ABSTRACT
One of the most common forms of cancer in fair skinned populations is Non-Melanoma Skin Cancer (NMSC), which primarily consists of Basal Cell Carcinoma (BCC), and cutaneous Squamous Cell Carcinoma (SCC). Detecting NMSC early can significantly improve treatment outcomes and reduce medical costs. Similarly, Actinic Keratosis (AK) is a common skin condition that, if left untreated, can develop into more serious conditions, such as SCC. Hyperspectral imagery is at the forefront of research to develop non-invasive techniques for the study and characterisation of skin lesions. This study aims to investigate the potential of near-infrared hyperspectral imagery in the study and identification of BCC, SCC and AK samples in comparison with healthy skin. Here we use a pushbroom hyperspectral camera with a spectral range of ≈ 900 to 1600 nm for the study of these lesions. For this purpose, an ad hoc platform was developed to facilitate image acquisition. This study employed robust statistical methods for the identification of an optimal spectral window where the different samples could be differentiated. To examine these datasets, we first tested for the homogeneity of sample distributions. Depending on these results, either traditional or robust descriptive metrics were used. This was then followed by tests concerning the homoscedasticity, and finally multivariate comparisons of sample variance. The analysis revealed that the spectral regions between 900.66-1085.38 nm, 1109.06-1208.53 nm, 1236.95-1322.21 nm, and 1383.79-1454.83 nm showed the highest differences in this regard, with <1% probability of these observations being a Type I statistical error. Our findings demonstrate that hyperspectral imagery in the near-infrared spectrum is a valuable tool for analyzing, diagnosing, and evaluating non-melanoma skin lesions, contributing significantly to skin cancer research.
Subject(s)
Keratosis, Actinic , Skin Neoplasms , Keratosis, Actinic/diagnosis , Keratosis, Actinic/pathology , Humans , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Hyperspectral Imaging/methods , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/pathology , Spectroscopy, Near-Infrared/methods , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/pathologyABSTRACT
La presente investigación estudia a un grupo de adolescentes que son parte de un constructo social, además de estar atravesando diferentes cambios físicos emocionales cognitivos y que estos llegan a depender del entorno social, cultural y económico. La comprensión desde la globalidad de la persona a este grupo de adolescentes dar lugar a futuras investigaciones en el ámbito de la danza desde una mirada psicomotriz.
Subject(s)
AdolescentSubject(s)
Humans , Male , Female , Respiratory Tract Diseases/epidemiology , Neuromuscular Diseases/complications , Neuromuscular Diseases/diagnosis , Blood Gas Analysis/methods , Spirometry/methods , Fluoroscopy/methods , Respiratory Tract Diseases/complications , Neuromuscular Diseases/physiopathology , Neuromuscular Diseases/therapy , Muscles/physiopathology , Expiratory Reserve Volume/physiology , Forced Expiratory Flow Rates/geneticsSubject(s)
Neuromuscular Diseases/complications , Respiration Disorders/therapy , Advance Directives , Ambulatory Care , Cardiovascular Diseases/complications , Combined Modality Therapy , Diagnostic Techniques, Respiratory System , Disease Management , Disease Progression , Home Care Services , Humans , Neuromuscular Diseases/physiopathology , Palliative Care , Patient Care Team , Pneumonia, Aspiration/etiology , Pneumonia, Aspiration/prevention & control , Pulmonary Atelectasis/etiology , Pulmonary Atelectasis/prevention & control , Respiration Disorders/etiology , Respiration Disorders/physiopathology , Respiration, Artificial/ethics , Respiration, Artificial/instrumentation , Respiration, Artificial/standards , Respiratory Function Tests , Respiratory Muscles/physiopathology , Respiratory Paralysis/etiology , Respiratory Paralysis/physiopathology , Respiratory Paralysis/therapy , Respiratory Therapy/standards , Terminal Care/ethics , Terminal Care/legislation & jurisprudence , Terminal Care/methods , TracheostomyABSTRACT
Se entrevistó a 115 pediatras Lima, Perú, acerca de sus conocimientos y conductas en salud oral así como su auto-percepción del conocimiento. Se obtuvo la frecuencia de respuestas correctas, nivel de conocimiento, conductas y auto-percepción; la relación entre conocimientos y conductas en salud oral y la relación entre el nivel de conocimiento y la auto-percepción del conocimiento. Sólo 20,9 por ciento tuvo conocimientos en higiene oral, 13,3 por ciento sobre control odontológico, 13 por ciento acerca de fluoruros, 70 por ciento sellantes, 39,1por ciento sobre dieta cariogénica y 9,6 por ciento sobre pastas dentales en infantes. A pesar de esto la percepción es de un conocimiento suficiente. Las conductas sobre salud oral en la consulta no se encuentran relacionadas con los conocimientos. La necesidad de interacción entre las áreas médicas y odontológicas se pone de manifiesto, los datos justifican la revisión de los currículos de medicina a fn de asegurar una adecuada transmisión de conocimientos en salud oral.
