de 20 para el 75% de matronas. El 40% de profesionales médicos trataría a una paciente con solo dismenorrea y sin planes de gestación con anticonceptivos orales; el 8% considera que el dolor con la menstruación es algo común. El 25% de profesionales especialistas en medicina de familia y comunitaria señalan la terapia de larga duración con antiinflamatorios no esteroideos como tratamiento de primera línea. Menos del 25% de ellos derivarían al especialista en Ginecología con solo sospechar endometriosis. Mayoritariamente los profesionales manifiestan interés en mejorar su formación en endometriosis. El 94,6% de las matronas consideran que tienen un papel estratégico en el manejo de pacientes con endometriosis. Conclusión: La demora en el diagnóstico de la endometriosis se debe en parte al desconocimiento de la enfermedad. Los profesionales de atención primaria constituyen la primera línea de atención sanitaria.(AU)


Objective: To analyze the level of knowledge of endometriosis in primary care doctors and midwives and to identify their training needs in this area. Design: Descriptive study conducted in the primary care services of the Health Area of Gran Canaria, through an anonymous online questionnaire. Results: One hundred and nineteen doctors and 37 midwives completed the questionnaire; 54.6% of doctors and 67.6% of midwives considered that their knowledge about endometriosis was poor. Less than 50% of healthcare professionals knew the National System of Health's guidelines for the management of women with endometriosis. Symptoms most frequently associated to endometriosis included: moderate/severe dysmenorrhea, chronic pelvic pain and sterility. Less frequently related ones included: digestive symptoms and catamenial urinary disorders; 80% of doctors suspected endometriosis in <10 women per year; 75% of midwives suspected this condition in <20 women per year; 40% of doctors would prescribe oral contraceptives to patients with dysmenorrhea who were not planning pregnancy; 8% of doctors considered that menstruation-associated pain was common. Medical therapy was the most frequently chosen first-line treatment; 25% of doctors would choose long-term NSAIDs therapy as a first-line treatment; less than 25% of them would refer a patient to the Gynecology service only for suspected endometriosis. Most health professionals expressed their interest in improving their knowledge about endometriosis; 94.6% of midwives considered that they played a strategic role in the identification and management of patients with endometriosis. Conclusion: Delays in the diagnosis of endometriosis are partially due to ignorance of the disease. Primary care professionals constitute the first line of health care. In this context, it is essential to develop specific training strategies, which would be welcome by health professionals.(AU)


Subject(s)
Humans , Female , Endometriosis/nursing , Endometriosis/prevention & control , Midwifery , Health Personnel/education , Health Literacy , Spain , Gynecology , Family Practice , Primary Health Care , Epidemiology, Descriptive , Surveys and Questionnaires
2.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 49(5): [e101939], jul.- ago. 2023. tab
Article in English | IBECS | ID: ibc-223262

ABSTRACT

Introduction This study analyzed the impact of patients’ age, sex, vaccination, immunosuppressive treatment, and previous comorbidities on the risk of developing persistent COVID-19 or SARS-CoV-2 virus reinfection. Method Population-based observational retrospective study of a cohort of 110,726 patients aged 12 years or older, who were diagnosed with COVID-19 between June 1st, 2021 and February 28th, 2022 in the island of Gran Canaria. Results 340 patients suffered reinfection. The combination of advanced age, female sex and lack of complete or incomplete vaccination against COVID-19 was strongly predictive of reinfection (p<0.05). In the 188 patients who developed persistent COVID-19, the persistence of symptoms was more frequent in adult patients, women, and patients with a diagnosis of asthma. Complete vaccination was associated with a lower risk of reinfection ([OR] 0.05, 95%CI 0.04–0.07; p<0.05) and of developing persistent COVID-19 ([OR] 0.07, 95%CI 0.05–0.10; p<0.05). None of the patients with reinfection or persistent COVID-19 died during the period of the study Conclusions This study confirmed the link between age, sex, asthma and risk of persistent COVID-19. It was not possible to define the patient's comorbidities as a factor that influences the development of reinfection, but its association with age, sex, type of vaccine and hypertension was demonstrated. Higher vaccination coverage was associated with a lower risk of persistent COVID-19 or SARS-CoV-2 reinfection (AU)


