Tendinopatías / Tendinopathies

Objetivo: Realizar una revisión bibliográfica, sobre la etiología, etiopatogenia y tratamiento de las tendinopatías, así como revisar la terminología utilizada. Material y método: Se consultaron diversas fuentes electrónicas y en papel. Se utilizó Pub-med como motor de búsqueda. Resultados: Estructuralmente, la lesión se caracteriza por una alteración de los tenocitos, una desorganización del colágeno, un aumento de la sustancia fundamental y un aumento de los vasos sanguíneos. Junto a todo ello, aparece una alteración de las metaloproteasas y sus inhibidores. Estas sustancias forman parte de la homeostasis normal del tendón, pero determinados factores de riesgo pueden alterar la regulación normal de estas sustancias y podrían contribuir a iniciar y mantener el proceso de forma indefinida. También se ha descrito que el proceso de apoptosis o muerte celular programada iniciada por un citocromo y una enzima podrían estar en su origen patogénico. Conclusiones: Persiste un desconocimiento del proceso que origina y mantiene la lesión. Debido a ello, en la actualidad se han propuesto diversas opciones terapéuticas con más o menos éxito, pero ninguna con una eficacia totalmente satisfactoria. Desde el punto de vista terminológico, el término usado de tendinitis no es adecuado (AU)

Objetive: To extensively review all publicated data regarding etiology, pathogenesis and treatment of this disease and, review the terminology that was used in these processes. Material y Methods: We consulted some electronic and paper knowledge sources and Pubmed was used as a search engine. Results: Morphologically, the basic lesion is a cellular alteration of tenocytes, collagen disorganization, and an increase in matrix content and blood vessels. Moreover, metalloproteases and its inhibitors are disturbed. A programmed apoptosis of cells initiated by a cytocrom has been suggested as the origin of the disease. Conclusions: Due to ignorance of it origin, no real effective treatment has been yet achieved. Some therapeutic interventions have been proposed, with variable degree of success. From the standpoint of terminology, the term most used of tendinitis is not suitable (AU)

Dietary fat, olive oil intake and breast cancer risk.

As part of a population-based case-control study on diet and breast cancer in Spain, the role of dietary fat and vegetable oils in breast cancer etiology was examined. A validated, semi-quantitative food-frequency questionnaire was completed by 762 women, 18-75 years of age, with histologically confirmed, newly diagnosed breast cancer, and 988 randomly selected female controls. For each food item and nutrient, the study subjects were divided into quartiles according to intake levels, with the lowest quartile serving as the reference category. Adjustment for total energy intake and other potential confounders was made using multiple logistic regression for all women as well as separately for pre- and post-menopausal women. Neither total fat intake nor specific types of fat were significantly associated with breast cancer in pre- or post-menopausal women. However, higher consumption of olive oil (rich in monounsaturated fat) was significantly related to a lower risk of breast cancer [for highest vs. lowest quartile of consumption, odds ratio (OR) = 0.66; 95% CI, 0.46-0.97] with a significant dose-response trend. While these findings do not support a relation between total fat intake and breast cancer risk, they do provide evidence for an inverse association between olive oil (and suggest one between monounsaturated fat) and risk of breast cancer.

Development and validation of a food frequency questionnaire in Spain.

To create a suitable instrument to estimate intakes of total calories, protein, carbohydrate, fats (saturated, mono and polyunsaturated), alcohol, cholesterol, fibre, vitamin A and vitamin C in epidemiological studies conducted in Spain, a food frequency questionnaire was developed and tested. In particular, the questionnaire was designed to be used in a large population-based case-control study of dietary factors in relation to breast and colorectal cancer among women from different Spanish regions. After identifying the most important food sources of the relevant nutrients in the study population, the final version of the questionnaire asked about consumption of 118 food items. Its reproducibility and validity were tested among 147 Spanish women aged 18-74 years. These subjects were asked to complete the questionnaire before and after completing four 4-day food records. The records were obtained at 3-month intervals designed to represent daily and seasonal changes (between 1990 and 1991). Using the information available from standard Spanish food composition tables, an ad hoc computer program was created to translate food consumption into nutrient intake. The reproducibility of the questionnaire was assessed by means of estimating correlations between nutrient scores measured with the same instrument twice, with a period of 1 year between estimates. Pearson correlation coefficients ranged from 0.51 for saturated fat to 0.88 for alcohol. In the validity study, correlation coefficients between diet records and the first and second questionnaires ranged between r = 0.20 for vitamin A and r = 0.88 for alcohol.(ABSTRACT TRUNCATED AT 250 WORDS)