One hundred fifteen pediatricians from Lima-Peru, were interviewed to analize their knowledge behaviors and perception of knowledg about oral health. Analyzis of data grave correct answer, knowledg level, behaviors and self-perception knowledge frequencies, relationship between knowledge and oral health behaviors and the relationship between the level of knowledge and self-perception of knowledge. Only 20.9 per cent had knowledge of oral hygiene, 13.3 per cent on dental checkup, 13 per cent about fluoride, 70 per cent sealants, 39.1 per cent on cariogenic diet and 9.6 per cent on Toothpastes in infants. Despite this perception is of sufficient knowledge. Oral health behaviors in the query are not related to knowledge. The need for interaction between medical and dental areas is evident, the data justify a revision of the curricula of medicine fn ensure adequate knowledge transfer in oral health.
Subject(s)
Male , Female , Humans , Adult , Middle Aged , Health Knowledge, Attitudes, Practice , Health Education, Dental , Fluorides , Oral Hygiene , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Existen diversos estudios sobre las alteraciones durante el proceso de formación de los dientes, como la hipoplasia. Esta puede ocurrir sólo durante la formación de esmalte; por consiguiente, si este tejido ha completado su calcificación, ningún defecto puede ser producido. La hipoplasia, cuando afecta de manera severa a los dientes anteriores compromete significativamente la estética del paciente; sin embargo, la restauración de estos defectos es importante no sólo debido a preocupaciones estéticas y funcionales, sino también debido al impacto psicológico. El presente artículo presenta un reporte de caso en el cual se describe la formación, probable etiología y las características clínicas de dientes anteriores afectados por la hipoplasia del esmalte. Se describe también los procedimientos del tratamiento de restauración, utilizando una técnica conservadora mediante el empleo de resinas compuestas.
There are several studies on teeth development process alterations, such as hypoplasia. This can happen only during enamel development; consequently, if this tissue has completed its calcification, no defect can be produced. Hypoplasia, when affects so severe the front teeth, compromise to significantly aesthetics patient. The restoration of these defects, however, is important not only because of aesthetic and functional concerns, but also because of the psychological impact. This article presents a case report which describes front teeth development, aetiology and clinical features affected by enamel hypoplasia. It also describes restoration treatment procedures, using a conservative technique through composite resin.