Introducción Se analizó el impacto de la edad, el sexo, la vacunación, el tratamiento inmunosupresor y las comorbilidades previas del paciente sobre la condición de riesgo de desarrollar COVID-19 persistente o reinfección por el virus del SARS-CoV-2. Método Estudio retrospectivo observacional de base poblacional en una cohorte de 110.726 pacientes de 12 o más años de edad diagnosticados de COVID-19 entre el 1 de junio de 2021 y el 28 de febrero de 2022 en la isla de Gran Canaria. Resultados Trescientos cuarenta pacientes sufrieron reinfección por COVID-19. La combinación de edad avanzada, sexo femenino y falta de vacunación completa o incompleta contra la COVID-19 fue fuertemente predictiva de reinfección (p<0,05). En los 188 pacientes que desarrollaron COVID-19 persistente, la persistencia de síntomas fue más frecuente en pacientes en edad adulta, mujeres y pacientes con diagnóstico de asma. La vacunación completa se asoció con un menor riesgo de reinfección ([OR] 0,05, IC 95% 0,04-0,07; p <0,05) y de desarrollar COVID-19 persistente ([OR] 0,07, IC 95% 0,05-0,10; p <0,05). Ninguno de los pacientes con reinfección o COVID-19 persistente falleció durante el período del estudio. Conclusiones Este estudio confirmó el vínculo entre la edad, el sexo, el asma y el riesgo de COVID-19 persistente. No se pudo definir las comorbilidades del paciente como factor que influye en el desarrollo de reinfección, pero sí se demostró su asociación con edad, sexo e hipertensión arterial. Una mayor cobertura de vacunación se asoció a un menor riesgo de COVID-19 persistente o reinfección por SARS-CoV-2 (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Pandemics , Recurrence , Retrospective Studies , Risk Factors , Spain/epidemiology
3.
Semergen ; 49(5): 101939, 2023.
Article in English | MEDLINE | ID: mdl-36889055

ABSTRACT

INTRODUCTION: This study analyzed the impact of patients' age, sex, vaccination, immunosuppressive treatment, and previous comorbidities on the risk of developing persistent COVID-19 or SARS-CoV-2 virus reinfection. METHOD: Population-based observational retrospective study of a cohort of 110,726 patients aged 12 years or older, who were diagnosed with COVID-19 between June 1st, 2021 and February 28th, 2022 in the island of Gran Canaria. RESULTS: 340 patients suffered reinfection. The combination of advanced age, female sex and lack of complete or incomplete vaccination against COVID-19 was strongly predictive of reinfection (p<0.05). In the 188 patients who developed persistent COVID-19, the persistence of symptoms was more frequent in adult patients, women, and patients with a diagnosis of asthma. Complete vaccination was associated with a lower risk of reinfection ([OR] 0.05, 95%CI 0.04-0.07; p<0.05) and of developing persistent COVID-19 ([OR] 0.07, 95%CI 0.05-0.10; p<0.05). None of the patients with reinfection or persistent COVID-19 died during the period of the study. CONCLUSIONS: This study confirmed the link between age, sex, asthma and risk of persistent COVID-19. It was not possible to define the patient's comorbidities as a factor that influences the development of reinfection, but its association with age, sex, type of vaccine and hypertension was demonstrated. Higher vaccination coverage was associated with a lower risk of persistent COVID-19 or SARS-CoV-2 reinfection.


Subject(s)
Asthma , COVID-19 , Adult , Humans , Female , SARS-CoV-2 , COVID-19/epidemiology , Spain/epidemiology , Reinfection , Retrospective Studies , Asthma/epidemiology
4.
Rev Esp Quimioter ; 36(2): 180-186, 2023 Apr.
Article in Spanish | MEDLINE | ID: mdl-36709415

