ABSTRACT
La terapia inhalada con broncodilatadores de acción larga es la base del tratamiento farmacológico de la EPOC. Con el fin conocer los que ofrecen un mejor control, se realizó una búsqueda en Medline (Pubmed). Se analizaron los estudios comparativos de terapia inhaladora en pacientes con EPOC. Tras la comparación entre la combinación fija LABA/LAMA frente LABA/CI en pacientes no exacerbadores, se concluye que hay un mejor control con LABA/LAMA. Dentro de las combinaciones LABA/CI, la combinación budesonida/formoterol ofreció un mejor control. En la terapia LAMA no hay grandes diferencias, pero comparada con LABA ofreció un mayor control. La triple terapia en un único dispositivo se muestra superior a la doble terapia y a la triple terapia en dos dispositivos, no habiendo diferencias relevantes entre las combinaciones disponibles (AU)
Inhaled therapy with long-acting bronchodilators is the base of pharmacological treatment in COPD. In order to find out those that offer better control, a search was carried out in Medline (Pubmed). Comparative studies of inhaler therapy in COPD patients were analyzed. The comparison between the fixed combination LABA/LAMA versus LABA/CI in non-exacerbating patients, revealed a better control with LABA/LAMA. Within the LABA/CI combinations, budesonide/formoterol combination offered better control. LAMA inhalers revealed no great differences, but when compared to LABA, it offered a better control. Regarding triple therapy in a single device, was superior to double therapy and to triple therapy in two devices, with no relevant differences among the available combinations(AU)
Subject(s)
Humans , Administration, Inhalation , Pulmonary Disease, Chronic Obstructive/drug therapy , Adrenal Cortex Hormones/administration & dosage , Adrenergic beta-2 Receptor Agonists/administration & dosage , Bronchodilator Agents/administration & dosage , Muscarinic Antagonists/administration & dosage , Drug Therapy, CombinationABSTRACT
Inhaled therapy with long-acting bronchodilators is the base of pharmacological treatment in COPD. In order to find out those that offer better control, a search was carried out in Medline (Pubmed). Comparative studies of inhaler therapy in COPD patients were analyzed. The comparison between the fixed combination LABA/LAMA versus LABA/CI in non-exacerbating patients, revealed a better control with LABA/LAMA. Within the LABA/CI combinations, budesonide/formoterol combination offered better control. LAMA inhalers revealed no great differences, but when compared to LABA, it offered a better control. Regarding triple therapy in a single device, was superior to double therapy and to triple therapy in two devices, with no relevant differences among the available combinations.
Subject(s)
Adrenergic beta-2 Receptor Agonists , Pulmonary Disease, Chronic Obstructive , Administration, Inhalation , Adrenal Cortex Hormones , Bronchodilator Agents , Drug Combinations , Drug Therapy, Combination , Humans , Muscarinic Antagonists/therapeutic use , Pulmonary Disease, Chronic Obstructive/drug therapyABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Acne Vulgaris/diagnosis , Candidiasis, Vulvovaginal/diagnosis , Migraine Disorders/diagnosis , Acne Vulgaris/therapy , Candidiasis, Vulvovaginal/therapy , Migraine Disorders/therapyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Atrial Fibrillation/drug therapy , Rivaroxaban/adverse effects , Pruritus/chemically induced , Anticoagulants/adverse effectsSubject(s)
Atrial Fibrillation/drug therapy , Factor Xa Inhibitors/adverse effects , Pruritus/chemically induced , Rivaroxaban/adverse effects , Aged , Atrial Fibrillation/complications , Embolism/etiology , Embolism/prevention & control , Factor Xa Inhibitors/administration & dosage , Female , Humans , Rivaroxaban/administration & dosageABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Cardiovascular Diseases/complications , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/prevention & control , Atrial Fibrillation/drug therapy , Atrial Fibrillation/prevention & control , Heart Failure/drug therapy , Heart Failure/prevention & control , Aspirin/therapeutic use , Anticoagulants/therapeutic use , Embolism/complications , Embolism/drug therapy , Repertory, Barthel , Arterial Pressure , Heart Rate , Cardiomegaly/complications , Cardiomegaly/drug therapy , Cardiomegaly/prevention & control , Vasodilator Agents/therapeutic useSubject(s)
Atrial Fibrillation/drug therapy , Atrial Flutter/drug therapy , Embolism/prevention & control , Platelet Aggregation Inhibitors/administration & dosage , Aged , Atrial Fibrillation/complications , Atrial Flutter/complications , Drug Therapy, Combination , Embolism/etiology , Humans , Male , Platelet Aggregation Inhibitors/therapeutic useABSTRACT
The case is presented of a 41 year-old women with a personal history of smoking and treated with oral contraceptives, who began taking analgesics and muscle relaxants due to a right cervical pain. As her clinical condition did not improve she was seen again. During the physical examination an increase of soft tissue in the right supraclavicular area was observed. The ultrasound revealed thrombosis of the internal jugular, subclavian, brachycephalic, axillar and humeral veins. We believe that upper-extremity deep venous thrombosis is a rare condition that must be considered in patients with oedema of the upper limbs. The key to a prompt diagnosis is to know the risk factors. Ultrasound is the standard approach.