Subject(s)
Humans , Male , Child , Dentition, Permanent , Dental Enamel Hypoplasia/therapyABSTRACT
OBJECTIVE: The aim of this study was to determine the impact of chronic obstructive pulmonary disease (COPD) on activities of daily living in a large group of patients in Spain who responded to a specific questionnaire. A second aim was to explore the practical utility of the questionnaire and determine which variables could be used to identify "fragile" patients or patients in greater need of attention. To do this, we examined the relationship between questionnaire results and clinical variables, lung function measurements, socioeconomic status, and validated quality of life questionnaires. METHODS: We conducted an observational, descriptive, multicenter, cross-sectional study in which 227 respiratory specialists from all over Spain collected data from 1057 patients with COPD. Each patient was given a specific questionnaire containing 7 items that measured the extent to which COPD affected different aspects of their lives. The patients rated each item on a scale of 0 to 2, depending on the level of impact. Total possible scores, thus, ranged from 0 to 14, and patients with a score of 9 or higher were classified as fragile. We then explored the relationship between questionnaire results and clinical variables, socioeconomic status, spirometric values, and quality of life as measured by the St George's Respiratory Questionnaire (SGRQ). RESULTS: We studied 1057 patients (95.2% male) with a mean (SD) age of 67 (9) years and a mean predicted forced expiratory volume in 1 second (FEV1) of 41.8% (13.3%). The mean questionnaire score was 6.3 (3.1). The activities that were affected most were sport and leisure, habitual physical activity, and sex life (major impact reported by 52.5%, 30.3%, and 20.2% of patients, respectively). We found a correlation between questionnaire scores and known disease severity markers such as SGRQ scores, dyspnea, number of exacerbations, and FEV1 in liters. Patients included in the fragile category were older and had a lower socioeconomic status. CONCLUSIONS: COPD impact questionnaire scores correlated well with SGRQ scores and the usual clinical variables and lung function measurements for evaluating disease severity (dyspnea, FEV1, and exacerbations). The questionnaire could, therefore, be a useful tool for identifying fragile patients who, in addition to having poorer clinical status and lung function measurements, have a lower socioeconomic status.
Subject(s)
Activities of Daily Living , Pulmonary Disease, Chronic Obstructive/complications , Quality of Life , Aged , Cross-Sectional Studies , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
Objetivo: Realizamos el estudio con el propósito de conocer, a través de un cuestionario específico, el impacto de la enfermedad pulmonar obstructiva crónica (EPOC) sobre las actividades de la vida diaria en un grupo amplio de pacientes en España. Asimismo estudiamos su relación con parámetros clínicos, funcionales y socioeconómicos, y con escalas validadas de calidad de vida, para evaluar su utilidad en la práctica habitual y determinar qué variables pueden definir a los pacientes "frágiles" o que requieren una mayor atención. Métodos: Se ha realizado un estudio observacional, descriptivo, multicéntrico y transversal, con la participación de 227 neumólogos de toda España, que incluyó a pacientes con el diagnóstico de EPOC. A todos éstos se les pasó un cuestionario específico con 7 preguntas que medían el impacto de la enfermedad sobre aspectos de la vida diaria Las respuestas se valoraron de 0 a 2, según el grado de afectación, lo que supone un intervalo entre 0 y 14 unidades. Definimos al paciente como "frágil" si presentaba valores iguales o mayores de 9 en el cuestionario de impacto. Se evaluó la relación entre la escala de impacto y variables clínicas, situación socioeconómica, espirometría y calidad de vida medida con el cuestionario específico St. George's Respiratory Questionnaire (SGRQ). Resultados: Estudiamos a 1.057 pacientes (un 95,2% varones), con una edad media (± desviación estándar) de 67 ± 9 años y volumen espiratorio forzado en el primer segundo (FEV1), expresado en porcentaje, del 41,8 ± 13,3%. La puntuación media del cuestionario de impacto fue de 6,3 ± 3,1. Las actividades con mayor afectación fueron deporte y ocio, actividad física habitual y vida sexual (mucha afectación en el 52,5, el 30,3 y el 20,2% de los pacientes, respectivamente). Encontramos relación entre la puntuación del cuestionario y parámetros conocidos de gravedad (SGRQ, disnea, número de agudizaciones y FEV1 expresado en litros). Los pacientes definidos como frágiles tenían mayor edad y menor nivel tanto cultural como económico. Conclusiones: El cuestionario de impacto de la EPOC se correlaciona bien con los clásicos parámetros clínicos y funcionales de valoración de la gravedad de la enfermedad (disnea, FEV1 y exacerbaciones) y con el cuestionario de calidad de vida relacionada con la salud SGRQ. Así pues, podría ser un instrumento útil para identificar un perfil de paciente frágil, que presenta, además de una peor situación clínica y funcional, una situación socioeconómica más desfavorecida