ABSTRACT

OBJECTIVE: To analyze the frequency of influenza and SARS-CoV-2 co-infections, as well as the differences in the course of disease (risk of mortality, hospital and intensive care admissions) in patients infected with the SARS-CoV-2 virus in relation to flu vaccination status in the 2021-2022 season. METHODS: Population-based observational retrospective study in a cohort of 19,850 patients diagnosed with COVID-19 between June 1, 2021 and February 28, 2022 on the island of Gran Canaria. RESULTS: A total of 1,789 patients (9%) diagnosed with COVID-19 had received flu vaccinations. 13,676 people (68.9%) had a full course of COVID-19 vaccinations. In the period between June 1, 2021 and February 28, 2022, 8 cases of flu and COVID-19 coinfection were recorded. Hypertension (18.5%), asthma (12.8%) and diabetes (7.2%) were the most frequent comorbidities. There were 147 deaths (0.7%). Older patients ([OR] 1.11 95% CI 1.09-1.13) and people with cancer ([OR] 4.21 95% CI 2.58-6.89) had a higher risk of dying from COVID-19 (p<0.05). Female sex was noted as a protective factor ([OR] 0.61 95% CI 0.40-0.92). CONCLUSIONS: Old age, male sex and cancer were independent prognostic factors for mortality. Three doses of SARS-CoV-2 vaccines and influenza vaccines were highly effective in preventing COVID-19-related deaths and hospital admissions. These findings suggest that flu vaccination can help control the pandemic.


Subject(s)
COVID-19 , Coinfection , Influenza Vaccines , Influenza, Human , Female , Humans , Male , COVID-19 Vaccines , Disease Progression , Influenza, Human/prevention & control , Retrospective Studies , SARS-CoV-2 , Spain , Vaccination
5.
J Environ Manage ; 316: 115329, 2022 Aug 15.
Article in English | MEDLINE | ID: mdl-35658264

ABSTRACT

The effect of the ZrO2 content on the performance (activity, selectivity, stability) of In2O3-ZrO2 catalyst has been studied on the hydrogenation of CO2/CO mixtures. This effect is a key feature for the viability of using In2O3-ZrO2/SAPO-34 tandem catalysts for the direct conversion of CO2 and syngas into olefins via oxygenates as intermediates. The interest of co-feeding syngas together with CO2 resides in jointly valorizing syngas derived from biomass or wastes (via gasification) and supplying the required H2. The experiments of methanol synthesis and direct synthesis of olefins, with In2O3-ZrO2 and In2O3-ZrO2/SAPO-34 catalysts, respectively, have been carried out under the appropriate conditions for the direct olefins synthesis (400 °C, 30 bar, H2/COX ratio = 3) in an isothermal fixed bed reactor at low space time values (kinetic conditions) to evaluate the behavior and deactivation of the catalysts. The Zr/In ratio of 1/2 favors the conversion of CO2 and COX, attaining good oxygenates selectivity, and prevents the sintering attributable to the over-reduction of the In2O3 (more significant for syngas feeds). The improvement is more remarkable in the direct olefins synthesis, where the thermodynamic equilibrium of methanol formation is displaced, and methanation suppressed (in a greater extent for feeds with high CO content). With the In2O3-ZrO2/SAPO-34 tandem catalysts, the conversion of COx almost 5 folds respect oxygenates synthesis with In2O3-ZrO2 catalyst, meaning the yield of the target products boosts from ∼0.5% of oxygenates to >3% of olefins (selectivity >70%) for mixtures of CO2/COX of 0.5, where an optimum performance has been obtained.


Subject(s)
Alkenes , Carbon Dioxide , Biomass , Catalysis , Methanol
9.
Cardiovasc Intervent Radiol ; 43(7): 987-995, 2020 Jul.
Article in English | MEDLINE | ID: mdl-31848672

ABSTRACT

PURPOSE: To assess the feasibility of performing same-day vascular flow redistribution and Yttrium-90 radioembolization (90Y-RE) for hepatic malignancies. MATERIALS AND METHODS: From November 2015 to February 2019, patients undergoing same-day hepatic flow redistribution during work-up angiography, 99mTechnetium-labeled macroaggregated albumin (99mTc-MAA) SPECT/CT and 90Y microsphere-RE, were recruited. Within 18 h following the delivery of 90Y resin microspheres, an 90Y-PET/CT study was performed. According to patients' vascular anatomy, flow redistribution was performed by microcoil embolization of extrahepatic branches (group A), intrahepatic non-tumoral vessels (group B) and intrahepatic tumoral arteries (group C). The accumulation of 99mTc-MAA particles and microspheres in the redistributed areas was qualitatively evaluated using a 5-point visual scale (grade 1 = < 25% accumulation; grade 5 = 100% accumulation). Differences in the distribution of microspheres among groups were assessed with Mann-Whitney U test. RESULTS: Twenty-two patients were treated for primary (n = 17) and secondary (n = 5) hepatic malignancies. The MAA-SPECT/CT showed uptake in all the redistributed areas. Regarding the accumulation of microspheres within the redistributed segments in all the groups, perfusion patterns were classified as 2 in 1 case, 4 in 6 cases and 5 in 15 cases. No statistically significant differences were observed between groups A and B-C (U value = 34, p = 0.32) and between groups B and C (U value = 26, p = 0.7). Mean predicted absorbed doses by the tumoral and normal hepatic tissues were 163.5 ± 131.2 Gy and 60.4 ± 69.3 Gy, respectively. Mean total procedure time (from work-up angiography to 90Y delivery) was 401 ± 0.055 min. CONCLUSION: Performing same-day redistribution of the arterial hepatic flow to the target and 90Y-microsphere delivery is feasible in the treatment of liver tumors. Clinical Trials Registry NCT03380130.