Subject(s)
Upper Extremity Deep Vein Thrombosis , Adult , Contraceptives, Oral/adverse effects , Female , Humans , Ultrasonography , Upper Extremity Deep Vein Thrombosis/chemically induced , Upper Extremity Deep Vein Thrombosis/diagnostic imagingABSTRACT
Presentamos el caso de una mujer de 41 años de edad entre cuyos antecedentes relevantes se encuentran ser fumadora y estar en tratamiento con anticonceptivos orales que acude a urgencias por un cuadro de dolor en la región cervical derecha fijo no irradiado pautándose analgésicos y relajantes musculares. Por la persistencia de la sintomatología acudió de nuevo a urgencias, donde se evidenció un aumento de partes blandas de la región laterocervical y supraclavicular derecha que borra el relieve de la clavícula por lo que se solicitó una ecografía de cuello que reveló una trombosis de vena yugular interna, subclavia, tronco braquiocefálico, vena axilar y humeral del lado derecho. Consideramos que la trombosis venosa profunda del miembro superior es una entidad poco frecuente, que se ha considerar en pacientes con edema del miembro superior. Las claves para su diagnóstico precoz pasan por conocer los factores de riesgo. La prueba diagnóstica de elección es la ecografía(AU)
The case is presented of a 41 year-old women with a personal history of smoking and treated with oral contraceptives, who began taking analgesics and muscle relaxants due to a right cervical pain. As her clinical condition did not improve she was seen again. During the physical examination an increase of soft tissue in the right supraclavicular area was observed. The ultrasound revealed thrombosis of the internal jugular, subclavian, brachycephalic, axillar and humeral veins. We believe that upper-extremity deep venous thrombosis is a rare condition that must be considered in patients with oedema of the upper limbs. The key to a prompt diagnosis is to know the risk factors. Ultrasound is the standard approach(AU)
Subject(s)
Humans , Female , Adult , Venous Thrombosis/complications , Venous Thrombosis/diagnosis , Anticoagulants/therapeutic use , Early Diagnosis , Diagnosis, Differential , Risk Factors , Venous Thrombosis/drug therapy , Venous Thrombosis/physiopathology , Venous Thrombosis , Radiography, Thoracic/methods , Radiography, Thoracic , Brachiocephalic TrunkABSTRACT
Presentamos el caso de una mujer de 41 años de edad entre cuyos antecedentes relevantes se encuentran ser fumadora y estar en tratamiento con anticonceptivos orales que acude a urgencias por un cuadro de dolor en la región cervical derecha fijo no irradiado pautándose analgésicos y relajantes musculares. Por la persistencia de la sintomatología acudió de nuevo a urgencias, donde se evidenció un aumento de partes blandas de la región laterocervical y supraclavicular derecha que borra el relieve de la clavícula por lo que se solicitó una ecografía de cuello que reveló una trombosis de vena yugular interna, subclavia, tronco braquiocefálico, vena axilar y humeral del lado derecho. Consideramos que la trombosis venosa profunda del miembro superior es una entidad poco frecuente, que se ha considerar en pacientes con edema del miembro superior. Las claves para su diagnóstico precoz pasan por conocer los factores de riesgo. La prueba diagnóstica de elección es la ecografía(AU)
The case is presented of a 41 year-old women with a personal history of smoking and treated with oral contraceptives, who began taking analgesics and muscle relaxants due to a right cervical pain. As her clinical condition did not improve she was seen again. During the physical examination an increase of soft tissue in the right supraclavicular area was observed. The ultrasound revealed thrombosis of the internal jugular, subclavian, brachycephalic, axillar and humeral veins. We believe that upper-extremity deep venous thrombosis is a rare condition that must be considered in patients with oedema of the upper limbs. The key to a prompt diagnosis is to know the risk factors. Ultrasound is the standard approach(AU)
Subject(s)
Humans , Female , Adult , Upper Extremity Deep Vein Thrombosis/diagnosis , Upper Extremity Deep Vein Thrombosis/drug therapy , Upper Extremity Deep Vein Thrombosis , Anticoagulants/therapeutic use , Risk Factors , Early Diagnosis , Upper Extremity Deep Vein Thrombosis/prevention & control , Upper Extremity Deep Vein Thrombosis/physiopathology , Deglutition Disorders/complicationsSubject(s)