Objective: The aim of this study was to determine the impact of chronic obstructive pulmonary disease (COPD) on activities of daily living in a large group of patients in Spain who responded to a specific questionnaire. A second aim was to explore the practical utility of the questionnaire and determine which variables could be used to identify "fragile" patients or patients in greater need of attention. To do this, we examined the relationship between questionnaire results and clinical variables, lung function measurements, socioeconomic status, and validated quality of life questionnaires. Methods: We conducted an observational, descriptive, multicenter, cross-sectional study in which 227 respiratory specialists from all over Spain collected data from 1057 patients with COPD. Each patient was given a specific questionnaire containing 7 items that measured the extent to which COPD affected different aspects of their lives. The patients rated each item on a scale of 0 to 2, depending on the level of impact. Total possible scores, thus, ranged from 0 to 14, and patients with a score of 9 or higher were classified as fragile. We then explored the relationship between questionnaire results and clinical variables, socioeconomic status, spirometric values, and quality of life as measured by the St George's Respiratory Questionnaire (SGRQ). Results: We studied 1057 patients (95.2% male) with a mean (SD) age of 67 (9) years and a mean predicted forced expiratory volume in 1 second (FEV1) of 41.8% (13.3%). The mean questionnaire score was 6.3 (3.1). The activities that were affected most were sport and leisure, habitual physical activity, and sex life (major impact reported by 52.5%, 30.3%, and 20.2% of patients, respectively). We found a correlation between questionnaire scores and known disease severity markers such as SGRQ scores, dyspnea, number of exacerbations, and FEV1 in liters. Patients included in the fragile category were older and had a lower socioeconomic status. Conclusions: COPD impact questionnaire scores correlated well with SGRQ scores and the usual clinical variables and lung function measurements for evaluating disease severity (dyspnea, FEV1, and exacerbations). The questionnaire could, therefore, be a useful tool for identifying fragile patients who, in addition to having poorer clinical status and lung function measurements, have a lower socioeconomic status
Subject(s)
Male , Female , Adult , Middle Aged , Aged , Humans , Sickness Impact Profile , Pulmonary Disease, Chronic Obstructive/complications , Health Surveys , Multicenter Studies as Topic , Risk Groups , Quality of LifeABSTRACT
El pénfigo vulgar en la infancia es muy infrecuente, con poco más de 50 casos descritos en la literatura. Presentamos un nuevo caso de pénfigo vulgar en un niño de 11 años, comentando su evolución y respuesta al tratamiento y revisamos los casos comunicados en este grupo de edad, con especial atención al manejo terapéutico y al pronóstico de esta enfermedad en la infancia
A new case of pemphigus vulgaris in an 11 years-old boy is reported. Pemphigus vulgaris is infrequent in childhood, with over 50 cases previously reported. We comment the evolution and the response to treatment. We reviewed other cases reported in children, with special attention to the therapeutic and the prognosis of the disease in childhood
Subject(s)
Male , Child , Humans , Pemphigus/diagnosis , Pemphigus/drug therapy , Pemphigus/surgery , Prednisone/therapeutic use , Glucocorticoids/therapeutic use , Azathioprine/therapeutic use , PrognosisSubject(s)
Facial Dermatoses/etiology , Sarcoidosis/etiology , Accidents, Traffic , Adult , Anti-Inflammatory Agents/therapeutic use , Cheek , Cicatrix/complications , Ear, External , Facial Dermatoses/diagnosis , Facial Dermatoses/drug therapy , Facial Dermatoses/pathology , Facial Injuries/complications , Humans , Male , Prednisone/therapeutic use , Sarcoidosis/diagnosis , Sarcoidosis/drug therapy , Sarcoidosis/pathologyABSTRACT