Subject(s)
Angiography , Embolization, Therapeutic/methods , Liver Neoplasms/blood supply , Liver Neoplasms/radiotherapy , Liver/blood supply , Technetium Tc 99m Aggregated Albumin/therapeutic use , Yttrium Radioisotopes/therapeutic use , Adult , Aged , Albumins , Feasibility Studies , Female , Humans , Male , Middle Aged , Positron Emission Tomography Computed Tomography , Regional Blood Flow/physiology , Tomography, Emission-Computed, Single-Photon/methods
10.
Sci Rep ; 9(1): 10020, 2019 07 10.
Article in English | MEDLINE | ID: mdl-31292504

ABSTRACT

By GWAS studies on celiac disease, gene expression was studied at the level of the whole intestinal mucosa, composed by two different compartments: epithelium and lamina propria. Our aim is to analyse the gene-expression and DNA methylation of candidate genes in each of these compartments. Epithelium was separated from lamina propria in biopsies of CeD patients and CTRs using magnetic beads. Gene-expression was analysed by RT-PC; methylation analysis required bisulfite conversion and NGS. Reverse modulation of gene-expression and methylation in the same cellular compartment was observed for the IL21 and SH2B3 genes in CeD patients relative to CTRs. Bioinformatics analysis highlighted the regulatory elements in the genomic region of SH2B3 that altered methylation levels. The cREL and TNFAIP3 genes showed methylation patterns that were significantly different between CeD patients and CTRs. In CeD, the genes linked to inflammatory processes are up-regulated, whereas the genes involved in the cell adhesion/integrity of the intestinal barrier are down-regulated. These findings suggest a correlation between gene-expression and methylation profile for the IL21 and SH2B3 genes. We identified a "gene-expression phenotype" of CeD and showed that the abnormal response to dietary antigens in CeD might be related not to abnormalities of gene structure but to the regulation of molecular pathways.


Subject(s)
Adaptor Proteins, Signal Transducing/genetics , Celiac Disease/pathology , DNA Methylation , Epigenomics/methods , Gene Expression Profiling/methods , Interleukins/genetics , Adolescent , Biopsy , Celiac Disease/genetics , Child , Child, Preschool , Duodenum/chemistry , Female , Gene Expression Regulation , Genetic Predisposition to Disease , Humans , Intestinal Mucosa/chemistry , Male , Proto-Oncogene Proteins c-ret/genetics , Tumor Necrosis Factor alpha-Induced Protein 3/genetics
11.
Eur Rev Med Pharmacol Sci ; 23(12): 5343-5350, 2019 Jun.
Article in English | MEDLINE | ID: mdl-31298386

ABSTRACT

OBJECTIVE: Interventional oncology (IO) is an emergent field in interventional radiology that can be considered the fourth pillar of oncology. Interventional oncology has the unique capability to treat malignancy in a loco-regional fashion enabling curative (percutaneous ablation), disease stabilization (intra-arterial chemo/radioembolization), and palliative treatment (such as biliary drainage or nephrostomy). The whole arsenal of IO acts by inducing necrosis and apoptosis, with interactions with the tumour's microenvironment potentially crucial for oncological outcomes. Considering that tumour's microenvironment is a pivotal target for both immuno-oncology and interventional-oncology, the interactions between these two anti-tumour weapons must be investigated to understand their synergy. Interestingly, substantial efforts have been directed to understand which technique combinations are best for specific tumours. This review article summarizes the latest scientific evidence highlighting the future prospective of this winning combination, integrating evidence-reported literature and experience-based perceptions.