Endometriosis/complications , Pneumothorax/drug therapy , Pneumothorax/etiology , Thoracic Diseases/complications , Adult , Endometriosis/drug therapy , Female , Gonadotropins/therapeutic use , Humans , Menstruation Disturbances/complications , Menstruation Disturbances/drug therapy , Pneumothorax/diagnosis , Recurrence , Thoracic Diseases/drug therapy , Thoracic Surgery, Video-AssistedABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Aortic Aneurysm/diagnosis , Chest Pain/etiology , Low Back Pain/etiology , Angioplasty, BalloonABSTRACT
El síndrome de Steinert o distrofia miotónica tipo I es la distrofia muscular más frecuente del adulto. Se trata de una enfermedad muscular autosómica dominante que presenta el fenómeno de anticipación. La anomalía molecular está causada por una expansión de repeticiones del trinucleótido que contiene citosina-timidina-guanosina en el gen DMPK (dystrophia miotónica proteincinasa) localizado en la región cromosómica 19q13.3. Presentamos el caso de un varón de 39 años con rasgos físicos característicos del síndrome de Steinert. Revisamos su historia natural y encontramos un origen congénito del mismo, llegamos hasta su bisabuela buscando el origen hereditario de su enfermedad. Dada la evolución del paciente, y debido a que se trata de una enfermedad con afectación multiorgánica, consideramos que los médicos de Atención Primaria deben desempeñar un papel clave en el control y seguimiento de los pacientes con síndrome de Steinert (AU)
Steinerts syndrome or myotonic dystrophy type I is the most frequent muscular dystrophy in the adult. It is an autosomal dominant muscular disease that exhibits the anticipation phenomenon. The molecular abnormality is caused by an expansion of a cytosine-thymine-guanine (CTG) trinucleotide repeats of the DMPK gene (Myotonic dystrophy protein kinase) located on chromosome 19q13.3. We present the case of a 39-year old man with typical clinical features of Steinerts disease. After reviewing his natural history, we found a congenital origin and of it, the hereditary origin of the disease going back to his great-grandmother. Because of the evolution of our patient and because Steinerts disease is a multi-organ disease, we consider that the family doctors should play a key role in the control and follow-up of patients with Steinert´s disease (AU)
Subject(s)
Humans , Male , Myotonic Dystrophy/genetics , Myotonic Dystrophy/physiopathology , Primary Health Care , Primary Health Care/methods , Intellectual Disability/genetics , Intellectual Disability/metabolism , Disorders of Excessive Somnolence/congenital , Respiratory Tract Diseases/genetics , Myotonic Dystrophy/blood , Myotonic Dystrophy/metabolism , Primary Health Care/classification , Primary Health Care , Intellectual Disability/psychology , Intellectual Disability/rehabilitation , Disorders of Excessive Somnolence/genetics , Respiratory Tract Diseases/metabolismABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Hepatitis/blood , Hepatitis/pathology , Dietary Supplements/adverse effects , Dietary Supplements/toxicity , Peritoneal Dialysis/methods , Peritoneal Dialysis/psychology , Pharmaceutical Preparations/administration & dosage , Hepatitis/complications , Hepatitis/metabolism , Dietary Supplements/analysis , Dietary Supplements/supply & distribution , Peritoneal Dialysis/nursing , Peritoneal Dialysis , Pharmaceutical PreparationsABSTRACT
Spinal epidural abscess is an infectious disorder with high morbidity and mortality rates, which is often associated with delayed diagnosis. We report a case of a 73-year-old man with cervical pyogenic spondylodiscitis complicated with epidural abscess following a prostatic biopsy. Clinical presentation included fever, malaise, neck rigidity in all axes, minor paresis of the right arm, and gait ataxia. A cervical vertebral magnetic resonance imaging (MRI) scan showed pyogenic spondylodiscitis with an epidural abscess. Blood, urine, and cerebrospinal fluid cultures were sterile. The patient was treated with intravenous vancomycin, metronidazole, and ceftazidime for 4 weeks, and was discharged from the hospital and treated with oral cloxacillin, metronidazole, and cefixime for another 2 weeks. His neurological symptoms disappeared completely, and he walked normally, without support. It is important for clinicians to be alert to symptoms accompanying back pain following a prostatic biopsy and to consider the possibility of a diagnosis of spinal abscess.