No disponible
Subject(s)
Male , Adult , Humans , Erythema/diagnosis , Erythema/drug therapy , Biopsy/methods , Sarcoidosis/complications , Sarcoidosis/diagnosis , Sarcoidosis/drug therapy , Prednisone/therapeutic use , Cicatrix/complications , Steroids/therapeutic use , Sarcoidosis/pathology , Cicatrix/therapy , Sarcoidosis/physiopathology , Microscopy/methods , Radiography, Thoracic , Prednisone/metabolism , Skin Diseases/diagnosis , Skin Diseases/therapy , Facial Dermatoses/diagnosis , Facial Dermatoses/therapyABSTRACT
Impaired health status may be a risk factor for frequent exacerbations and hospital admission and, in turn, exacerbations and admissions may further impair the health status of patients with COPD. We have investigated the variables associated with frequent exacerbations (3 or more per year) and admission, with particular interest in health status, in a cohort of ambulatory patients with moderate to severe COPD attended by chest physicians in Spain. A total of 227 investigators included 1057 patients with a mean predicted FEV1 of 41.8%. The mean total score on the St. George's Respiratory Questionnaire (SGRQ) was 47.9 units, and 300 patients (28.4%) had 3 or more exacerbations the previous year and 344 (32.6%) were admitted at least once during the same period. In multivariate analysis only the SGRQ total score was significantly associated with both frequent exacerbations (OR = 1.04; 95% CI = 1.01-2.12; p<0.0001) and admission (OR = 1.01; 95% CI = 1.00-1.02; p = 0.0008). Other variables significantly associated with frequent exacerbations were chronic mucus hypersecretion, increased baseline dyspnea, comorbidity, GOLD stage IV and treatment with inhaled corticosteroids. Variables associated with admission were lower educational level, increased number of exacerbations, use of long-term oxygen therapy and use of short acting beta-2 agonists. An impaired health status is associated with an increased number of exacerbations and with admission to hospital in the previous year. These results, together with previous studies, confirm that impairment in health status in COPD is both a marker of risk for, and a consequence of, frequent exacerbations and admissions.
Subject(s)
Health Status , Patient Admission , Pulmonary Disease, Chronic Obstructive/physiopathology , Surveys and Questionnaires , Aged , Cohort Studies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , SpainABSTRACT
El síndrome de hipersensibilidad a fármacos se define por la triada clínica de fiebre, erupción cutánea y afectación de órganos internos. Múltiples fármacos se asocian con sintomatología cutánea aislada (exantema o erupción maculopapulosa), mientras que sólo unos pocos fármacos se asocian con el síndrome de hipersensibilidad. Fármacos relacionados con este síndrome son los anticonvulsivantes, antibióticos, sulfasalazinas y antirretrovirales. A pesar de las múltiples reacciones medicamentosas descritas en estos pacientes, este es el primer caso de síndrome de hipersensibilidad a sulfasalazina en un paciente con infección por el VIH que se recoge en la literatura dermatológica
Drug hypersensitivity syndrome is defined by the clinical triad of fever, rash, and internal organ involvement. Numerous drugs have been associated with isolated cutaneous eruptions (particularly of the simple exanthematic or maculopapular type), while only a limited number of drugs are associated with drug hypersensitivity syndrome. Drugs commonly associated with drug hipersensitivity syndrome in elude the anticonvulsants, antibiotics, sulfasalazines and antiretrovirals. Despite the numerous drug reactions described in HIV patients, up to our knowledge, this is the first case, of drug hypersensitivity syndrome to sulfasalazines in an HIV patient has not been previously reported
Subject(s)
Male , Adult , Humans , HIV Infections/complications , Sulfasalazine/adverse effects , Drug Hypersensitivity/diagnosis , Uveitis/drug therapyABSTRACT
No disponible
Subject(s)
Male , Aged , Humans , Metaplasia/etiology , Antineoplastic Agents/adverse effects , Keratinocytes/pathology , Eccrine Glands/pathology , Diagnosis, Differential , Syringoma/pathologyABSTRACT