Subject(s)
Ablation Techniques/methods , Antineoplastic Agents, Immunological/administration & dosage , Medical Oncology/methods , Neoplasms/therapy , Radiology, Interventional/methods , CTLA-4 Antigen/antagonists & inhibitors , CTLA-4 Antigen/immunology , Clinical Trials as Topic , Humans , Medical Oncology/trends , Neoplasms/immunology , Programmed Cell Death 1 Receptor/antagonists & inhibitors , Programmed Cell Death 1 Receptor/immunology , Progression-Free Survival , Radiology, Interventional/trends , Treatment Outcome , Tumor Microenvironment/drug effects , Tumor Microenvironment/immunology , Tumor Microenvironment/radiation effects
12.
Eur Rev Med Pharmacol Sci ; 22(12): 3896-3904, 2018 06.
Article in English | MEDLINE | ID: mdl-29949165

ABSTRACT

Percutaneous liver ablation has become a cornerstone of the recently developed subspecialty of radiology - that is, interventional oncology. Thermal ablation technology has evolved rapidly during the past decades, with substantial technical and procedural improvements that can help obtain better clinical outcomes and safety profiles. Due to the widespread use of percutaneous ablation, a comprehensive review of the methodologic and technical considerations seems to be mandatory. This article summarizes the expert discussion and report from Mediterranean Interventional Oncology Live Congress (MIOLive 2017) that was held in Rome, Italy, integrating evidence-reported literature and experience-based perceptions, to assist not only residents and fellows who are training in interventional radiology but also practicing colleagues who are approaching to this locoregional treatment.


Subject(s)
Ablation Techniques/methods , Carcinoma, Hepatocellular/surgery , Liver Neoplasms/surgery , Humans , Radiology, Interventional
13.
Eur Rev Med Pharmacol Sci ; 22(2): 372-381, 2018 01.
Article in English | MEDLINE | ID: mdl-29424893

ABSTRACT

Transarterial therapies in the setting of primary and secondary liver malignancies are becoming an essential part of the oncology landscape. The mechanism of action of c-TACE is the induction of tumor necrosis due to the high concentration of the chemotherapeutic that is delivered only locally and to the embolic effect that causes ischemia and increased dwell time of the chemotherapeutic in the tumor. Recently, DEB-TACE has emerged as a variation of c-TACE with the potential for the selective delivery of large amounts of drugs to the tumor for a prolonged period, thereby decreasing plasma levels of the chemotherapeutic agent and related systemic effects. There is an increasing consensus that compared with conventional lipiodol-based regimen, DEB-TACE offers standardized methodology, is more reproducible and is associated with improved response and significantly better safety profile. Using an easy to access point by point format, this manuscript summarizes the expert discussion from the Mediterranean Interventional Oncology Live Congress (MIOLive 2017) about the role of TACE in the treatment of liver tumors.


Subject(s)
Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic , Liver Neoplasms/therapy , Carcinoma, Hepatocellular/pathology , Chemoembolization, Therapeutic/adverse effects , Congresses as Topic , Ethiodized Oil/chemistry , Humans , Liver Neoplasms/pathology , Neoplasm Recurrence, Local , Patient Selection
14.
Oncotarget ; 9(5): 6652-6656, 2018 Jan 19.
Article in English | MEDLINE | ID: mdl-29464101

ABSTRACT

Sorafenib is a multi-kinase inhibitor and a vascular endothelial growth factor (VEGF) inhibitor approved to treat patients with advanced hepatocellular carcinoma, renal cell carcinoma and differentiated thyroid carcinoma. Its most common side effects are asthenia/fatigue, skin toxicity, diarrhea and arterial hypertension. Reported respiratory adverse reactions include dyspnea, cough, pleural effusion and hoarseness. The aim of this report is to describe for the first time the occurrence of pneumatocele in two patients treated with Sorafenib. Patients had no respiratory symptoms and alternative diagnoses were ruled out. Primary tumors were different (liver metastases from a pancreatic neuroendocrine tumor and hepatocellular carcinoma) but both patients had been treated with yttrium 90 radioembolization 9 and 17 months before starting on Sorafenib, respectively. No complications occurred and Sorafenib withdrawal was followed by radiologic improvement.

15.
Radiologia (Engl Ed) ; 60(2): 156-166, 2018.
Article in English, Spanish | MEDLINE | ID: mdl-29108656

ABSTRACT

Percutaneous and endovascular techniques take an important role in the therapeutic management of patients with hepatocarcinoma. Different techniques of percutaneous ablation, especially indicated in tumors up to 2cm diameter offer, at least, similar results to surgical resection. Taking advantage of double hepatic vascularization and exclusive tumor nutrition by the artery, several endovascular techniques of treating the tumor have been developed. Intra-arterial administration of embolizing particles, alone or charged with drug (chemoembolization), will produce ischemia and consequent necrosis with excellent results in selected patients. Certain types of particles may exclusively be carriers of a therapeutic agent when they incorporate a radioisotope that facilitates the direct intratumoral selective irradiation (radioembolization). This technique has demonstrated its efficacy in lesions not susceptible to be treated with other methods and should be considered, together with ablation and chemoembolization, in the therapeutic algorithms of hepatocarcinoma.


Subject(s)
Ablation Techniques , Carcinoma, Hepatocellular/therapy , Embolization, Therapeutic , Liver Neoplasms/therapy , Aged , Humans , Male , Middle Aged
16.
Eur Rev Med Pharmacol Sci ; 21(18): 4014-4021, 2017 Sep.
Article in English | MEDLINE | ID: mdl-29028102

ABSTRACT

Microsphere and particle technology represent the next-generation agents that have formed the basis of interventional oncology, an evolving subspecialty of interventional radiology. One of these platforms, yttrium-90 microspheres, is increasingly being used as a treatment modality for primary and secondary liver tumors. Due to the widespread use of radioembolization, a comprehensive review of the methodologic and technical considerations seems to be mandatory. This article summarizes the expert discussion and report from Mediterranean Interventional Oncology Live Congress (MIOLive 2017) that was held in Rome, Italy, integrating evidence-reported literature and experience-based perceptions, to assist not only residents and fellows who are training in interventional radiologists but also practicing colleagues who are approaching to this intra-arterial treatment.


Subject(s)
Embolization, Therapeutic , Liver Neoplasms/therapy , Contrast Media/chemistry , Humans , Italy , Liver/anatomy & histology , Liver/diagnostic imaging , Liver/pathology , Liver Neoplasms/pathology , Microspheres , Yttrium Radioisotopes/chemistry
17.
Rev. esp. anestesiol. reanim ; 64(8): 472-475, oct. 2017.
Article in Spanish | IBECS | ID: ibc-165892

ABSTRACT

En un pequeño porcentaje de pacientes, la estimulación sonora, táctil e incluso nociceptiva en presencia de una ligera profundidad anestésica no provoca la aparición de ondas cerebrales propias de la activación cerebral (ondas α, β), sino que desencadena un enlentecimiento del trazado de las ondas del electroencefalograma. Presentamos el caso de una paciente en la que se registra una actividad cerebral muy enlentecida en el electroencefalograma procesado del monitor del índice biespectral, así como una disminución del valor algorítmico, que dura aproximadamente 5min en el momento de la educción anestésica, coincidiendo con la estimulación sonora y táctil, que tras mantenerla en observación durante 24h en el postoperatorio, no coincide con ningún trastorno a nivel cerebral que lo pueda justificar (AU)


In a small percentage of patients, sound, touch and even nociceptive stimulation in the presence of a light anaesthetic depth does not cause an electroencephalogram wave pattern of cortical activation (α, β waves) as would be expected, but leads to a slowed electroencephalogram pattern instead. We report the case of a patient who on emerging from anaesthesia showed very slowed brain activity on the electroencephalogram and reduced algorithmic value, that lasted approximately 5min coinciding with sound and tactile stimulation. After keeping her under observation for 24h during the postoperative period she did not present any brain disorder that could justify that event (AU)


Subject(s)
Humans , Female , Aged , Electroencephalography , Conscience , Monitoring, Intraoperative/instrumentation , Monitoring, Intraoperative/methods , Anesthesia/methods , Hysterectomy/methods , Lymph Node Excision/methods , Propofol/therapeutic use , Fentanyl/therapeutic use , Glasgow Coma Scale
18.
An Sist Sanit Navar ; 40(1): 85-92, 2017 Apr 30.
Article in Spanish | MEDLINE | ID: mdl-28534553