El vitíligo es un trastorno de la pigmentación cutáneo benigno que conlleva una evidente repercusión cosmética, social y psicológica. Las opciones terapéuticas para el manejo del vitíligo son múltiples, aunque en la mayoría de los casos sólo se obtienen respuestas parciales e incompletas. En los últimos años, se han investigado otros fármacos, entre ellos Tacrolimus, más selectivos, potentes y con menores efectos locales adversos. Por este motivo, los inmunomoduladores tópicos se perfilan como una posible terapia eficaz en numerosas dermatosis inflamatorias, entre ellas el vitíligo. A continuación aportamos nuestra experiencia clínica preliminar en el manejo del vitíligo con Tacrolimus tópico a partir de la descripción de tres casos clínicos, con vitíligo de localización facial y acral. En todos ellos se pautó Tacrolimus tópico 0,1% en pomada junto con fotoexposición solar controlada de 15 minutos aproximadamente. En los tres casos, a los pocos meses de tratamiento, se observó repigmentación completa y en islotes en el vitiligo de localización facial. En cambio no se observó ningún tipo de respuesta en el vitíligo de zona acral. Tampoco se observaron efectos adversos locales después de meses de tratamiento. Los resultados obtenidos, igual como en otras publicaciones recientes, plantean Tacrolimus como una opción rápida, segura y eficaz en un subgrupo de vitíligos. No obstante, son necesarios un mayor número de estudios clínicos controlados para confirmar los buenos resultados de Tacrolimus en el tratamiento del vitíligo
Vitiligo is an acquired, idiopathic disorder characterized by depigmented macules which involves an obvious cosmetic, social and psychological repercussion. Current treatment modalities for the management of vitiligo are multiple but, unfortunatelly, most of cases achieve inconsistent and incomplete responses. Recently, new pharmacological agents have been investigated like Tacrolimus. They are more selective, powerful, and with no local adverse side effects. For that reason, these immunosuppressive agents might be an effective therapy for inflammatory skin disorders such as vitiligo. We report our preliminary clinical experience in the management of vitiligo with topical Tacrolimus ointment. We describe three patients with vitiligo affecting the face in two of them, and the face and back of hands in the latest. Tacrolimus 0,1% ointment was applied, twice-daily, in conjuntion with natural sunlight exposure after the application, during fifteen minutes. After several months of treatment, two patients developed complete repigmentation of the face, with no response on back of hands, in one of them. The latest showed a noticeable follicular repigmentation. Repigmentation persists after several months after finishing the therapy. None of the patients had any local adverse effects. In conclusion, Tacrolimus ointment could be a rapidly, efficacious, and safe option for the treatment of vitiligo. Despite the good results achieved by our patients, larger studies that are double-blinded and placebo controlled would be helpful to prove the efficacy of topical tacrolimus in the treatment of vitiligo
Subject(s)
Humans , Adjuvants, Immunologic/pharmacokinetics , Vitiligo/drug therapy , Adjuvants, Immunologic/administration & dosage , Administration, Topical , Phototherapy , Skin PigmentationABSTRACT
El trabajo se ha elaborado en dos partes: la primera incluye el contexto y perfil de salud de Bolivia y las bases conceptuales para la integración de información científico técnicas relevantes en salud; la segunda parte incluye el diagnóstico y plataforma de la situación de información científico técnica del país y listas de las diversas instituciones generadoras, intermedias y usuarias de información relevante para el trabajo
Subject(s)
Information Science , Information Services , Information Systems , BoliviaABSTRACT
El documento esta dividido en seis etapas: diagnostico situacional del portal la Biblioteca de Desastres, búsqueda, selección, organización y sistematización de la información para el portal, coordinación para el diseño, estructura de componentes y sistematización de los diferentes servicis en la pagina web, búsqueda, archivo y registro de imágenes para la biblioteca virtual de desastres, localizador de información con relación a sitios de interés para la actualización de la biblioteca, búsqueda de información nacional en instituciones involucradas en el área de desastres.(au)
Subject(s)
Disaster Warning , Library Automation , Libraries , User-Computer Interface , Bolivia , Disaster Emergencies , Disaster PlanningABSTRACT
El documento trata sobre los sistemas y servicios de salud presenta: anexos de catalogación alfabetica de titulos, catalogo numerico - coleccion de documentos, portal principal de la pagina web, referencias bibliograficas, textos completos.(au)