ABSTRACT

BACKGROUND: Osteosarcoma paediatric patients are usually treated with intra-arterial chemotherapy (QTia) which is admi-nistered directly to the tumour. This procedure exposes patients to ionizing radiation. Paediatric patients are especially sensitive to this exposure. METHODS: The total amount of ionizing radiation received from QTia administration was quantified in a group of 16 osteo-sarcoma paediatric patients from the Clínica Universidad de Navarra. RESULTS: The median of the total radiation received per patient was 33.4 Gy·cm2 (IQR: 43.33 Gy·cm2), and the median number of procedures performed per subject was 10 (IQR: 6.5). CONCLUSIONS: The study highlights the importance of quantifying the radiation received by a group of children and adoles-cents affected by osteosarcoma during treatment with QTia. Long-term side effects of this radiation should be considered in pae-diatric patients. Currently, there are no previous studies that provide data of the amount of ionizing radiation received through this procedure.


Subject(s)
Bone Neoplasms/drug therapy , Osteosarcoma/drug therapy , Radiation Exposure/statistics & numerical data , Radiation, Ionizing , Radiography, Interventional , Adolescent , Angiography , Arteries , Child , Child, Preschool , Female , Humans , Male , Retrospective Studies
19.
Rev Esp Anestesiol Reanim ; 64(8): 472-475, 2017 Oct.
Article in English, Spanish | MEDLINE | ID: mdl-28347549

ABSTRACT

In a small percentage of patients, sound, touch and even nociceptive stimulation in the presence of a light anaesthetic depth does not cause an electroencephalogram wave pattern of cortical activation (α, ß waves) as would be expected, but leads to a slowed electroencephalogram pattern instead. We report the case of a patient who on emerging from anaesthesia showed very slowed brain activity on the electroencephalogram and reduced algorithmic value, that lasted approximately 5min coinciding with sound and tactile stimulation. After keeping her under observation for 24h during the postoperative period she did not present any brain disorder that could justify that event.


Subject(s)
Consciousness Monitors , Delayed Emergence from Anesthesia/physiopathology , Electroencephalography , Aged , Arousal , Delayed Emergence from Anesthesia/diagnosis , Diagnosis, Differential , Female , Humans , Hypoxia-Ischemia, Brain/diagnosis , Hysterectomy , Physical Stimulation , Uterine Neoplasms/surgery
20.
Rev. esp. anestesiol. reanim ; 64(1): 46-49, ene. 2017.
Article in Spanish | IBECS | ID: ibc-158904

ABSTRACT

La tigeciclina es un antibiótico de amplio espectro estructuralmente similar a la minociclina y que comparte algunos de los efectos adversos de las tetraciclinas. Presentamos el caso de una mujer de 68 años que se trató con tigeciclina por una sepsis de origen desconocido y desarrolló al 5° día de tratamiento un cuadro sugerente de pancreatitis aguda con dolor abdominal junto con elevación de enzimas pancreáticas. Tras descartar diferentes etiologías y basándonos en la escala de Naranjo para la probabilidad de reacciones adversas a fármacos, la tigeciclina fue la causa probable de la pancreatitis aguda, complicación de la cual ha habido 5 comunicaciones en la base de datos del sistema español de farmacovigilancia desde 2009. Se recomienda una vigilancia estrecha de signos y síntomas abdominales durante el uso de tigeciclina, ya que los efectos adversos en el aparato digestivo son los más prevalentes con este fármaco (AU)


Tigecycline is a broad spectrum antimicrobial agent, structurally similar to minocycline and that shares some tetracycline-related side effects. A case report is presented on a 68-year-old female who received tigecycline for a sepsis of unknown origin and who, in the following 5 days, developed abdominal pain and elevated pancreatic enzymes, which suggested acute pancreatitis. After ruling out other origins, and according to the Naranjo adverse drug reaction probability scale, tigecycline was the probable cause of the acute pancreatitis, a complication that has been reported 5 times in the database of the Spanish pharmacosurveillance system since 2009. Close monitoring of abdominal signs and symptoms is recommended during treatment with tigecycline, since adverse effects affecting the digestive system are the most prevalent ones when using this drug (AU)


Subject(s)
Humans , Female , Middle Aged , Pancreatitis/drug therapy , Pancreatitis/surgery , Minocycline/adverse effects , Minocycline/therapeutic use , Drug-Related Side Effects and Adverse Reactions/complications , Drug-Related Side Effects and Adverse Reactions/diagnosis , Pancreatitis/chemically induced , Critical Care , Anti-Bacterial Agents/adverse effects
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